Ontario patients choose emergency departments over walk-in clinics to avoid being ‘fired’ by family doctors

Some Ontario patients who have family doctors are using emergency departments for non-urgent care services in order to avoid being taken off their doctor’s patient roster. If a patient’s physician is a member of a family health team in Ontario, and the patient visits another primary care physician, such as in a walk-in clinic, the family health team will get a deduction from a potential bonus payment. That payment accounts for 10 percent of a physician’s compensation. A physician may choose to take the patient off their patient roster if they visit another primary healthcare provider, Ontario’s ministry of health told CTV News. Visiting an emergency department is not a condition to be taken off a roster, and this may be why patients are choosing the emergency department over a walk-in clinic when they need care and their physician isn’t available. Patients may misunderstand that being taken off the roster doesn’t always mean they no longer have a doctor. It just means that a physician may get paid a different way. The physician won’t be remunerated through the patient being on the roster, but through a fee-for-service model. “It just means I’m putting them in a different category so that my office doesn’t lose the funding we're getting from the government to take care of that roster of patients,” Dr. Allan Grill, chief of family medicine at Markham Stouffville Hospital explained to CTV News.Earlier in May, almost 100 people responded to a callout by CTV News for personal experiences about getting taken off a physician’s patient roster. Many of the respondents said they didn’t know the consequences of visiting another primary care provider until after they were dropped as patients by their family physician. Others said they were concerned about being de-rostered. Some reported that they visited a walk-in clinic after the wait time for an appointment with their family doctor was too long.The fear of being de-rostered means patients are visiting emergency department with urinary tract infections, runny noses, sore throats and fevers. “They do need treatment but they don't necessarily need treatment in the emergency department,” said Jennefer Muir, a registered nurse in a London, Ont. emergency department. The situation “floods the emergency department with non-urgent cases that could have been seen elsewhere.”Dr. Grill said a solution to the confusion and concern over de-rostering is to have conversations with patients about the rules and expectations of a family practice. Read: Perspectives on Ontario healthcare from a recent graduate

Ontario patients choose emergency departments over walk-in clinics to avoid being ‘fired’ by family doctors

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