On Sept. 16, the Times 91原创 published my letter in which I asked for somebody in the Ministry of Health to answer questions regarding the implications for patients of de-enrolled family doctors.
Last week I received an official letter from the ministry signed by the chair of the Medical Services Commission.
I would like to share the information from this letter to people who, like my wife and myself, are patients of a de-enrolled doctor and also to the people who may be in a similar situation in the near future:
• A de-enrolled family doctor is not insured and is not reimbursable by MSP.
• If a de-enrolled physician is providing services outside facilities defined in the Medicare Protection Act (hospitals for example), the amount that may be charged is not limited by the act; in other words the doctor can charge whatever he/she chooses.
• The financial impact on patients is not limited to the amount paid to the de-enrolled physician; all laboratory services and diagnostic imaging ordered by a de-enrolled family doctor are not reimbursable by MSP and must be paid by the patients.
• Patients referred to enrolled specialists/surgeons by the de-enrolled doctors may be charged privately; this answer was not clear as to how much and requires further clarification.
• Requirements for drug prescriptions are set by the College of Physicians and Surgeons and there is no difference between enrolled and de-enrolled doctors.
The letter stated that the commission is responsible for administration of the Medicare Protection Act and that the purpose of the act is to preserve the health-care system ”in which access to necessary medical care is based on need and not on an individual’s ability to pay.”
Is it only me who noticed the contradiction between this statement and the financial impact for the patients of a de-enrolled family doctor?
Our provincial and federal governments, one of whose main responsibilities is to provide accessible and quality health care for 91原创s, knew about this growing health-care problem for quite some time and did very little to resolve it. And now we are moving to the two-tier system with no clearly defined rules and regulations.
I watched closely the comments to the excellent editorial of Sept. 30. I noticed that most of MDs are in support of family doctors’ de-enrolment from MSP, one even applauded the doctors who started charging patients directly and was surprised: “What took so long for this to happen?”
From these comments I concluded that:
1. We will see many more de-enrolled family doctors in Victoria very soon; and
2. Many doctors don’t see de-enrolment as “abasing their profession,” but as a legitimate way to push the government to resolve their financial demand.
And we, the patients, stuck in between, are just collateral damage.
