Policy matters
Many of the issues reviewed centred on miscommunications between patient and physician .
The expectation that requires physicians to take into consideration the patient ’ s ability to pay and to consider whether it would be appropriate to reduce or waive fees is comparable to positions set out by the OMA , CMA and other Canadian medical regulatory authorities . The CMA ’ s Code of Ethics , for example , states that “ in determining professional fees to patients for non-insured services , consider both the nature of the service provided and the ability of the patient to pay .” Many of the issues reviewed centred on miscommunications between patient and physician . For this reason , a new section of the draft policy is devoted to setting out specific expectations relating to the communication of fees . Specifically , the draft policy now requires physicians to communicate any fees that will be charged in advance of providing the service and encourages physicians to take proactive steps to both educate and inform patients regarding fees for uninsured services . This could , for example , include posting a notice in the office that lists the fees . The draft policy also sets out expectations for when insured and uninsured services are being proposed or provided together or when uninsured services are being offered as an alternative to insured services . More specifically , the draft policy requires physicians to clearly indicate for which services the fee is being charged and to clearly and impartially describe the differences between insured and uninsured treatment options .
For example , in the instance of a patient who needs cataract surgery , the physician must discuss all uninsured services with the patient and give the patient the option of receiving medically necessary tests and lenses without charge . In fact , when a patient makes a voluntary choice to purchase a lens with features that are not medically necessary , the Ministry of Health and Long-Term Care requires that a credit for the cost of the medically necessary lens appear on the invoice given to the patient . Following other Canadian medical regulatory authorities , the draft policy now sets out specific requirements that must be in place before a physician may bill for a missed or cancelled appointment . Physicians , for example , should have a system in place to facilitate the cancellation process , have informed the patient in advance , and have been available at the time of the appointment to see the patient . The draft policy also makes the point that a block fee may not be appropriate in all practice settings where uninsured services are provided , noting that appropriateness will depend on a number of factors including , but not necessarily limited to , the nature of the physician-patient relationship . To participate in the consultation , please go to www . cpso . on . ca under the Policies and Publications tab . MD
About the
Nominate A Physician for the 2018 Awards
The College of Physicians and Surgeons of Ontario presents four Council Awards every year to physicians who have demonstrated excellence in the eight physician roles identified as the essential qualities needed to practise modern medicine . The College is now accepting nominations for the 2018 Council Award . Further details can be found in the insert between page 40-41 and on the College ’ s website www . cpso . on . ca .
Issue 1 , 2017 Dialogue 23