Doctors not responsible for pricey tests

Re: Pay doctors more? It’s not simple — July 3

There has been perpetual innuendo that doctors as gatekeepers have a significant role in the cost of health care. The statement is on par with ancient Greek mythology.

Doctors are not paid for ordering X-rays, ECGs and other tests.

For the first many years of OHIP, patient demands were significant. Around 1978, I wrote to the minister of health for Ontario and said that 80 per cent of ER visits are not emergencies. She responded that “If a patient thinks it is an emergency, it is an emergency.” It is hard to argue with logic like that. Several years later, a study by one of Toronto’s hospitals showed that 80 per cent of ER visits were not emergencies.

The difference in cost between a doctor’s office and an ER visit is considerable. The long waits for an office visit, consultants’ appointments and ERs did not exist before OHIP or for the first years of OHIP.

Tests are obligatory. If one fractures one’s ankle, one has a set of X-rays done. If one has jaundice, one gets a series of liver tests done.

Patients and their lawyers require tests. Immigration authorities, insurance companies, workers’ compensation boards, colleges and nursing homes require X-ray examinations or preadmission tests.

No politician would dare to tell of the millions of dollars of medical costs that legal and illegal immigrants generate before they become significant taxpayers and OHIP contributors.

I retired 18 years ago. Presumably there have been changes, but the innuendo persists. Dr. Andrew A. Horn, MD, CM, CRCP Guelph