Wait times for IUDs expected to drop after province increases doctors' compensation

Doctors in B.C. who provide contraception care are breathing a sigh of relief after the province agreed to increase billable fees for IUD insertion in an effort to encourage more physicians to provide the service.

Wait times for women looking to get an appointment for IUD insertion spiked last year after the province announced free prescribed birth control.

The province started to cover the costs of some prescription contraceptives, including hormonal intrauterine devices, or IUDs, on April 1 of last year. 

The following month, Dr. Renee Hall, medical co-director at Willow Clinic in Vancouver, told CBC News that while doctors applauded the move to make prescribed birth control free, more funding was needed to meet demand because wait lists for IUDs were rising and there weren't enough physicians to meet calls for the service.

Hall said last week her clinic decided to close its wait list in December after it ballooned to more than 2,000 people. 

"We had 2,200 to 2,300 people [on the wait list] in mid-December and we just closed off the online bookings for now until we can work through all those folks," Hall said.

"Especially at a clinic like ours, we are using freezing all the time to help with pain management and we have more difficult IUD insertions, or people who've never had one before, and we had no ability to bill for that before."  

She said the fees doctors received before the province made its funding adjustments didn't cover the expenses for those procedures, and some doctors were paying out of pocket as a result. 

Fee changes began in December

The province told CBC News the contraceptive fee changes became effective Dec. 1, 2023. They include increases for IUD insertions that bump the fee to $55.22 from $46.79. Doctors can also now bill $25 for pain management.

Hall hopes the increased funding will help bring back doctors who used to provide the service and encourage new physicians to provide the service so more British Columbians can have access to IUD insertion in their community.

"It's definitely improved our ability, my ability as a medical director to hire more people who are interested in providing this sort of care," Hall said. 

She said the new fee structure has allowed her to hire four new doctors and her clinic is working hard to shorten the wait list for IUD appointments. She hopes the clinic will be able to book new patients by the spring.  

Doctors of B.C. (DoBC) is calling this an improvement and said it's a result of physician advocacy to support critical, front-line contraceptive care to patients. 

"Physicians and their organizations had been tirelessly advocating for improved fee-for-service compensation for contraceptive procedures, to ensure that the full range of options is accessible for patients across British Columbia," DoBC wrote online. 

In August, Zeenat Reynolds said she reached out to a few clinics across the Lower Mainland to make an appointment to have her IUD removed, but the soonest she could get an appointment was December. 

"I wanted my IUD out," Reynolds said. "[There were] many symptoms that I was having that I was attributing to the IUD ... it was making me a lot more anxious."

As a registered nurse, Reynolds said she understood the delays.

"I talked to my patients. I hear their stories about their wait times for certain things, but I didn't think getting something as simple as an IUD removal would take this long."

The province said in a statement it went through a consultation process with DoBC and B.C. Family Doctors (BCFD) to determine the appropriate changes needed to contraceptive fees. 

The Ministry of Health said it relies on the expertise of BCFD to advise on the gaps and appropriate response for effective fee changes.