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Plan for private MRI clinic at Hillside scrapped after failed appeals

Brittany Buna had hoped to offer private-pay MRI scans of extremities like knees, but was denied accreditation by the College of Physicians and Surgeons
Workers pack up an MRI machine outside Hillside shopping centre on June 6. DARREN STONE, TIMES COLONIST

Brittany Buna watched as a brand-new MRI machine was removed from her Victoria clinic to be shipped back to the United States last week.

Buna had hoped to open her new business, Extremity MRI, in leased space at Hillside shopping centre last spring, charging $750 for a private-pay MRI scan of extremities such as knees, ankles, feet, hands, wrists, forearms and elbows.

But the MRI machine, purchased for about $325,000 US, never saw a paying customer, after Buna was denied accreditation by the College of Physicians and Surgeons.

She appealed and lost twice, and saw the writing on the wall for her third appeal, which was scheduled for September, so she pulled the plug.

“I’m just really sad,” said Buna, 32, who said she had a radiologist on board for the business. “I’m a pretty persistent person but I’ve gone through almost every avenue to try to make this work.”

In B.C., MRIs, which use a magnetic field and radio-wave pulses to create detailed 3D images, are typically used in public hospitals to create images of organs, blood vessels, muscles, joints, tumours and areas of infection.

Buna, a lawyer working in the Saanich and Sidney offices of Beacon Law Centre, said she wanted to offer low-cost diagnostic scans for people typically left waiting the longest for non-urgent but life-altering pain in their extremities.

The extremity MRI uses customized coils to only scan the limb of concern. It is more comfortable than a full-body enclosed MRI machine, requires one MRI tech rather than two, is more energy-efficient, plugs into a wall outlet, and doesn’t use expensive helium, as does a full-size MRI, said Buna. It is also helpful for people with claustrophobia.

Buna said in the end, she was willing to adopt any private or public model needed to operate successfully and she was happy to be fully regulated and monitored and comply with any rules, but the college was “making it next to impossible.”

“I could have done more homework here,” she conceded.

Buna said she was up against an NDP government that opposes private clinics, and various regulatory bodies saying different things. There was a lack of regulations or guidelines for private operators, and the obligation to prepare her facility for inspection without any promise of accreditation.

“They’re all pointing their fingers at each other to make sure that these facilities don’t open,” she said. There was also a “huge shift” in key players involved in the approval process which, she said, added another hurdle.

Buna believes some degree of private health care is needed alongside the public health-care system to reduce wait times, but she doesn’t see that happening any time soon in B.C. “I just don’t think that time was on my side,” she said.

MRI and CT scans are insured benefits covered under the Medical Services Plan when delivered in a diagnostic facility approved by the Medical Services Commission.

Physicians can refer patients to a public or private facility, but in the case of the private option, the patient pays.

WorkSafeBC and ICBC use some private-pay services for their clients.

West Coast Medical Imaging in Uptown, which provided publicly funded diagnostic imaging such as X-rays, mammograms and ultrasounds, had been offering private-pay options for MRIs until it received a warning last October from the Medical Services Commission to stop private pay for medically necessary MRIs because it was in contravention of the Medicare Protection Act.

For Buna, it turned out to be about a $150,000 learning experience — a fraction of what it might have cost had she not had expertise in writing business contracts and had the manufacturer not reimbursed her and taken back the machine.

The College of Physicians and Surgeons said earlier this year it was not able to discuss an individual facility’s accreditation status or delays or denials in accreditation approval.

“Facilities that are not compliant with all of the requirements for accreditation, do not receive an accreditation award,” the college said in an emailed statement. However, facilities can continue to seek accreditation until they demonstrate compliance.

Buna said she plans to use the leased space as a health clinic selling custom bracing and orthotics, set to open next month. Buna said she can write a solid business contract but the realities of running a business have been educational.

“In one aspect this was a huge loss but in another aspect I now have so many more opportunities,” said Buna, adding she has made incredible contacts in and outside health care, people who want to help the health-care system.

“I still have the goal to provide people health care in one aspect or another.”

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