Patients of Beta Therapeutics in Saanich can see a family physician for medically necessary services beginning in May without paying a membership fee.
In early December, the clinic’s new family physician, Dr. Dan Cutfeet, de-enrolled from the Medical Services Plan. That allowed the clinic to charge patients a monthly fee of $110, based on an annual cost of $1,320.
De-enrolled physicians constitute only 0.1 per cent of those in British Columbia; there’s about seven in the province. Physicians who are not enrolled in MSP can order lab, imaging or diagnostic tests, but patients must pay for the fees themselves and will not be reimbursed by MSP.
“He’s going to be rejoining the public health care system, enrolling as of April 15,” Health Minister Adrian Dix told the Times Colonist in an interview Wednesday. In other cases, approval for re-enrollment by the Medical Services Commission has taken up to a year, he said.
By re-enrolling in MSP, Cutfeet can resume offering publicly insured medical services, and Beta Therapeutics’ patients will be able to receive medically necessary services without paying a fee, Dix said.
“I’m delighted to have him back in the system,” said Dix. “I think that’s good news, it’s obviously just one doctor but it’s significant.”
Beta Therapeutics clinic director Samantha Rocha said the clinic will offer a more fullsome statement in weeks. “At the moment our focus and priority is on our current panel of patients.”
The clinic will not charge fees for physician services that are covered by MSP as of the month after Cutfeet’s re-enrollment, she said.
Last year, Rocha said she and her business partner were doing their best to make their services as affordable as possible in hopes that negotiations between the province and Doctors of B.C. bring more solutions to light, saying based on what’s decided, the clinic would “evaluate potential changes to our model.”
The province later negotiated both an overall Physicians Master Agreement and a new Longitudinal Family Practice Model which is an alternate form of payment family doctors could register under as of Feb. 1.
The family physician payment model offers an alternative to the “fee-for-service” model, which compensates family doctors at a base level of about $32 per patient visit. Under that model, doctors would have to see more patients for a shorter time to partially cover time spent on paperwork, overhead and other services.
The new model means a family doctor working 1,680 hours a year, who sees 1,250 patients with cases of average complexity, and has 5,000 visits from patients a year, will earn at least $385,000 — compared to about $250,000 under the fee-for-service model. It also narrows the gap between family doctors and hospitalists, who are paid close to $300,000 a year to work in hospitals without having to pay overhead.
Since February more than half of the approximate 4,100 physicians working in full-time family practice have signed on, in addition to about 300 new doctors.
“I think it’s significant that we continue to build momentum with respect to primary care and family medicine, and that’s reflected in the now well over 2,500 doctors who have joined the longitudinal family practice payment model, which is remarkable, said Dix. “Those are very positive signs.”
In December, Dix asked the independent Medical Services Commission, which oversees the Medical Services Plan, to investigate at least two other Greater Victoria clinics that charge fees for possible contravention of the Medicare Protection Act or Canada Health Act.
Dix has also asked the commission to review private fee-based services offered by Telus Health MyCare to ensure there’s no queue-jumping for patients who pay the fee, which isn’t allowed under the Canada Health Act.
Telus’s LifePlus package — which includes around-the-clock access to a health-care practitioner and costs about $4,500 annually — and other fee-based services have drawn criticism that they’re creating a two-tier health care system.
On Dec. 1 the Medical Services Commission applied to B.C. Supreme Court for an injunction to stop Telus’s LifePlus program from charging membership fees to patients in return for preferential around-the-clock access to a health-care practitioner.
The commission, an independent body, completed its investigation last summer. The injunction against Telus Health, and specifically Telus’s LifePlus program, alleges contraventions of the Medicare Protection Act.
Telus' LifePlus — which costs about $4,650 in the first year and $3,650 for subsequent years —has about 4,000 customers and 25 doctors in B.C.
The injunction “solely” relates to Telus’s LifePlus program and the membership fees charged under that program, and does not touch on Telus Health’s “significant role” in delivering online and phone health-care services, said Dix last year.
According to court documents filed by the commission, Telus Health maintains its fees for LifePlus are solely for uninsured preventative services and its members receive equal access to MSP-insured services. Telus Health says it has not contravened the act.
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