Another family clinic in the capital region is to charge patients an annual membership fee for its services, provided by doctors who are not registered with the Public Medical Services Scheme. Beta Therapeutics in Royal Oak is accepting new patients starting Nov. 1, charging a monthly fee of $110 — based on an annual cost of $1,320 — for its “family medicine subscription.” Clinic manager Samantha Rocha said the clinic, on West Saanich Road, chose to charge fees “out of necessity,” adding that it is difficult to sustain a family medicine practice in Victoria, “where operating costs are prohibitive even for the most established clinics”. “We tried very hard to balance the needs of all parties involved,” he said. “We hope our model can provide access to comprehensive care for patients while building a sustainable practice for primary care providers with a greater focus on work-life balance.” The clinic, originally established in 2019, will begin with a family physician, Dr. Dan Cutfeet, who came to the West Coast from Ontario in 2010 and works in Alert Bay. Beta Therapeutics says patients will be attached to a nurse practitioner or family doctor in Victoria and will be entitled to 15-, 20- and 30-minute consultations, the ability to book appointments online and “all the standard services you would receive in a doctor’s office or intermediate clinic.” The clinic aims to see patients within a week of requests. Beta Therapeutics hopes the $110 per person per month is more affordable than the “concierge or executive medicine options out there,” Rocha said, adding that some people have told her they would budget for such a fee given the importance of the service. Physicians licensed by the College of Physicians and Surgeons of BC have a few billing options. They can enroll in the Medical Services Program and bill MSP directly for services to patients, or they can enroll but bill patients’ MSP rates directly, leaving patients the option of seeking reimbursement from the MSP. Physicians can also choose not to enroll in the MSP or opt out and bill patients directly. Generally, patients cannot seek reimbursement from the MSP for services provided by a physician who is not enrolled in the plan. Fewer than 0.1 percent of family doctors opt out of MSP, and while the Department of Health said it does not have much experience with this scenario, it says it is “not concerned that being removed from MSP is a risk to our public health care system currently”. The ministry said it expects all doctors to comply with the Canada Health Act and the Medicare Protection Act. “The Medical Services Commission is aware of the concerns regarding Beta Therapeutics’ charges and is following up as appropriate,” the department said in a statement. Beta Therapeutics’ move follows an announcement by Saanich physician Dr. Perpetua Nkechi Nwosu, of Perpetual Health Center on Shelbourne Street, that it will charge patients an annual fee of $1,500 — which will be waived for children of patients — starting Nov. 1. Some of Nwosu’s patients said they can’t or won’t pay the fee, while others say they will because they don’t want to lose their family doctor. Like Beta Therapeutics’ family doctor, Nwosu is deregistering from MSP. Premier John Horgan was asked on Wednesday at a media event in Langford about deregistration and GP billing. While he didn’t say anything specifically about doctors charging patients, Horgan said the province continues to work with the federal government to “reimagine health care so we can meet the challenges of an aging population, and that includes doctors.” “Of course, I’m concerned about the challenges we face in terms of delivering public health services in Canada, not just in British Columbia,” Horgan said. About one million people in B.C. who want a family doctor say they can’t find one, including about 100,000 in the South Island. Horgan said there were more doctors aged 70 and over in the South Island than anywhere else in the country. The province is working with Doctors of BC to recruit and retain family doctors, new ways to compensate doctors and plans to retain older doctors to mentor new ones, Horgan said. Doctors of BC and the province are in negotiations for a new Master Physician Agreement expected to be announced in late fall. Horgan said he is encouraged to see physicians working with the Department of Health to find solutions to overhead, education and retention challenges. Ottawa needs to work with the provinces on a human resources strategy, “because we can’t just keep poaching from other parts of the country,” he said. Last month, the province and Doctors of BC announced $118 million in temporary stabilization funding for family doctors in private practices and medical clinics to help with operating costs. Applications are open now and funding is available from October 1 to January 31, 2023, of approximately $25,000 per physician. Beta Therapeutics calls the interim funding a welcome first step in addressing the state of primary care in BC. “The reality is, however, that these funds do not bring about positive changes for patients who are not currently attached to a family doctor and have been for some time,” Rocha said. [email protected]
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