Private Medicine

[goldom1234]

Hey All,

 

Wanted to create this threat to discuss some ideas around about the future of private medicine. With looming cuts in Alberta and already cuts in Ontario, it's time for family physicians but also specialists as a whole, to move away from the broken government funded healthcare model to more private medicine.

 

It has to be noted that in Quebec which has the lowest reimbursements 15% of GPs run cash only practices aka they don't accept government insurance period.

 

There was also a case in Montreal where surgeons were caught taking bribes to move people to the front of the line. In the future, there won't be anything like this happening in the shadows, but in the open as it is in the US, Britain, France, Germany...ie simply two tier healthcare.

 

Furthermore, I think as physicians, we have to stick together and simply refuse to work if the fees get too low.

Case in point, the legal profession. Despite an overabundence of lawyers in Canada, legal fees aren't dropping as no self respecting lawyer will work for pathetic pay after going through so much education and incurring alot of debt.

 

This thread is to discuss the future of medicine esp private medicine in Canada, which is simply inevitable due to government. Agree or disagree, please comment.

[ralk]

Keep in mind that physician payments have increased quite significantly over the past 20 years, particularly in the last 7-8 years (in Ontario at least). Some pushback against that trend is inevitable, particularly given rising healthcare costs overall. It is perfectly reasonable for fees to decrease after overall compensation rose so much. The implicit assumption here - that physicians are underpaid - has little historical merit.

 

As for the role of private services, they most certainly would increase physician pay, but not for productive reasons; at least if you're departing from the single-payer system (currently, private services do exist, but receive payments in much the same fashion as public services. The economics of health care are skewed by the dual problem of high, inelastic demand and poor understanding of quality (even among knowledgeable consumers). As a result people will pay quite highly for seemingly superior care even if it is no more effective. Therefore, prices can rise quite substantially, including physician compensation, without any actual improvement in results. In practice, this is what happens - the US being a perfect example.

 

If higher physician pay is considered a sufficiently important benefit for significantly higher overall health care costs, then I suppose more privatized medicine is worthwhile.

[Guest Physioprospect]

Wtf are you talking about the fees getting too low? You make $40 for sitting there for 5 mins and writing a prescription. Lawyers dont know how good they have it.. for only 3 yrs post grad they charge so much more than other professions that also have multiple years post grad (physio, audiology, SPL).

[goldom1234]

Wtf are you talking about the fees getting too low? You make $40 for sitting there for 5 mins and writing a prescription. Lawyers dont know how good they have it.. for only 3 yrs post grad they charge so much more than other professions that also have multiple years post grad (physio, audiology, SPL).

 

 

Maybe you should have gone in to law then...but honestly every post you do you just flame and flame. Firstly it's $33 in Ontario and involves a history, physical, diagnosis and then prescription(and in that order). Involves 10 minutes of work or more and doesn't distinguish between a COPD exacerbation in a long time smoker with CHF etc etc and a URTI in an otherwise healthy kid(as you see how the billing works no one wants to see complex patients).

 

And with government decreasing fees more and more, be prepared for spending even less time with your doc that your "5 mins" as their overhead doesn't diminish just cause Deb Matthews diminished her or his fee schedule so he/she has to move quicker and quicker.

 

Regarding the physical that you flame about in past posts, with the recent changes a young person like you wouldn't likely be able to get one as it wouldn't be worth 40 or 50 bucks or so(aka the new "Personalized Health Review") to do one. Now with private medicine(which I'm advocating for btw) a Physical would be delisted from the OHIP schedule so you could come in pay the doc their fee and get as much time as you want(like in a law office) or any other private enterprise. Right now it's illegal.

 

A person cannot serve two masters. A doctor cannot serve two masters too-the gov't(which pays your fees and changes then at will impacting your care) and the patient(which may have a totally different set of priorities than the gov't and is frustrated their doc isn't listening too them and instead practising how the government demands).

Hence Private Medicine(like exec physicals, concierge medicine, outright cash payment) allows a doc to serve one master, the ultimate one, namely the patient.

[Guest Physioprospect]

Maybe you should have gone in to law then...but honestly every post you do you just flame and flame. Firstly it's $33 in Ontario and involves a history, physical, diagnosis and then prescription(and in that order). Involves 10 minutes of work or more and doesn't distinguish between a COPD exacerbation in a long time smoker with CHF etc etc and a URTI in an otherwise healthy kid(as you see how the billing works no one wants to see complex patients).

 

And with government decreasing fees more and more, be prepared for spending even less time with your doc that your "5 mins" as their overhead doesn't diminish just cause Deb Matthews diminished her or his fee schedule so he/she has to move quicker and quicker.

 

Regarding the physical that you flame about in past posts, with the recent changes a young person like you wouldn't likely be able to get one as it wouldn't be worth 40 or 50 bucks or so(aka the new "Personalized Health Review") to do one. Now with private medicine(which I'm advocating for btw) a Physical would be delisted from the OHIP schedule so you could come in pay the doc their fee and get as much time as you want(like in a law office) or any other private enterprise. Right now it's illegal.

 

A person cannot serve two masters. A doctor cannot serve two masters too-the gov't(which pays your fees and changes then at will impacting your care) and the patient(which may have a totally different set of priorities than the gov't and is frustrated their doc isn't listening too them and instead practising how the government demands).

Hence Private Medicine(like exec physicals, concierge medicine, outright cash payment) allows a doc to serve one master, the ultimate one, namely the patient.

 

Ya I do flame cuz i am sick of how the health care system works. Becoming a Dr. is a lliscence to print money with no accountability for patient care. My dad nearly died due to neglect from physicians. He had radiating pain from his jaw for a few days, went three times to his Dr. to be turned away without being given more than a glance. Knew something was wrong, went to the dentist and found out he had an abcess tooth. Infection had already spread and it was a mess. Sick of this, take the time to actually put your hands on a patient, look in their mouth, feel their lymph nodes not just think its a headache that will go away so you can quickly move onto the next patient and collect your money. Its BS. I could understand the need to survive if your only making 60K a year but their are very very few poor physicians.

[leviathan]

Hence Private Medicine(like exec physicals, concierge medicine, outright cash payment) allows a doc to serve one master, the ultimate one, namely the patient.

There are very few patients who would pay out of pocket for their health care. Almost everyone has health insurance, and whether it's from the government or from a private carrier, they are all going to impose restrictions on what they will reimburse you for.

[marshan]

People pay for private healthcare all the time.

 

Some invest in naturaceuticals, gym memberships, private long term care facilities, some even go overseas to get procedures that aren't offered in Canada.

 

I personally don't think it's something that's going to stop. Can physicians ethically offer a different health care style simply because patients are willing to pay for it? That, I'm not sure. I'm torn.