Doctors can’t drop patients over fees, watchdog rules

Physicians must continue to see those who don’t pay for extras

CALGARY — Alberta doctors who dump patients who can’t or won’t shell out for uninsured services could face discipline from the province’s medical watchdog.

Dr. Trevor Theman, registrar for the College of Physicians and Surgeons of Alberta, said new rules passed Friday will require doctors who join concierge clinics to keep seeing existing patients for their normal medical needs, regardless of whether they agree to pay for extras.

“You can’t discriminate against patients for any number of reasons, including socio-economic status,” Theman said. “We interpret that to mean you can’t say to a patient, ‘I will see you or not see you based on your willingness to pay for uninsured services.’ ”

Under the new rules, a patient whose doctor relocates to a boutique clinic will have to be given written notice 45 days in advance, and will have a further year to decide whether to continue seeing the physician at his new practice.

The only exception is for cases where doctors substantially alter the scope of their practice or who relocate a year after closing or leaving a previous location.

The watchdog’s move comes in the wake of a public inquiry that found wellheeled clients who paid annual fees of up to $10,000 to join the Helios Wellness Centre in Calgary got preferential access to cancer screening, and a Postmedia News story that found patients were abandoned when their physicians joined another private clinic.

Theman has said the new rules could have major implications for the business models of rapidly growing concierge facilities that promise prompt and unrushed appointments, and where family physicians typically see fewer patients but who may also receive additional compensation from the fees charged for uninsured services.

While the CPSA’s governing council took aim at what some consumer groups have called two-tier primary care, it balked Friday at a broader definition of insured services that would have questioned the ethics of Alberta’s private diagnostic imaging industry.

Theman said the current definition of what the College considers insured are those services listed on the Schedule of Medical Benefits that doctors use to bill the province’s health insurance plan.

A draft standard passed by the council in September would have also included other medically necessary services such as MRIs and CT scans that are publicly provided through Alberta’s hospitals.

In the face of “robust” feedback from hundreds of doctors and patients concerned the rules would result in a ban on private imaging that might further lengthen the queue in the public system, the council has opted for further study.

Theman said the Alberta Medical Association, which represents doctors’ financial interests, and other groups will be invited to join a working group that he hopes will report back to the council in March with a clearer definition of insured and uninsured services.