Some private clinics to close after accessory fees nixed

CTV Montreal: Some private clinics closing after fees nixed At least three private clinics that perform thousands of colonoscopies and gastroscopies in Montreal every year are closing.

At least three private clinics performing thousands of colonoscopies and gastroscopies every year in Montreal are planning to close, CTV Montreal has learned.

Doctors say the closures are due to Quebec’s health minister no longer allowing them to charge accessory fees.

Upwards of 15,000 patients every year choose to go to private clinics in the Montreal region. The government pays the doctor about $160 to perform the procedure and patients are charged $500-600 for other expenses.

“The government does not pay for the nurses, the government does not pay for equipment or repairs which is very expensive to do,” said Dr. Barry Stein, a colorectal cancer surgeon who works at the MUHC four days a week.

On Fridays, he works at MD Specialists, a private clinic in Westmount where doctors from several different hospitals work part-time.

Patients who go to the private clinic are worried about wait times in the public system, said Stein.

“We diagnose a lot of serious illnesses here – colitis and cancer and polyps – which if left untreated go on to become cancer,” he said.

Stein said the private clinic's last day is Dec. 10.

“We're going to close,” he said.

Quebec Health Minister Gaetan Barrette decided that sometime next year, doctors will no longer be able to charge patients accessory fees for health services that are publicly funded, like colonoscopies and gastroscopies.

“I feel terrible about it because I don't know where the thousands of patients that we treat here, the prevention that we do, the early diagnosis that we do, where are those people going to go?” said Stein.

The parallel private system is controversial in Quebec.Some say it creates a two-tier system, but Dr. Josee Parent,president of the Quebec Association of Gastroenterologists, said it exists for a reason.

“The private system only develops if there's a wait time in the public system. When there's no wait time in the public system there are no private clinics, so private clinics elsewhere in the province closed because there were no longer delays in those areas. Montreal is the problem area,” said Parent.

CTV has confirmed at least two other clinics also plan to close:Endovision in the Cotes-des-Neiges area and Clinique 1037 near UQAM, where CHUM chief of gastroenterology Dr. Anand Sahai works part-time.

“I believe that there are a minimum of 500-1000 patients (at CHUM) who are waiting for endoscopies, with a delay that surpasses established guidelines. If our clinics close, I do not see how the public system can accept the overload in the Montreal region. This will seriously lead to people unnecessarily presenting with advanced cancers or pre-cancerous lesions,” said Sahai.

Parent agreed.

“Our concern is that we already have some unacceptable delays in the public system. If we add those patients we think the delays will get even longer,” she said.

At the MUHC, one fully equipped endoscopy room is not used at all.

The MUHC said it is not in their plan to open the room, given their current budget situation.

Barrette would not say how the ministry will solve the problem of longer waiting lists for endoscopies should the private system collapse.

“We will address the situation when the time will come,” said Barrette.

When asked if the hospitals will be able to handle the influx of patients, he said: “I am sure we can take that over, there's no doubt in my mind.”

Stein said he hopes Barrette finds a solution.

“In the optimal system, I would say that all the physicians who work here would be very happy if the hospital had resources in order to meet the requirements of the population,” he said.

In the meantime, Stein, a 25-year medical expert, is calling around to various hospitals to see if they have any time available for him on Fridays after Dec. 11. He said he wants to work and has had no luck so far.