With overhead costs rising and
patients' demands for uninsured services growing, some
doctors are realizing that charging 'block fees' can
help them get paid for all their time.
In Calgary, for instance, the economy
is booming yet many of the city's FPs are closing their
practices, says Dr Linda Slocombe, president of the
Calgary and Area Physician's Association. "The overhead
costs have become too much with high rent prices."
To cover costs, many are turning
to directly charging patients annual block fees for
uninsured services like filling out forms and doing
telephone or email consults.
This practice, however, has caught
docs some flak throughout the country from patients
who consider it a money grab. With a solid understanding
of the rules, doctors can calm their patient's fears
while getting their due — as much as $20,000 a
year extra for some family practices, by some estimates.
FOLLOW
THE RULES
A spate of block fee violations over the past few months
has drawn the public's ire. In April, the College of
Physicians and Surgeons of BC ordered one clinic to
stop promising fee-paying patients shorter wait times,
reported the Vancouver Sun. Some doctors and clinic
managers have threatened to kick patients out of their
practices if they don't cough up the dough. One, Dr
Thomas J Barnard of Leamington, ON, had his licence
suspended two months and was hit with a $2,500 fine.
Those offences can be avoided,
however. Guidelines for billing patients are simple,
and similar across the country. Doctors can set their
own block fee rates, but must offer their patients the
option to pay piecemeal. Patients must be told how much
each service costs individually and be given a list
of services covered by the annual fee. Doctors cannot
charge for priority booking and cannot turn away a patient
who doesn't want to pay.
PAY
POTENTIAL
Despite the straightforward rules and the promise of
thousands of dollars, block fees aren't employed by
FPs very often. Dr Ed Schollenberg, registrar of the
College of Physicians and Surgeons of New Brunswick,
says the college brought out guidelines for block fees
back in 1999. "We thought it was a likely thing that
people would do," he says. But it hasn't caught on there.
Many physicians across the country
have made effective use of block fees, however. Dr Timothy
Foggin of Burnaby, BC, found a new way to use annual
fees. Recently he began using the CMA's latest web invention,
mydoctor.ca, a tool that enables MDs to answer their
patients' questions and monitor various conditions online.
Because provincial billing schedules still haven't been
tailored to factor in emerging technologies like mydoctor.ca,
Dr Foggin decided this is exactly what block fees were
designed for. He began giving patients who choose online
consults the option of paying $25 for each virtual visit
or a $40 to $100 a block fee for multiple consults.
His experiment looks promising: he already has about
30 patients paying his block fees and, in early June,
he sent out 600 letters to ask others if they'd be interested.
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PATIENTS & PRACTICE
