Get rid of daily patient cap, says B.C. walk-in clinic founder
CBC News | Posted: January 20, 2017 10:08 PM | Last Updated: January 21, 2017
Walk-in clinics closing early because of the province's daily cap on patients, says Mike McLoughlin
Critics are wondering whether B.C.'s walk-in clinic system needs an overhaul after some British Columbians hit by the flu or winter vomiting bug have been turned away by clinics closing early.
Mike McLoughlin, the founding director of the Walk-In Clinics of B.C. Association, told CBC's The Early Edition walk-in clinics are closing early during flu season because of the province's cap on the number of patients doctors can get paid for in a day.
Doctors get paid per patient until they've reached 50 patients in a day, McLoughlin explained. After that, they get 50 per cent of the billing till 65 patients. After they've seen 65 patients, they don't get paid at all.
"They can't afford to stay open if they're only getting paid half or not at all for the services they're providing," McLoughlin explained.
"You'll see a lot of clinics will have a sign posted on their doors saying exactly that, saying we may have to close early if we reach our cap."
McLoughlin said the daily cap makes it especially difficult for patients to get care during busy times when demand is high.
"Sometimes, people go from clinic to clinic to clinic and spend the whole day looking for a clinic that's going to be open and then they end up in emergency," he said. "It just makes it a lot more difficult for patients to get access to the care that they need.
Attempt to increase quality of care
A spokesperson for B.C.'s Ministry of Health said the policy was adopted to make sure doctors have the time they need with patients to make a correct diagnosis and maintain sufficient patient records.
"Allowing doctors to have this time is important for ensuring patient care and safety," the spokesperson told CBC News.
But McLoughlin disputed the idea that limiting the number of patients doctors would ensure better quality of care.
"What ensures quality of care is that [doctors] are properly trained, properly regulated and they're professionals and they practice according to a set of ethical and professional standards," he said.
"[The province] could limit it on a weekly or monthly basis and that would address the concerns about doctors that are high billers, rather than forcing the issue onto a daily basis."
Overhaul the system completely: expert
One expert, however, says the problem isn't the cap but the entire volume-driven fee-for-service health care system.
John Calvert, an associate professor in the Faculty of Health Sciences at Simon Fraser University, said doctors are forced to rely on more patient visits to increase revenue.
"The result is we see arguably more treatments than we ought to be seeing and we're not seeing the resources we do have used in the system as effectively as possible." ," he said.
Calvert said B.C. should consider options like creating a salary-based option for interested physicians or creating more multi-disciplinary clinics that employ other professionals like nurse practitioners.
With files from The Early Edition
To listen to the interview, click on the links labelled Doctor protests walk-in clinic patient cap and Thinking of new ways to deliver B.C. healthcare
Corrections:- An earlier version of this story said Mike McLoughlin was a doctor. He is the founding director of the Walk-In Clinics of B.C. Association but he is not a doctor. January 21, 2017 2:39 AM