Walk-in doc­tors want equal pay

The Daily Courier - - CANADA - By The Cana­dian Press

VAN­COU­VER — Doc­tors at over 300 walk-in clin­ics in Bri­tish Columbia want fair pay­ment for their work com­pared with those in full fam­ily prac­tice, says the head of an as­so­ci­a­tion that’s ral­ly­ing its mem­bers to in­crease ac­cess and prof­its through in­no­va­tive tech­nol­ogy.

Mike McLough­lin, found­ing di­rec­tor of the Walk-In Clin­ics of BC As­so­ci­a­tion, said the fa­cil­i­ties fill a gap for pa­tients who can’t get a fam­ily physi­cian or same-day ap­point­ments and should be con­sid­ered an im­por­tant part of re­form­ing pri­mary care.

The as­so­ci­a­tion gath­ered for its an­nual gen­eral meet­ing Fri­day, where mem­bers were ex­pected to dis­cuss var­i­ous is­sues such as ne­go­ti­a­tions be­tween the govern­ment and Doc­tors of BC, the as­so­ci­a­tion that rep­re­sents the province’s physi­cians, whose master agree­ment will ex­pire in March.

McLough­lin said walk-in doc­tors of­ten see pa­tients with com­plex con­di­tions such as di­a­betes, high blood pressure and chronic ob­struc­tive pul­monary dis­ease but can’t charge the ex­tra fees that are paid to full fam­ily physi­cians.

“Step up and pay the doc­tors for equal work that they do,” said McLough­lin, who, along with his wife, a fam­ily doc­tor, owns a walkin clinic in Kelowna.

He said some walk-in clin­ics have been forced to close as doc­tors re­tire and there aren’t enough new ones to re­place them, and pa­tients can end up go­ing from one clinic to the next or to the emer­gency room, cost­ing the health­care sys­tem more money.

McLough­lin said ac­cess to care is fur­ther eroded by a quota for walk-in doc­tors who are paid to see up to 50 pa­tients a day, fol­lowed by half the fee pay­ment — or about $30 for a ba­sic visit — un­til they reach 65 pa­tients and then they get no fee at all.

“It’s wrong. This 50-per­son-a-day cap has cre­ated this anx­i­ety among pa­tients that they gotta get there early to see a doc­tor,” he said, adding long line­ups out­side clin­ics means they must close when the quota is reached.

He said many of the clin­ics could con­sider work­ing to­wards en­hanc­ing tech­nol­ogy to pro­vide pa­tients with bet­ter ser­vice, beyond see­ing wait times on­line.

McLough­lin also called on the govern­ment to work to­ward al­low­ing pa­tients’ elec­tronic med­i­cal records to be ac­ces­si­ble to any physi­cian they see, whether they are at their reg­u­lar doc­tor’s of­fice, a walk-in clinic or an emer­gency depart­ment.

Dr. Eric Cadesky, pres­i­dent of Doc­tors of BC, said walk-in clin­ics pro­vide “episodic care” but their physi­cians don’t do the work to jus­tify an an­nual bonus for treat­ing com­plex con­di­tions that must be reg­u­larly mon­i­tored through an on­go­ing re­la­tion­ship with pa­tients.

“Every day I prob­a­bly call 10 to 20 pa­tients, I prob­a­bly email an­other 10 or 30 pa­tients,” he said. “Some­times the per­son doesn’t need to see a doc­tor and some­times I may not be in the of­fice. It may be on the week­end or I may be away, but I’m able to con­tinue that re­la­tion­ship and help peo­ple make the best de­ci­sion pos­si­ble.”

Con­ti­nu­ity of care is miss­ing in walk-in clin­ics, though he’s hope­ful they will be in­volved in changes to pri­mary care, Cadesky said.

“In an ideal sys­tem, pa­tients would be able to ac­cess doc­tors that know them and know their his­tory and are able to care for them in the con­text of an on­go­ing re­la­tion­ship.”

Health Min­is­ter Adrian Dix said walk-in clin­ics could be part of the move to at­tach more pa­tients to fam­ily doc­tors through yet-to-be opened pri­mary care net­works that will have var­i­ous health-care providers in­clud­ing nurse prac­ti­tion­ers, phys­io­ther­a­pists and di­eti­cians.

“We have a very sig­nif­i­cant group of peo­ple who are un­at­tached to a fam­ily doc­tor, cur­rently in ex­cess of 750,000 peo­ple,” he said.

“Walk-in clin­ics ab­so­lutely play a valu­able role to­day, and I ac­tu­ally think there’s po­ten­tial for them as pri­vate pri­mary care net­works to work with other prac­ti­tion­ers in the com­mu­nity.”

The govern­ment is work­ing to har­mo­nize elec­tronic med­i­cal records in or­der to en­hance time­sav­ing ac­cess to pa­tient in­for­ma­tion af­ter the pre­vi­ous govern­ment’s failed at­tempts cost mil­lions of dol­lars, Dix said.

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