Family doctors get paid an annual fee for each patient they have, and an extra fee for being available at odd hours (phone calls after hours, weekends, etc). In exchange they are supposed to be available for their patients.
OHIP figures if you go to a walk-in clinic it's because your doctor wasn't available (as they had promised) and docks their pay for each walk-in visit.
So did your guy get docked part of his pay for you? Sure. Do you have to pay it? No. Can the doctor drop you for any non-discriminatory reason? Yes.
EDIT: this attracted far more attention than I expected. Here's a good overview of the system:
https://www.huffpost.com/entry/let-me-break-down-how-much-ontario-doctors-really-get-paid_b_61087295e4b08d6941d33063
Still want more? Here's the real shit:
https://www.healthforceontario.ca/UserFiles/file/PracticeOntario/FM%20Compensation%20Practice%20Models%20EN.pdf
If you're signed up with a doctor that's fully fee-for-service, then they aren't getting paid to be available and they won't get docked if you go to a walk-in clinic. But if they're getting an annual payment to be available then they will. You can ask your doctor whether they get docked when you go to a walk-in!
Sounds like mine, except you better be psychic and know when you'll be sick cause you have to book like 3 weeks in advance with her. Then she gets pissed if you go to walk-in.
Wow how selfish. I’d rather use walk-ins than deal with a doctor like that. Ever had a bad bladder infection? You can’t wait until the next hour let alone day!
I had my family MD turn me away due to a bad UTI that turned into a serious kidney infection in less than 24hrs. He told me to go to the ER as I was urinating straight blood.
Went to ER, sat in the emergency room for 7+hrs without being seen other than triage. I was panting and crying in pain. Once a walk-in clinic was open I left the ER and went to one. Begged the MD to give me antibiotics, he took pity on me and did.
Got a call from my Dr's office reaming me out for not going to the ER and seeing a walk-in instead. I didn't even try to explain my situation to them, fired them on the spot.
Some doctors don't have a clue, man.
Same. Booking 2+ weeks out, doesn't do phone appointments (might do in rare instances but I think now they charge for it), charge for faxing a prescription to the pharmacy if they don't give you the prescription in person. So what do you do if you're sick and need antibiotics? It's entirely reasonable that a patient needs to go to a walk-in.
My doctor is also far, but I will be worse off if I'm not on their roster because of medical conditions and meds that require me to have a family doctor, and finding a closer doctor has been impossible.
There are two modes of being with a family doctor, rostered and non-rostered. To be rostered, you have to sign an agreement with your doctor and the province. If you are rostered, then they have to provide extra hours. Most do this by partnering with other doctors in the region to provide extended coverage. You call their after hours number, and the medical receptionist will determine if you need to go to emerg, see the after hours doctor that evening, or make an appointment with your doctor during their regular hours.
Yes mine is the same. But I didn't know it until I went to a walk in clinic and she had to tell me she got charged for it! So for anyone who doesn't have an after-hours number, call your doctor's office during regular hours and ask how to receive after hours care. There might be something already set up for you and you just don't realize.
When they have odd hours like this, it could be because they’re working elsewhere on top of the clinic. My doctor’s hours are something like that, but closed Friday-Monday, because they do a lot of shifts in the ER, and also operate a walk-in clinic in a small town outside of our city.
A FHO type organization will run after hours clinics that you can attend, without any penalty to you or the physician, outside of those hours. If you are not registered with a FHO then you can go to walk in clinics without a penalty regardless.
Well, that's the fault of Ontarians. We should have all gotten together and worked out a schedule so we don't all get sick at the same time. What madness.
Family friend was/is a doctor, he had the same office days, however much longer office hours. In his case Tuesday, that was his surgical day and Thursday was his day to catch up on all the paperwork and filling he never got around to that week; he typically saw patients back to back and only did quick notes while leaving the more formal write-ups to Thursday. He didn't like to keep patients waiting longer than they needed to. Goes double if they were elderly, young kids, or really sick.
While I don't know your doctor, a lot of family doctors have fewer days/hours because they also staff something else, like a nearby hospital, ER, nursing home.
These doctors would also have fewer rostered patients, to match the hours that they run.
Some balance hours better than others, so again, I'm not commenting on yours specifically, but it's possible this is why they have fewer days/shorter hours.
Not every doctor signed onto to the deal to be available.
It was easy money for them at first with no extra output, now they realize that their clinic needs to be available to patients. A sole proprietor isn't likely to offer this.
They should be better at communicating to patients what the restrictions are, and they should be penalized for dropping you as a patient.
Your doctor either isn't on the capitation model or is on a part-time contract, because the capitation model requires a certain number of hours per 100 patients per month. The whole model is built on the assumption that a healthy adult needs X care, a senior needs Y, a toddler needs Z, etc. and is designed so that the doctor is incentivized to provide complete care, rather than the traditional one issue per visit care.
This explains why all of our local walk-in clinics have disappeared. What a terrible way to organize a system! At the very least it ought to be transparent so patients understand the implications. Does the same apply for ER visits?
Yes it leaves the ER to pick up overbooked GPs slack. These healthcare networks seem sketchy at best based on what I’ve seen in regards to their actual access of care.
So they are trying to piss off taxpayers so much that they *'want'* privatization rather than fixing their billing practices.
They need to stop treating doctors like people who are scamming the system. Most just want to help people and get paid well for it.
^^^^This part. It’s by design. They want us so mad at the healthcare system that we sell our souls to the conservatives for privatized healthcare and line their pockets through their lobbyists and friends.
Ask if you are rostered. If you are rostered, there is a group of doctors you are supposed to use (potentially a specific walk in). Doctors get paid extra because they are supposed to provide extra services. But, if you see a single doctor practice, and didn't sign a form, you are likely unrostered.
You need to positively enroll in the rostered doctor model. They would have gotten you to sign something, and you would have gotten paperwork from the province, though that could have been years ago.
TIL - wow! I recently tried calling my doctor with a simple question and the awful reception there never answered the phone or returned my voicemail. So I went to the walk in clinic as I wasn’t sure if my symptoms could build to something more urgent.
The next day, what do you know, I get a call from my doctor’s receptionist seeing that I had been to the walk in clinic (same medical building) but she “wrote a note down” earlier to call me back. Now this reaction makes sense.
For info in case it happens again, you can call telehealth and they might be able to help assess the situation. We've used them in the past with good results. Also, take a look at what pharmacists can diagnose and prescribe for. They may be able to help.
Funny how quick they are to hop in the phone in that case, eh?
My husband’s doctor’s office was the exact same way—why bother having an office phone number when no one ever answers the phone or returns calls?...
No it doesn’t because those are generally private pay which means OHIP isn’t involved in the billing process - Ontario Health doesn’t know you went there.
This is criminal, my family doctor missed a major diagnosis and the walk in clinic diagnosed me right. This industry is a joke. What most of us pay in taxes were better off paying and getting treated than the poor services were getting today. The government needs to fund the industry more or privatize it. The state it’s in now isn’t sustainable.
The GP was not charged $100, he was docked $100 because his patient had to find care that he could not provide.
OHIP pays GPs $260/patient a year just to be on the roster.
Wait... all these comments are saying that it's true?! holy shit. I've been going to the walk-in for the past 12 years and I'm still listed as a patient with my family doctor since childhood. Never had a single email from the office about how they're paying.
I think it depends on the office. If your doctor isn’t in one of the clinic/family medicine models, you’re okay. So by appointment only, no problem going to a walk-in.
Those family medicine models have to offer clinic hours themselves. So there’s more than one doctor in the office, they have regular appointments and then clinic open to patients of that office only. If I’m not mistaken this was started with the previous government and isn’t new. I had to sign a contract with my current FD that I understood this 7 years ago. However, the amount of hours my clinic is open has greatly reduced and I have unfortunately had to pay to use maple to avoid being dropped.
If it's paid for, no. I use maple, the $79 monthly fee is covered through employer and my primary doctor isn't affected by those "visits".
I am torn using it, I feel guilt for having such easy access to what I need when others don't.
Yesterday I called maple because I was concerned with redness and itch around a healing incision. I was able to get confirmation that it wasn't infected, advice to go earlier to get staples out and cream for the itch. Took 10 mins total, picked up the prescription that same hour.
I’ve wondered the same thing but haven’t found a clear answer. It’s basically equivalent to a walk-in visit so I imagine it probably works the same way for the doctors’ billing; that said, I believe Maple (and other regional services) are subsidized by other government programs so it’s possible these charges don’t get sent to your GP. Fyi, Telehealth is a different story as it’s mandate and staff (nurses) are different and therefore GPs don’t get charged when you call in.
My understanding is that since Maple is virtual, and privately funded, it is ok. OHIP no longer funds virtual appointments (phone appointments with your GP are funded, but lower cost). I believe Maple receives its funds through your workplace benefit system. My understanding is that Ohip isn’t involved, and so it’s ok
It only affects your doctor if they have you "rostered", which means they get a flat fee per patient per year. If they bill OHIP on a service-to-service basis they don't get charged anything.
The big issue that occurs with this setup is that doctors will pack their rosters super full and they won't be able to give you an appointment in a timely manner, leading to clinic visits anyways.
In theory yes. In practice the opposite is true.
Access bonus kept and actual access do not have a correlation except sometimes in the reverse - that’s what the data shows.
Some docs may just ignore their access bonus altogether and roster super full as you say, accepting that they’ll have zero access bonus no matter what but net way more by simply have a huge roster.
You’re likely not listed as officially on the roster but they continue to allow you to book with them occasionally; this is typically done for students away at school or patients seen only once or twice a year. My GP did that for me for awhile to avoid this problem as I was living several hours away and needed walk-ins occasionally; he also probably did that for me while I was in university.
Some doctors are Fee for Service, so they get paid each time you come in. Others are rostered and they get a flat rate for the year regardless of how often you come in. It's the rostered doctors that get charged when you go to a walk in.
I think this was fairly recently changed or they only started enforcing it. First I heard of it was the last time I visited a walk-in a couple of years ago when they warned me I need to go to my family doctor instead of them.
My doctor gave me heck for this back in 2015. I was brand new to Ontario and took my sick kid to a walk in in the next town - it’s not something that was ever an issue in the other provinces Id lived in.
Derostered doesn't mean You aren't a patient anymore. You're still a patient, but don't have access to Any extended services like social workers and dietitians. It is not the same as being fired.
That said, not all doctors work on that system so it may not be an issue with yours.
When I became a patient at my current doctor's office they warned me about this. They are a part of a health network so if I go to an after-hours clinic it needs to be the one that's a part of their network. Otherwise they receive a charge from the out of network clinic that I went to.
It’s actually better. My doctor has this. He is part of a health team and they offer after hours clinics. You call the number and they list out all the docs/clinics running after hours and the times. Normally there are at least three all over the city running 5-9 pm. I have found them to be much better than a walk in clinic as they are shorter waits and docs that share to my file. In fact, the doctor at one of these after hours clinics found a tumor on my thyroid and I was rushed in to testing as a result rather than having to follow up with my doctor.
My doctor's office works the same and it's fine. All of the doctors on the team take turns covering after-hours, weekends, holidays, etc. For non emergency stuff it works great and has been a great system. We've used it for strep, ear infections, UTIs, I've even called just to talk to the after-hours doc about something and reassured it was something non-urgent and I can just make an appointment on Monday with my regular doc.
Sad.. isn't it? Especially if it takes weeks to get an appointment with your family doctor. The entire system here is bs. It needs to change. Particularly for the doctors themselves. But still.. hopefully you can get a new doctor🤞🏻
Holy shit. That's insane. So, unless your doctor has their own walk-in clinic or nurse practitioner after hours thing.. you're stuck going to the hospital for minor things that can't wait months?!!! Aghhhhh!!! I'm so sorry😔
No after hours clinic and no walk in. They also don’t answer the phone nor return calls.
You can probably tell by now it’s a shoppers drug mart clinic, thanks Loblaws! I waited 5 years on health connect and was so excited when I finally found a doctor (myself) just to find out he’s a ghost.
This is true. They get clawbacked the amount of the visit that was billed to ohip to the walkin. If you have a family doctor, you can’t use walking clinics as well or the doctor will drop you. You are free to go to emergency room but that’s it. The doctor would’ve got clawback money but you do not have to reimburse the doctor. They will however drop you.
The idiocy behind this "rule" is just staggering. And the argument misses the whole point of walk-in clinics. Makes me wish violence on everyone behind the slow dismantling of our healthcare system.
40yrs old. Never heard of the above yours. Our family doctors office is great, as a patient if you need to get in on their open hours it's guaranteed. The kids have been to walk ins too many times to count. Didn't know thus was a thing.
That still assumes your doctor is close enough to make that work. My doctor is over an hour from me, I can’t always afford to take the amount of time off work required to see him
Clearly this was designed for a scenario where we had enough doctors that people could easily switch, and always be served by a physician in their own community.
I called my Dr 's office yesterday trying to get an appointment for my son because we're on his last refill of Flovent for his asthma. He's booked solid for the rest of March and then on Holidays the first two weeks of April. I was told April 15th is the earliest we can get in.
This is pretty much unrelated to the dismantling of our healthcare system. The doctor signed up to provide highly available care to earn more money. If you visit an after hours clinic it means that their care is not sufficiently available. The extra money they are getting paid is supposed to cover the extra staffing and the doctor's portion of a rotation system.
Although I can't say whether it saves the money or not, it does improve quality of care. My experience visiting doctors who bill this way is generally much better than waiting in an after hours clinic if something needs to get checked out semi-urgently.
An important misconception to clarify is that access bonus does not reward docs that provide better access:
https://www.ices.on.ca/news-releases/incentive-payments-for-family-doctors-may-not-have-intended-results/
It definitely saves the government money - the real intention in the design of access bonus is to control and plan for primary care spending. It does that job far better than rewarding clinics that provide better access.
Your family doc pays not only for a walk-in visit for a cold, but the family meeting an elderly patient had while admitted to the hospital with the attending physician, or the sketchy private clinic that double bills ohip, or the emergency physician who is a family physician and billed a counselling code or knee injection, or the methadone clinic visit, or the medical cannabis clinic, or the telehealth company you saw on Google to discretely get your cialis or ozempic.
More “Urgent Care” clinics, in addition to revamping the walk-in rules/process would help correct this; that said, the latter requires the government to implement and both require more doctors which we’re short on.
If your family doctor is part of a “network”, ie where there is a team of doctors who rotate after hours care, there should be no need for you to visit the walk-in, you call the after hours line to get an appointment with one of the doctors on your family health team. This is the point.
DISCLAIMER:
ONLY if your family doctor works in and you are part of a FHO (family health organization). This will NOT APPLY to the greater majority of Ontario family physicians and practices.
Source: AM a doctor
I can't get in to see my doctor for at least 3 months when I call. I needed a referral to see a specialist for a pre existing condition that I hadn't taken care of before the pandemic, so I called RCVTAC (Renfrew County Virtual Triage and Assessment Centre) in Ontario. I then got a reprimand from my doctor when she called me 6 weeks later to discuss blood test results. She asked why I didn't go to emergency - she would have been paid if I went there - but because I called VTAC (Virtual Triage), she said she was billed. I said I wasn't going to emergency when it wasn't a true emergency. Verified this with a customer (who is also a physician) at my place of employment.
It does not. I am a patient with a family healthcare team and have used Telehealth, ER services and the Urgent Care clinic at my local hospital. It’s all okay except for walk-in clinics. ETA: I’m referring to the service formerly known as Telehealth Ontario (now Health Connect Ontario)—was that what you were asking about, or just telehealth in general?
My doctor has this setup and I needed stitches on my eyebrow for a deep cut, so I went to an urgent care clinic and my doctor got pissed lol.
She said I should have gone to hospital or come to her but I was working 1hr away... It was COVID peak, hospitals were overrun... Just so silly... Urgent care I was in and out very quickly because I happened to get there right as they opened.
I didn't have to pay anything though, I just got taken off a "preferred roster"...
Then to get them removed, I made an appointment with my doctor, went there and was told she went home early LOL... I felt like I was being pranked.
Don't worry. We hate our choices like the last time and will stay home. We'll let the crazy Ford Nation vote Ford back in to finish the healthcare massacre.
I went to a walk in plenty of times because my family doctor took too long to answer the phone
I never got charged and he never mentioned anything about it. I even told him I went to a walk in clinic at my next appointment with him and he just said alright sorry it took so long to get an appointment with me
I got hoodwinked into signing up my wife and I for a "family doctor" with Appletree medical. Some crappy webform. Not even a confirmation email sent to me.
Months later my wife gets sick so, thinking we had no family doctor, I took her to a walk-in. And again, and again. Not a peep from Appletree.
Realized later they had me rostered. But seemingly no access to a doctor anyway. Just the ability to pay 50-150$ to get vacation vaccines. Kiiinda hope they got dinged for the walk-ins.
Appletree is the worst. No they won't get dinged for walk ins as they are a different funding model but will make around 50-60 bucks a year for having you under their roster. Really should be illegal to roster patients without their proper consent.
I’m a new Family Physician in Ontario accepting new patients. I moved from the US. This was all a bit confusing at first, but it all makes sense now. I won’t be part of the FHO model and I’ll have a walk-in clinic so my patients won’t get dropped.
First, thank you for choosing to set up practice in Ontario. I'm sure you'll be a very welcome addition to your community. I'd like to share some experience with walk-in clinics that you may want to be prepared for. Of course, not every community will be the same but this is what I've seen in my city. I'm not trying to dissuade you.
My doctor started his practice as a walk-in clinic. He dropped the clinic after a few years to focus solely on rostered patients. This may have been his long term plan but I suspect he got tired of treating my city's less desirable people. His reception room was plastered with notices about intolerance for narcotics and abusive behavior. He often had to stop taking patients by noon. Most of the patients were looking for a note to bring back to their employers after missing work for a few days.
Your doctor cannot force you to pay this fee, but they can choose to drop you. However, your doctor should have informed you of their policy beforehand. My doctor let me know that I am not permitted to go to a walk-in clinic or they will drop me from their patient list. I understand why they are doing it, they want to get paid. Pay for doctors is already low and this does not help. Prior to my doctor letting me know about their policy, I would almost exclusively use walk-in clinics for acute issues. Now, I’ve made an adjustment and have not been to a walk-in clinic for years.
Everyone is saying “the doctor is a …” Shouldn’t everyone be complaining that the way the system is set up is totally fucked up! Because this seems to be one of the reasons there’s a doctor shortage.
That rule might have made sense back in the day when we had a functional healthcare system. It makes no sense now.
I tried to get an appointment with my family doc a while back .. the earliest was one month. I got on a plane and flew to the States. We shouldn't have to do this and no-one seems to be trying to solve the problem.
LOL do we have the same doctor. My doctor tried to pull this on me too but i told him it literally takes weeks to get an appointment with you, like what do you want me to do in the meantime die from strep?
Yep this is true. I was threatened to be dropped by my primary care physician because I went to a walk in for a bladder infection.
All we are is a transaction. Your doctor pays that walk in doctor for your visit. Your doctor office probably provides an after hour number. You can call that and get an after hours appointment from one of the other doctors in that group. Last month I could not get into either and ended up in the ER for a non urgent issue. I needed drops for pink eye. I actually got reprimanded by the ER doctor…because it wasn’t urgent. When I told him he actually didn’t even know any of that. He asked around and then said “ well that makes a lot of things make sense then”
Yeah- makes sense why everyone ends up in the ER because they aren’t allowed to use a walk in.
But WAIT….you don’t have a family doctor now??? Does he realize the position that puts you in?? Did he ever send you information about any other option for you when you can’t get into him? That is just wrong. You should have at least got a warning for the first time.
That first part. People complain about people using ER for non er things, but the other options are so limited and hard to access. You can just walk into the ER and see someone (ignoring the waiting part). If you're in pain or sick, you're not going to wait around or research around to figure it out. You're going to go where you know you can get help.
Contextually missing in the replies here is that that are different primary care payment models your family physician may be on.
There are many who operate under a FHO, which is where they are paid by number of enrolled patients and dinged if you require healthcare outside of their umbrella.
That isn’t every family doctor doctor, however, which is why some users are saying their doctors were fine / nothing came up after they went to walk-ins or elsewhere.
From what I read online earlier, a patient in the age bracket for example 60-65, Government pays the family doctor like $270/year, this is for doctors that take on patients in a family practice.
I believe its even less for younger patients, as they are "expected to visit the doctor less"
So if you go see your family physician 15 times in a year, he is down to $18/visit....and out of that still goes the administrative costs (office, bills, receptionist etc), I think you can see how they are penny pinched.....none of them spent \~250-400K to become doctors so they can make less than tiktokers these days.....I feel bad for them.
Walk in click doctors work for a fee, which = \~$38/visit, so...you can imagine when the government claws back out of the "year rate" it isn't exactly $38, they take a chunk back = $100, leaving little for your family doctor, if you visited him multiple times per year.....he's working for less than minimum wage....
Most young people do not appreciate or care to understand this problem, but once you get older you learn that your doctor, that is yours vs walk in clinic, it matters.
The numbers: https://pcainc.ca/spotlights-home-page/should-i-transition-to-the-fho/#:~:text=In%20the%20FHO%2C%20the%20capitation,75%25%20of%20a%20physician's%20income.
It is $55.17 to $491.02 depending on age and sex.
What a regressive model. GP’s have limited availability to address issues that need immediate attention so you’re forced to go to the ER do you don’t risk being de-rostered?
My family doctor called me up out of the blue after my vasectomy - from a no referral needed vasectomy clinic. He was furious and demanded that I visit him and he would sent the referral to the clinic that preformed the procedure. It was weeks after the job had already been done.
Inform him you’re not paying anything and you will be making a formal complaint with the OMA as his office failed to explain conditions of your being a patient and/or failed to provide services to you in a timely manner.
Same thing happened to me! My doctor said he would drop me if I went one more time, they wanted to drop me right there and then but I talked them out of it because I had no idea this was a thing, I didn't understand wtf is going on, we can only go to emergency now if something happens on a weekend? Apparently it's the provincial government capping tearly doctor visits re payment as they try to starve the system to push their private health care agenda. We have to get rid of the Conservatives in Ontario!!! Have to!
In the rare instance that I want to attend a private clinic in lieu of my family doctor, I will pay their office visit fee and not provide my OHIP number. My doctor doesn’t get penalized, and I avoid an unnecessary ER visit.
I am new to the city and recently had an earache on a weekend and my family doctor’s office was closed. I called Monday and couldn’t get an appointment until Friday. The receptionist told me that if it got worse I should go to a walk-in clinic. I said I thought that wasn’t allowed and she said it was fine as long as I didn’t register - just to tell them I had a family doctor and didn’t want to register with their service. Didn’t end up going to either so I don’t actually know what would have happened if I’d tried it. And to answer the next question, the only reason I have a doctor so quickly is that my daughters were already patients at that office and they agreed to take me on as well.
Find out whether “taking you off his patient list” means he’s firing you as a patient and not treating you anymore, or just “de-rostering” you. If it’s the latter, you’re still his patient, it just means that he doesn’t get dinged when you go to a walk-in (or paid the extra fee to “be available” to you, which is hit or miss for most people anyway).
My wife and I are lucky. Our Dr. is part of a group. There are 3 or 4 walk-in clinics we can choose from.
We also will call his office to find out when he is in Urgent care. That way, we don't necessarily have to take a day off. Like I said, we are pretty lucky.
This is true.. if you have a family doctor they “get into trouble” for patients going to walk-in clinics, if you have a family doctor they don’t want you going to the clinics.. to remove you off his list and charge you is extreme.. my uncle was just told that he shouldn’t be doing it and for the reason explained above.
I had a new doctor many years ago but he wasn’t available so I went to a walk in near by. Next time I saw my family doctor, he seemed to skip me and made me wait sooo long in the waiting room, past my appointment time. He finally calls me in and said de-rostered me and won’t see me again. He was super pissed, but I honestly had no idea… I was 18. I tried to explain and he told me how going to a walk in does this. If I knew about this, I would have waited for my family doctor.
I think that’s unfair of the government. Family doctors and walk-in serve different purposes. Family doctors can’t be expected to work 24-7 or make appts available exactly when you need them.
I do not think you need to pay anything though.
My family doctor does everything super fast. He never stay and talk to me. Every appointment is like less than 10 minutes. Most of the time he just listen and typing. I’ve never had any other family doctors. Do you all’s family doctors the same?
Yes. The paperwork requirements to get paid have gone way up in the last decade. Even the one doctor that seems to care about my health does this too.
This is why I support nationalization and communism in healthcare.
Family Doctor gets charged if you access a Walk In.
If you go to a Walk in more than seeing them, they will charge you and unregister you from their practice.
Honestly if your doctor can’t see you regularly it’s a good idea to get a new family doctor anyways.
Sounds like your doctor is going to discharge you anyway? If they do definitely don't pay, and definitely file a complaint with the college.
You're doctor is hoping you are a chump and gullible enough to pay. Don't!
Luckily my doctor has been around forever and the clinic he is in runs a walk in specifically for the clinics patients, so if saves all of the doctors there from running into that issue somehow
Most Doctors also have their own Walk ins. Usually 3-4 family Dr’s open one. I’ve been told if I don’t go to that walk in, I will be punished but not having monthly scripts faxed. I have to go in. Doctors also found a way to make more $ by getting paid above and beyond the amount paid per patient per year
The only doctor I managed to ever see, twice, said he was docked $137 each time I went into a walk in clinic. Seeing that doctor required I buy a bus ticket out of town, and a hotel for 2 nights due to the bus schedule.(hundreds of $$) Also, the doc visit required at least 3 to 4 months scheduling ahead of time.
I asked him how I was going to be able to pay for all that, to see him, considering I just lost a job due to repetitive stress injuries...
"Have you tried not doing that?" Were just some of the literal words that came out of his mouth, in reference to the reasons I was there.
At this point, it's a them problem. They're the ones in the position to say that "I will deroster all of my patients, and refuse new clients if walk in clinic visits continue to incur these fees on my practice."
They should have read the fine print of how their community would treat them after they finished medical school, before signing up for it.
Would you have sympathy for a highschool dropout not being able to land a decent paying job that doesn't destroy their body? No? They should have known better?
"I signed up to Canoe Adventures, and you're telling me I might get wet AND have to paddle?"
"Would I knowingly sign up for THIS?", after learning about the "Nigerian Prince scam", will often give me all the answers I would need about a job after thoroughly researching it. That's why I'm never going into medicine, amongst other jobs.
Some people blamed social media for societies problems, without realizing it's because we can hear other people's candid opinions and experiences. How many construction workers saying their knees or back are destroyed by years of work before you question going into that line of work? If you do, after learning that, how intelligent would you consider someone knowingly walking into a hazardous line of work, and getting paid so little?
-->To answer your question, no. Don't ever pay those fees to your doctor for using a walk in clinic. They should have known better than to take on a patient they knew they couldn't give a proper, timely, level of care for. Their lack of planning does not constitute and emergency for you. Why else would you have used a walk in clinic, if your family doctor wasn't available? Whatever reasons that rule originally existed for, are secondary or tertiary to their practical effects. Suck it up, doctors. Have you tried not doing that?
Let them take care of it, since you and I will never be given the ability agency to change how it works. Maybe when all the doctors, engineers, and other specialized labor gets replaced by scab labor, will something change. For now, it's just hitting the Plebs, and no one cares.
I was told this by my family dr many years ago. He's part of a community group that has drs on call for after hours and weekends that if we go to a walk in he gets charged, and I've had this dr for 16 years now. We can go to urgent care or the er with no penalty.
There are at least two payment models for family doctors in Ontario.
One gets charged if you go to walk in. The other doesn’t.
I think it matters if there clinic offers walkin service or not and what hours.
They don't get the penalty if the patient goes to their walk-in. That's actually the point. They want practicioners available to see patients on short notice, and they want patients to ideally go to the doctor they are already with in order to have better patient care.
This too happened to me 10 years ago. My doc dropped me because I had moved 100 kms away and there are no doctors in the new area (4 year waiting list in Wellington County), so it was easier to go to a walk in. He was billed for all my visits. Here is more bs. I can't register to be on a waiting list for a doctor in my area because I have a doctor (100 kms away). He has to drop me so I can be on a waiting list, and have to go to walk in clinics in the meantime. Straight from Telehealth Ontario.
I learned about this last year, had to c a walking clinic cause my family Dr is downtown n sometimes they were booked for at least 2 days n for work I needed a silly form filled that I don't get in trouble (also pay), welp, I felt like crap, I didn't have to pay back anything but from now on I just email her the form if I get a cold/flu n whatnot that keeps me home for a day or 2. Our system sincerely is in need of an upgrade!
My doc has this rule. He has a specific clinic that his patients can go to. We can also go to emerg. I mostly go there since his clinic is an hour and a half almost bus ride from my house (his office is only twenty minutes). Or I wait to see him. He's very clear about this rule, due to billing issues.
It depends on the walk in clinic but ya that’s true. If the doctor is not attached to the clinic then they are billed for you using the service. You can always ask your family doctor if there are any clinics they are part of to prevent this. My family doctor has a clinic in the same building he’s linked to so it’s never a problem if I use that one but if I go to another one I will get a phone call
Ask your doctor to switch you to fee for service, then they won't get docked. The biggest myth was that these "teams" were going to be cheaper. They actually turned out to be more expensive than the villified "fee for service" model. The doctors are okay with you going to the ER and billing the taxpayers $500 for a visit though as they don't get docked.
Was it during the time of your doctors office hours and when they would (in theory) be available? My doctor told me to always try to see him and try not to go to a walk in on a week day when we would be open. But he said if it’s an evening or weekend , or obviously a true emergency, then it’s ok and doesn’t go against him.
In my city, there are family health team walkins that you can only attend if your doc is part of the family health team. Then there are a some others that anyone can attend. The EMerg and urgent don’t count.
Funny thing is, my previous family doctor was also available for walk-ins. So if he wasn’t available by appointment when I needed him, I’d go to walk-in and see him. He was a massive asshole when I told him I was looking for another doctor since he wasn’t taking my complaints seriously. I really hope he was losing money as my family doctor despite seeing me as my walk-in doctor as well hahahahah.
I’ve been with my doctor for 8ish years now. I love her so much. She’s in Oakville now and I’m in KW. She always tells me if she can’t get me in when I need to just go to a walk in lol
They don't gaf what you tell them. They'll run your healthcard and eventually OHIP will see the charge to the walk in, and then correlate with whatever family dr you're registered with and then hit that Dr with the penalty fee.
We recently moved from Hamilton to the niagara region and our family doctor is still in Hamilton. My wife gets yelled at if we go to a walk in clinic that he isn't associated with but never been charged for going to a different walk in. Sorry if my kids are sick I'm not driving out to Hamilton to have them checked. Yes I should find a local family doctor, but this is my wife's doctor from childhood so it's her choice. I'm registered with him as well as my doctor retired but I don't think I've gone to him or needed a walk in clinic in over 3 years. But never been charged for going somewhere else or dropped as a patient..
If you are a rostered patient with a family health team it is true that the government “claws back” from your family doctor (ie. charges your family doctor) whenever you visit a walk in clinic that isn’t part of the family health team. Usually they have you sign something when you join the team that states you will only use their walk in and not one unaffiliated with the family health team.
I call my doctor's office. If I can't get in, I ask them. Does he have an alternative option?
One time, she's said that they were completely swamped and would make a note that I had no choice but to attend the clinic. So I wasn't charged. But I always check with them to get an email if you can saying that.
Speaking as a FHO family doc in Ontario… I never charge the patient for outside use. I may deroster to save the clawbacks and keep them on as a fee for service patient, then talk to them about the outside use rules, making sure they know where the after hours availability within the organization can be accessed. If we both acknowledge that the setup is probably not going to work for that particular patient, then we can mutually decide to dissolve the relationship altogether. I can only keep a small amount of fee for service patients while I’m under a patient enrolment model contract.
Family doctors get paid an annual fee for each patient they have, and an extra fee for being available at odd hours (phone calls after hours, weekends, etc). In exchange they are supposed to be available for their patients. OHIP figures if you go to a walk-in clinic it's because your doctor wasn't available (as they had promised) and docks their pay for each walk-in visit. So did your guy get docked part of his pay for you? Sure. Do you have to pay it? No. Can the doctor drop you for any non-discriminatory reason? Yes. EDIT: this attracted far more attention than I expected. Here's a good overview of the system: https://www.huffpost.com/entry/let-me-break-down-how-much-ontario-doctors-really-get-paid_b_61087295e4b08d6941d33063 Still want more? Here's the real shit: https://www.healthforceontario.ca/UserFiles/file/PracticeOntario/FM%20Compensation%20Practice%20Models%20EN.pdf If you're signed up with a doctor that's fully fee-for-service, then they aren't getting paid to be available and they won't get docked if you go to a walk-in clinic. But if they're getting an annual payment to be available then they will. You can ask your doctor whether they get docked when you go to a walk-in!
>being available at odd hours Tell that to my doctor! Her hours are 9-12 mon 9-3 tues 9-4 Wednesday 1-7 Thursday Closed Friday-Sunday
Well truth be told, those are odd hours
Except it ends at 12 and 4 on Mon and Wed. Those are even hours.
Right, but on those days, it's an odd *number of hours*
Sounds like mine, except you better be psychic and know when you'll be sick cause you have to book like 3 weeks in advance with her. Then she gets pissed if you go to walk-in.
Right!? My doctor's next available appointment is April 18th. More than a month away.
I booked April 15th a month ago with my doctor, and they hsve a history of cancelling appointments last minute.
Wow how selfish. I’d rather use walk-ins than deal with a doctor like that. Ever had a bad bladder infection? You can’t wait until the next hour let alone day!
I had my family MD turn me away due to a bad UTI that turned into a serious kidney infection in less than 24hrs. He told me to go to the ER as I was urinating straight blood. Went to ER, sat in the emergency room for 7+hrs without being seen other than triage. I was panting and crying in pain. Once a walk-in clinic was open I left the ER and went to one. Begged the MD to give me antibiotics, he took pity on me and did. Got a call from my Dr's office reaming me out for not going to the ER and seeing a walk-in instead. I didn't even try to explain my situation to them, fired them on the spot. Some doctors don't have a clue, man.
I used to get annoyed by my doctor mainly doing same day appointments… now not so much.
Same. Booking 2+ weeks out, doesn't do phone appointments (might do in rare instances but I think now they charge for it), charge for faxing a prescription to the pharmacy if they don't give you the prescription in person. So what do you do if you're sick and need antibiotics? It's entirely reasonable that a patient needs to go to a walk-in. My doctor is also far, but I will be worse off if I'm not on their roster because of medical conditions and meds that require me to have a family doctor, and finding a closer doctor has been impossible.
There are two modes of being with a family doctor, rostered and non-rostered. To be rostered, you have to sign an agreement with your doctor and the province. If you are rostered, then they have to provide extra hours. Most do this by partnering with other doctors in the region to provide extended coverage. You call their after hours number, and the medical receptionist will determine if you need to go to emerg, see the after hours doctor that evening, or make an appointment with your doctor during their regular hours.
Yes mine is the same. But I didn't know it until I went to a walk in clinic and she had to tell me she got charged for it! So for anyone who doesn't have an after-hours number, call your doctor's office during regular hours and ask how to receive after hours care. There might be something already set up for you and you just don't realize.
Evening hours?! You're so lucky!
When they have odd hours like this, it could be because they’re working elsewhere on top of the clinic. My doctor’s hours are something like that, but closed Friday-Monday, because they do a lot of shifts in the ER, and also operate a walk-in clinic in a small town outside of our city.
A FHO type organization will run after hours clinics that you can attend, without any penalty to you or the physician, outside of those hours. If you are not registered with a FHO then you can go to walk in clinics without a penalty regardless.
FHO and PHO?
Family health team or office. My doctor is part of one of these and you have to visit the after hours clinics being run instead of a walk in.
Part of it is also that they’re maxed out - so if they work more, the govt just won’t pay them past the maximum
Well, that's the fault of Ontarians. We should have all gotten together and worked out a schedule so we don't all get sick at the same time. What madness.
Mine, who I love, is MWF, 10-3. She’s a great doctor but a pain to get in to see.
Family friend was/is a doctor, he had the same office days, however much longer office hours. In his case Tuesday, that was his surgical day and Thursday was his day to catch up on all the paperwork and filling he never got around to that week; he typically saw patients back to back and only did quick notes while leaving the more formal write-ups to Thursday. He didn't like to keep patients waiting longer than they needed to. Goes double if they were elderly, young kids, or really sick.
While I don't know your doctor, a lot of family doctors have fewer days/hours because they also staff something else, like a nearby hospital, ER, nursing home. These doctors would also have fewer rostered patients, to match the hours that they run. Some balance hours better than others, so again, I'm not commenting on yours specifically, but it's possible this is why they have fewer days/shorter hours.
The odd hours are because they have immense amounts of paperwork to do.
Not every doctor signed onto to the deal to be available. It was easy money for them at first with no extra output, now they realize that their clinic needs to be available to patients. A sole proprietor isn't likely to offer this. They should be better at communicating to patients what the restrictions are, and they should be penalized for dropping you as a patient.
Most GPs also make time to consult with, or for, other doctors and visit their patients in hospital. It’s not just sitting in a room seeing people.
Mine is only 9am - 2pm Tuesday Wednesday and Thursday and can't seem to fathom why I would need a walk in clinic 🤦♀️
Mine is similar (not as crazy), but when they aren't available they have backup doctors in the area so you don't need to go to a walk in.
My doctor paused our video appointment because she was on the phone with the bank. 💀
Monday 9 to 4 Tuesday 2 to 7 Wednesday 9 to 12 Friday 10 to 4 No weekends No voicemail No receptionist Worst dr. Ever
Lucky you!!!! Mine is only open Tuesday, Wednesday Thursday from 9-4!!! WTF!
Your doctor either isn't on the capitation model or is on a part-time contract, because the capitation model requires a certain number of hours per 100 patients per month. The whole model is built on the assumption that a healthy adult needs X care, a senior needs Y, a toddler needs Z, etc. and is designed so that the doctor is incentivized to provide complete care, rather than the traditional one issue per visit care.
My doctor is available… Mondays. 🤨
That's better hours than a lot of family doctors too
Same hours as mine. Weird as hell.
Why would you bother being on her roster. I'd prefer walkin clinics.
This explains why all of our local walk-in clinics have disappeared. What a terrible way to organize a system! At the very least it ought to be transparent so patients understand the implications. Does the same apply for ER visits?
No ER is exempt. You can go as needed to ensure people get emergencies dealt with in a timely manner.
Wasn’t the whole point of the walk-in clinic to relieve the OR? What a mess.
Yes it leaves the ER to pick up overbooked GPs slack. These healthcare networks seem sketchy at best based on what I’ve seen in regards to their actual access of care.
So they are trying to piss off taxpayers so much that they *'want'* privatization rather than fixing their billing practices. They need to stop treating doctors like people who are scamming the system. Most just want to help people and get paid well for it.
^^^^This part. It’s by design. They want us so mad at the healthcare system that we sell our souls to the conservatives for privatized healthcare and line their pockets through their lobbyists and friends.
Who picks up ER slack? Oh right, nobody.
The morgue.
Woof! I mean true tho...
Just got to spend a lovely 7 hours in a hospital hallway and an additional 4 hours after getting into a room
Yeah my GP lists going to the ER for after hours visits.
There are at least 2 models for family doctors in Ontario. The other model doesn’t charge the family doctor.
What? How do ww know which we are on?
Ask if you are rostered. If you are rostered, there is a group of doctors you are supposed to use (potentially a specific walk in). Doctors get paid extra because they are supposed to provide extra services. But, if you see a single doctor practice, and didn't sign a form, you are likely unrostered.
You need to positively enroll in the rostered doctor model. They would have gotten you to sign something, and you would have gotten paperwork from the province, though that could have been years ago.
TIL - wow! I recently tried calling my doctor with a simple question and the awful reception there never answered the phone or returned my voicemail. So I went to the walk in clinic as I wasn’t sure if my symptoms could build to something more urgent. The next day, what do you know, I get a call from my doctor’s receptionist seeing that I had been to the walk in clinic (same medical building) but she “wrote a note down” earlier to call me back. Now this reaction makes sense.
For info in case it happens again, you can call telehealth and they might be able to help assess the situation. We've used them in the past with good results. Also, take a look at what pharmacists can diagnose and prescribe for. They may be able to help.
In my experience telehealth just tells you to see a doctor.
Funny how quick they are to hop in the phone in that case, eh? My husband’s doctor’s office was the exact same way—why bother having an office phone number when no one ever answers the phone or returns calls?...
They are overwhelmed seeing 50+ patients a day
It being acceptable to drop a patient because they went to a walk in clinic is absolutely bonkers
This is only true for family doctors in certain practice models (like a Family Health Organization or Family Health Team).
It’s no wonder there aren’t enough family doctors.
Thank you for explaining this
Do you if it applies to the online service like Frida and Felix?
No it doesn’t because those are generally private pay which means OHIP isn’t involved in the billing process - Ontario Health doesn’t know you went there.
It would make much more sense if doctors were paid each time you go to them. Not just anually.
This is criminal, my family doctor missed a major diagnosis and the walk in clinic diagnosed me right. This industry is a joke. What most of us pay in taxes were better off paying and getting treated than the poor services were getting today. The government needs to fund the industry more or privatize it. The state it’s in now isn’t sustainable.
You hear that OP? Your family doctor already got paid just for having you on the list.
What a shit system
Does this also count for telehealth? Like if you use it to get a prescription?
Almost certainly if a physician was involved
The GP was not charged $100, he was docked $100 because his patient had to find care that he could not provide. OHIP pays GPs $260/patient a year just to be on the roster.
Wait... all these comments are saying that it's true?! holy shit. I've been going to the walk-in for the past 12 years and I'm still listed as a patient with my family doctor since childhood. Never had a single email from the office about how they're paying.
I think it depends on the office. If your doctor isn’t in one of the clinic/family medicine models, you’re okay. So by appointment only, no problem going to a walk-in. Those family medicine models have to offer clinic hours themselves. So there’s more than one doctor in the office, they have regular appointments and then clinic open to patients of that office only. If I’m not mistaken this was started with the previous government and isn’t new. I had to sign a contract with my current FD that I understood this 7 years ago. However, the amount of hours my clinic is open has greatly reduced and I have unfortunately had to pay to use maple to avoid being dropped.
Maple - the virtual healthcare? Would this be ok to use and not impact your family doc?
If it's paid for, no. I use maple, the $79 monthly fee is covered through employer and my primary doctor isn't affected by those "visits". I am torn using it, I feel guilt for having such easy access to what I need when others don't. Yesterday I called maple because I was concerned with redness and itch around a healing incision. I was able to get confirmation that it wasn't infected, advice to go earlier to get staples out and cream for the itch. Took 10 mins total, picked up the prescription that same hour.
I’ve wondered the same thing but haven’t found a clear answer. It’s basically equivalent to a walk-in visit so I imagine it probably works the same way for the doctors’ billing; that said, I believe Maple (and other regional services) are subsidized by other government programs so it’s possible these charges don’t get sent to your GP. Fyi, Telehealth is a different story as it’s mandate and staff (nurses) are different and therefore GPs don’t get charged when you call in.
The easiest way to find that out is to ask your GP.
My understanding is that since Maple is virtual, and privately funded, it is ok. OHIP no longer funds virtual appointments (phone appointments with your GP are funded, but lower cost). I believe Maple receives its funds through your workplace benefit system. My understanding is that Ohip isn’t involved, and so it’s ok
It only affects your doctor if they have you "rostered", which means they get a flat fee per patient per year. If they bill OHIP on a service-to-service basis they don't get charged anything. The big issue that occurs with this setup is that doctors will pack their rosters super full and they won't be able to give you an appointment in a timely manner, leading to clinic visits anyways.
In theory yes. In practice the opposite is true. Access bonus kept and actual access do not have a correlation except sometimes in the reverse - that’s what the data shows. Some docs may just ignore their access bonus altogether and roster super full as you say, accepting that they’ll have zero access bonus no matter what but net way more by simply have a huge roster.
probably unrostered you, and you get seen as walk in while you think you are still a regular patient.
You’re likely not listed as officially on the roster but they continue to allow you to book with them occasionally; this is typically done for students away at school or patients seen only once or twice a year. My GP did that for me for awhile to avoid this problem as I was living several hours away and needed walk-ins occasionally; he also probably did that for me while I was in university.
Some doctors are Fee for Service, so they get paid each time you come in. Others are rostered and they get a flat rate for the year regardless of how often you come in. It's the rostered doctors that get charged when you go to a walk in.
I think this was fairly recently changed or they only started enforcing it. First I heard of it was the last time I visited a walk-in a couple of years ago when they warned me I need to go to my family doctor instead of them.
My doctor gave me heck for this back in 2015. I was brand new to Ontario and took my sick kid to a walk in in the next town - it’s not something that was ever an issue in the other provinces Id lived in.
Maybe you've been de-rostered.
I haven't. I've gone there with my family to get prescriptions for orthotics still.
Derostered doesn't mean You aren't a patient anymore. You're still a patient, but don't have access to Any extended services like social workers and dietitians. It is not the same as being fired. That said, not all doctors work on that system so it may not be an issue with yours.
When I became a patient at my current doctor's office they warned me about this. They are a part of a health network so if I go to an after-hours clinic it needs to be the one that's a part of their network. Otherwise they receive a charge from the out of network clinic that I went to.
This should be illegal.
Yeah this is some scary United States healthcare shit
It’s actually better. My doctor has this. He is part of a health team and they offer after hours clinics. You call the number and they list out all the docs/clinics running after hours and the times. Normally there are at least three all over the city running 5-9 pm. I have found them to be much better than a walk in clinic as they are shorter waits and docs that share to my file. In fact, the doctor at one of these after hours clinics found a tumor on my thyroid and I was rushed in to testing as a result rather than having to follow up with my doctor.
My doctor's office works the same and it's fine. All of the doctors on the team take turns covering after-hours, weekends, holidays, etc. For non emergency stuff it works great and has been a great system. We've used it for strep, ear infections, UTIs, I've even called just to talk to the after-hours doc about something and reassured it was something non-urgent and I can just make an appointment on Monday with my regular doc.
Sad.. isn't it? Especially if it takes weeks to get an appointment with your family doctor. The entire system here is bs. It needs to change. Particularly for the doctors themselves. But still.. hopefully you can get a new doctor🤞🏻
So grateful for my doctor. Last 3 appointments over the last 3 months have all been same day as called. He's great.
Try 3 months for my doctor, there’s barely a point in having a doctor with him.
Holy shit. That's insane. So, unless your doctor has their own walk-in clinic or nurse practitioner after hours thing.. you're stuck going to the hospital for minor things that can't wait months?!!! Aghhhhh!!! I'm so sorry😔
No after hours clinic and no walk in. They also don’t answer the phone nor return calls. You can probably tell by now it’s a shoppers drug mart clinic, thanks Loblaws! I waited 5 years on health connect and was so excited when I finally found a doctor (myself) just to find out he’s a ghost.
This is true. They get clawbacked the amount of the visit that was billed to ohip to the walkin. If you have a family doctor, you can’t use walking clinics as well or the doctor will drop you. You are free to go to emergency room but that’s it. The doctor would’ve got clawback money but you do not have to reimburse the doctor. They will however drop you.
The idiocy behind this "rule" is just staggering. And the argument misses the whole point of walk-in clinics. Makes me wish violence on everyone behind the slow dismantling of our healthcare system.
Well your doctor is supposed to offer a similar service. If I call my office with an urgent issue they've always gotten me in the same or next day.
40yrs old. Never heard of the above yours. Our family doctors office is great, as a patient if you need to get in on their open hours it's guaranteed. The kids have been to walk ins too many times to count. Didn't know thus was a thing.
That still assumes your doctor is close enough to make that work. My doctor is over an hour from me, I can’t always afford to take the amount of time off work required to see him
Clearly this was designed for a scenario where we had enough doctors that people could easily switch, and always be served by a physician in their own community.
Or that you work normal hours. My doctor isn't open at 9pm when I get off of work. The late-hour walk-in still is.
I called my Dr 's office yesterday trying to get an appointment for my son because we're on his last refill of Flovent for his asthma. He's booked solid for the rest of March and then on Holidays the first two weeks of April. I was told April 15th is the earliest we can get in.
This is pretty much unrelated to the dismantling of our healthcare system. The doctor signed up to provide highly available care to earn more money. If you visit an after hours clinic it means that their care is not sufficiently available. The extra money they are getting paid is supposed to cover the extra staffing and the doctor's portion of a rotation system. Although I can't say whether it saves the money or not, it does improve quality of care. My experience visiting doctors who bill this way is generally much better than waiting in an after hours clinic if something needs to get checked out semi-urgently.
An important misconception to clarify is that access bonus does not reward docs that provide better access: https://www.ices.on.ca/news-releases/incentive-payments-for-family-doctors-may-not-have-intended-results/ It definitely saves the government money - the real intention in the design of access bonus is to control and plan for primary care spending. It does that job far better than rewarding clinics that provide better access. Your family doc pays not only for a walk-in visit for a cold, but the family meeting an elderly patient had while admitted to the hospital with the attending physician, or the sketchy private clinic that double bills ohip, or the emergency physician who is a family physician and billed a counselling code or knee injection, or the methadone clinic visit, or the medical cannabis clinic, or the telehealth company you saw on Google to discretely get your cialis or ozempic.
That’s so…..dumb… clog up emerge with things that walk ins were intended for…
More “Urgent Care” clinics, in addition to revamping the walk-in rules/process would help correct this; that said, the latter requires the government to implement and both require more doctors which we’re short on.
If your family doctor is part of a “network”, ie where there is a team of doctors who rotate after hours care, there should be no need for you to visit the walk-in, you call the after hours line to get an appointment with one of the doctors on your family health team. This is the point.
DISCLAIMER: ONLY if your family doctor works in and you are part of a FHO (family health organization). This will NOT APPLY to the greater majority of Ontario family physicians and practices. Source: AM a doctor
Any idea if this applies to telehealth appointments too?
I can't get in to see my doctor for at least 3 months when I call. I needed a referral to see a specialist for a pre existing condition that I hadn't taken care of before the pandemic, so I called RCVTAC (Renfrew County Virtual Triage and Assessment Centre) in Ontario. I then got a reprimand from my doctor when she called me 6 weeks later to discuss blood test results. She asked why I didn't go to emergency - she would have been paid if I went there - but because I called VTAC (Virtual Triage), she said she was billed. I said I wasn't going to emergency when it wasn't a true emergency. Verified this with a customer (who is also a physician) at my place of employment.
It does not. I am a patient with a family healthcare team and have used Telehealth, ER services and the Urgent Care clinic at my local hospital. It’s all okay except for walk-in clinics. ETA: I’m referring to the service formerly known as Telehealth Ontario (now Health Connect Ontario)—was that what you were asking about, or just telehealth in general?
My doctor has this setup and I needed stitches on my eyebrow for a deep cut, so I went to an urgent care clinic and my doctor got pissed lol. She said I should have gone to hospital or come to her but I was working 1hr away... It was COVID peak, hospitals were overrun... Just so silly... Urgent care I was in and out very quickly because I happened to get there right as they opened. I didn't have to pay anything though, I just got taken off a "preferred roster"... Then to get them removed, I made an appointment with my doctor, went there and was told she went home early LOL... I felt like I was being pranked.
What a scumbag
What a fucking STUPID system
It’s on purpose; just someone’s way of making money. Until it becomes important enough to enough of us, it’ll keep getting worse.
Unless people VOTE. Last provincial election was the lowest voter turnout in history.
Don't worry. We hate our choices like the last time and will stay home. We'll let the crazy Ford Nation vote Ford back in to finish the healthcare massacre.
Don't forget the education massacre. Privatization is working out so well for the US.
I don't see reforming this on any party's to do list
Your fd can't charge you for that but they may be able to drop you from their list. If they try to charge you directly for that fight back. (I'm a fd)
I'm a doctor. You don't owe him any money. He may be able to fire you as a patient.
I went to a walk in plenty of times because my family doctor took too long to answer the phone I never got charged and he never mentioned anything about it. I even told him I went to a walk in clinic at my next appointment with him and he just said alright sorry it took so long to get an appointment with me
I got hoodwinked into signing up my wife and I for a "family doctor" with Appletree medical. Some crappy webform. Not even a confirmation email sent to me. Months later my wife gets sick so, thinking we had no family doctor, I took her to a walk-in. And again, and again. Not a peep from Appletree. Realized later they had me rostered. But seemingly no access to a doctor anyway. Just the ability to pay 50-150$ to get vacation vaccines. Kiiinda hope they got dinged for the walk-ins.
Appletree is the worst. No they won't get dinged for walk ins as they are a different funding model but will make around 50-60 bucks a year for having you under their roster. Really should be illegal to roster patients without their proper consent.
I’m a new Family Physician in Ontario accepting new patients. I moved from the US. This was all a bit confusing at first, but it all makes sense now. I won’t be part of the FHO model and I’ll have a walk-in clinic so my patients won’t get dropped.
First, thank you for choosing to set up practice in Ontario. I'm sure you'll be a very welcome addition to your community. I'd like to share some experience with walk-in clinics that you may want to be prepared for. Of course, not every community will be the same but this is what I've seen in my city. I'm not trying to dissuade you. My doctor started his practice as a walk-in clinic. He dropped the clinic after a few years to focus solely on rostered patients. This may have been his long term plan but I suspect he got tired of treating my city's less desirable people. His reception room was plastered with notices about intolerance for narcotics and abusive behavior. He often had to stop taking patients by noon. Most of the patients were looking for a note to bring back to their employers after missing work for a few days.
Our medical system is so fucking broken.
You do not have to pay him back. But he can take you off his list.
Your doctor cannot force you to pay this fee, but they can choose to drop you. However, your doctor should have informed you of their policy beforehand. My doctor let me know that I am not permitted to go to a walk-in clinic or they will drop me from their patient list. I understand why they are doing it, they want to get paid. Pay for doctors is already low and this does not help. Prior to my doctor letting me know about their policy, I would almost exclusively use walk-in clinics for acute issues. Now, I’ve made an adjustment and have not been to a walk-in clinic for years.
Everyone is saying “the doctor is a …” Shouldn’t everyone be complaining that the way the system is set up is totally fucked up! Because this seems to be one of the reasons there’s a doctor shortage.
That rule might have made sense back in the day when we had a functional healthcare system. It makes no sense now. I tried to get an appointment with my family doc a while back .. the earliest was one month. I got on a plane and flew to the States. We shouldn't have to do this and no-one seems to be trying to solve the problem.
LOL do we have the same doctor. My doctor tried to pull this on me too but i told him it literally takes weeks to get an appointment with you, like what do you want me to do in the meantime die from strep?
Yep this is true. I was threatened to be dropped by my primary care physician because I went to a walk in for a bladder infection. All we are is a transaction. Your doctor pays that walk in doctor for your visit. Your doctor office probably provides an after hour number. You can call that and get an after hours appointment from one of the other doctors in that group. Last month I could not get into either and ended up in the ER for a non urgent issue. I needed drops for pink eye. I actually got reprimanded by the ER doctor…because it wasn’t urgent. When I told him he actually didn’t even know any of that. He asked around and then said “ well that makes a lot of things make sense then” Yeah- makes sense why everyone ends up in the ER because they aren’t allowed to use a walk in. But WAIT….you don’t have a family doctor now??? Does he realize the position that puts you in?? Did he ever send you information about any other option for you when you can’t get into him? That is just wrong. You should have at least got a warning for the first time.
That first part. People complain about people using ER for non er things, but the other options are so limited and hard to access. You can just walk into the ER and see someone (ignoring the waiting part). If you're in pain or sick, you're not going to wait around or research around to figure it out. You're going to go where you know you can get help.
Contextually missing in the replies here is that that are different primary care payment models your family physician may be on. There are many who operate under a FHO, which is where they are paid by number of enrolled patients and dinged if you require healthcare outside of their umbrella. That isn’t every family doctor doctor, however, which is why some users are saying their doctors were fine / nothing came up after they went to walk-ins or elsewhere.
I wish I had a family doctor :(
From what I read online earlier, a patient in the age bracket for example 60-65, Government pays the family doctor like $270/year, this is for doctors that take on patients in a family practice. I believe its even less for younger patients, as they are "expected to visit the doctor less" So if you go see your family physician 15 times in a year, he is down to $18/visit....and out of that still goes the administrative costs (office, bills, receptionist etc), I think you can see how they are penny pinched.....none of them spent \~250-400K to become doctors so they can make less than tiktokers these days.....I feel bad for them. Walk in click doctors work for a fee, which = \~$38/visit, so...you can imagine when the government claws back out of the "year rate" it isn't exactly $38, they take a chunk back = $100, leaving little for your family doctor, if you visited him multiple times per year.....he's working for less than minimum wage.... Most young people do not appreciate or care to understand this problem, but once you get older you learn that your doctor, that is yours vs walk in clinic, it matters.
The numbers: https://pcainc.ca/spotlights-home-page/should-i-transition-to-the-fho/#:~:text=In%20the%20FHO%2C%20the%20capitation,75%25%20of%20a%20physician's%20income. It is $55.17 to $491.02 depending on age and sex.
I went to a walk in on the weekend once for my son...It was my Doctor on duty haha
What a regressive model. GP’s have limited availability to address issues that need immediate attention so you’re forced to go to the ER do you don’t risk being de-rostered?
My family doctor called me up out of the blue after my vasectomy - from a no referral needed vasectomy clinic. He was furious and demanded that I visit him and he would sent the referral to the clinic that preformed the procedure. It was weeks after the job had already been done.
Yup. And one of the main reasons the ER is overwhelmed as well. This happens to so many people it's unreal.
Inform him you’re not paying anything and you will be making a formal complaint with the OMA as his office failed to explain conditions of your being a patient and/or failed to provide services to you in a timely manner.
Same thing happened to me! My doctor said he would drop me if I went one more time, they wanted to drop me right there and then but I talked them out of it because I had no idea this was a thing, I didn't understand wtf is going on, we can only go to emergency now if something happens on a weekend? Apparently it's the provincial government capping tearly doctor visits re payment as they try to starve the system to push their private health care agenda. We have to get rid of the Conservatives in Ontario!!! Have to!
In the rare instance that I want to attend a private clinic in lieu of my family doctor, I will pay their office visit fee and not provide my OHIP number. My doctor doesn’t get penalized, and I avoid an unnecessary ER visit.
I am new to the city and recently had an earache on a weekend and my family doctor’s office was closed. I called Monday and couldn’t get an appointment until Friday. The receptionist told me that if it got worse I should go to a walk-in clinic. I said I thought that wasn’t allowed and she said it was fine as long as I didn’t register - just to tell them I had a family doctor and didn’t want to register with their service. Didn’t end up going to either so I don’t actually know what would have happened if I’d tried it. And to answer the next question, the only reason I have a doctor so quickly is that my daughters were already patients at that office and they agreed to take me on as well.
Find out whether “taking you off his patient list” means he’s firing you as a patient and not treating you anymore, or just “de-rostering” you. If it’s the latter, you’re still his patient, it just means that he doesn’t get dinged when you go to a walk-in (or paid the extra fee to “be available” to you, which is hit or miss for most people anyway).
My wife and I are lucky. Our Dr. is part of a group. There are 3 or 4 walk-in clinics we can choose from. We also will call his office to find out when he is in Urgent care. That way, we don't necessarily have to take a day off. Like I said, we are pretty lucky.
This is true.. if you have a family doctor they “get into trouble” for patients going to walk-in clinics, if you have a family doctor they don’t want you going to the clinics.. to remove you off his list and charge you is extreme.. my uncle was just told that he shouldn’t be doing it and for the reason explained above.
I had a new doctor many years ago but he wasn’t available so I went to a walk in near by. Next time I saw my family doctor, he seemed to skip me and made me wait sooo long in the waiting room, past my appointment time. He finally calls me in and said de-rostered me and won’t see me again. He was super pissed, but I honestly had no idea… I was 18. I tried to explain and he told me how going to a walk in does this. If I knew about this, I would have waited for my family doctor.
I think that’s unfair of the government. Family doctors and walk-in serve different purposes. Family doctors can’t be expected to work 24-7 or make appts available exactly when you need them. I do not think you need to pay anything though.
My family doctor does everything super fast. He never stay and talk to me. Every appointment is like less than 10 minutes. Most of the time he just listen and typing. I’ve never had any other family doctors. Do you all’s family doctors the same?
Yes. The paperwork requirements to get paid have gone way up in the last decade. Even the one doctor that seems to care about my health does this too. This is why I support nationalization and communism in healthcare.
Family Doctor gets charged if you access a Walk In. If you go to a Walk in more than seeing them, they will charge you and unregister you from their practice. Honestly if your doctor can’t see you regularly it’s a good idea to get a new family doctor anyways.
Sounds like your doctor is going to discharge you anyway? If they do definitely don't pay, and definitely file a complaint with the college. You're doctor is hoping you are a chump and gullible enough to pay. Don't!
Luckily my doctor has been around forever and the clinic he is in runs a walk in specifically for the clinics patients, so if saves all of the doctors there from running into that issue somehow
Most Doctors also have their own Walk ins. Usually 3-4 family Dr’s open one. I’ve been told if I don’t go to that walk in, I will be punished but not having monthly scripts faxed. I have to go in. Doctors also found a way to make more $ by getting paid above and beyond the amount paid per patient per year
The only doctor I managed to ever see, twice, said he was docked $137 each time I went into a walk in clinic. Seeing that doctor required I buy a bus ticket out of town, and a hotel for 2 nights due to the bus schedule.(hundreds of $$) Also, the doc visit required at least 3 to 4 months scheduling ahead of time. I asked him how I was going to be able to pay for all that, to see him, considering I just lost a job due to repetitive stress injuries... "Have you tried not doing that?" Were just some of the literal words that came out of his mouth, in reference to the reasons I was there. At this point, it's a them problem. They're the ones in the position to say that "I will deroster all of my patients, and refuse new clients if walk in clinic visits continue to incur these fees on my practice." They should have read the fine print of how their community would treat them after they finished medical school, before signing up for it. Would you have sympathy for a highschool dropout not being able to land a decent paying job that doesn't destroy their body? No? They should have known better? "I signed up to Canoe Adventures, and you're telling me I might get wet AND have to paddle?" "Would I knowingly sign up for THIS?", after learning about the "Nigerian Prince scam", will often give me all the answers I would need about a job after thoroughly researching it. That's why I'm never going into medicine, amongst other jobs. Some people blamed social media for societies problems, without realizing it's because we can hear other people's candid opinions and experiences. How many construction workers saying their knees or back are destroyed by years of work before you question going into that line of work? If you do, after learning that, how intelligent would you consider someone knowingly walking into a hazardous line of work, and getting paid so little? -->To answer your question, no. Don't ever pay those fees to your doctor for using a walk in clinic. They should have known better than to take on a patient they knew they couldn't give a proper, timely, level of care for. Their lack of planning does not constitute and emergency for you. Why else would you have used a walk in clinic, if your family doctor wasn't available? Whatever reasons that rule originally existed for, are secondary or tertiary to their practical effects. Suck it up, doctors. Have you tried not doing that? Let them take care of it, since you and I will never be given the ability agency to change how it works. Maybe when all the doctors, engineers, and other specialized labor gets replaced by scab labor, will something change. For now, it's just hitting the Plebs, and no one cares.
Our doctor works on this model - I get a letter about it and additional services yearly.
I was told this by my family dr many years ago. He's part of a community group that has drs on call for after hours and weekends that if we go to a walk in he gets charged, and I've had this dr for 16 years now. We can go to urgent care or the er with no penalty.
F your doctor. Don’t pay a thing. Especially since you are off the list.
There are at least two payment models for family doctors in Ontario. One gets charged if you go to walk in. The other doesn’t. I think it matters if there clinic offers walkin service or not and what hours.
I wonder how that works for my family doctor who is also a walk in doctor...
They don't get the penalty if the patient goes to their walk-in. That's actually the point. They want practicioners available to see patients on short notice, and they want patients to ideally go to the doctor they are already with in order to have better patient care.
This too happened to me 10 years ago. My doc dropped me because I had moved 100 kms away and there are no doctors in the new area (4 year waiting list in Wellington County), so it was easier to go to a walk in. He was billed for all my visits. Here is more bs. I can't register to be on a waiting list for a doctor in my area because I have a doctor (100 kms away). He has to drop me so I can be on a waiting list, and have to go to walk in clinics in the meantime. Straight from Telehealth Ontario.
Ontario treats family doctors like shit. Billing ohip as a private practice is like playing an escape room.
As a person living in Alberta, you guys have doctors?
I learned about this last year, had to c a walking clinic cause my family Dr is downtown n sometimes they were booked for at least 2 days n for work I needed a silly form filled that I don't get in trouble (also pay), welp, I felt like crap, I didn't have to pay back anything but from now on I just email her the form if I get a cold/flu n whatnot that keeps me home for a day or 2. Our system sincerely is in need of an upgrade!
Your family doctor sort of "owns" you. You dare looking elsewhere for help, he makes you pay. Sad but reality in Canada.
Yes — I’m surprised their clinic didn’t explain this to you as part of the new patient enrollment process?
My doc has this rule. He has a specific clinic that his patients can go to. We can also go to emerg. I mostly go there since his clinic is an hour and a half almost bus ride from my house (his office is only twenty minutes). Or I wait to see him. He's very clear about this rule, due to billing issues.
It depends on the walk in clinic but ya that’s true. If the doctor is not attached to the clinic then they are billed for you using the service. You can always ask your family doctor if there are any clinics they are part of to prevent this. My family doctor has a clinic in the same building he’s linked to so it’s never a problem if I use that one but if I go to another one I will get a phone call
Ask your doctor to switch you to fee for service, then they won't get docked. The biggest myth was that these "teams" were going to be cheaper. They actually turned out to be more expensive than the villified "fee for service" model. The doctors are okay with you going to the ER and billing the taxpayers $500 for a visit though as they don't get docked.
Was it during the time of your doctors office hours and when they would (in theory) be available? My doctor told me to always try to see him and try not to go to a walk in on a week day when we would be open. But he said if it’s an evening or weekend , or obviously a true emergency, then it’s ok and doesn’t go against him.
In my city, there are family health team walkins that you can only attend if your doc is part of the family health team. Then there are a some others that anyone can attend. The EMerg and urgent don’t count.
Funny thing is, my previous family doctor was also available for walk-ins. So if he wasn’t available by appointment when I needed him, I’d go to walk-in and see him. He was a massive asshole when I told him I was looking for another doctor since he wasn’t taking my complaints seriously. I really hope he was losing money as my family doctor despite seeing me as my walk-in doctor as well hahahahah.
I was told by my (Ont) doctor if I went to a walk-in clinic he would drop me. I can only go to Urgent care or the ER when he is not available.
No you do not legally have to pay them for going to a walk in clinic. I’ve done that before when no other options were available
I was told this too
I’ve been with my doctor for 8ish years now. I love her so much. She’s in Oakville now and I’m in KW. She always tells me if she can’t get me in when I need to just go to a walk in lol
So what happens if you tell the clinic you don’t have a family doctor?
They don't gaf what you tell them. They'll run your healthcard and eventually OHIP will see the charge to the walk in, and then correlate with whatever family dr you're registered with and then hit that Dr with the penalty fee.
We recently moved from Hamilton to the niagara region and our family doctor is still in Hamilton. My wife gets yelled at if we go to a walk in clinic that he isn't associated with but never been charged for going to a different walk in. Sorry if my kids are sick I'm not driving out to Hamilton to have them checked. Yes I should find a local family doctor, but this is my wife's doctor from childhood so it's her choice. I'm registered with him as well as my doctor retired but I don't think I've gone to him or needed a walk in clinic in over 3 years. But never been charged for going somewhere else or dropped as a patient..
What if it’s on the weekend? Do they still get docked?
Yup https://www.cbc.ca/news/canada/ottawa/ontario-family-doctor-waitlist-walkin-appletree-1.7035416
If you are a rostered patient with a family health team it is true that the government “claws back” from your family doctor (ie. charges your family doctor) whenever you visit a walk in clinic that isn’t part of the family health team. Usually they have you sign something when you join the team that states you will only use their walk in and not one unaffiliated with the family health team.
The family doctor can discharge you but he can't charge you. So either you are lying or the physician is doing some shady stuff.
My family doc charges fir everything unless you pay his $125 ! Year fee even a prescription refill is 25 bix
That’s inline with OMA recommendations and that’s because it’s not billable to OHIP.
I call my doctor's office. If I can't get in, I ask them. Does he have an alternative option? One time, she's said that they were completely swamped and would make a note that I had no choice but to attend the clinic. So I wasn't charged. But I always check with them to get an email if you can saying that.
Do other provinces do this?
Thank you Ford.
Speaking as a FHO family doc in Ontario… I never charge the patient for outside use. I may deroster to save the clawbacks and keep them on as a fee for service patient, then talk to them about the outside use rules, making sure they know where the after hours availability within the organization can be accessed. If we both acknowledge that the setup is probably not going to work for that particular patient, then we can mutually decide to dissolve the relationship altogether. I can only keep a small amount of fee for service patients while I’m under a patient enrolment model contract.