Ontario patients visiting emergency rooms out of fear of being booted by family doctor
It was a busy night in the emergency department of a hospital in London, Ont., and Jennefer Muir, a registered nurse of 16 years, was working the triage desk when a mother came in with an ear-infected child.
“I asked them why they didn't go to their family doctor, why they didn't go to a walk-in clinic and they stated that their family doctor was currently away … And they had been told in the past that if they go to a walk-in clinic or the urgent care centre, they'll be taken off the roster for their family doctor,” Muir said.
The wait was projected to be eight hours, but they stayed, Muir said. “Unfortunately, it happens all the time,” she added.
The mother is among a number of Ontario patients who are now visiting emergency departments out of fear of being de-rostered from their doctor’s office – a loophole that results in hospitals dealing with non-urgent cases, and disrupts continuity of care paramount to family medicine, according to health-care experts.
Ontario's Ministry of Health told CTV News a patient visiting an emergency room is not a ministry condition for de-enrollment from a physician’s roster. However, the ministry said, a physician may decide to de-enroll a patient if they receive care from more than one health care provider. For example, at a walk-in clinic.
“But that doesn't mean I'm firing them,” Dr. Allan Grill, Chief of Family Medicine at Markham Stouffville Hospital, said, explaining how the enrollment system at his clinic works, in which doctors are paid per patient, regardless of how many times they visit.
“It just means I'm putting them in a different category so that my office doesn't lose the funding we're getting from the government to take care of that roster of patients,” Dr. Grill added.
That separate category is a fee-for-service model, which means his patients can still book an appointment at his office, he just gets paid by the province each time he provides a service to a patient.
However, dozens of people who reached out to CTV News said their doctors threatened to entirely drop them as patients if they received care elsewhere.
To get around this issue, some have visited the emergency room to receive care without running the risk of losing a coveted spot on a physician’s list. Muir said the confusion around the issue “floods the emergency department with non-urgent cases that could have been seen elsewhere.”
Daily, patients come in with urinary tract infections, sniffles, sore throats and fevers, Muir said. “They do need treatment but they don't necessarily need treatment in the emergency department.”
Karin Bowyer, 62, sought care in the emergency room a couple years ago, dehydrated with non-stop nausea after contracting long COVID-19.
Peterborough resident Karin Bowyer, 62, said she has gone to the emergency room instead of a walk-in clinic to avoid getting de-rostered. “If I can't get in to see my doctor, I can't go to a walk-in clinic as she will drop me,” Bowyer said about her family doctor in Brighton, an hour drive from her home in Peterborough. “So, I have to go to the emergency room at the hospital and use resources that take away from people urgently needing care.”
Since then, she’s suffered chronic back pain tied to arthritis and hasn’t had bloodwork done. “If I do have any health concerns, I just tend to ignore them,” Bowyer said.
The College of Physicians and Surgeons of Ontario (CPSO), responsible for the professional conduct of doctors practicing in Ontario, mandates a doctor only end their relationship with a patient if reasonable efforts have been made to resolve a given situation in the best interest of the patient.
Part of halting patients with non-urgent issues from going to the emergency room involves physician-to-patient conversations clarifying the rules and expectations of a family practice, Dr. Grill said.
“I wouldn't want my patient to go to an emergency room for a type of care that they can get from my office because there's some sort of worry about being de-rostered. That is not the message we want to send in family medicine.”
CTVNews.ca Top Stories
Your father’s diet before you were born could have affected your health, a new study suggests
Your father's diet before you were born could have played a role in your health, a new study has found.
Ottawa Food Bank receives largest donation in its 40-year history
210,000 pounds of food was delivered to the Ottawa Food Bank on Saturday, the largest donation in its 40-year history.
Singh 'more alarmed' after reading report, but won't break from Liberal-NDP agreement
Federal NDP Leader Jagmeet Singh says he is 'even more alarmed than before' after reading the un-redacted report alleging there are MPs and senators who are participating to some degree in foreign interference efforts.
Joe Alwyn says breakup with Taylor Swift was 'a hard thing to navigate'
Joe Alwyn is speaking publicly for the first time about the end of his years-long relationship with Taylor Swift.
Clooney and Roberts help Biden raise US$30 million-plus at a star-studded Hollywood gala
Some of Hollywood's brightest stars headlined a fundraiser for U.S. President Joe Biden that took in a record US$30 million-plus for a Democratic candidate, according to his campaign, in hopes of energizing would-be supporters for a White House contest they said may rank among the most consequential in U.S. history.
Prince William shares childhood photo of him and King Charles III for Father's Day
Prince William on Sunday shared a photograph showing him as a child with his father, King Charles III, to mark Father’s Day in the United Kingdom this year.
Global study ranks two Canadian cities high on list of most expensive places to buy a home
As Canadians continue to struggle with the extremely high cost of buying a home in some of the country’s major urban centres, a new global report is underscoring just how expensive some of those markets are.
'We're in pretty good shape': Calgary goes low in water consumption after state of local emergency declared
On a day that a local state of emergency was declared in Calgary, city residents answered a request from the mayor and emergency officials to use less water.
A new tax filing system could give Canadians more than $1 billion in unclaimed benefits: PBO
Canadians would get more than $1 billion in unclaimed benefits each year through an automatic tax filing system, according to a report published by the Parliamentary Budget Officer (PBO).