Signs are going up in Ottawa’s growing Findlay Creek community, promising something many residents are struggling to find, a family doctor. But this new option comes at a cost. “There needs to be some pressure alleviated on the current system and this is a phenomenal alternative for that,” said Evan Hawes, CEO of Hawes Health. Hawes Health is preparing to open three Ottawa locations in January, with plans to expand into pharmacies across Ontario and beyond. Patients would pay a $50 registration fee and $30 a month for access to family medicine. “On the monthly side, that’s going to cover everything. There’s no limit on how many times you can use it. There are no additional fees that come out of nowhere or per appointment. This is literally the cheapest possible that we could make, while providing your full traditional family medicine for people,” said Hawes. “We’re talking about hundreds of thousands that could be attached to primary care with this model.” The company says it has commitments from more than 100 American physicians. Once licensed in Ontario, Hawes says some would relocate to Canada, while others would continue living part-time in the United States, providing virtual care with support from nurse practitioners. “We do not bill OHIP and our services are not covered by OHIP which is why it is paid for,” Hawes said. “All of these doctors happen to be people working on the U.S. side that decided to stop treating Americans and treat Canadians instead and they took a pay cut to do so.” Ontario’s Ministry of Health says virtual appointments with doctors physically outside the province aren’t covered by OHIP. But the membership model is raising concerns about patients paying for access to primary care. “We should not be permitting the desperation of patients and the profit interest of these business-driven clinics to be reshaping our health care system,” said Kevin Skerrett, researcher with the Ottawa Health Coalition. The Ottawa Health Coalition has criticized the growing role of private health care, raising concerns about affordability and access for patients who cannot afford to pay. “That need for the care of a family doctor should not be an opportunity to diverge from the fundamental principles of our public health care system, which rests on access, universality and not having to pay for health care services,” said Skerrett. Ontario has rules prohibiting patients from being charged for OHIP-covered medical services and Hawes says as more doctors move to Canada, he wants to bring their services into the publicly funded system. “Our goal is if we can get these people to dip their toes in the water, some of these American doctors and see how great Canada is, that we can bring them here and not have them opt out of an OHIP model,” he said. The College of Physicians and Surgeons of Ontario (CPSO) say fully licensed doctors may provide virtual care to existing patients while temporarily outside the province, under certain conditions. But it remains unclear whether that extends to physicians living part-time in the United States and treating Ontario patients virtually. Under Ontario’s As of Right pathway, American physicians can begin practising while completing their registration requirements but must be physically present in Ontario when treating patients. As for those providing virtual care from the United States, Hawes says he wants the province to extend OHIP coverage to those appointments as well. “Unfortunately, the way that the system is right now, that is not covered, and it’s unfortunate,” said Hawes. “We would love to work with the government and say, ‘Look at what we’re doing. We have the capacity to take on 500,000 people just in Ontario. If you wanted to cover it, we would move in that direction in a heartbeat.’ Right now, there seems to be a consensus that we’re in this for the money.” In Ottawa alone, the company says its model could provide family medicine to as many as 10,000 residents. But Hawes says the proposal has faced backlash online, including hostility directed at some of the American physicians being recruited. He says he welcomes discussions with the Ontario government about making the services publicly funded. For now, patients would have to pay. And while the province has outlined its rules governing OHIP coverage, it has not confirmed whether Hawes Health’s specific membership model complies with those regulations.
