This is either a "Teach Me About..." or a "Things They Should Invent", depending on how accurate my current understanding is.
My understanding is that (in Ontario, at least) primary care physicians are only compensated for the thing you make the appointment for, which is why you're only supposed to bring up one issue per appointment.
Is this understanding correct?
If this is correct, I wonder if the medical system could be improved by allowing doctors to bill for whatever they actually end up doing. This occurs to me because of a recent experience with my dentist. I was in for a check-up and cleaning, and it was discovered that I needed a filling. So they did the filling too, then and there, without having to make another appointment. It would be convenient if doctors could do this too. Would billing for everything they end up doing make this happen?
If I'm misunderstanding how doctors are compensated and they do bill for actual work done, why are you only supposed to bring up one issue per appointment? The idea of one issue per appointment is culturally pervasive enough that there must be more of a reason than simply because there are people waiting in line after you.
7 comments:
Umm... I'm actually really surprised by this whole post. I 've never hear dof the this "one issue per appointment" idea, and always bring my laundry list of things I want to bring up when I see my doctor.
It's clearly something you got form somewhere, but as far as I know, it's certianly not how doctor's billings work - they keep records of what they actually do for you, (i.e. number pof prescriptions written, tests performed, etc.) and I 'm fairly confident that's how they get paid. Although ultimately, I think these are just assumptions I'm making and are no more likely to be valid than the conclusions you've come to based on your own experiences.
...It may be that when you're making your appointment, they like to know what it's specifically for so they can more accurately determine how mcuh time you'll need and schedule your appointment accordingly?
My family doctor used to have a one-issue-per-appointment rule, and I understood that she could only bill OHIP for one issue at a time.
However, she moved her practice, joined a different medical group, and now has no such rule. In fact, she freely encourages me to group issues together in one appointment.
Similarly, in her old practice didn't give prescription refills to the pharmacy. You had to make an appointment and go in just for a refill. They said that was because the doctors weren't compensated for the refill service. But the current medical centre allows the pharmacy to fax in a request, and they handle the refill.
I don't know what changed.
"...It may be that when you're making your appointment, they like to know what it's specifically for so they can more accurately determine how mcuh time you'll need and schedule your appointment accordingly?"
In the old practice, there were actually signs at reception and in every exam room, telling you one issue only, and if you had a second issue, you needed to make a separate appointment. It was very inconvenient.
I have been able to get more than one thing done in an appointment (for example, I was in to get my birth control renewed, and the doctor also gave me a vaccine that I was overdue for), but I'm not under the impression that you can go in expecting it. It's like how sometimes if you're buying something in cash and you're owed 24 cents in change but the cashier is low on pennies, they'll just give you a quarter. But it would be a bit assholic to outright expect them to give you more change than you're owed.
Right, so we have three different models here. So how are family doctors compensated?
There is a fair amount of googleable information, but I'm not smart enough to understand it.
I just saw this. Not sure if it will help or make things worse.
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