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Some doctors are charging both government and patients privately in illegal double-dipping practice

Posted: June 15, 2017

THE GLOBE AND MAIL (INCLUDES CORRECTION)LAST UPDATED:

Regulators are doing little to stop doctor-owned clinics from quietly making desperate patients open their wallets to bypass long lines for everything from simple appointments to major surgery. Kathy Tomlinson reports

Rosalia Guthrie is still astounded that it cost her $4,350 to get her shoulder injury assessed by a surgeon who works in Canada’s public health-care system.

She had been waiting in agony for 16 months to see Dr. William Regan when she called his office, asking how much longer it would be. His secretary gave her the number of another clinic to call – so she did. That’s when Ms. Guthrie learned there was another way in to see the surgeon – with no lineup.

But it would cost her. “The woman there called me back … and gave me three [appointment] times … right away,” says Ms. Guthrie, 67, of Salmon Arm, B.C., who was told that she had reached Dr. Regan’s other, private clinic. “Then she said, ‘You have to pay.’”

Ms. Guthrie is among 47 patients whose cases The Globe and Mail looked at as part of an investigation into the extent of unlawful extra-billing by Canadian doctors, who work on both sides of the health-care fence, in public facilities and private clinics.

In theory, doctors who bill the public health-care system aren’t allowed to charge patients a cent to get necessary medical treatment. It’s illegal. If they do, Ottawa and the provinces are supposed to stop them.

The Globe found the reality to be quite different. As health-care costs and wait lists grow, regulators are doing little to stop doctor-owned clinics from quietly and increasingly making patients pay for quicker access – for everything from appointments to surgery. Patients and doctors on all sides of the health-care debate agree on one thing: This is happening in part because the system is in what many call a “mess,” where some people suffering in pain aren’t seen and treated quickly in public facilities.

Enter the private clinics, whose numbers have crept up in the last decade or so. The Globe compiled data on 71 of them, across the country, almost all owned by physicians. Those clinics sell what some call “private options,” for which most of them charge patients hundreds, even thousands, of dollars. The data show that at least 63 per cent of 699 doctors listed as owning or working at those 71 private-pay facilities also work in the public system – an indication the rules against extra-billing are widely ignored.

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