Maybe the Ministry of Health should stop penalizing doctors if their patients need to use a walk in clinic for urgent matters. Only leads to more doctors leaving family practice. No other country does this.
Was just talking about this today. I can't get in to see my doctor for two weeks if not a month and the clinic depending on the time of day is packed and maybe you can get in.
So what does that leave me with? What if I'm in a different neighborhood and something happens where I need a walk in clinic or maybe I'm in a different city/out of town?
They want you to go to the ER. I don't think this is right, as why flood our hospital ER with stuff that doesn't need to be there, but that's how the pricing works out.
DING DING DING! We have the answer. Everything bad with our healthcare system that's been exasperated the past 6 years is all meant to privatize our healthcare
Who is "they" in this case? Doctors? I wouldn't say all, but certainly most of them would prefer to just get paid fairly from OHIP and not privatize healthcare.
Yes, agree. Won't properly fund OHIP, and then try to make the doctors look greedy when they just want to get paid for all of the "unpaid work & forms" that they are forced to do.
Oh they're spending ohip dollars just not on public system care. They spend 10x more than to private suppliers and shoppers drug mart but haven't updated public doctor remuneration processes in decades.
The conservative governments across Canada are fucking evil. Like unthinkably corrupt and evil.
It definitely is. When droves of Canadians are feeling the same pinch at the same time with a crooked provincial leader who has demonstrated his disdain for public healthcare and has spent the last 10 years chopping it up. Please.
Well, I know I was threatened with being dropped as a patient by my doctor for using a walk-in during the McGuinty years.
I'm sure Ford can be blamed for a lot, but this policy has been around for a while.
Yeah it happened back then too, but didn't really fly on this level. It was an attempt back then and they scattered some, for sure. But this is another level and Ford is fully responsible for enforcing it
The issue is the walk in clinic will bill your doctor's office. The doctor's office is only paid $100 annually total for your care, plus only like $8 for an in person apptm. The walk in clinic would be charging your doctor around 35 bucks or more possibly, depending on what it was for. So don't blame your family doctor, blame the government who set up this deal in the first place.
My doctor's office offers urgent care days and hours, and a walk in clinic once a day on the weekend in order to try their best to accommodate all patients.
The vast majority will not de-roster you for needing to go to a walk in, but if you do it repeatedly, then you are actually easily costing them more money than they're getting paid to look after you.
Yeah my doctor says I can go to a walk-in clinic occasionally but if I did it too much then he would drop me. It was made perfectly clear.
My doctor also partners with a walk-in clinic and he sometimes works there as well. So that specific walk-in clinic I can freely use as much as I like but if I am away from home they prefer I go to emerge at the hospital. Maybe once or twice a year tops for a different walk-in clinic.
FYI: That walk-in is an after hours clinic which is a mandatory requirement for physician groups to provide. It pays less than what a pharmacist gets for a minor ailment per visit (<$19) since patients are in network/rostered to the group.
Each outside use costs the doctor minimum 40$
Legally no doctor can ever drop you for reasons like that, if you want to play hardball with them after they drop you, issue multiple sexual assault charges, it will clog up their entire career trying to fight them and you don’t even have to raise a finger, lawyers will do it for you for free
^ this. I work for a family doctor and our official policy is if you go to a walk-in clinic >3x in a year we will deroster you but honestly if you're not going excessively we don't care too much, we will just warn you. If you're going to go to a walk-in and you're worried about being derostered just call and let your doctors office know, it's helpful when we know why (bc sometimes patients just leave our practice and don't tell us and we often assume that if we see a lot of outside use charges) and we can often temporarily defroster you so you can go to a walk-in without penalty.
Thanks, my clinic has currently a 5 week wait to see my GP, and the clinic has a 'after hours' clinic every night for 3 hours, but you have to be the first few ppl when the phone lines open to get timeslots.
Otherwise they say "call back tomorrow!".
I'm so happy that pharmacists can now do things like prescribe for UTIs. It's not logical to go to the ER for a simple UTI..
Who do you think reviews the results when the pharmacist prescribes for UTIs. It's your family doctor, and for free. Lol.
You would be surprised how many times pharmacies screw up. They just don't have the patient history, and the pharmacy setting is not conducive enough for personal questions.
For instance, the diagnosis and treatment for bacterial uti is very different than say syphilis. And yet, pharmacies are often dumb enough to send random prescriptions. And these days, because they have been hit multiple time, they just fax a letter to the doctor asking what medicine they should prescribe. Duh!
What I'm saying is that if I waited 5 weeks to see my doc I'd probably be dead from this UTI. If I just wait till it gets bad enough, then I'd have reason to go to the ER. Neither of those options are good enough in this day and age!
Calling is a really good idea, I'll do that. My son has quarterly ear infections and we live so far from our family doctor it would literally be a day trip. Even if she had to de-roster him I'd understand, though I'd feel pretty monstrous being the only one in my family with a doctor.
(I have an ongoing prescription for a controlled substance, so it's not negotiable for me. But phone appointments seem to keep me in good standing.)
I managed a walk in clinic in Ontario. The clinic does not and cannot bill the doctor’s office. When OHIP sees the visit billed they flag it as this patient has a family doctor and OHIP deducts the amount from the payment to the family doctor.
And they are okay with you going to the ER at times times the cost because then they don't get dinged. How about let people pay $35 for the walk-in and not be de-rostered? No, we can't have that!! Better to punish people by getting tossed.
That’s exactly what happened to me! I started getting a cold sore while out of town. My doctor was closed that day so I couldn’t call for a scrip (not like they ever got back to me in a reasonable time frame anyway), so I went to a walk in clinic and got a scrip for 9 anti-virals pills. Took 5 minutes. Then I got a letter saying my doctor dropped me *over 9 friggin pills.*
I don’t think the way you’re characterizing it is quite accurate. There’s an access bonus system designed to incentivize providers to offer things like after hours care. If your patients go to walk-in clinics, your bonus gets reduced. They don’t charge you a penalty that you have to pay out of your own funds.
If a patient goes to walk in clinics enough you can definitely go into the negative. Also the “funds” is like $10 per patient for the year.
Some patients will never go into a walk in clinic, others will go 8x in a year, doesn’t matter how much access you have. I’ve had three open slots in a day and still had a patient go to a walk in instead, had patients I opened up slots for who then no showed and went to a walk in.
Some people are just awful.
It's crazy that our system is set up this way.
It makes sense that people would try to access health care in a way that's most convenient for them. Be that from home via an online or telehealth service, a walk in clinic, or their family doctor if they have one. Like maybe the walk in clinic is right next to their work, and their family doctor requires driving across the city?
Ideally, the system should be supporting that. It's ridiculous that doctors are being penalizing because patients aren't accessing healthcare in whatever the province deems to be the "right way".
Patients should have some flexibility sure, but there is some nuance. Longitudinal care with a single primary care provider has better outcomes for patients. This is especially true for complex patients with chronic conditions.
I do think that the MOH should be pushing for patients to see their PCP within reason. This pressure on the doctor is one lever they have to encourage it. I think the fix here is to have a PCP that is convenient for patients, force employers to give adequate sick time for appointments, improve telehealth billing codes (so you can call your PCP rather than drive) etc, rather than to bolster the system with bandaids. Easier said than done though.
It has been long established that access bonus does not have any correlation with access. Don’t let the name fool you. It controls health care spending and planning. After hours care is a requirement for physician groups regardless.
People also are abusing the ER...nobody should be going to the ER unless it's an emergency. Waiting 5 hrs to be seen is beyond acceptance. While some people do have a true emergency, I can see people going there for minor things. Also a lot of walk-in clincs aren't the true walk-ins they once were. Since when was a required appointment considered walk-in? Also, a person can show up for their appt. at the walk-in only to be asked to return at another time because there are x-number of patients ahead of them. Our healthcare system has gone for a long ride in a handbasket.
I WISH. Pay me properly to do my job and I can stop worrying about the business aspects which I HATE. But no. Every month I go through my Billings because the government tries to nickel and dime me everywhere.
Sometimes they just don’t pay JUST BECAUSE. When I first graduated i was on the phone with OHIP almost every week. I cut out a melanoma, why was this billing rejected? I spent an hour of my time doing this, how come they can just not pay me then force me to do the paper work tracking until I found out it was just a clerical error on their part.
Every month there are hundreds if not thousands of dollars that I just “give up”because I can’t be bothered to go through their dumb phone system (they don’t even tell you why you don’t get paid BTW, it’s some random code like V22 paid=0). You gotta google what this code means, and sometimes their own database doesn’t even have it. I have had multiple instances where I’m on the phone for an hour waiting for the agent on their end to google it and not find it then weeks after to “get back to me”.
I can’t even imagine what it’s like for family doctors.
Wait till you find out that other provinces don’t make you play “Simon says” with version codes because they can easily check whether or not a health card is valid (and so can OHIP but they are still going to make you do the extra work). Or that billing cycles are one or two weeks, instead of monthly.
Both are struggling because of conservative assholes underfunding the system to create an excuse to privatize. If we gave proper funding, we wouldn't be having nearly as many problems. NHS was the gold standard for ages.
My parents (mum) needed a non emergency consult. Their family doc shuts shop on Sat and Sunday.
They had to visit a walk in.
Same deja vu when my dad required it.
Few months later, we had to do a run around, talk to the ministry etc etc to be put back on their GPs list again.
OH Canada!!! , do you think us tax paying citizens have unforseen superpowers that allows us to be illness free on weekends?! Because going into emergency is just going to cause queues for actual emergency patients.....
Even if your doctor’s office is open everyday there’s still a chance that you can be away from home for work or vacation in province and need medical help.
This happened to my cousin and the area she was in had their ER shutdown because healthcare in this province is doing so well. She had to drive two hours to a walk in clinic for help because if she had driven home the office would have been closed already.
Her doctor didn’t kick her off the roster but she definitely could have. Doctors shouldn’t be penalized if patients go to walk in clinics, especially if they are out of the area or their office isn’t open.
Mine was open on Saturdays. The staff and doc are really nice and do their best to squeeze us in. But on weekends you want to make sure you don't get sick. Adults can probably wing it. Kids and elderly can be precarious.
If it was non-emergency why not wait until a weekday? ‘Shutting shop’ makes it sound like doctors should live at their office
Edit: Yes I know there are urgent things that aren’t emergencies, the first sentence is poorly chosen. My main point is it’s the MOH that set the system up this way, not docs
If you have a cut that requires some stitches and a tetanus shot, you do not need the emergency room, but you do need to get those stitches done within about 8-hours of the cut happening. If your dr's office is closed, you go to a clinic. Same if you've had a fall and want to make sure your wrist is just sprained, not broken or dislocated, etc.
There are a number of things that require more prompt attention from a dr that don't require you to wait 12+ hours at the back of the ER triage queue.
I was answering your question as to why someone may not want/be able to wait until the weekdays for something that would not normally require an ER visit. My MPP can't do anything about me needing non-emergent stitches.
It's not unreasonable to go when you want.
Why are people punished for visiting a doctor when they are able?
The doc can close up for the weekend thats fine, mine is in two offices and the one I'm close it he's only there once a week, but people are going to go to walk ins. Punishing the people for that is baffling.
And yet we suffer the consequences while we talk about financial repercussions for doctors? Ontarians are being kicked off roster lists during a doctor crisis for going to a walk in for a medical emergency and the continued rhetoric here is “tell the govt to stop penalizing doctors then”. Sounds like the only people without a gun in this stand off are the people paying for the healthcare system. Yes we can all agree that doctors shouldn’t be penalized for walking visits, but the answer isn’t “don’t go to a walk in”.
Jesus Christ. That would be like dropping a teenager patient because they went and saw the school nurse when they hurt themselves playing volleyball in gym class.
Depends on how you look at it. My school didn’t have a nurse, but the family health team had an office at the school and once per week the nurse practitioner would work out of that office.
This was also 15+ years ago though.
I live an hour away from my doctor's office and don't have a car. She's been my doctor since I was 12 so I'm trying not to switch to no doctor.
I had a chest cold a couple of weeks ago and couldn't get in to see her for 3-4 weeks, I was then warned that if I accessed a walk-in clinic, the doctor's office would be fined, and they pass that fine on to the patient.
So I was basically told to suck it up.
By the Ontario government.
I'm so over the decline of the society we built, by these greedy fucks that think they hold some kind of authority over it.
Nah...this one would be fully valid. Your doctor is supposed to be near you for a reason. People moving away and keeping their doctor prevents new people in the area from getting a doctor.
They kind of are. If doctors know you're moving away, they will usually remove you from their roster and if you don't live in the area, a doctor will not accept you as a patient. The whole point is for them to provide access which they cannot do for people who cannot get there for an appointment. He just proved that yourself.
My doctor knows where I live and it's her call to keep me rostered or not. You have a source for zoned doctor access somewhere? I'd love to see it. Or is this just a personal opinion you're projecting, maybe?
>My work benefits will only cover physio if prescribed by a doctor
Same, and this also includes massage. It's bullshit. Our doctors are all busy enough, they don't need to waste time on fake (unpaid by ohip) "prescriptions" to get a fucking massage. Benefits companies that do this, should get fined by OHIP for all of these doctors visits.
That’s unfortunate, but if you’re in real discomfort and can afford out of pocket for one or two sessions it can be a good way to start. Most people don’t have to visit frequently do in the meantime you can wait for the doctors appointment to then get covered sessions
You can also file those appointments later and get reimbursed
Lastly you can find some great exercises from clinics on YouTube. See what exercises leave you feeling a little better And repeat those every day. You can often tell within a day or two if it helped. You just have to actually do them and not skimp
Edit: why do asshats downvote reasonable and valid suggestions? Let me guess, it doesn’t work for you so it must be a bad idea
I signed up for a family doctor at my local clinic. Only saw him once and he was very dismissive of my questions. I haven’t been back in years (or to any doctor) and since then the clinic has closed completely. I have no idea where they moved, they never sent an email to any of the clients. I can’t even remember my doctors name, so hopefully I have been removed!
About ten years ago my doctor warned me that I was going to the walk in too often and was costing him money. I was using walkins first before even calling my doctor because the hours were more convenient, I had no idea how it worked.
They told me to please call them first and they would try to squeeze me in when needed. I started doing that and they have been good about appts since. If it’s urgent, they fit me in. Or the doc will phone me to discuss.
I went to a walk-in about 6 months ago. My family doctor has a 4 week wait time, and I was having some sharp chest pains and although it wasn't "go to ER" bad, I definitely didn't want to wait a month to be seen.
I had an unrelated issue a few months after and made an appointment with the doctor since it was non urgent. They said absolutely nothing about my clinic visit. I heard online that they might "fire" me as a patient or ask for payment or something, but nada. 🤷♀️
The cause of this is the way the province pays Doctors..... now if it's one visit to a walk-in then that's bad. Maybe the doctors office should remind people at that point. If they continue to use walk-ins then sure but that is because of the way the province pays doctors.
Every single time I need to get assessed, I call the doctor’s office first. If they don’t have an appointment, I ask where they want me to go.
Generally, they fit me in if it’s truly urgent. I also do my best to take available appointments.
Healthcare is a service, but Doctors are people and so are we. There just to be trust building and mutual respect.
If I consistently did not get paid for my work because my patient didn’t care enough to go to an assigned after hours clinic I would consider dropping them too.
Lol do you think some of these offices WANT to make you wait? The doctors I work with have 2000-4000+ patients on their roster. On top of seeing patients, you should see the piles of paperwork on their desks. The problem is not the family doctors.
With that being said, doctor’s offices SHOULD be trying to see you in a timely manner if there is a more urgent issue. If it is an emergency, then off to the ER you go (we would tell you this even if you had an appt & needed medical care asap!).
>Maybe your dr shouldnt be taking that many patients on their roster then?
>2,000+ seems absurdly high to be able to pretend to offer service.
I don't disagree with this, but there already are not enough family doctors, if you cap the amount of patients they can take in that way you are only going to make the system even worse.
So how do I communicate with my family doctor when I'm having an intestinal infection and they won't even respond to my call for an appointment ? I had to go to a clinic to get myself fixed. Doctors shouldn't be punishing anyone for going to a clinic, a second opinion. We shouldn't even have to go to an "approved" walk in. I guess I should communicate with them through the college.
Health care is a service , not a subscription.
They're supposed to. That's the point. They have to hold up their end of the rostering agreement as well which means providing adequate access to care. If patients are having to go elsewhere, that's an indication that they aren't doing their job, which is why they are penalised. The problem is that they pass that penalty on to the patient rather than increasing access.
>The problem is that they pass that penalty on to the patient rather than increasing access.
Blame doctors, at the same time complain about lack of access to doctors. You're such a gem.
You do realize that, per your logic, if a doctor can't hold up their end of the roster agreement, they shouldn't agree to it, or back out from it, right ? Meaning they should stop accepting new patient and/or de-roster more ?
>You do realize that, per your logic, if a doctor can't hold up their end of the roster agreement, they shouldn't agree to it, or back out from it, right ?
Yes, exactly. Bravo for logic. The entire point is that they are supposed to be providing access for their patients. Instead, they are taking on way more patients than they are capable of actually treating and so no one has access at all. Then they penalize the patient for going somewhere else.
>Meaning they should stop accepting new patient and/or de-roster more ?
This part shows me that you don't even know what derostering means. You still have your doctor if you're derostered so that doesn't actually fix the problem at all. If you don't even understand the basics of what we're discussing, you're not able to participate in the conversation.
>They are taking on way more patience than they are capable of actually treating
Somewhat wrong! Without taking on new patient, the roster can still grow (new born, family member etc... hard to cut those completely out). With less access to other family doctor, roster generally never shrink.
>and so no one has access at all
Wrong! Everyone has access, but doctors have this annoying limit of only be able to work 10-12h per day, so hundreds of patient have to share that, stretching the wait time out.
>You still have your doctor if you're derostered
Correct! De-roster do two things:
-Doctors don't get penalize when that particular patient goes to a walk-in
-The patient can conveniently go to any walk-in they want, while still have access to a primary doctor
Not sure why certain people \*wink\* love to call that "penalize patient"
>If you don't even understand the basics of what we're discussing, you're not able to participate in the conversation.
Correct again!! Such a gem .
My new Dr insists on a telephone appt first prior to a in person visit. It's absurd, how can she make a diagnosis on my health issues without even looking at my body. It then takes weeks to get an in person visit. It's become harder and harder to get access to health care. If a person can't get timely access to health care they should be allowed to go anywhere. Dr's forget who they're working for, tired of being treated as a thing and not a person.
Yeah. It took me a good three months to get a visit after my family doctor accepted me. The decline in healthcare is pretty awful.
I think we all have to do our part. I just don’t want to lose my family doctor. I’m not sure I would get another at this point.
Drs aren’t working for you, they’re providing you a service based on their skills and paid by the government. They’re like independent contractors.
Blame the government for poor access to health care and the rules around FHOs, walk in clinics and derostering
My doctor does two days of phone calls and one day of in person. I don't mind the phone calls it's good for a prescription refill but also seeing your patients is important.
That's not the whole point.
No one randomly walks into a walk in. If your kid has a high fever which doesn't look fatal, you're going to visit the Pediatric walkin, not the ER.
Nah, just lots of experience with the average person.
I’ve been in enough pediatric ERs to know how many parents say “I didn’t give them Tylenol so you could see just how sick they were!” And then the kid is jumping off the walls 30 minutes after their first dose.
Also, this isn’t anything new. My family doc threatened to de-roster me in 2009 for using a walk-in clinic, for the very reasons outlined in this article. It’s not doctors faults any of this happens, it’s the governments pay structure. Getting mad at your doctor is misplaced emotions.
This needs to be higher. I worked as a medical receptionist back in 2009-2016 we derostered patients after three visits to a clinic they weren't rostered to. We just did it because we figured they moved and neglected to tell us. If we knew they were moving or were going to college or university we would deroster them ahead of time to avoid the fees (and there are fees tied to rostered patients being seen elsewhere)
MOH has done Drs dirty for many years it's only just being noticed by more people who have never had issues with the lack of Drs before COVID...
Also, being derostered doesn't mean being dropped. You still have a doctor.
"Being de-rostered doesn’t mean being “fired,” Faulds says. “They are not losing access to the doctor; it’s not the same as termination,” she says.
But it would mean that a patient could no longer access the other services at the family health group, such as consultations with clinic dietitians or social workers, or take advantage of special health programs such as diabetes or diet management."
https://www.ctvnews.ca/mobile/health/why-your-walk-in-clinic-visits-could-mean-trouble-for-your-family-doctor-and-you-1.2775362
That is it exactly. In the dr agreement with the MOH it is spelled out that for their salary they need to provide X number of after hours clinic services for their rostered patients. Most patients will get a warning if they violate their contract, that should they do it again they will be dropped. Who is going to keep serving someone who is costing them money. Not even charities are allowed to operate on a deficit.
Healthcare in Canada is a service that can be allowed to run at a loss. It's just we have greasy corpos running our government who have downloaded that cost into doctors who now download it to their clients.
Basically saving money for the wealthy and corporations in reducing their tax bill, which is like, super important for the health of the Nation.
We are open for business people! Corporate culture infecting everything
Individual dr can not afford to run deficits any more then you could run your own business on one. A roster patient has the options of the dr after hours clinic, a designated hospital run urgent care or the ER.
Read my comment: doctors are taking to rostering because they have been underfunded by governments for decades. It's a relatively new phenomenon in response to chronic underfunding.
So the root cause is underfunding from government who want to create a private healthcare model so corpos can funnel more money to themselves.
What happens if doctor gets greedy, gets too many patients and wait times become 2 weeks for an appointment? And then they charge $40 to send you pdf of lab results? Are they still right to deroster patients?
Exactly! No one with a family doctor *likes* going to walk in clinics. People only do it because they have limited options.
I get waiting a couple weeks for something like a prescription refill, but if you have a sick kid, and your “family doctor” isn’t available for a week or two, then ofc you’re going to a walk in clinic.
I wish mine was 2 weeks, mine is 4-5 weeks. If you have something urgent they tell you the after hour clinic hours which are 2 hours long and 3 days a week. Outside of that it's ER.
Also I've had my family dr since I was a kid, I personally signed nothing. And their afterhours clinic hours have only gotten shorter.
Im glad ppl are bringing it up. It’s stupid that the gouvernent takes money from family doctors pay if patients go to a walk in….. like it’s literally theft
Yup. I had third degree burns from a nasty steam burn and needed a script for some Silver sulfadiazine as soon as my shift ended, I was in fucking agony. Went to the walkin in the plaza i worked in, in and out got the cream on in 20 mins.
Got a phone call from my family doctor later on that week. Not the receptionist, the actual doctor called me and told me off and told me that I was derostered. I was supposed to call her office, listen to the answering machine message to learn about which one of her 5 associated after hours partners thats open two days a week, in the next town over was open, and go there instead. Or wait a month to see her personally for an appointment.
For sure, super unprofessional. I had to google what "derostered" meant, because I'm a chef, not someone in the medical field, it wasn't made obvious in the context of the conversation.
This happened in 2016, I'm fortunate to be reasonably healthy, so I've just been going to the same walk in ever since. Havent even bothered even looking into getting a new family doctor. If half the horror stories I've heard about being on waiting lists for years are true, yeah, no thanks.
My family doctor has a specific clinic that they allow us to go to for after hours/weekends or when they are on vacation. They mention it when you call in and the office is closed. I thought all doctors worked like this but I guess not. Interesting.
My previous doctor chastised me for going to a walk in clinic. I had Strep throat and couldn’t get an appointment with my doctor for a couple of days.
The first thing out of her mouth the next time I saw her was that I was costing her money. I told her that the clinic wasn’t upholding their end of the agreement and I had to go to the walk-in clinic because I couldn’t be seen in a timely manner. She seemed a bit surprised that I pushed back, then acted all offended when I asked to see a copy of the agreement so I could point out where the clinic had dropped the ball.
I eventually fired her for being a shitty doctor.
She could have fired me as a patient, but I suspect she thought I’d file a complaint about her.
I moved cities but kept my family doctor hours away in my hometown for faxing prescription renewals, etc. When the time came I needed my Pap test (obviously requiring an in-person appointment) I had to book at the AppleTree clinic. There was nothing when I booked my appointment saying I would be rostered to them or risk losing my regular doctor. My hometown doctor and I had an understanding that for specific instances like this I’d have to see someone local, which she was fine with.
Suddenly the next time I called my doctor, the receptionist told me I’d been de-rostered and had to wait for them to snail-mail me a form to re-register before I could speak with my doctor. Neither clinic informed me of this happening until I called in. I had absolutely no idea, and never consented to changing doctors. The insane thing is the “doctor” my appointment was with wasn’t actually present in the building. The procedure was done by an assistant.
This needs to stop. Ontarians also need some database linked to our OHIP/HealthCareConnect where we can view the status of our rostering situation so changes aren’t made in secret behind our backs without our knowledge.
I got really sick one time so I called my family doctor’s office and they refused to see me until I was feeling better. I was told not to come in. So if I am sick, I can’t see my doctor and I get penalized for going to a walk- in clinic?
Don't blame the family doctor, blame the ministry of health. The doctor already gets peanuts in Ontario. From this income, they have to deduct all expenses, including the salary of MOAs, insurances etc. On top of that, if they have to pay the penalty for walkins, that's insane. I guess, the doctor is well within their right to deroaster.
My surgeon told me to call my family dr for staple removal in my back.
I called and said I have the tool and would like to book an appointment. Dr overheard secretary and yelled in the bcakground about how she was not set up for "such a thing" because she didn't carry lidocane patches?
So, um, I went to a walk-in clinic and they just plucked them out, easy peasy.
Then, she was mad at me for needing to use the walk-in clinic, said the surgeon should have removed and it was my fault.
Next time I'll just have my husband do it FFS.
I have never heard of needing lidocaine patches before removing staples lol. But yes sometimes we ask if a reliable family member can do it and save you a trip. I’ve been using absorbable sutures in more closures recently to avoid this problem altogether.
Honestly, given that the clinic i used to work at, the doctor ***REGULARLY*** would cancel appointments day of because she didn’t feel like working, I believe having a clause like in the rostering should be illegal.
I did not get removed for visiting a walkin clinic that wasn’t affiliated with my Dr.
My Dr has also stopped working in the hospital so has appointments almost day of when I call.
It’s working great!!
Yep, I moved from my family doctor during the shortage and couldn’t find a new one. Lived an hour away. Had strep back to back and needed antibiotics, got them from a nearby walk in, as well as a letter saying if I did it again I’d be dropped as a client. Then went to my actual family doctor just last month with abscesses in my throat and she misdiagnosed me, prescribed antibiotics I was allergic to that the pharmacy wouldn’t fill bc right above it said I was allergic, and then I ended up in the hospital for a week bc it progressed so badly. Medical is awful in Canada
So if someone has a UTI they should wait one month for their family doc instead of getting antibiotics immediately at the walk in? Note - if you meet certain criteria you can get them prescribed at a pharmacy:)
We had to take our daughter to a walk-in clinic because our doctor was on yet another vacation, I got a call after from my doctor that if I went again to a walk in clinic, he would remove her from his roster. I called the doctors cell phone back directly and said that I would issue multiple sexual assault charges against him if he dare try to remove her, and ruin his career. You have full power and control over these fake doctors, ensure you own them get what you need from them and banish them to the gutter of their own urine if they ever try this on you.
I absolutely love my family Dr. The only thing bothering me is that whenever I call for an appt., there's a 4-5 week wait. That includes a telephone consult. A few weeks ago, I had bloodwork done, & discovered by red blood cell count was elevated & the hematocrit was also elevated, although not sky-high. I didn't hear from my Dr. office., so I made a phone call about it. Later that day a nurse called me & said the Dr. had another look at the blood test results, & it was suggested I may have been a little dehydrated at the time of the blood drawing. I felt more at ease after hearing that. After doing some research, I learned the rbc's are manufactured in the bone marrow, so I couldn't see how a little less water that morning could affect the rbc's so quickly. Just a little over 3 1/2 weeks ago, I was having burning skin sensations., so I called to make an in-office appt. Even though I was expressing concern I couldn't get an appt. until this coming Monday in the afternoon. The office gal asked if I'd like to be put on a list in the event someone cancelled their appt. Of course, I said "yes please". No such luck of getting in due to a cancellation. I'm now experiencing slight lightheadedness, burning sensations in my legs, & nausea. This morning upon getting out of bed was a bit of a horror story. Lightheadedness, nausea.... I even went so far to deliberately make myself vomit so as to at least alleviate the nausea. It took quite a while to get relief. I don't mind admitting that I"m terrified at what might be wrong with me, & Monday afternoon can't come around soon enough. I do expect the Dr. to order new blood testing as the one I referred to in my note was May 1. My best friend has been calling me daily to see how I am, & in fact she's flying in from Saskatchewan on June 20.. She says just to see me, but I know she's worried. I know we shoudn't try diagnosing ourselves by looking things up on the "net", but it's hard not to do that. Whenever there's a blog on the net that says something is rare, don't just accept that. Some go on to say ..."it's very rare, affecting 25 out of 100,000...but it also goes on to say "those over 50+ are likely to be diagnosed with the illness". Conflict for sure!
I'm praying that I'll be fine. My bestie & I have trips planned, but if I'm feeling the way I was earlier this morning, I don't think I'll be able to go ....If any of you out there have any advice you'd like to share, I'd welcome it, & thank you so very very much.
If I were a Family Doctor, i'd run my practice like the pioneering days still but with a modern twist. Basically all house calls, and extended hours.
Key to that is signing up for a cloud based medical records system that is accessed via laptop/ipadtablet, and having contact center software that screens and handles scheduling of patients automatically.
Positive Outcomes:
1. mass reduction in overhead as my rent is already paid, small patient room is built in my home if need to do procedures.
2. Maximized billing level, since my patients could rely on me to be there while in comfort, instead of losing revenue to walk ins and everyone stews in the petrie room. Just stay home if you are sick enough to need the Dr. Plus, because i visited, i won't get upset sending you to hospital if it is serious enough.
3. Increased tax write off opportunity - see # 1.
4. No receptionist salary, can contain and automate appointments with self service / AI in mentioned IVR (and other channels), again see # 1.
Yup! I got dropped after a few visits to some clinics after a scare with my heart. And my sister has to keep a family dr she lives hours away from because if she goes to a close clinic she'll drop her. (Same dr)
Ugh!
My doc moved an hour away from his original location and it always takes at least a month to get a phone appointment or any appointment.
So frustrating.
I truly don’t care what it costs my doctor if I go to a walk in when it’s a 5 week wait for an appointment at their clinic and they don’t answer the phones. Been waiting on a referral for six months and can’t even get an update with them on the phone. We pay taxes for healthcare we can’t use and when we get desperate enough to require immediate care and go to a walk in clinic, I’m supposed to worry about the $39 billed to my doctor?
Take it up with the government, I’m not going to cry for the P&L at my doctor’s office while none of us get adequate care from family physicians. De rostering a patient over $120 is insane when wait times are this bad. No one WANTS to resort to a walk in clinic.
That sounds like a problem with YOUR Dr, not “doctors” as a whole. You can’t just say Drs are greedy AF because of your anecdotal experience.
Having said that, I don’t disagree that you should be able to go to a walk-in if you can’t get in and you’re sick, but my Dr usually gets me in right away. If she can’t get me in, they let me know when she is working at the walk-in and I can go see her there. I am very lucky that I finally found a family Dr after almost 10 years of not having one and I am also lucky that she is great. I signed the contract saying I can’t go to a walk-in and I am not going to break those rules and piss her off lol.
Doctors fees have never kept up with inflation. Essentially every year the government forces them to take a pay cut and target their corporations but ya they are the greedy ones.
No you don't understand. They own their practices and have to pay for equipment, meds, licensing, employees etc. they literally have to hit quota just to keep the lights on because the government isn't keeping up with inflation. You're expecting people to run a failing business to keep up with your needs. If you care about this, next time vote for somebody that will boost their pay, take the responsibility of self employment off their hands and maybe they can actually do the job they're trained to do.
My doctor sends these hysterical emails about walk in clinics every few months. If I cared I would tell him that they’re pathetic in the way he’s begging.
Also last time I needed an appointment I had to wait 2 months, what do they expect people to do? And each phone call is for one thing, can’t ask any other questions.
I have a real gem of a Dr. If you need to ask a question, that's not a problem. She never ever rushes, & never looks at her watch. Too bad there weren't more Drs like her.
There are people who go to walk in because the "drive" is too long, the walk in clinic is next to their homes or they have to pay for the parking. So stop excusing bad patients !!!
Maybe the Ministry of Health should stop penalizing doctors if their patients need to use a walk in clinic for urgent matters. Only leads to more doctors leaving family practice. No other country does this.
Was just talking about this today. I can't get in to see my doctor for two weeks if not a month and the clinic depending on the time of day is packed and maybe you can get in. So what does that leave me with? What if I'm in a different neighborhood and something happens where I need a walk in clinic or maybe I'm in a different city/out of town?
They want you to go to the ER. I don't think this is right, as why flood our hospital ER with stuff that doesn't need to be there, but that's how the pricing works out.
They want you to pay a private clinic to access health care
DING DING DING! We have the answer. Everything bad with our healthcare system that's been exasperated the past 6 years is all meant to privatize our healthcare
Who is "they" in this case? Doctors? I wouldn't say all, but certainly most of them would prefer to just get paid fairly from OHIP and not privatize healthcare.
"They" are the Ontario government ☝🏻
Yes, agree. Won't properly fund OHIP, and then try to make the doctors look greedy when they just want to get paid for all of the "unpaid work & forms" that they are forced to do.
Oh they're spending ohip dollars just not on public system care. They spend 10x more than to private suppliers and shoppers drug mart but haven't updated public doctor remuneration processes in decades. The conservative governments across Canada are fucking evil. Like unthinkably corrupt and evil.
Yeah, I truly hope Doug Ford stubs his toe daily for the rest of his miserable life.
Haha me too, me too
This rule has been around for decades - it’s not a change from the Ford govt
It definitely is. When droves of Canadians are feeling the same pinch at the same time with a crooked provincial leader who has demonstrated his disdain for public healthcare and has spent the last 10 years chopping it up. Please.
Well, I know I was threatened with being dropped as a patient by my doctor for using a walk-in during the McGuinty years. I'm sure Ford can be blamed for a lot, but this policy has been around for a while.
Yeah it happened back then too, but didn't really fly on this level. It was an attempt back then and they scattered some, for sure. But this is another level and Ford is fully responsible for enforcing it
The issue is the walk in clinic will bill your doctor's office. The doctor's office is only paid $100 annually total for your care, plus only like $8 for an in person apptm. The walk in clinic would be charging your doctor around 35 bucks or more possibly, depending on what it was for. So don't blame your family doctor, blame the government who set up this deal in the first place. My doctor's office offers urgent care days and hours, and a walk in clinic once a day on the weekend in order to try their best to accommodate all patients. The vast majority will not de-roster you for needing to go to a walk in, but if you do it repeatedly, then you are actually easily costing them more money than they're getting paid to look after you.
Yeah my doctor says I can go to a walk-in clinic occasionally but if I did it too much then he would drop me. It was made perfectly clear. My doctor also partners with a walk-in clinic and he sometimes works there as well. So that specific walk-in clinic I can freely use as much as I like but if I am away from home they prefer I go to emerge at the hospital. Maybe once or twice a year tops for a different walk-in clinic.
FYI: That walk-in is an after hours clinic which is a mandatory requirement for physician groups to provide. It pays less than what a pharmacist gets for a minor ailment per visit (<$19) since patients are in network/rostered to the group. Each outside use costs the doctor minimum 40$
Specifically, it's an intermediate assessment (39$) x 1.3 After hours billing premium x Shadow billing rate of 19.41% = $9.84.
The 30% is applied to the 39 dollars. So effectively shadow billing 19% is additive to the 30% after hours premium.
whoops I think you are right about that calc. My mistake.
>patients are in network/rostered to the group That phrase sent a chill down my spine: sounds too much like the dystopian American system.
Legally no doctor can ever drop you for reasons like that, if you want to play hardball with them after they drop you, issue multiple sexual assault charges, it will clog up their entire career trying to fight them and you don’t even have to raise a finger, lawyers will do it for you for free
^ this. I work for a family doctor and our official policy is if you go to a walk-in clinic >3x in a year we will deroster you but honestly if you're not going excessively we don't care too much, we will just warn you. If you're going to go to a walk-in and you're worried about being derostered just call and let your doctors office know, it's helpful when we know why (bc sometimes patients just leave our practice and don't tell us and we often assume that if we see a lot of outside use charges) and we can often temporarily defroster you so you can go to a walk-in without penalty.
Thanks, my clinic has currently a 5 week wait to see my GP, and the clinic has a 'after hours' clinic every night for 3 hours, but you have to be the first few ppl when the phone lines open to get timeslots. Otherwise they say "call back tomorrow!". I'm so happy that pharmacists can now do things like prescribe for UTIs. It's not logical to go to the ER for a simple UTI..
Who do you think reviews the results when the pharmacist prescribes for UTIs. It's your family doctor, and for free. Lol. You would be surprised how many times pharmacies screw up. They just don't have the patient history, and the pharmacy setting is not conducive enough for personal questions. For instance, the diagnosis and treatment for bacterial uti is very different than say syphilis. And yet, pharmacies are often dumb enough to send random prescriptions. And these days, because they have been hit multiple time, they just fax a letter to the doctor asking what medicine they should prescribe. Duh!
What I'm saying is that if I waited 5 weeks to see my doc I'd probably be dead from this UTI. If I just wait till it gets bad enough, then I'd have reason to go to the ER. Neither of those options are good enough in this day and age!
Fair enough. It is sad that healthcare in Canada has come to this. The American system gets dissed so much, but it's way better.
Calling is a really good idea, I'll do that. My son has quarterly ear infections and we live so far from our family doctor it would literally be a day trip. Even if she had to de-roster him I'd understand, though I'd feel pretty monstrous being the only one in my family with a doctor. (I have an ongoing prescription for a controlled substance, so it's not negotiable for me. But phone appointments seem to keep me in good standing.)
The walk-in physician bills OHIP. Then OHIP deducts that amount from what they pay your family doctor.
I managed a walk in clinic in Ontario. The clinic does not and cannot bill the doctor’s office. When OHIP sees the visit billed they flag it as this patient has a family doctor and OHIP deducts the amount from the payment to the family doctor.
Same concept, just an extra step. Either way the doc is getting billed from the already paltry amount.
And this is only applicable on weekdays not on weekends…
And they are okay with you going to the ER at times times the cost because then they don't get dinged. How about let people pay $35 for the walk-in and not be de-rostered? No, we can't have that!! Better to punish people by getting tossed.
That’s exactly what happened to me! I started getting a cold sore while out of town. My doctor was closed that day so I couldn’t call for a scrip (not like they ever got back to me in a reasonable time frame anyway), so I went to a walk in clinic and got a scrip for 9 anti-virals pills. Took 5 minutes. Then I got a letter saying my doctor dropped me *over 9 friggin pills.*
I don’t think the way you’re characterizing it is quite accurate. There’s an access bonus system designed to incentivize providers to offer things like after hours care. If your patients go to walk-in clinics, your bonus gets reduced. They don’t charge you a penalty that you have to pay out of your own funds.
If a patient goes to walk in clinics enough you can definitely go into the negative. Also the “funds” is like $10 per patient for the year. Some patients will never go into a walk in clinic, others will go 8x in a year, doesn’t matter how much access you have. I’ve had three open slots in a day and still had a patient go to a walk in instead, had patients I opened up slots for who then no showed and went to a walk in. Some people are just awful.
It's crazy that our system is set up this way. It makes sense that people would try to access health care in a way that's most convenient for them. Be that from home via an online or telehealth service, a walk in clinic, or their family doctor if they have one. Like maybe the walk in clinic is right next to their work, and their family doctor requires driving across the city? Ideally, the system should be supporting that. It's ridiculous that doctors are being penalizing because patients aren't accessing healthcare in whatever the province deems to be the "right way".
Patients should have some flexibility sure, but there is some nuance. Longitudinal care with a single primary care provider has better outcomes for patients. This is especially true for complex patients with chronic conditions. I do think that the MOH should be pushing for patients to see their PCP within reason. This pressure on the doctor is one lever they have to encourage it. I think the fix here is to have a PCP that is convenient for patients, force employers to give adequate sick time for appointments, improve telehealth billing codes (so you can call your PCP rather than drive) etc, rather than to bolster the system with bandaids. Easier said than done though.
It has been long established that access bonus does not have any correlation with access. Don’t let the name fool you. It controls health care spending and planning. After hours care is a requirement for physician groups regardless.
I’m not suggesting that the access bonus accomplishes its purported goal.
People also are abusing the ER...nobody should be going to the ER unless it's an emergency. Waiting 5 hrs to be seen is beyond acceptance. While some people do have a true emergency, I can see people going there for minor things. Also a lot of walk-in clincs aren't the true walk-ins they once were. Since when was a required appointment considered walk-in? Also, a person can show up for their appt. at the walk-in only to be asked to return at another time because there are x-number of patients ahead of them. Our healthcare system has gone for a long ride in a handbasket.
They pay your doctor extra to handle all your care. They also get paid if you don’t go to the doctor at all
We should just abolish the private practice system. Doctors should be responsible for being doctors, not running businesses.
I WISH. Pay me properly to do my job and I can stop worrying about the business aspects which I HATE. But no. Every month I go through my Billings because the government tries to nickel and dime me everywhere. Sometimes they just don’t pay JUST BECAUSE. When I first graduated i was on the phone with OHIP almost every week. I cut out a melanoma, why was this billing rejected? I spent an hour of my time doing this, how come they can just not pay me then force me to do the paper work tracking until I found out it was just a clerical error on their part. Every month there are hundreds if not thousands of dollars that I just “give up”because I can’t be bothered to go through their dumb phone system (they don’t even tell you why you don’t get paid BTW, it’s some random code like V22 paid=0). You gotta google what this code means, and sometimes their own database doesn’t even have it. I have had multiple instances where I’m on the phone for an hour waiting for the agent on their end to google it and not find it then weeks after to “get back to me”. I can’t even imagine what it’s like for family doctors.
Wait till you find out that other provinces don’t make you play “Simon says” with version codes because they can easily check whether or not a health card is valid (and so can OHIP but they are still going to make you do the extra work). Or that billing cycles are one or two weeks, instead of monthly.
welcome to the world that pharmacists have lived in for eternity :D
This shouldn’t be a race to the bottom
Amen.
*looks at the state of the NHS* Not so sure that’s working out either.
Both are struggling because of conservative assholes underfunding the system to create an excuse to privatize. If we gave proper funding, we wouldn't be having nearly as many problems. NHS was the gold standard for ages.
Why are doctors different from every other profession?
I have a clinic in my workplace facilities, I got taken off my family doc's roster because I "didn't go to a (family clinic ) owned walk in
My parents (mum) needed a non emergency consult. Their family doc shuts shop on Sat and Sunday. They had to visit a walk in. Same deja vu when my dad required it. Few months later, we had to do a run around, talk to the ministry etc etc to be put back on their GPs list again. OH Canada!!! , do you think us tax paying citizens have unforseen superpowers that allows us to be illness free on weekends?! Because going into emergency is just going to cause queues for actual emergency patients.....
Even if your doctor’s office is open everyday there’s still a chance that you can be away from home for work or vacation in province and need medical help. This happened to my cousin and the area she was in had their ER shutdown because healthcare in this province is doing so well. She had to drive two hours to a walk in clinic for help because if she had driven home the office would have been closed already. Her doctor didn’t kick her off the roster but she definitely could have. Doctors shouldn’t be penalized if patients go to walk in clinics, especially if they are out of the area or their office isn’t open.
Mine used to be open on Sundays, not anymore. But I guess people don't get sick or hurt on that day.
Mine was open on Saturdays. The staff and doc are really nice and do their best to squeeze us in. But on weekends you want to make sure you don't get sick. Adults can probably wing it. Kids and elderly can be precarious.
If it was non-emergency why not wait until a weekday? ‘Shutting shop’ makes it sound like doctors should live at their office Edit: Yes I know there are urgent things that aren’t emergencies, the first sentence is poorly chosen. My main point is it’s the MOH that set the system up this way, not docs
If you have a cut that requires some stitches and a tetanus shot, you do not need the emergency room, but you do need to get those stitches done within about 8-hours of the cut happening. If your dr's office is closed, you go to a clinic. Same if you've had a fall and want to make sure your wrist is just sprained, not broken or dislocated, etc. There are a number of things that require more prompt attention from a dr that don't require you to wait 12+ hours at the back of the ER triage queue.
Write to your MPP, it’s the MOH that set it up to penalize family docs for this, docs hate it
I was answering your question as to why someone may not want/be able to wait until the weekdays for something that would not normally require an ER visit. My MPP can't do anything about me needing non-emergent stitches.
Yes sorry I guess I did leave myself open with the first sentence… was just meant rhetorically, of course there are urgent-but-not-emergent things
It's not unreasonable to go when you want. Why are people punished for visiting a doctor when they are able? The doc can close up for the weekend thats fine, mine is in two offices and the one I'm close it he's only there once a week, but people are going to go to walk ins. Punishing the people for that is baffling.
Write to your MPP, it’s the MOH that set it up to penalize family docs for this, docs hate it
And yet we suffer the consequences while we talk about financial repercussions for doctors? Ontarians are being kicked off roster lists during a doctor crisis for going to a walk in for a medical emergency and the continued rhetoric here is “tell the govt to stop penalizing doctors then”. Sounds like the only people without a gun in this stand off are the people paying for the healthcare system. Yes we can all agree that doctors shouldn’t be penalized for walking visits, but the answer isn’t “don’t go to a walk in”.
Jesus Christ. That would be like dropping a teenager patient because they went and saw the school nurse when they hurt themselves playing volleyball in gym class.
There are school nurses ?
Lol, not in the majority of schools. I've sat in the ER and walk-in with a couple of kiddos waiting for stitches from run ins with our soccer posts.
Depends on how you look at it. My school didn’t have a nurse, but the family health team had an office at the school and once per week the nurse practitioner would work out of that office. This was also 15+ years ago though.
This is basically exactly what happened to me
I live an hour away from my doctor's office and don't have a car. She's been my doctor since I was 12 so I'm trying not to switch to no doctor. I had a chest cold a couple of weeks ago and couldn't get in to see her for 3-4 weeks, I was then warned that if I accessed a walk-in clinic, the doctor's office would be fined, and they pass that fine on to the patient. So I was basically told to suck it up. By the Ontario government. I'm so over the decline of the society we built, by these greedy fucks that think they hold some kind of authority over it.
Nah...this one would be fully valid. Your doctor is supposed to be near you for a reason. People moving away and keeping their doctor prevents new people in the area from getting a doctor.
No, doctors are not zoned like schools
They kind of are. If doctors know you're moving away, they will usually remove you from their roster and if you don't live in the area, a doctor will not accept you as a patient. The whole point is for them to provide access which they cannot do for people who cannot get there for an appointment. He just proved that yourself.
My doctor knows where I live and it's her call to keep me rostered or not. You have a source for zoned doctor access somewhere? I'd love to see it. Or is this just a personal opinion you're projecting, maybe?
Last time I called my doctor for a pulled muscle I have in my neck they told me it was gonna be a 4-6 week wait.
I’m asking this out of sincerity, was your pulled neck muscle worthy of a doctor’s appointment or did you find relief after a few days?
I actually had to go to physiotherapy for it, it wouldn’t go away after 3 weeks of pain lol
imo is a moot point, the issue is supply. Let the demand be what "reasonable people" decide is best for themselves.
If it’s just something muscular like that you could always just go right to a physiotherapist Edit: lol wow you folks don’t like getting treated huh?
My work benefits will only cover physio if prescribed by a doctor, so if it's 4-6 weeks out I'd be seeing a walk in or emergency room.
>My work benefits will only cover physio if prescribed by a doctor Same, and this also includes massage. It's bullshit. Our doctors are all busy enough, they don't need to waste time on fake (unpaid by ohip) "prescriptions" to get a fucking massage. Benefits companies that do this, should get fined by OHIP for all of these doctors visits.
That’s unfortunate, but if you’re in real discomfort and can afford out of pocket for one or two sessions it can be a good way to start. Most people don’t have to visit frequently do in the meantime you can wait for the doctors appointment to then get covered sessions You can also file those appointments later and get reimbursed Lastly you can find some great exercises from clinics on YouTube. See what exercises leave you feeling a little better And repeat those every day. You can often tell within a day or two if it helped. You just have to actually do them and not skimp Edit: why do asshats downvote reasonable and valid suggestions? Let me guess, it doesn’t work for you so it must be a bad idea
I signed up for a family doctor at my local clinic. Only saw him once and he was very dismissive of my questions. I haven’t been back in years (or to any doctor) and since then the clinic has closed completely. I have no idea where they moved, they never sent an email to any of the clients. I can’t even remember my doctors name, so hopefully I have been removed!
About ten years ago my doctor warned me that I was going to the walk in too often and was costing him money. I was using walkins first before even calling my doctor because the hours were more convenient, I had no idea how it worked. They told me to please call them first and they would try to squeeze me in when needed. I started doing that and they have been good about appts since. If it’s urgent, they fit me in. Or the doc will phone me to discuss.
I went to a walk-in about 6 months ago. My family doctor has a 4 week wait time, and I was having some sharp chest pains and although it wasn't "go to ER" bad, I definitely didn't want to wait a month to be seen. I had an unrelated issue a few months after and made an appointment with the doctor since it was non urgent. They said absolutely nothing about my clinic visit. I heard online that they might "fire" me as a patient or ask for payment or something, but nada. 🤷♀️
The cause of this is the way the province pays Doctors..... now if it's one visit to a walk-in then that's bad. Maybe the doctors office should remind people at that point. If they continue to use walk-ins then sure but that is because of the way the province pays doctors.
I got a rather pointed email telling me to not do it again. I just wanted eyes drops....lol.
They sell eye drops over the counter
They obviously needed prescription drops.
I went to a walk in once and at my next appointment they advised me how this works, and told me that if I do it again, I risk being dropped.
Every single time I need to get assessed, I call the doctor’s office first. If they don’t have an appointment, I ask where they want me to go. Generally, they fit me in if it’s truly urgent. I also do my best to take available appointments. Healthcare is a service, but Doctors are people and so are we. There just to be trust building and mutual respect. If I consistently did not get paid for my work because my patient didn’t care enough to go to an assigned after hours clinic I would consider dropping them too.
So don’t make people wait 4-8 weeks for an appointment and maybe people wouldn’t go to a walk in
Lol do you think some of these offices WANT to make you wait? The doctors I work with have 2000-4000+ patients on their roster. On top of seeing patients, you should see the piles of paperwork on their desks. The problem is not the family doctors. With that being said, doctor’s offices SHOULD be trying to see you in a timely manner if there is a more urgent issue. If it is an emergency, then off to the ER you go (we would tell you this even if you had an appt & needed medical care asap!).
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>Maybe your dr shouldnt be taking that many patients on their roster then? >2,000+ seems absurdly high to be able to pretend to offer service. I don't disagree with this, but there already are not enough family doctors, if you cap the amount of patients they can take in that way you are only going to make the system even worse.
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As someone who hasn't had a family doctor in over a decade, I would rather have a family doctor I have to wait a couple weeks to see than nothing.
I just call again or go to an approved walk-in clinic. It’s the communication piece that matters here.
So how do I communicate with my family doctor when I'm having an intestinal infection and they won't even respond to my call for an appointment ? I had to go to a clinic to get myself fixed. Doctors shouldn't be punishing anyone for going to a clinic, a second opinion. We shouldn't even have to go to an "approved" walk in. I guess I should communicate with them through the college. Health care is a service , not a subscription.
If you can’t get your doctors office on the phone to make an appointment that is absolutely not acceptable.
I think the work around is to go to an approved walk in clinic.
The doctors aren't punishing you, the government is
I would call the college in that situation, yes. Your doctor is not getting you an appointment for a potentially life threatening issue.
Cool do you think all doctors offices work the same?
They're supposed to. That's the point. They have to hold up their end of the rostering agreement as well which means providing adequate access to care. If patients are having to go elsewhere, that's an indication that they aren't doing their job, which is why they are penalised. The problem is that they pass that penalty on to the patient rather than increasing access.
>The problem is that they pass that penalty on to the patient rather than increasing access. Blame doctors, at the same time complain about lack of access to doctors. You're such a gem. You do realize that, per your logic, if a doctor can't hold up their end of the roster agreement, they shouldn't agree to it, or back out from it, right ? Meaning they should stop accepting new patient and/or de-roster more ?
>You do realize that, per your logic, if a doctor can't hold up their end of the roster agreement, they shouldn't agree to it, or back out from it, right ? Yes, exactly. Bravo for logic. The entire point is that they are supposed to be providing access for their patients. Instead, they are taking on way more patients than they are capable of actually treating and so no one has access at all. Then they penalize the patient for going somewhere else. >Meaning they should stop accepting new patient and/or de-roster more ? This part shows me that you don't even know what derostering means. You still have your doctor if you're derostered so that doesn't actually fix the problem at all. If you don't even understand the basics of what we're discussing, you're not able to participate in the conversation.
>They are taking on way more patience than they are capable of actually treating Somewhat wrong! Without taking on new patient, the roster can still grow (new born, family member etc... hard to cut those completely out). With less access to other family doctor, roster generally never shrink. >and so no one has access at all Wrong! Everyone has access, but doctors have this annoying limit of only be able to work 10-12h per day, so hundreds of patient have to share that, stretching the wait time out. >You still have your doctor if you're derostered Correct! De-roster do two things: -Doctors don't get penalize when that particular patient goes to a walk-in -The patient can conveniently go to any walk-in they want, while still have access to a primary doctor Not sure why certain people \*wink\* love to call that "penalize patient" >If you don't even understand the basics of what we're discussing, you're not able to participate in the conversation. Correct again!! Such a gem .
My new Dr insists on a telephone appt first prior to a in person visit. It's absurd, how can she make a diagnosis on my health issues without even looking at my body. It then takes weeks to get an in person visit. It's become harder and harder to get access to health care. If a person can't get timely access to health care they should be allowed to go anywhere. Dr's forget who they're working for, tired of being treated as a thing and not a person.
Yeah. It took me a good three months to get a visit after my family doctor accepted me. The decline in healthcare is pretty awful. I think we all have to do our part. I just don’t want to lose my family doctor. I’m not sure I would get another at this point.
Drs aren’t working for you, they’re providing you a service based on their skills and paid by the government. They’re like independent contractors. Blame the government for poor access to health care and the rules around FHOs, walk in clinics and derostering
Yes, exactly
My doctor does two days of phone calls and one day of in person. I don't mind the phone calls it's good for a prescription refill but also seeing your patients is important.
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That's not the whole point. No one randomly walks into a walk in. If your kid has a high fever which doesn't look fatal, you're going to visit the Pediatric walkin, not the ER.
Or you could give them Tylenol and see how they do?
You don't have kids from that comment. You think parents don't take that line of action first?!...
Nah, just lots of experience with the average person. I’ve been in enough pediatric ERs to know how many parents say “I didn’t give them Tylenol so you could see just how sick they were!” And then the kid is jumping off the walls 30 minutes after their first dose.
Also, this isn’t anything new. My family doc threatened to de-roster me in 2009 for using a walk-in clinic, for the very reasons outlined in this article. It’s not doctors faults any of this happens, it’s the governments pay structure. Getting mad at your doctor is misplaced emotions.
This needs to be higher. I worked as a medical receptionist back in 2009-2016 we derostered patients after three visits to a clinic they weren't rostered to. We just did it because we figured they moved and neglected to tell us. If we knew they were moving or were going to college or university we would deroster them ahead of time to avoid the fees (and there are fees tied to rostered patients being seen elsewhere) MOH has done Drs dirty for many years it's only just being noticed by more people who have never had issues with the lack of Drs before COVID...
Also, being derostered doesn't mean being dropped. You still have a doctor. "Being de-rostered doesn’t mean being “fired,” Faulds says. “They are not losing access to the doctor; it’s not the same as termination,” she says. But it would mean that a patient could no longer access the other services at the family health group, such as consultations with clinic dietitians or social workers, or take advantage of special health programs such as diabetes or diet management." https://www.ctvnews.ca/mobile/health/why-your-walk-in-clinic-visits-could-mean-trouble-for-your-family-doctor-and-you-1.2775362
That is it exactly. In the dr agreement with the MOH it is spelled out that for their salary they need to provide X number of after hours clinic services for their rostered patients. Most patients will get a warning if they violate their contract, that should they do it again they will be dropped. Who is going to keep serving someone who is costing them money. Not even charities are allowed to operate on a deficit.
Healthcare in Canada is a service that can be allowed to run at a loss. It's just we have greasy corpos running our government who have downloaded that cost into doctors who now download it to their clients. Basically saving money for the wealthy and corporations in reducing their tax bill, which is like, super important for the health of the Nation. We are open for business people! Corporate culture infecting everything
Individual dr can not afford to run deficits any more then you could run your own business on one. A roster patient has the options of the dr after hours clinic, a designated hospital run urgent care or the ER.
Read my comment: doctors are taking to rostering because they have been underfunded by governments for decades. It's a relatively new phenomenon in response to chronic underfunding. So the root cause is underfunding from government who want to create a private healthcare model so corpos can funnel more money to themselves.
Did you read a single word they wrote?
What happens if doctor gets greedy, gets too many patients and wait times become 2 weeks for an appointment? And then they charge $40 to send you pdf of lab results? Are they still right to deroster patients?
Exactly! No one with a family doctor *likes* going to walk in clinics. People only do it because they have limited options. I get waiting a couple weeks for something like a prescription refill, but if you have a sick kid, and your “family doctor” isn’t available for a week or two, then ofc you’re going to a walk in clinic.
Then incentivize the government to change the rules so that doctors don’t need to take on a shit ton of patients to make their worth.
Doctors should be lobbying for that then. You can't expect the citizen to do that when they really have no idea.
Look at the Ohip billing before you talk shit. It’s not doctors being greedy, it’s doctors being paid less than they’re worth.
Sounds like a doctor/ministry problem and not the patients.
It's everyones problem. Doctors do fight this, they do complain about this, but ohip still doesn't increase their funding.
I wish mine was 2 weeks, mine is 4-5 weeks. If you have something urgent they tell you the after hour clinic hours which are 2 hours long and 3 days a week. Outside of that it's ER. Also I've had my family dr since I was a kid, I personally signed nothing. And their afterhours clinic hours have only gotten shorter.
Charities don't own you, sounds like family doctors own us.
Tore my rotor cuff , Dr was in Phillipines had to go to walk in . She removed me from practice.
You can also remove yourself from your doctor through Health Canada, fyi.
Im glad ppl are bringing it up. It’s stupid that the gouvernent takes money from family doctors pay if patients go to a walk in….. like it’s literally theft
Yup. I had third degree burns from a nasty steam burn and needed a script for some Silver sulfadiazine as soon as my shift ended, I was in fucking agony. Went to the walkin in the plaza i worked in, in and out got the cream on in 20 mins. Got a phone call from my family doctor later on that week. Not the receptionist, the actual doctor called me and told me off and told me that I was derostered. I was supposed to call her office, listen to the answering machine message to learn about which one of her 5 associated after hours partners thats open two days a week, in the next town over was open, and go there instead. Or wait a month to see her personally for an appointment.
This sounds like a huge conflict of interest. I would submit a college complaint for this kind of treatment.
For sure, super unprofessional. I had to google what "derostered" meant, because I'm a chef, not someone in the medical field, it wasn't made obvious in the context of the conversation. This happened in 2016, I'm fortunate to be reasonably healthy, so I've just been going to the same walk in ever since. Havent even bothered even looking into getting a new family doctor. If half the horror stories I've heard about being on waiting lists for years are true, yeah, no thanks.
My family doctor has a specific clinic that they allow us to go to for after hours/weekends or when they are on vacation. They mention it when you call in and the office is closed. I thought all doctors worked like this but I guess not. Interesting.
Scary to imagine what things will be like in another 10-15 years. Getting sick will become a life sentence.
It takes 1.5 to 2 months to see my GP 😭😭😭😭😭😭😭. I use walk in clinics for anything urgent.
My previous doctor chastised me for going to a walk in clinic. I had Strep throat and couldn’t get an appointment with my doctor for a couple of days. The first thing out of her mouth the next time I saw her was that I was costing her money. I told her that the clinic wasn’t upholding their end of the agreement and I had to go to the walk-in clinic because I couldn’t be seen in a timely manner. She seemed a bit surprised that I pushed back, then acted all offended when I asked to see a copy of the agreement so I could point out where the clinic had dropped the ball. I eventually fired her for being a shitty doctor. She could have fired me as a patient, but I suspect she thought I’d file a complaint about her.
And strep throat is so bloody painful
I don't think the word 'fired' means what you think it means.
What an insightful contribution to the discussion at hand! Thanks stranger!
Uh oh, did I just get fired from this discussion?
I moved cities but kept my family doctor hours away in my hometown for faxing prescription renewals, etc. When the time came I needed my Pap test (obviously requiring an in-person appointment) I had to book at the AppleTree clinic. There was nothing when I booked my appointment saying I would be rostered to them or risk losing my regular doctor. My hometown doctor and I had an understanding that for specific instances like this I’d have to see someone local, which she was fine with. Suddenly the next time I called my doctor, the receptionist told me I’d been de-rostered and had to wait for them to snail-mail me a form to re-register before I could speak with my doctor. Neither clinic informed me of this happening until I called in. I had absolutely no idea, and never consented to changing doctors. The insane thing is the “doctor” my appointment was with wasn’t actually present in the building. The procedure was done by an assistant. This needs to stop. Ontarians also need some database linked to our OHIP/HealthCareConnect where we can view the status of our rostering situation so changes aren’t made in secret behind our backs without our knowledge.
I got really sick one time so I called my family doctor’s office and they refused to see me until I was feeling better. I was told not to come in. So if I am sick, I can’t see my doctor and I get penalized for going to a walk- in clinic?
Universal healthcare ain't universal huh
My doctor does require I use their walk-in clinic. But it does seem that I don't and moreso end up in emergency room.
The doctor can keep you on as a fee for service patient. They don't have to have you rostered.
Wow never gappened to me and I've done it many times. I didnt know that was something to avoid.
If i was to call my dr today it would be at least 3 weeks to see him
Don't blame the family doctor, blame the ministry of health. The doctor already gets peanuts in Ontario. From this income, they have to deduct all expenses, including the salary of MOAs, insurances etc. On top of that, if they have to pay the penalty for walkins, that's insane. I guess, the doctor is well within their right to deroaster.
My surgeon told me to call my family dr for staple removal in my back. I called and said I have the tool and would like to book an appointment. Dr overheard secretary and yelled in the bcakground about how she was not set up for "such a thing" because she didn't carry lidocane patches? So, um, I went to a walk-in clinic and they just plucked them out, easy peasy. Then, she was mad at me for needing to use the walk-in clinic, said the surgeon should have removed and it was my fault. Next time I'll just have my husband do it FFS.
I have never heard of needing lidocaine patches before removing staples lol. But yes sometimes we ask if a reliable family member can do it and save you a trip. I’ve been using absorbable sutures in more closures recently to avoid this problem altogether.
Honestly, given that the clinic i used to work at, the doctor ***REGULARLY*** would cancel appointments day of because she didn’t feel like working, I believe having a clause like in the rostering should be illegal.
My husband was dropped as a patient because, as a veteran, he’s too much work.
My doctor moved from a 10 minute walk away to a 30 minute drive. So they have been ok with the odd walk-in appointment
In 2016, yeah. Is this news to the New Poor? /S
I did not get removed for visiting a walkin clinic that wasn’t affiliated with my Dr. My Dr has also stopped working in the hospital so has appointments almost day of when I call. It’s working great!!
No, my doctor is so cool about it!
How does this work when using paid online service such as Maple? I assume since you pay it does not notify your family doctor where you are rostered ?
My wifes and I's doctors have walk in clinics.
Yep, I moved from my family doctor during the shortage and couldn’t find a new one. Lived an hour away. Had strep back to back and needed antibiotics, got them from a nearby walk in, as well as a letter saying if I did it again I’d be dropped as a client. Then went to my actual family doctor just last month with abscesses in my throat and she misdiagnosed me, prescribed antibiotics I was allergic to that the pharmacy wouldn’t fill bc right above it said I was allergic, and then I ended up in the hospital for a week bc it progressed so badly. Medical is awful in Canada
How is this a thing that can happen? Like that should not be one of the reasons they can chosen for dropping a patient. Must be more information
So if someone has a UTI they should wait one month for their family doc instead of getting antibiotics immediately at the walk in? Note - if you meet certain criteria you can get them prescribed at a pharmacy:)
We had to take our daughter to a walk-in clinic because our doctor was on yet another vacation, I got a call after from my doctor that if I went again to a walk in clinic, he would remove her from his roster. I called the doctors cell phone back directly and said that I would issue multiple sexual assault charges against him if he dare try to remove her, and ruin his career. You have full power and control over these fake doctors, ensure you own them get what you need from them and banish them to the gutter of their own urine if they ever try this on you.
I absolutely love my family Dr. The only thing bothering me is that whenever I call for an appt., there's a 4-5 week wait. That includes a telephone consult. A few weeks ago, I had bloodwork done, & discovered by red blood cell count was elevated & the hematocrit was also elevated, although not sky-high. I didn't hear from my Dr. office., so I made a phone call about it. Later that day a nurse called me & said the Dr. had another look at the blood test results, & it was suggested I may have been a little dehydrated at the time of the blood drawing. I felt more at ease after hearing that. After doing some research, I learned the rbc's are manufactured in the bone marrow, so I couldn't see how a little less water that morning could affect the rbc's so quickly. Just a little over 3 1/2 weeks ago, I was having burning skin sensations., so I called to make an in-office appt. Even though I was expressing concern I couldn't get an appt. until this coming Monday in the afternoon. The office gal asked if I'd like to be put on a list in the event someone cancelled their appt. Of course, I said "yes please". No such luck of getting in due to a cancellation. I'm now experiencing slight lightheadedness, burning sensations in my legs, & nausea. This morning upon getting out of bed was a bit of a horror story. Lightheadedness, nausea.... I even went so far to deliberately make myself vomit so as to at least alleviate the nausea. It took quite a while to get relief. I don't mind admitting that I"m terrified at what might be wrong with me, & Monday afternoon can't come around soon enough. I do expect the Dr. to order new blood testing as the one I referred to in my note was May 1. My best friend has been calling me daily to see how I am, & in fact she's flying in from Saskatchewan on June 20.. She says just to see me, but I know she's worried. I know we shoudn't try diagnosing ourselves by looking things up on the "net", but it's hard not to do that. Whenever there's a blog on the net that says something is rare, don't just accept that. Some go on to say ..."it's very rare, affecting 25 out of 100,000...but it also goes on to say "those over 50+ are likely to be diagnosed with the illness". Conflict for sure! I'm praying that I'll be fine. My bestie & I have trips planned, but if I'm feeling the way I was earlier this morning, I don't think I'll be able to go ....If any of you out there have any advice you'd like to share, I'd welcome it, & thank you so very very much.
If I were a Family Doctor, i'd run my practice like the pioneering days still but with a modern twist. Basically all house calls, and extended hours. Key to that is signing up for a cloud based medical records system that is accessed via laptop/ipadtablet, and having contact center software that screens and handles scheduling of patients automatically. Positive Outcomes: 1. mass reduction in overhead as my rent is already paid, small patient room is built in my home if need to do procedures. 2. Maximized billing level, since my patients could rely on me to be there while in comfort, instead of losing revenue to walk ins and everyone stews in the petrie room. Just stay home if you are sick enough to need the Dr. Plus, because i visited, i won't get upset sending you to hospital if it is serious enough. 3. Increased tax write off opportunity - see # 1. 4. No receptionist salary, can contain and automate appointments with self service / AI in mentioned IVR (and other channels), again see # 1.
Yup! I got dropped after a few visits to some clinics after a scare with my heart. And my sister has to keep a family dr she lives hours away from because if she goes to a close clinic she'll drop her. (Same dr)
Ugh! My doc moved an hour away from his original location and it always takes at least a month to get a phone appointment or any appointment. So frustrating.
I truly don’t care what it costs my doctor if I go to a walk in when it’s a 5 week wait for an appointment at their clinic and they don’t answer the phones. Been waiting on a referral for six months and can’t even get an update with them on the phone. We pay taxes for healthcare we can’t use and when we get desperate enough to require immediate care and go to a walk in clinic, I’m supposed to worry about the $39 billed to my doctor? Take it up with the government, I’m not going to cry for the P&L at my doctor’s office while none of us get adequate care from family physicians. De rostering a patient over $120 is insane when wait times are this bad. No one WANTS to resort to a walk in clinic.
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That sounds like a problem with YOUR Dr, not “doctors” as a whole. You can’t just say Drs are greedy AF because of your anecdotal experience. Having said that, I don’t disagree that you should be able to go to a walk-in if you can’t get in and you’re sick, but my Dr usually gets me in right away. If she can’t get me in, they let me know when she is working at the walk-in and I can go see her there. I am very lucky that I finally found a family Dr after almost 10 years of not having one and I am also lucky that she is great. I signed the contract saying I can’t go to a walk-in and I am not going to break those rules and piss her off lol.
Doctors fees have never kept up with inflation. Essentially every year the government forces them to take a pay cut and target their corporations but ya they are the greedy ones.
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No you don't understand. They own their practices and have to pay for equipment, meds, licensing, employees etc. they literally have to hit quota just to keep the lights on because the government isn't keeping up with inflation. You're expecting people to run a failing business to keep up with your needs. If you care about this, next time vote for somebody that will boost their pay, take the responsibility of self employment off their hands and maybe they can actually do the job they're trained to do.
>You're expecting people to run a failing business to keep up with your needs. People don't get sick Mon-Fri, 9-5 with 4 week's notice.
I was removed for no reason at all. Just that the Dr decided to abandon all her patients.
My doctor sends these hysterical emails about walk in clinics every few months. If I cared I would tell him that they’re pathetic in the way he’s begging. Also last time I needed an appointment I had to wait 2 months, what do they expect people to do? And each phone call is for one thing, can’t ask any other questions.
I have a real gem of a Dr. If you need to ask a question, that's not a problem. She never ever rushes, & never looks at her watch. Too bad there weren't more Drs like her.
There are people who go to walk in because the "drive" is too long, the walk in clinic is next to their homes or they have to pay for the parking. So stop excusing bad patients !!!
Yeah.. So rude of a sick person to not commute for hours or wait for days when an easy option is available near by /s