Ontario may be facing primary-care crisis, medical association warns

Many clinics at risk of closing due to payment delay for virtual visits

OTTAWA—Nearly half the primary-care clinics in Ontario are at risk of closing their doors if the provincial government can’t immediately pay doctors for virtual visits, according to a survey by the Ontario Medical Association (OMA).

Most clinics have been serving patients through virtual appointments, such as over the phone, whenever possible to try to limit potential exposures to COVID-19.

The Ontario government created new billing codes last month to allow doctors to be paid for those appointments.

But the medical association said its members recently discovered the government’s computer system wouldn’t be updated to accommodate the new codes until June or July, though the government now expects payments to be made in early May.

“We co-operated with the government to make those codes,” OMA president Dr. Sohail Gandhi said.

Without the income from those appointments, “there’s no income, there’s no ability to pay for a receptionist, or a nurse or rent,” he said.

The association fears the province could be heading for a primary-care crisis if the government doesn’t do something soon.

Many doctors have also been hit financially because elective and non-urgent procedures have been cancelled, to protect patients and leave room for hospitals to focus on a potential influx of COVID-19 cases.

“So it’s a double whammy,”

Gandhi said.

The association surveyed 4,830 members across the province, and 49 per cent said they will be forced to close their clinics if something doesn’t change.

Of those, 70 per cent said they expected those closures to last at least three months.

If the trend holds across the province, it could affect as many as 900,000 patients in Ontario, according to the OMA. Ontario Health Minister Christine Elliott acknowledged the problem and said she’s in discussions with the OMA to find a solution.

“We know that there’s a problem right now with them getting paid for the virtual visits, that’s part of the way our system is,” Elliot said at a briefing Friday.

Gandhi said he worries about what happens once the first wave of COVID-19 passes, if a big chunk of the health-care system isn’t there.

“I feel betrayed and completely devalued,” respirologist Dr. Neil Maharaj wrote on the OMA’s website. He effectively shut down his clinic and offered virtual visits to patients in an effort to stop the spread of the coronavirus.

“They’ve turned their backs on doctors, plain and simple. We are expected to take unreasonable personal risks while simultaneously fund the healthcare costs for this pandemic.”

Half of doctors surveyed, including immunologist and allergist Dr. Zainab Abdurrahman, said they have already had to reduce staff as a result of the sudden lack of income.

“Like many others, we are scrambling trying to find ways to be able to pay our rent, as it is likely we do not have any income coming in next month,” Abdurrahman said.