Re: HEALTH CARE - User fees
Mar 19th, 2010
Incidentally, my wife renews prescriptions every six months (if she does go on salary, she is thinking of doing it every year).
BTW.... Is your wife's staff computer illiterate too?

Incidentally, my wife renews prescriptions every six months (if she does go on salary, she is thinking of doing it every year).

I don’t know about your points 1 and 2 (doctor vetting his own words etc.), but the doctor followed the proper procedure. Normally the doctor would send the chart directly to your new doctor, and most will charge you a fee for that.
Also doctor won’t give you possession of the chart. As I said before, the doctor is responsible for it. If you borrow the chart for photocopying and never return, the doctor is sunk if the College or the government asks him to produce the chart and he cannot produce it.
My wife never gives the chart to the patient. If patient wants to look at the chart, she will give him/her the photocopy, and for that he has to pay according to Ontario Medical Association guidelines. And their fee is pretty stiff too; they charge more than a dollar a page or something like that. A 100 page chart would set you back more than 100 $.

The last I heard, the projection was that unless something changes, our health care system will be using up 70 to 75% of our gov'ts budgets by around 2025. That is unsustainable.

Funny how we call our public healthcare system free and universal.
People are discouraged by lengthy wait times to see specialists and people are discouraged from taking prescriptions they cannot afford and the quality of care ranks slightly ahead of other third world coutries.
We cover less and less and add more and more small fees, is this our solution for a sustainable free and universal public healthcare system? The cherry on the cake is many Canadians are hell bent against private healthcare too.
Can't wait to see what our healthcare system is like in 10 years, i'm sure there will be fewer fees and shorter wait times by keeping private healthcare out of canada, great plan canada !

That's all doctors get is $20 from the gov't per visit? No wonder there's a shortage around here.

I wonder how that dispensing fee has helped the small drug stores? I go to one at the grocery store. They eat the fee - and probably add it to the meat and cheese


You're trying to tell me that it's costing them more time and money now then it did years ago when they did not charge the patient? It can be sent electronically now in split seconds. I don't know about your wife's office but my doctor has a computer on his desk and no paper file in front of him when I go to see him. When he wants to look back in his file, he doesn't have to scan through pages and pages of papers, he just scrolls the page like the rest of us do. Prescriptions are printed off the same way with a quick signature on the bottom of the page. When I see my doctor it's always for a renewal so I go every 3 months. I am never there longer than 3 - 5 min. (of his time).

Your key words are "Ontario Med. Assoc. guidelines". There is a set fee for transferring a file and that fee in BC is $35.00 (was $25.00 just a short few years ago). The chart does belong to the doctor and he must keep a copy but the chart also belongs to me under the Freedom of Information Act and it should not be vetted. Vetting is simply to stop the doctor from being sued over making any derogatory comments. In my case the doctor made a false statement and vetted his part in my leaving his practice. His staff openly made fun of the fact that I requested my own file under the Freedom of Information Act., and that was on a page in the file I was given.

It's probably closer to $25, but that's about it, for a general visit with no procedures and no psych. councilling (ie, an hour discussing your depression).
And you're right, that's why it's hard to get doctors, because out of that money, they have to pay rent, office expenses, receptionist, etc.

Maybe doctors need to take a page out of the book of the old days (prior to '59) when patient care was primary and remuneration was secondary. In days of yore the typical family doctor would travel around his community at all hours of the day and night making house calls to treat desperately ill patients and quite often there was no money for him, but the grateful patient wouldn't send him away empty handed, be it a dozen eggs or a venison roast. I'm not sure how that worked on the income tax but at least the spirit was right.

It's probably closer to $25, but that's about it, for a general visit with no procedures and no psych. councilling (ie, an hour discussing your depression).
And you're right, that's why it's hard to get doctors, because out of that money, they have to pay rent, office expenses, receptionist, etc.

And that's why they group together in large offices and pay only a couple of people. Patients are booked approx. every 10 min. so 6 per hour is the minimum they see plus those they see in the hospital and those they see in the after hours clinics so they earn in excess of $1000.00 per day. Must be really hard to take. We have a very arrogant South African doctor here. He spoke about his home overlooking the ocean and how he likes to sit out on his deck and watch the sun go down. He said "It just doesn't get any better". Tough life that's for sure.

A doctor in JLM's city left the city because is wife divorced him and re-married. He could not handle seeing her with another man. He packed up and left within a few days after she re-married. All his files went to some storage area (he didn't make any arrangements) and I don't know who was in charge but I do know that when it was necessary, somone had to go pull the file from his stored records. I guess it's different in all provinces. There were a lot of un-happy people over that.

It occurred to me about 20.5 minutes ago that when the dispensing fees for medication was going to cost $2 for those on assistance, there was a flurry of doomsday warnings. Now, it has become the norm and in my opinion is a small token fee to not only offset some cost but also to discourage over medicating for simple ailments. A manageable fee makes sense.
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If the user fees were clearly outlined prior to the visit and was manageable it may lessen visits for routine issues. It also may encourage better health since people with chronic minor health problems will soon learn how to maintain themselves better.
The issue of a manageable fee has to be addressed. For example, the cost for a dentist isn't covered, but poor dental health is a condition commonly suffered by those with lower incomes. They simply can't afford to go.
Personally, while I understand the need for a change in the financial situation as it relates to healthcare, I fear loosing such easy access to a service I do not use regularly but have comfort in knowing it's there. Really, as silly as it sounds, it's the principal of losing that safety cushion that makes me concerned. But, then again, that makes me the same as the ones with the Placards in front of Parliament screaming about the now accepted prescription dispensing fees. With or without user fees, our standard of care wont be compromised. Just the wait for it will.

And that's why they group together in large offices and pay only a couple of people. Patients are booked approx. every 10 min. so 6 per hour is the minimum they see plus those they see in the hospital and those they see in the after hours clinics so they earn in excess of $1000.00 per day. Must be really hard to take. We have a very arrogant South African doctor here. He spoke about his home overlooking the ocean and how he likes to sit out on his deck and watch the sun go down. He said "It just doesn't get any better". Tough life that's for sure.

You're right - some doctors are very arrogant- I met one in Grand Forks (he never treated me) but to give the Devil his due he was an excellent doctor, apart from his bedside manner. I don't begrudge most doctors what they earn. Their days are long and their weeks are long, they gave up anywhere from 7 to 10 years of their life and earning opportunities to get where they are. If a plumber or electrician or Premier wants to go out and get drunk after work he can, the doctor has to be in top form should an emergency arise. I think most of them are damn fine people.

You're right - some doctors are very arrogant- I met one in Grand Forks (he never treated me) but to give the Devil his due he was an excellent doctor, apart from his bedside manner. I don't begrudge most doctors what they earn. Their days are long and their weeks are long, they gave up anywhere from 7 to 10 years of their life and earning opportunities to get where they are. If a plumber or electrician or Premier wants to go out and get drunk after work he can, the doctor has to be in top form should an emergency arise. I think most of them are damn fine people.

Ha! Our family doctor in Penticton was a great doctor. He was also a great drunk! He actually came to our house on a house call once and he was loaded! Some years later I was talking to a nurse friend about him. She said he was horrible at the hospital because he was drunk most of the time. In those days, doctors did their own surgery. I had no idea when he removed my tonsils and later my adenoids that he might well have been completely out of it and the same applies to him delivering our two sons. He was at least sober enough to know that the cord was wrapped around my sons neck twice and he managed to remove it before it hurt him in anyway. Scary to think of it now though.

Now VanIsle, one must make allowances for foreigners. Especially if he is black, life must have been very hard for him back home, being the victim of apartheid. Perhaps he could be forgiven some arrogance.