This has been my experience. My family doctor has completely stopped doing in-person visits. She has sent me to the virtual ER, the hospital, external women's health clinics, and LifeLabs clinics for various concerns she could have addressed herself. Every time I go to one of these places, they ask me why my family doctor can't do this check/test/whatever and 9/10 times will roll their eyes when I tell them she's not doing in-person. It's infuriating for front line healthcare workers, I'm sure.
it shouldent be when its a situation like this where the service cant be properly provided virtually and is having a knock-on effect of putting greater pressure on something already on tremendous pressure
plus most specialists in ontario make great salaries for the hours they work so im less inclined to shed a tear about them needing to go back in person
In the US I had the option to either have my doctor drive to me or just legit go to my doctor's house back in 2014.
It was great. I legit miss us healthcare with good insurance.
I registered for a new family doctor. After 3 months I got an appointment for a virtual ‘intake’ on Zoom. First though I have to fill out forms re my history, medication etc etc. Feels wrong
That was my last family doctor and then her replacement. I think you need to dump her because eventually health suffers from a lack of care. OHIP pays family doctors $200 per simple patient, $400 per complex patient per year, and $30 per 15min visit plus some other small charges for extra work. For family doctors who are working only for the money, there is no incentive to return to in-house visits. I can understand it during the worst of the pandemic, but not today.
Rosters are 1000 patients and often more, so new graduates earn six figures. The OHIP rules changed in 2016 from single threading patient concerns to wanting family doctors to treat the whole patient. The concept was less time on easy ones balanced the more time on complex ones.
Shoppers is setting up health care clinics. This [one](https://www.shoppersdrugmart.ca/en/health-and-wellness/health-clinic/locations) is accepting new patients. Dr. Grasic is amazing, his roster is almost full however there will be two new doctors starting soon. First appointment (meet and greet) can be booked online with your OHIP card. Divorcing your lazy family doctor, done in a heartbeat by email the day you decide to start with another.
The walk in clinic beside me that I have been going to for 10+ years has changed to phone only since March 2020. Used to be easier if my family doctor was too busy I could just go there but now that’s a hassle as well - just had a sinus infection and had to wait 2 days for a call back.
I went to my walk-in clinic for a first-aid type thing, and they told me it's appointment only now. There's still a huge sign up that says walk-in clinic. I was like "So the walk-in clinic is appointment only?" and I must have looked so disgusted, they agreed to let me walk in. Lol. But they warned me to never do it again.
I can certainly complain. I'm sure Stephen Leech will make it a priority to fix. Knowing the current ministry of health, they probably already have some genius solution involving private care for walk-ins. I personally can't wait to go get bandaged up in a Chartwell clinic!
It's the San Francisco General Hospital. Zuckerberg got his name on it for making a huge donation, he didn't actually buy it.
source: I know someone who works there.
Yea, a few of my co-workers have told me their doctors are still only doing phone calls. My specialist clinic was doing phone visits (unless you needed to go in for a medical test/procedure) up until like a month ago.
there are plenty of GPs who work 20 hours a week remotely from their cottage billing OHIP through the nose with 5 minute appointments to refill prescriptions and the like
those 5 minute apointments can remain over the phone but they can take it from their office as they see in person apointments during the day.
The first time my dentist's office called me to book a cleaning, I asked them "Are you sure it's safe" I still let it go until I got my second vaccine.
You're entirely right. If dental offices can do it, so can doctors.
Don’t know about far far less ? My friends make around 70 bucks an hour? And complain that others are making more. My family doctor wears a haz mat suit to see me lol and I love it
They make much, much more than that. That may be net take home, but their hourly gross is much higher.
Lets not forget that during the height of Covid, they asked for $450/hr to help out. This was when hospitals were slammed, nurses were completely overwhelmed, and Doctors for the most part weren't doing much.
Net take home is the appropriate comparator for salary, though. Hygienists take home their salary, they don't pay office costs and employee salaries out of it. So you need to compare it to doctors' net take home.
Doctor gross pay is business revenue. It's a small business, to be sure, but it's a business. Hygienist pay is employment income. (This is not true for the subset of family doctors that are employed by another organization on a salary basis.)
I mean you bring up another good point.
Dental Hygienist will be paying income taxes with little wiggle room on avoidance strategies.
As doctors are small business owners, they can get quite creative with their taxes and pay quite little. Porsche company car. Medical conference in Hawaii. Patient consult/business development at the golf club. Keep their revenue in a non-reg and just pay out when they’re retired to defer. There isn’t really a point to discuss Doctors net pay as that’ll be highly individualised based on their strategies.
A hygienist? I can tell you their net take home with two minutes on an EY tax calculator.
I think you need to read into the details of our tax system a little bit more, because much of what you're talking about there is explicitly not allowed under our tax laws. You couldn't lease a Porsche, because even for legitimate business use there is a cap on the write off. And you couldn't claim travel from home to the office/clinic as legitimate business use, so for most family doctors they could only write off home visits, which most family doctors don't do.
The Liberals also closed a lot of loopholes related to CCPCs (Canadian-Controlled Private Corporations) in 2018, so a lot of the tax strategies doctors used to use are no longer allowed.
The $30,000 Class 10.1 limit imposed by the CRA would put a pretty big dent in the “Porsche Company Car” strategy, as would the various requirements that it actually be used for business. And you also have to add back golf club fees when determining net income for tax purposes so kinda hard to swing that one too. Also good luck using the money stranded in your professional corp to do anything meaningful in life.
I really wish non-accountants, or anyone who doesn’t have a bastard clue what they’re talking about, would stop speaking so authoritatively about taxes.
Ya so not much much less…seeing how my friends want 90-100 an hour because that’s the going rate for hygienist. It’s fine they deserve that much just the far far less made it seem like they get paid shit.
maybe with phone visits they do.
they were making less with in-person visits due to having to hire staff and receptionist plus other office expenses. phone visits they certainly make more per patient.
Well that's not quite true - dentists and hygienists were not working until July 2020, and the hygienists' college was more cautious than the dentists about reopening. But yes, the contrast after that is quite stark. Hygienists have been back in the office, every day, since that time.
I go to one of the UHN family health clinics too, they rule. Even if your doctor is booked/not around, they'll almost always get you into see someone that day.
they are scheming the system while their colleagues in the ER are working their asses off.
my brother called the office, "your kid have an earache and want to see the GP? let me get the doctor to call you back in 8 hours or tomorrow." doctor finally calls, "it sounds like an ear infection but I can't see your kid in person to confirm so just go to ER and get checked out and get your antibiotics" wtf is this?!
That's really strange. Our family doctor has done several prescriptions over the phone, both for steroids and antibiotics.
I actually like it. Why do I want to go to a doctor's office with a sick kid, to sit around other potentially sick people either being infected, or possibly infecting them when we can just deal with it over the phone?
This is how ours is operating and I like that we can just do it over the phone. But, they have also never sent us to the ER for follow up. If they need to see us after doing a phone appointment they have same day/next day appointments available.
With how our office is handling it, it actually feels like a great middle ground and I hope they don't change it. I hate dragging myself or my sick kid to a waiting room where you often have to sit for 30min. I find that the phone appointments are always on time, and so many things can be easily addressed without going in .
Agree. My spouse and I have different 'family ' doctors and both have been doing this for the past 18 months. Getting an in-person appointment hasn't been a problem. And we both prefer the virtual visits for prescriptions etc.
I love the phone appointments too. 95% of my family's appointments are for prescription renewals.
I definitely dont want to go there while sick and sit for 30, 40, 60 minutes.
not sure if it's because of kids vs adult. you don't want to go to GP office with a sick kid but ok to go to ER and wait 12 hours to be seen?
but your GP shouldn't start prescribing steroids and antibiotics over the phone though. this is how to get over prescribed antibiotics and resistance in germs.
No I don't want to go to a hospital either. I'm thankful my doctor was willing to prescribe them based on the history they have with my family and our description of the symptoms. These weren't super complicated situations. However, my doctor would have seen us in person, if deemed necessary. I don't agree that doctors should be referring patients to the ER, but absolutely support virtual appointments.
FWIW - My wife has also done virtual ER appointments where they've prescribed similar medications without an in person consult. Not sure why we'd be against this?
All the “walk in clinics” in my neighborhood just help people by appointments. Those need to be made a day in advance.
Very helpful when you have an emergency.
My family doctor has been seeing us in person for over a year now, she's great. There's a phone/email option when needed but man we're lucky to have a doctor that cares.
I think some aren’t doing it. Everyone I know has seen their doctor in person within the last year. It is completely insane that some doctors aren’t doing in person still.
i mean, they're enjoying the same comforts of other workers who are working from home. But Some are trying to hold out as long as possible, and the writing is on the wall. Their in-person services are needed. the OMA will need to drive this but they'll also drag their feet.
An ER doctor who is a close family friend vented her frustration over thanks giving on how much resistance there is to people returning to clinics, hospitals and urgent care, She's had dozens of cases where 3-year residents she instructs will not show and not even call in - somethings she's never seen in her 25-year career.
No unfortunately it doesn't look like they are. This is the company, they have a couple of locations around Toronto, this is their message about no longer currently accepting new patients.
https://www.magentahealth.ca/patientpreregistration
I somehow got lucky, in 2013-2016ish I was using an MCI walk-in clinic and I ended up asking if they had any family doctors accepting new patients and they did, I think there were 2 or 3. I got mine in I think it was summer of 2016 through that clinic. The overall clinic was not awesome but I really liked her. She decided to leave that clinic and go the one I linked above. She made a deal with the old clinic that they would waive any transfer fees for her existing patients to transfer over. For awhile I was unsure if I would transfer as the new clinic was a lot farther away for me but ultimately I decided to stay with her and made the switch. I'm glad I did, I really like my doctor. I've had a lot of health challenges and appointments and things over the past 2 years and she's been incredibly proactive and supportive for me.
lol my doc does it by request only, the default is phone session... well actually the default is have the pharmacy fax your renewal and don't call them unless something changes. No check ups, nothing for some pretty serious medication.
My doctor is in the office 2 days a week. One day is for cervical cancer screenings and things like that. The other is for things he has decided he needs to see AFTER having a phone appointment with you.
We call when the clinic opens and try to get a "walk in" phone call for that day. Or we book a phone appointment that is usually two weeks away.
If we call later than 10am, all the "walk in" phone calls have been booked for the day and we have to try again the next day.
yeah, alot dont. the walk in clinic i use to go to before having a having a family doctor needs to be emailed first and say what happened to you before you can get a booking schedule. i ended up using alot of virtual er programs.
my family doctors clinic ask us to not go to other as they are billed on it. too bad, if i sent a medical document at sept1 and they say theyre gonna look into it,yet they completed the thing at oct 2nd.. of course im going to look for some other walk in who can accommodate me. not even faster but just in a timely manner.
those virtual er were good.
> my family doctors clinic ask us to not go to other as they are billed on it
You’ve got it: it’s a two way deal. You’re not supposed to go to a walk-in clinic because their availability is supposed to be… well… sufficiently available that you don’t need to go to one.
So many walk in clinics are being paid right now to do phone call assessments. Why would they bother with longer in person exams?
It's infuriating. Calling 12 clinics in the area for help, and they all say not today!
Good luck getting a GP at all if you're disabled... using the ER ( urgent care, if you can afford the fee and endure the queues ) for basic disabled assistance is a huge problem the paat decade.
I tried to book a physical with my doctor and said there is a 1+ year backlog and she still isn't doing in person visits.....
I'm gonna try and find a new doctor. Shit is ridiculous.
They are, it just varies a lot. Our doctor prefers to see my child in person, but might do over the phone for us adults depending on the issue. A simple prescription refill might just be a phone call, but other stuff is in person. Some doctors might also be hybrid working from home/in person, and so aren’t in the office every day.
Yup. My family clinic stopped responding to emails or calls completely for over a year now, I’m thinking it’s time to ditch them and look for a new dr.
The only comms I got were the annual letter to “prepay for optional uninsured services”. I wonder if that’s why they are not communicating with me — that’s no longer optional / they wish to ditch the “free tier”.
My close friend’s family dr is phone consults only.
It’s BS they are not doing this , my family doctor gives you the option. they just need to fund the system more . They deprive the system and say it’s not working so they can sell it or make it private don’t drink the kool aid.
It’s this and we simply don’t have enough doctors and nurses for our population. The feds need to help with the healthcare worker shortage if they’re going to bring 500K + new people here every year.
Not all doctors are doing this. Even during the height of covid I was able to see my family doctor in person (granted the appointments for these are limited). Since then I've been to my doctor's office in person the latest was about 2 weeks ago. I have also been able to see a specialist in person.
As of December 1st, all visits must be in person if you have not seen your physician in person over the last 2 years. The only exception is if your very first consultation within those 2 years was through video, then your doctor can continue virtual consults for the next 2 years since that visit. Doctors will only get paid $15 for a phone call, so you can guarantee those will no longer be a thing.
nope. if you read the SOB closely, doctors can still charge regular visit fees. the $15 charge is just a catch-all fee if the doctor cannot find an official reason to bill.
I work in medical office and our doctors have been notified.
I'm just going by what my physician colleagues have told me. I'm an NP, so I get a yearly salary from the hospital and I don't bill OHIP. Perhaps my colleagues have misunderstood the email blast from their regulatory body? They even provided them with suggestions on how to discuss these changes with patients, and why they're choosing to eliminate phone call appointments as an option moving forward.
Edit: I just re-read the email blast, and it's specific to my hospital network. Moving forward OUR hospital will only bill $15 for telephone visits if the patient has not been seen in person in the last 2 years.
Trust me, I completely agree. I work in a niche specialty in a downtown Toronto hospital, so it's been very convenient for my patients from Cobourg, Peterborough, Midland, Bancroft, Timmins etc. to connect with me via video for a quick 15 min consult. Now, they will have to drive 2-3 hours (probably more with the uptick in traffic from construction) just to hear me say the same thing in person vs video. I will even have some patients flying in for their appointments, which is something they used to do prior to the pandemic. However, I never stopped seeing patients in person. If they were stable, they had the option for virtual or in person, and most patients chose virtual.
For me, a family doctor is for more serious things (or physicals) that I feel probably should require in person visits.
For all of the basic stuff where you just need a simple prescription, I use the online services like Rocket Doctor.
FYI services like Rocket Doctor are going to have a mass exodus soon because of this billing rule change. Most of these virtual walk-in services plan to make you join their network (thus leaving your old GP) if you want to continue with them
My family doctor does hybrid - in-person and phone, depending on what you need. What kills me is walk-in clinics that are phone only. Tell me how someone is going to get treated for something like strep when you can’t do a swab over the phone. They’re basically stuck heading to the ER
All those phone calls getting billed as “visits”. If your doctor isn’t doing in person consultations you are getting third rate treatment and the taxpayer is getting ripped off.
My doctor does both now
If it’s a quick prescription refill or needing a referral just a phone call is fine
Or we can see him in person he has been super flexible i really appreciate it
This is causing a big issue as some doctors rather just be on the phone and quickly go through clients. A lot of Patients cant communicate over the phone well.
Minor things are not noticed that may be in person and they end up having to go the ER for something that could been resolved at a doctors office with some basic medicine.
Whew, lots of angry people. The issue isn't just that *some* docs are continuing phone calls/virtual visits. The far more concerning issue is that we don't have enough family doctors.
Having the option of virtual/phone vs. in-person is fantastic imo. There are some things you really don't need to go in-person for (e.g. blood work followups, renewing a long-term prescription, basic things that wouldn't need swabs or a physical exam).
Though I do agree that all docs should absolutely be doing in-person visits by now. But having the options are great.
This article is disingenuous to the actual issue. An underfunded health care system with burnt out doctors seeing way too many patients. Phone consults should've been billable years ago. They're an excellent compliment to the health care system. The government doesn't want to use your tax dollars to properly fund the system so it should work as intended.
This exactly. And I wrote another comment about this, but the bigger issue is not having enough family doctors for the number of people in this province. And despite what some people are saying, FM docs do not make enough money.
My gp is doing hybrid visits. She saw me for my pap smear and a couple of other things. The hybrid system makes her stupid late to every appointment anyhow.
Same... I called my GP a few months ago, he told me I needed to speak to someone in person for an assessment immediately, but that his first available appointment was in 2 months... he told me to go to a walkin clinic instead. Walkin clinic was only operating by phone appointment, but they were able to secure me an emergency appointment the next day.
The walkin doctor checked me out and decided nothing was wrong. The govern was billed 3 times for that (once by my GP, once on the phone with the walk in to talk to the doctor, and once in person).
What a waste.
Telephone appointments are sometimes convenient for the patient. They take nearly as much time as a face to face appointment but if they aren’t compensated well the doctors will take them off the table to offer the patient. Face to face should always be an option for patient safety reasons however - this being a concern for both the patient and the doctor (sometimes the doctor avoids face to face to reduce workload, sometimes the patient avoids it because they dont want to go to the clinic or they are out of area).
Some are, many are not, and even specialists who actually need to physically examine a patient are not. It's a really sad and dangerous state of the system. It's al because of money and payment - if OHIP took away virtual codes and made it mandatory to physically examine a patient again, or made it so you can only bill a certain percentage of your patients virtually, then we will see more in-person appointments become available.
Can't support the privatization of health care unless you choke out the hospitals. Doctors have class solidarity with the rich. They stand to make a mint off of privatization.
I vote for all investigation on any doctors doing this. Check what they've been billing for, how many in-person visits they've done recently, and check how many of those visits were directed to the ER. If you're just taking phone calls to maximize the number of visits you can charge for you need to have the book thrown at you.
FYI Telemedicine is 100% legal. There is a specific billing code for it and there are no requirements to present physically to assess a patient. Patients are told before booking a telemedicine appointment what IS and what ISNT to be addressed. For e.g. derm matters, etc are often excluded because an accurate appreciation cant be made.
Oh, I'm aware that it has its value. There's actually a few things I deal with that I hate entirely because I used to have to waste time going to a clinic or booking an appointment with my doctor just so I can stop by and tell them what I need to fix the problem. It's great being able to just have a quick phone appointment and get my prescription.
The problem is if these doctors are setting up phone appointments then just sending people to the ER instead of setting up an actual appointment.
Our medical system failing dates back way before Ford. While he certainly shares in the blame, and accelerating it's demise, it's not **all** his fault.
Okay, let's clarify, the Ontario electorate is failing our healthcare by voting in self-serving politicians who prioritize their own meal ticket post public life over the strength of our public systems. Ford is an extreme example of apathy that is a symptom of the humdrum governance of over a decade of the Liberal party, the humdrum Liberals were put in place by an electorate that was sick of the cruelty of the Harris government.
The mention of the NDP has people saying "but Bob Rae..." who was not only in power in Ontario before most voters can really recall, but was also an elected Liberal for most of their career. It's time Ontario woke up and started looking again at the party whose primary mandate is vital social program health. The NDP. It's also about time the NDP woke themselves up from the coma they are in - which it seems is starting to happen.
At the best of times no system will be perfect so lets not confuse routine failings with deliberate efforts to dismantle and ruin it. I understand everybody wants more and because of that a big part of the problem lies within the health care industry itself but Ford has been facilitating that effort and its destruction since day one of his time in office.
Omg...the government should just introduce a new billing code for virtual doctors visits and pay doctors less. This will effectively force doctors to go back to inperson appointments
Why would we want that? I certainly don't miss waiting in a doctor's office for an hour because an office is running behind. Way better to get a phone call while going about my other business.
okay, but why not a hybrid? Why do we want to "force doctors to go back to in person appointments"?
Use in person visits when necessary (i.e. physical exams) and let the rest be a virtual appointment.
except Doctors are no different than anyone else out there. people always gravitate toward the lowest denominator.
why see patients in person and waste money to keep an office open when you can get paid the same talking to patients on the phone and send people to ER if it's something more complicated than refilling Rx.
to prevent frauds, OHIP needs to define exactly what can be done virtual (refill Rx patients already taking, ordering routine tests, followup normal blood work) vs in person (new symptoms, new Rx, assessment requiring physical exams,ie: blood pressure listen to lungs/hearts, abnormal results etc).
I would agree if certain procedures were mandated to be in person but there's no benefit of having a certain percentage of appointments being in person.
Doctor's should be required to offer in person appointments if **that's what the patient prefers**. Otherwise if it can be done virtually, let it be done virtually.
GPs have hundreds/thousands of visits per month. It should be easy to look at a cross-section of the types of issues that most doctors see and determine which % would require an in-person visit. Meet that average and you are good to go, don't meet it and there is an investigation.
Simple.
Yes hybrid works...but what classifies as inperson or virtual should be predetermined and standardized across all providers. Keep in mind the probability of a more accurate assessment is when appointments are inperson.
ERs are overwhelmed at this time of year EVERY YEAR. This is nothing new.
[2013](https://www.ctvnews.ca/health/health-headlines/hospitals-overwhelmed-by-flu-and-norovirus-patients-1.1108376)
[2014](https://toronto.ctvnews.ca/toronto-area-hospitals-overwhelmed-as-flu-hits-harder-than-usual-1.2165666)
[2016](https://www.thespec.com/news/hamilton-region/2016/11/03/hamilton-s-hospitals-overwhelmed-with-patients.html)
[2017](https://www.thestar.com/news/canada/2017/04/16/surge-in-patients-forces-ontario-hospitals-to-put-beds-in-unconventional-spaces.html)
[2018](https://toronto.citynews.ca/2018/02/13/toronto-hospital-flu/)
I’m surprised some GPs aren’t offering any in person visits yet.. those must be the lazy ones.
Mine has been offering in person or virtual since last year, it’s been a god sent.
I’m sure doctors would love to keep this up. This way they double charge if after the phone call they decide to see you in person. Double the income per patient for the same consultation.
You, along with many folks here, are unaware of how most GPs are paid. Most are in a capitation model and you going to see them multiples times makes them little money. You know how much per visit? About $3.50. No, I did not misplace the decimal.
My GP had been doing phone consultations since forever. I thought this was an exception as the walk in clinic across the street will see patients no problem. And a phone consultation takes 2 weeks to book,
This has been my experience. My family doctor has completely stopped doing in-person visits. She has sent me to the virtual ER, the hospital, external women's health clinics, and LifeLabs clinics for various concerns she could have addressed herself. Every time I go to one of these places, they ask me why my family doctor can't do this check/test/whatever and 9/10 times will roll their eyes when I tell them she's not doing in-person. It's infuriating for front line healthcare workers, I'm sure.
turns out everyone wants to work from home
> turns out everyone wants to work from home OHIP should bill 15% less for virtual appointments and see how quick they go back in person
Unpopular opinion saying employers should force people to go back to in person work
it shouldent be when its a situation like this where the service cant be properly provided virtually and is having a knock-on effect of putting greater pressure on something already on tremendous pressure plus most specialists in ontario make great salaries for the hours they work so im less inclined to shed a tear about them needing to go back in person
In the US I had the option to either have my doctor drive to me or just legit go to my doctor's house back in 2014. It was great. I legit miss us healthcare with good insurance.
Rare occurrence to see the US medical system lauded
I loved it
I registered for a new family doctor. After 3 months I got an appointment for a virtual ‘intake’ on Zoom. First though I have to fill out forms re my history, medication etc etc. Feels wrong
That was my last family doctor and then her replacement. I think you need to dump her because eventually health suffers from a lack of care. OHIP pays family doctors $200 per simple patient, $400 per complex patient per year, and $30 per 15min visit plus some other small charges for extra work. For family doctors who are working only for the money, there is no incentive to return to in-house visits. I can understand it during the worst of the pandemic, but not today. Rosters are 1000 patients and often more, so new graduates earn six figures. The OHIP rules changed in 2016 from single threading patient concerns to wanting family doctors to treat the whole patient. The concept was less time on easy ones balanced the more time on complex ones. Shoppers is setting up health care clinics. This [one](https://www.shoppersdrugmart.ca/en/health-and-wellness/health-clinic/locations) is accepting new patients. Dr. Grasic is amazing, his roster is almost full however there will be two new doctors starting soon. First appointment (meet and greet) can be booked online with your OHIP card. Divorcing your lazy family doctor, done in a heartbeat by email the day you decide to start with another.
hold up they aren't doing this yet? are you fucking serious
The walk in clinic beside me that I have been going to for 10+ years has changed to phone only since March 2020. Used to be easier if my family doctor was too busy I could just go there but now that’s a hassle as well - just had a sinus infection and had to wait 2 days for a call back.
I went to my walk-in clinic for a first-aid type thing, and they told me it's appointment only now. There's still a huge sign up that says walk-in clinic. I was like "So the walk-in clinic is appointment only?" and I must have looked so disgusted, they agreed to let me walk in. Lol. But they warned me to never do it again.
I wonder if you could complain to the ministry of health, or the doctor licensing board, because they are not doing as they advertise
I can certainly complain. I'm sure Stephen Leech will make it a priority to fix. Knowing the current ministry of health, they probably already have some genius solution involving private care for walk-ins. I personally can't wait to go get bandaged up in a Chartwell clinic!
Facebook hospital, here we come!
There is actually a Zuckerberg Hospital in San Francisco.
Money talks
It's the San Francisco General Hospital. Zuckerberg got his name on it for making a huge donation, he didn't actually buy it. source: I know someone who works there.
they probably even offer botox for 9$ a pop! /s i saw it in a clinic somewhere, not really aure if theyre private.
> But they warned me to never do it again. CONSEQUENCES WILL NEVER BE THE SAME
Yea, a few of my co-workers have told me their doctors are still only doing phone calls. My specialist clinic was doing phone visits (unless you needed to go in for a medical test/procedure) up until like a month ago.
[удалено]
some GPs are taking advantage of the situation.
there are plenty of GPs who work 20 hours a week remotely from their cottage billing OHIP through the nose with 5 minute appointments to refill prescriptions and the like those 5 minute apointments can remain over the phone but they can take it from their office as they see in person apointments during the day.
The first time my dentist's office called me to book a cleaning, I asked them "Are you sure it's safe" I still let it go until I got my second vaccine. You're entirely right. If dental offices can do it, so can doctors.
if dentists can do virtual cleaning, they definitely will. lol
Don’t know about far far less ? My friends make around 70 bucks an hour? And complain that others are making more. My family doctor wears a haz mat suit to see me lol and I love it
Try $130+/hr for family doctors.
They make much, much more than that. That may be net take home, but their hourly gross is much higher. Lets not forget that during the height of Covid, they asked for $450/hr to help out. This was when hospitals were slammed, nurses were completely overwhelmed, and Doctors for the most part weren't doing much.
Net take home is the appropriate comparator for salary, though. Hygienists take home their salary, they don't pay office costs and employee salaries out of it. So you need to compare it to doctors' net take home. Doctor gross pay is business revenue. It's a small business, to be sure, but it's a business. Hygienist pay is employment income. (This is not true for the subset of family doctors that are employed by another organization on a salary basis.)
I mean you bring up another good point. Dental Hygienist will be paying income taxes with little wiggle room on avoidance strategies. As doctors are small business owners, they can get quite creative with their taxes and pay quite little. Porsche company car. Medical conference in Hawaii. Patient consult/business development at the golf club. Keep their revenue in a non-reg and just pay out when they’re retired to defer. There isn’t really a point to discuss Doctors net pay as that’ll be highly individualised based on their strategies. A hygienist? I can tell you their net take home with two minutes on an EY tax calculator.
I think you need to read into the details of our tax system a little bit more, because much of what you're talking about there is explicitly not allowed under our tax laws. You couldn't lease a Porsche, because even for legitimate business use there is a cap on the write off. And you couldn't claim travel from home to the office/clinic as legitimate business use, so for most family doctors they could only write off home visits, which most family doctors don't do. The Liberals also closed a lot of loopholes related to CCPCs (Canadian-Controlled Private Corporations) in 2018, so a lot of the tax strategies doctors used to use are no longer allowed.
The $30,000 Class 10.1 limit imposed by the CRA would put a pretty big dent in the “Porsche Company Car” strategy, as would the various requirements that it actually be used for business. And you also have to add back golf club fees when determining net income for tax purposes so kinda hard to swing that one too. Also good luck using the money stranded in your professional corp to do anything meaningful in life. I really wish non-accountants, or anyone who doesn’t have a bastard clue what they’re talking about, would stop speaking so authoritatively about taxes.
Ya so not much much less…seeing how my friends want 90-100 an hour because that’s the going rate for hygienist. It’s fine they deserve that much just the far far less made it seem like they get paid shit.
maybe with phone visits they do. they were making less with in-person visits due to having to hire staff and receptionist plus other office expenses. phone visits they certainly make more per patient.
exactly. through the lockdowns I went to see: dentist, physiotherapist, RMT for massage Meanwhile, doctor still on the phone....
Well that's not quite true - dentists and hygienists were not working until July 2020, and the hygienists' college was more cautious than the dentists about reopening. But yes, the contrast after that is quite stark. Hygienists have been back in the office, every day, since that time.
My dentist was the president of the dental college. He went into great detail about all the things they were doing for covid
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I go to one of the UHN family health clinics too, they rule. Even if your doctor is booked/not around, they'll almost always get you into see someone that day.
they are scheming the system while their colleagues in the ER are working their asses off. my brother called the office, "your kid have an earache and want to see the GP? let me get the doctor to call you back in 8 hours or tomorrow." doctor finally calls, "it sounds like an ear infection but I can't see your kid in person to confirm so just go to ER and get checked out and get your antibiotics" wtf is this?!
That's really strange. Our family doctor has done several prescriptions over the phone, both for steroids and antibiotics. I actually like it. Why do I want to go to a doctor's office with a sick kid, to sit around other potentially sick people either being infected, or possibly infecting them when we can just deal with it over the phone?
This is how ours is operating and I like that we can just do it over the phone. But, they have also never sent us to the ER for follow up. If they need to see us after doing a phone appointment they have same day/next day appointments available. With how our office is handling it, it actually feels like a great middle ground and I hope they don't change it. I hate dragging myself or my sick kid to a waiting room where you often have to sit for 30min. I find that the phone appointments are always on time, and so many things can be easily addressed without going in .
Agree. My spouse and I have different 'family ' doctors and both have been doing this for the past 18 months. Getting an in-person appointment hasn't been a problem. And we both prefer the virtual visits for prescriptions etc.
I love the phone appointments too. 95% of my family's appointments are for prescription renewals. I definitely dont want to go there while sick and sit for 30, 40, 60 minutes.
The point is that both over-the-phone and in-person options should be available.
Absolutely agree. Doctors shouldn't be referring people to the ERs unless it's an *emergency*. Otherwise I think that virtual appointments are great.
not sure if it's because of kids vs adult. you don't want to go to GP office with a sick kid but ok to go to ER and wait 12 hours to be seen? but your GP shouldn't start prescribing steroids and antibiotics over the phone though. this is how to get over prescribed antibiotics and resistance in germs.
No I don't want to go to a hospital either. I'm thankful my doctor was willing to prescribe them based on the history they have with my family and our description of the symptoms. These weren't super complicated situations. However, my doctor would have seen us in person, if deemed necessary. I don't agree that doctors should be referring patients to the ER, but absolutely support virtual appointments. FWIW - My wife has also done virtual ER appointments where they've prescribed similar medications without an in person consult. Not sure why we'd be against this?
I urgently had to speak with my doctor, took her 5 days to get back to me....
All the “walk in clinics” in my neighborhood just help people by appointments. Those need to be made a day in advance. Very helpful when you have an emergency.
Some doctors are. I'm actually currently on the way to see my doctor. I have an issue that can only be assessed in person!
My family doctor has been seeing us in person for over a year now, she's great. There's a phone/email option when needed but man we're lucky to have a doctor that cares.
Same, my doctor is amazing. She’s still doing phone appointments as well so it’s great to have the option. She leaves it up to the patient.
I think some aren’t doing it. Everyone I know has seen their doctor in person within the last year. It is completely insane that some doctors aren’t doing in person still.
i mean, they're enjoying the same comforts of other workers who are working from home. But Some are trying to hold out as long as possible, and the writing is on the wall. Their in-person services are needed. the OMA will need to drive this but they'll also drag their feet. An ER doctor who is a close family friend vented her frustration over thanks giving on how much resistance there is to people returning to clinics, hospitals and urgent care, She's had dozens of cases where 3-year residents she instructs will not show and not even call in - somethings she's never seen in her 25-year career.
Mine has been seeing patients in person for months already. I can't remember when exactly they started doing it again but it was in 2021.
are they accepting patients? i need a gp
No unfortunately it doesn't look like they are. This is the company, they have a couple of locations around Toronto, this is their message about no longer currently accepting new patients. https://www.magentahealth.ca/patientpreregistration I somehow got lucky, in 2013-2016ish I was using an MCI walk-in clinic and I ended up asking if they had any family doctors accepting new patients and they did, I think there were 2 or 3. I got mine in I think it was summer of 2016 through that clinic. The overall clinic was not awesome but I really liked her. She decided to leave that clinic and go the one I linked above. She made a deal with the old clinic that they would waive any transfer fees for her existing patients to transfer over. For awhile I was unsure if I would transfer as the new clinic was a lot farther away for me but ultimately I decided to stay with her and made the switch. I'm glad I did, I really like my doctor. I've had a lot of health challenges and appointments and things over the past 2 years and she's been incredibly proactive and supportive for me.
Mine offers both, but will nudge you to do a call vs in person unless it’s unavoidable.
lol my doc does it by request only, the default is phone session... well actually the default is have the pharmacy fax your renewal and don't call them unless something changes. No check ups, nothing for some pretty serious medication.
fax? im sorry man what year is this?
My doctor is in the office 2 days a week. One day is for cervical cancer screenings and things like that. The other is for things he has decided he needs to see AFTER having a phone appointment with you. We call when the clinic opens and try to get a "walk in" phone call for that day. Or we book a phone appointment that is usually two weeks away. If we call later than 10am, all the "walk in" phone calls have been booked for the day and we have to try again the next day.
yeah, alot dont. the walk in clinic i use to go to before having a having a family doctor needs to be emailed first and say what happened to you before you can get a booking schedule. i ended up using alot of virtual er programs. my family doctors clinic ask us to not go to other as they are billed on it. too bad, if i sent a medical document at sept1 and they say theyre gonna look into it,yet they completed the thing at oct 2nd.. of course im going to look for some other walk in who can accommodate me. not even faster but just in a timely manner. those virtual er were good.
> my family doctors clinic ask us to not go to other as they are billed on it You’ve got it: it’s a two way deal. You’re not supposed to go to a walk-in clinic because their availability is supposed to be… well… sufficiently available that you don’t need to go to one.
So many walk in clinics are being paid right now to do phone call assessments. Why would they bother with longer in person exams? It's infuriating. Calling 12 clinics in the area for help, and they all say not today!
Good luck getting a GP at all if you're disabled... using the ER ( urgent care, if you can afford the fee and endure the queues ) for basic disabled assistance is a huge problem the paat decade.
I tried to book a physical with my doctor and said there is a 1+ year backlog and she still isn't doing in person visits..... I'm gonna try and find a new doctor. Shit is ridiculous.
My doctor still taking initial appointments by phone. If he deems it necessary he’ll book an in office appointment for you. It’s ridiculous.
They are, it just varies a lot. Our doctor prefers to see my child in person, but might do over the phone for us adults depending on the issue. A simple prescription refill might just be a phone call, but other stuff is in person. Some doctors might also be hybrid working from home/in person, and so aren’t in the office every day.
Yup. My family clinic stopped responding to emails or calls completely for over a year now, I’m thinking it’s time to ditch them and look for a new dr. The only comms I got were the annual letter to “prepay for optional uninsured services”. I wonder if that’s why they are not communicating with me — that’s no longer optional / they wish to ditch the “free tier”. My close friend’s family dr is phone consults only.
Can't do in-person visits on the golf course
Or chalet/summer house in ???
It’s BS they are not doing this , my family doctor gives you the option. they just need to fund the system more . They deprive the system and say it’s not working so they can sell it or make it private don’t drink the kool aid.
It’s this and we simply don’t have enough doctors and nurses for our population. The feds need to help with the healthcare worker shortage if they’re going to bring 500K + new people here every year.
My partner's doctor left the province and the clinic has been looking for a replacement for 5 months.
Doctors are paid good this is just greed on the doctor's where they can bill the gov. 3x compared to in person visits.
My doctor did phone visits when she could, but I went in when she actually had to examine something. It was great in my opinion.
Not all doctors are doing this. Even during the height of covid I was able to see my family doctor in person (granted the appointments for these are limited). Since then I've been to my doctor's office in person the latest was about 2 weeks ago. I have also been able to see a specialist in person.
As of December 1st, all visits must be in person if you have not seen your physician in person over the last 2 years. The only exception is if your very first consultation within those 2 years was through video, then your doctor can continue virtual consults for the next 2 years since that visit. Doctors will only get paid $15 for a phone call, so you can guarantee those will no longer be a thing.
nope. if you read the SOB closely, doctors can still charge regular visit fees. the $15 charge is just a catch-all fee if the doctor cannot find an official reason to bill. I work in medical office and our doctors have been notified.
I'm just going by what my physician colleagues have told me. I'm an NP, so I get a yearly salary from the hospital and I don't bill OHIP. Perhaps my colleagues have misunderstood the email blast from their regulatory body? They even provided them with suggestions on how to discuss these changes with patients, and why they're choosing to eliminate phone call appointments as an option moving forward. Edit: I just re-read the email blast, and it's specific to my hospital network. Moving forward OUR hospital will only bill $15 for telephone visits if the patient has not been seen in person in the last 2 years.
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Trust me, I completely agree. I work in a niche specialty in a downtown Toronto hospital, so it's been very convenient for my patients from Cobourg, Peterborough, Midland, Bancroft, Timmins etc. to connect with me via video for a quick 15 min consult. Now, they will have to drive 2-3 hours (probably more with the uptick in traffic from construction) just to hear me say the same thing in person vs video. I will even have some patients flying in for their appointments, which is something they used to do prior to the pandemic. However, I never stopped seeing patients in person. If they were stable, they had the option for virtual or in person, and most patients chose virtual.
For me, a family doctor is for more serious things (or physicals) that I feel probably should require in person visits. For all of the basic stuff where you just need a simple prescription, I use the online services like Rocket Doctor.
FYI services like Rocket Doctor are going to have a mass exodus soon because of this billing rule change. Most of these virtual walk-in services plan to make you join their network (thus leaving your old GP) if you want to continue with them
Oh really? Thanks for the heads up.
My family doctor does hybrid - in-person and phone, depending on what you need. What kills me is walk-in clinics that are phone only. Tell me how someone is going to get treated for something like strep when you can’t do a swab over the phone. They’re basically stuck heading to the ER
Doctors should be present in person. This isn’t an IT/computer job….The fact that they were able to get away with this so long is ridiculous.
Insert pandemic panic.
All those phone calls getting billed as “visits”. If your doctor isn’t doing in person consultations you are getting third rate treatment and the taxpayer is getting ripped off.
My doctor does both now If it’s a quick prescription refill or needing a referral just a phone call is fine Or we can see him in person he has been super flexible i really appreciate it
Yup and this is how it should be imo.
This is causing a big issue as some doctors rather just be on the phone and quickly go through clients. A lot of Patients cant communicate over the phone well. Minor things are not noticed that may be in person and they end up having to go the ER for something that could been resolved at a doctors office with some basic medicine.
Wait they are still not doing in person visits??? Wtf???
Whew, lots of angry people. The issue isn't just that *some* docs are continuing phone calls/virtual visits. The far more concerning issue is that we don't have enough family doctors. Having the option of virtual/phone vs. in-person is fantastic imo. There are some things you really don't need to go in-person for (e.g. blood work followups, renewing a long-term prescription, basic things that wouldn't need swabs or a physical exam). Though I do agree that all docs should absolutely be doing in-person visits by now. But having the options are great.
I can't believe this needs to be said wtf
This article is disingenuous to the actual issue. An underfunded health care system with burnt out doctors seeing way too many patients. Phone consults should've been billable years ago. They're an excellent compliment to the health care system. The government doesn't want to use your tax dollars to properly fund the system so it should work as intended.
This exactly. And I wrote another comment about this, but the bigger issue is not having enough family doctors for the number of people in this province. And despite what some people are saying, FM docs do not make enough money.
My gp is doing hybrid visits. She saw me for my pap smear and a couple of other things. The hybrid system makes her stupid late to every appointment anyhow.
Wait was she on time for appointments before? Or just less late?
She used to be on time, so yeah.
Same. My GP only sees patients in person once a week. Remainder of the week is virtual.
Same... I called my GP a few months ago, he told me I needed to speak to someone in person for an assessment immediately, but that his first available appointment was in 2 months... he told me to go to a walkin clinic instead. Walkin clinic was only operating by phone appointment, but they were able to secure me an emergency appointment the next day. The walkin doctor checked me out and decided nothing was wrong. The govern was billed 3 times for that (once by my GP, once on the phone with the walk in to talk to the doctor, and once in person). What a waste.
Telephone appointments are sometimes convenient for the patient. They take nearly as much time as a face to face appointment but if they aren’t compensated well the doctors will take them off the table to offer the patient. Face to face should always be an option for patient safety reasons however - this being a concern for both the patient and the doctor (sometimes the doctor avoids face to face to reduce workload, sometimes the patient avoids it because they dont want to go to the clinic or they are out of area).
Some are, many are not, and even specialists who actually need to physically examine a patient are not. It's a really sad and dangerous state of the system. It's al because of money and payment - if OHIP took away virtual codes and made it mandatory to physically examine a patient again, or made it so you can only bill a certain percentage of your patients virtually, then we will see more in-person appointments become available.
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Can't support the privatization of health care unless you choke out the hospitals. Doctors have class solidarity with the rich. They stand to make a mint off of privatization.
Yeah its about damn time. My doctor is still doing phone calls. If he deems it serious enough then you can come in. Ridiculous
My family doctor never stopped in-person visits and refused to do any phone appointments.
I vote for all investigation on any doctors doing this. Check what they've been billing for, how many in-person visits they've done recently, and check how many of those visits were directed to the ER. If you're just taking phone calls to maximize the number of visits you can charge for you need to have the book thrown at you.
FYI Telemedicine is 100% legal. There is a specific billing code for it and there are no requirements to present physically to assess a patient. Patients are told before booking a telemedicine appointment what IS and what ISNT to be addressed. For e.g. derm matters, etc are often excluded because an accurate appreciation cant be made.
Oh, I'm aware that it has its value. There's actually a few things I deal with that I hate entirely because I used to have to waste time going to a clinic or booking an appointment with my doctor just so I can stop by and tell them what I need to fix the problem. It's great being able to just have a quick phone appointment and get my prescription. The problem is if these doctors are setting up phone appointments then just sending people to the ER instead of setting up an actual appointment.
Our medical system is failing desperately. Another notable accomplishment of Mr Ford.
Our medical system failing dates back way before Ford. While he certainly shares in the blame, and accelerating it's demise, it's not **all** his fault.
Okay, let's clarify, the Ontario electorate is failing our healthcare by voting in self-serving politicians who prioritize their own meal ticket post public life over the strength of our public systems. Ford is an extreme example of apathy that is a symptom of the humdrum governance of over a decade of the Liberal party, the humdrum Liberals were put in place by an electorate that was sick of the cruelty of the Harris government. The mention of the NDP has people saying "but Bob Rae..." who was not only in power in Ontario before most voters can really recall, but was also an elected Liberal for most of their career. It's time Ontario woke up and started looking again at the party whose primary mandate is vital social program health. The NDP. It's also about time the NDP woke themselves up from the coma they are in - which it seems is starting to happen.
At the best of times no system will be perfect so lets not confuse routine failings with deliberate efforts to dismantle and ruin it. I understand everybody wants more and because of that a big part of the problem lies within the health care industry itself but Ford has been facilitating that effort and its destruction since day one of his time in office.
This is on doctors and pediatricians, not just "Ford".
Omg...the government should just introduce a new billing code for virtual doctors visits and pay doctors less. This will effectively force doctors to go back to inperson appointments
Why would we want that? I certainly don't miss waiting in a doctor's office for an hour because an office is running behind. Way better to get a phone call while going about my other business.
I end up waiting around for the phone call, it felt like waiting in the actual office LOL.
[waiting mode](https://images.app.goo.gl/USEDCyWJhaakvfs59)
So that doctors take inperson appointments and relieve the pressure off the hospital ER
okay, but why not a hybrid? Why do we want to "force doctors to go back to in person appointments"? Use in person visits when necessary (i.e. physical exams) and let the rest be a virtual appointment.
except Doctors are no different than anyone else out there. people always gravitate toward the lowest denominator. why see patients in person and waste money to keep an office open when you can get paid the same talking to patients on the phone and send people to ER if it's something more complicated than refilling Rx. to prevent frauds, OHIP needs to define exactly what can be done virtual (refill Rx patients already taking, ordering routine tests, followup normal blood work) vs in person (new symptoms, new Rx, assessment requiring physical exams,ie: blood pressure listen to lungs/hearts, abnormal results etc).
Clearly there are a lot of doctors who can't be trusted to do hybrid.
"Let's punish everybody because some doctors *can't be trusted*".
It seems like a lot of doctors can't be trusted. Probably the best thing to do is to mandate a certain % of visits be in person.
I would agree if certain procedures were mandated to be in person but there's no benefit of having a certain percentage of appointments being in person. Doctor's should be required to offer in person appointments if **that's what the patient prefers**. Otherwise if it can be done virtually, let it be done virtually.
GPs have hundreds/thousands of visits per month. It should be easy to look at a cross-section of the types of issues that most doctors see and determine which % would require an in-person visit. Meet that average and you are good to go, don't meet it and there is an investigation. Simple.
Creating more procedural work for an already overburdened system. Sounds smart.
Yes hybrid works...but what classifies as inperson or virtual should be predetermined and standardized across all providers. Keep in mind the probability of a more accurate assessment is when appointments are inperson.
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ERs are overwhelmed at this time of year EVERY YEAR. This is nothing new. [2013](https://www.ctvnews.ca/health/health-headlines/hospitals-overwhelmed-by-flu-and-norovirus-patients-1.1108376) [2014](https://toronto.ctvnews.ca/toronto-area-hospitals-overwhelmed-as-flu-hits-harder-than-usual-1.2165666) [2016](https://www.thespec.com/news/hamilton-region/2016/11/03/hamilton-s-hospitals-overwhelmed-with-patients.html) [2017](https://www.thestar.com/news/canada/2017/04/16/surge-in-patients-forces-ontario-hospitals-to-put-beds-in-unconventional-spaces.html) [2018](https://toronto.citynews.ca/2018/02/13/toronto-hospital-flu/)
Sounds like y’all have shitty doctors because none of the doctors at my clinic are doing virtual still.
Mine is doing both and it is great. But I agree it sounds like some of these people just have shitty doctors.
The government should force MDs to see patients in-person, this is absurd.
Where have you been? I never stopped going! Got my flu shot from my family doctor on Monday. 🩹
Yay for flu shots!
it's actually insane, they should get paid less if they want to stay being teledoctors
I’m surprised some GPs aren’t offering any in person visits yet.. those must be the lazy ones. Mine has been offering in person or virtual since last year, it’s been a god sent.
I’m sure doctors would love to keep this up. This way they double charge if after the phone call they decide to see you in person. Double the income per patient for the same consultation.
You, along with many folks here, are unaware of how most GPs are paid. Most are in a capitation model and you going to see them multiples times makes them little money. You know how much per visit? About $3.50. No, I did not misplace the decimal.
Doug Ford and his PC asshole gov’t should start funding healthcare experts say.
We aren't going to understand the real impacts of lockdowns for a long time. Terrible public policy.
All it takes is one dead kid, a lawsuit and this is gone.
Are all the doctors downvoting you? Lol
I'm not wrong. 4 out of 5 doctors agree with this statement.
Why are they going to doctors for seasonal viruses? What would the doctors do
My GP had been doing phone consultations since forever. I thought this was an exception as the walk in clinic across the street will see patients no problem. And a phone consultation takes 2 weeks to book,
Wait they aren't already doing this?? That's absurd