Difficult times ahead in health care

The time is coming when doctors will begin refusing to take older patients, primarily because of the fee system.

There is a significant challenge facing the health departments of every province.

The time is coming when doctors will begin refusing to take older patients, primarily because the fee system, for some doctors, discriminates against the elderly in many provinces.

Family doctors can be paid the same amount for the care of any patient, but elderly patients take up a lot more time as they have much more complex issues.

This particular issue is currently taking place in Ontario, while across the country, fewer new doctors are specializing in geriatric medicine.

This, despite the obvious aging changes in the population that will necessitate more medical support for the elderly.

In Canada, there are three options for payments to doctors.

The first is fee for service, which means that doctors can charge a set fee for services provided.

If this is the only payment method used, it creates a problem for governments that have no idea how much doctors will be charging to the system in any given period of time.

The second method is called capitation, in which doctors are paid a set fee each month for the patients they serve, regardless of the services provided for each patient. In other words, if a patient visits once a year or once a week, the doctor is paid the same amount for that patient.

Obviously, this method causes the most complications for a doctor whose practice may serve a large proportion of elderly people.

The third method is a straight salary, where doctors are paid to work a certain number of hours and to serve a certain number of patients. This fixes the cost of health care to a particular area, but creates problems when doctors act more as employees than as concerned professionals.  In essence, it limits the flexibility of health care by fixing hours and services.

Most provinces in Canada utilize a blended form of these payment methods to try and deal with different regional needs.

Rural doctors and urban doctors do not practice the same kind of medicine, nor do obstetricians or geriatric doctors.

But if we are going to ensure a high quality of medical care at all levels, we have to ensure that a formula for compensation is worked out that gives all doctors a fair compensation opportunity.

Without that, we risk losing our best doctors to other countries or we risk being in a position where some provinces are ‘have’ and some are ‘have not’ when it comes to services or quality of services.

Between the provincial governments and the doctors, a reasonable solution to this problem needs to be negotiated, and soon.

There are difficult times ahead in the health care business.

As the elderly population increases, there will be a natural rise in demands on the medical system and if we are going to attract enough people to employment in the medical sector, and work to ensure there are enough practitioners to serve all segments of the population that need service, then we have to put the right policies and pay schedules in place.

The worse-case scenario would be a growing elderly population combined with a shrinking number of doctors who either can, or will, serve that population.


Graham Hookey writes about education, and eldercare (ghookey@yahoo.com).

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Maple Ridge Return-It centre serves as pilot for new beverage recycling effort

Haney Bottle Depot will be part of a six-month trial where consumers don’t have to sort their cans

Foundation seeks to bring ‘meaningful’ art to Hammond

Asking Maple Ridge residents for suggestions on design and theme for two large community murals

Pitt Meadows one step closer to developing North Lougheed Study Area

City council endorsed the revised NLSA land use plan on Tuesday, July 7

Ride for cancer in Langley will take place Sunday, despite COVID-19

Annual fundraiser will be ‘really different,’ but classic cars are expected, organizer promises

B.C. identifies 20 new COVID-19 cases, travellers specified in count

Pandemic total 3,028 cases, 51 people from outside Canada

B.C. residents can go to the Royal BC Museum for half price this summer

Museum reopening in phases, COVID-19 measures in place

Filing deadline in RCMP sexual-harassment class-action extended due to COVID-19

Plaintiffs now have until January 2021 to submit claims for up to $222,000

Jamie Bacon pleads guilty to charge in Surrey Six case

The plea brings an end to a complex legal case that has spanned more than a decade

Hefty undeclared driver charges piling up, ICBC warns customers

Average extra penalty $2,971 after an at-fault accident

Survey, hotline launched amid probe into racist blood-alcohol guessing game at B.C. hospital

Mary Ellen Turpel-Lafond has been appointed to lead an investigation by Health Minister Adrian Dix

B.C. appeals judge’s decision to leave three clubhouses in Hells Angels hands

The province has filed two notices of appeal related to the B.C. Supreme Court decision

Conservation officers relocate Spirit bear known to roam northwestern B.C.

Bear roamed valley north of Terrace for many years

B.C. premier applauds call to decriminalize drug possession

Police shouldn’t struggle with health issues, Horgan says

Most Read