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Comment: If doctors can opt out, we have a two-tier system

Doctor plans to charge patients an annual $1,500 fee after dropping out of the Medical Services Plan.
Alex Briker's doctor is de-enrolling from the Medical Services Plan and charging patients an annual fee, which raises questions about Canada’s much-vaunted “universal” health care, he writes. THOMAS KIENZLE, THE ASSOCIATED PRESS

A commentary by a Saanich resident.

My wife and I, both super seniors (75 plus), were lucky to be accepted by Dr. Perpetua Nkechi Nwosu as her patients after the retirement of our family doctor.

During the past several weeks, we were astonished to read news reports about Dr. Nwosu, especially the latest, “Saanich doctor is not backing down,” from Aug. 31.

From this article we learned about Dr. Nwosu’s decision to de-enrol from the Medical Services Plan and start charging patients a $1,500 annual fee.

According to Dr. Nwosu: “The reason we have de-enrolled is to provide holistic care which episodic care does not encourage.”

We have not received any official letter from the office of Dr. Nwosu, but understandably we are concerned that if we do not agree to pay for the “holistic care” service that we are not looking for, and in our opinion is just a complement to the traditional medical treatments, we’ll join the one million B.C. residents who don’t have a family doctor.

Before making our decision we hope to get answers, from somebody in the Health Ministry, to the following questions:

• What are the exact implications for patients who are getting services from de-enrolled doctors (access to lab tests, referrals to specialists, writing prescriptions, etc.)?

• Can a specialist and/or surgeon de-enrol from MSP?

• Can the family doctor who is enrolled in MSP charge its patients for the additional holistic treatments?

• What is the conclusion/decision of the Medical Services Commision in regards to the Dr. Nwosu case? If Dr. Nwosu’s request for payment is legal, what was the need for the review by this commision?

• How many doctors who choose to de-enrol are required for the Health Ministry to realize that the integrity of the public care system is at risk?

The suggestion from the office of Dr. Nwosu that patients who choose not to pay will have an option “to register with a MSP-billing family practice, or go to a government funded urgent and primary care centre” is a mockery considering the situation with family doctors in Victoria.

Financial compensation for doctors should be resolved between the government and medical professionals, but using patients, especially seniors, as pawns in these debates/ negotiations is morally and ethically wrong.

And the last point: If de-enrolled family doctors are legal and they can charge patients any amount they choose, which was a big surprise to us, then we should stop pretending that we have a universal health care system in Canada and start admitting that we are moving to a two-tier system.

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