Mike McLoughlin, founding director of the Walk-In Clinics of BC Association, said to CBC’s The Early Edition
that walk-in clinics are closing early during flu season because of a provincial cap on the number of paying patients doctors can accommodate in a day.
BC doctors are allowed to get full payment from up to 50 patients in a day, he explained. They then get only 50% of the billing for the next 15 patients, and after that they don’t get any payment. “They can't afford to stay open if they're only getting paid half, or not at all for the services they're providing,” McLoughlin said.
The cap is also troublesome for patients whenever demand for clinic care surges. “Sometimes, people go from clinic to clinic to clinic and spend the whole day looking for a clinic that's going to be open and then they end up in emergency," he said.
A representative of BC’s ministry of health clarified that the policy aims to ensure adequate time for doctors to make a correct diagnosis and maintain patient records. “Allowing doctors to have this time is important for ensuring patient care and safety,” the spokesperson said.
McLoughlin, however, challenged the notion. “What ensures quality of care is that [doctors] are properly trained, properly regulated and they're professionals and they practice according to a set of ethical and professional standards,” he argued. He also suggested that expanding the timeframe of the cap to a weekly or monthly basis “would address the concerns about doctors that are high billers.”
John Calvert, an associate professor in the Faculty of Health Sciences at Simon Fraser University, thinks the problem isn’t the cap, but rather the whole volume-driven fee-for-service healthcare system. Under the current setup, doctors rely on a higher number of patient visits to get more revenue.
“The result is we see arguably more treatments than we ought to be seeing and we're not seeing the resources,” he said.
According to Calvert, BC should consider alternatives such as implementing a salary-based option for interested physicians, or setting up more multi-disciplinary clinics with other professionals like nurse practitioners.
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The practicality of limits imposed on BC’s walk-in clinic system has been called into question following reports that patients suffering from the flu or winter vomiting bug were turned away by clinics closing early.