# Finding a family doctor (GP)



## Money172375 (Jun 29, 2018)

Is the doctor crisis nationwide? Or just an Ontario problem. Ours is retiring so know we’re on the (what will be a painful) search.

we can’t even use the nearby walk-in clinic once our family doctor retires since you need to be assigned to a doctor.

it‘s quite disappointing that in Canada, we can’t easily find a GP. We’re minutes from. City of 30,000 and 90 mins from the GTA.


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## cainvest (May 1, 2013)

Money172375 said:


> we can’t even use the nearby walk-in clinic once our family doctor retires since you need to be assigned to a doctor.


Is that an Ontario thing? Seems weird you can't use a walk-in ...


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## Money172375 (Jun 29, 2018)

cainvest said:


> Is that an Ontario thing? Seems weird you can't use a walk-in ...


Not all of Ontario. At my previous home, you could use any walk in clinic in the city. Where I am now, you need to be assigned to a local family doctor to use an after hours clinic. So weird.


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## AltaRed (Jun 8, 2009)

I think the doctor shortage is everywhere. Certainly very much a shortage in BC.

Fortunately, we were able to latch on to a new immigrant in 2012 by watching the media and finding out a certain clinic would be taking on a new doctor shortly and we could put in an expression of interest. We went through the interview process and we mutually agreed on us being patients. It is also thankful our doc is at least 30 years our junior. We have a chance of possibly holding on to him until we go out boots first.


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## cainvest (May 1, 2013)

Money172375 said:


> Not all of Ontario. At my previous home, you could use any walk in clinic in the city. Where I am now, you need to be assigned to a local family doctor to use an after hours clinic. So weird.


Wow, that is messed up.


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## m3s (Apr 3, 2010)

Money172375 said:


> Is the doctor crisis nationwide? Or just an Ontario problem. Ours is retiring so know we’re on the (what will be a painful) search.
> 
> we can’t even use the nearby walk-in clinic once our family doctor retires since you need to be assigned to a doctor.
> 
> it‘s quite disappointing that in Canada, we can’t easily find a GP. We’re minutes from. City of 30,000 and 90 mins from the GTA.


Veterans leaving the Canadian military for medical reasons are waiting years for a family doctor

Oh but they still have to pay OHIP and high taxes for this "free" non-existent healthcare

It's an absolute disgrace


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## Mechanic (Oct 29, 2013)

It's a big problem here in BC. We have many friends without doctors, where Dr has retired and no replacement. Some have found a NP but still many without. We currently have one ourselves, as we got lucky and a friend asked his Dr if he would take us on when we moved here about 6 years ago. A brief interview and the Dr agreed to take us on. Problem looming now is he is fast approaching retirement too. I don't think the healthcare system is lucrative enough in Canada to attract new doctors, too much administration on the doctors part for not enough reward ?


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## james4beach (Nov 15, 2012)

After how society mistreated and disrespected doctors during the pandemic, don't be surprised to see huge numbers of them (and nurses) retire and leave forever.

Among my doc friends, I personally know two front line doctors in their 30s who are already planning on leaving the profession. Burned out and not supported by government when they needed the most help.

In some parts of Canada, the provincial governments outright ignored the pleas and advice of doctors.


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## m3s (Apr 3, 2010)

james4beach said:


> After how society mistreated and disrespected doctors during the pandemic, don't be surprised to see huge numbers of them (and nurses) retire and leave forever.
> 
> Among my doc friends, I personally know two front line doctors in their 30s who are already planning on leaving the profession. Burned out and not supported by government when they needed the most help.


The great resignation in underway

There's several known crisis on the horizon that hasn't hit mainstream awareness yet

Lots of wealth is leaving Canada and lots of countries are welcoming them in


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## Beaver101 (Nov 14, 2011)

james4beach said:


> After how society mistreated and disrespected doctors during the pandemic, don't be surprised to see huge numbers of them (and nurses) retire and leave forever.
> 
> Among my doc friends, I personally know two front line doctors in their 30s who are already planning on leaving the profession. Burned out and not supported by government when they needed the most help.
> 
> In some parts of Canada, the provincial governments outright ignored the pleas and advice of doctors.


 ... the young folks don't need doctors when they got their social medias on their iphone to self-diagnose, self-exam, self-medicate, as well as influence others if not self ... I digress.

Well, well, well, before the ink on my post here has tried - see post #4161 in the "Politics" thread as a perfect example.


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## like_to_retire (Oct 9, 2016)

Money172375 said:


> Ours is retiring so know we’re on the (what will be a painful) search.


I believe there are about 1.3 million people in Ontario that don't have a family doctor. My doctor retired last year and I spent months and months wasting my time looking and phoning to get a new doctor at all the clinics. Quite a discouraging job. Every single one of them says they are not accepting new patients and do not have a waiting list. They all said I have to register with Ontario Health Care Connect.

I eventually gave up my search and registered with Health Care Connect. The reason, it seems to me, that clinics pass all requests to Health Care Connect is that there are kickbacks if they participate. From the Health Care Professionals site it says: "_New fees and fee enhancements are available to family physicians participating in a primary care physician enrollment model who accept patients through this program._". Of course they will participate......

This government service is suppose to put you in touch with a doctor or nurse practitioner. The trouble is that the lists are long. The list, a number of years ago in my city, was around 30K, but I understand that these Health Care Connect lists have doubled in most cities, so there are probably 60,000 people ahead of me who want a doctor. They do say the lists are also based on merit, so maybe my age might buy me a few positions. Who knows, I'll probably be dead by the time I work my way up to the top.

The situation means I've had to go to the walk in clinic to get anything taken care of. It opens at 9AM, but people start showing up at 7:30AM, and they start taking names on first come, first served basis. The line isn't filled with people waiting to get an annual checkup like in your doctor's office - these people are all sick. It's been fun going there during COVID - I've had to go twice. It's interesting how many more people show up at 9AM (the actual opening time) and get to the registration desk and they're told the wait time is around 6 hours now and they should try the emergency ward instead. It's an education to arrive real early for their next visit.

It's concerning for me at 72 years old that I won't be getting annual checkups like my GP use to do. That's not what walk in clinics are for. They're there if you can't wait for an appointment with your family doctor. So no more regular screenings of any kind for me unfortunately. The emergency wards will be getting many more people presenting with undiagnosed conditions because the people have no primary care to catch the problems early.

The solution is easy. What seems revealing to me is that I can drive around town and on practically every block I see a Dental office sign that boldly advertises that they're "accepting new patients". No problem finding a dentist. I can call my dentist and get an appointment any time and if I don't like that dentist I can go down the block and get a new one. I think it's pretty obvious that the difference between the number of dentists and the number of doctors has to do with private care versus public. There has to be some compromise between those two systems to undo this problem. I've heard some people recommend co-pay systems that work well in other countries. But we shouldn't get too comfortable with how easy it is to get a dentist today, because the NDP and Liberals are conspiring to bring that all to an end.

ltr


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## Money172375 (Jun 29, 2018)

like_to_retire said:


> I believe there are about 1.3 million people in Ontario that don't have a family doctor. My doctor retired last year and I spent months and months wasting my time looking and phoning to get a new doctor at all the clinics. Quite a discouraging job. Every single one of them says they are not accepting new patients and do not have a waiting list. They all said I have to register with Ontario Health Care Connect.
> 
> I eventually gave up my search and registered with Health Care Connect. The reason, it seems to me, that clinics pass all requests to Health Care Connect is that there are kickbacks if they participate. From the Health Care Professionals site it says: "_New fees and fee enhancements are available to family physicians participating in a primary care physician enrollment model who accept patients through this program._". Of course they will participate......
> 
> ...


Simply getting access to a walk in clinic in my area would be awesome. They all require you to be an existing Patient of a local GP. The only other option is virtual doctors such as through Good Doctors. Good Doctors Clinics - Good Doctors Medical Clinics


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## m3s (Apr 3, 2010)

like_to_retire said:


> The solution is easy. What seems revealing to me is that I can drive around town and on practically every block I see a Dental office sign that boldly advertises that they're "accepting new patients". No problem finding a dentist. I can call my dentist and get an appointment any time and if I don't like that dentist I can go down the block and get a new one. I think it's pretty obvious that the difference between the number of dentists and the number of doctors has to do with private care versus public. There has to be some compromise between those two systems to undo this problem. I've heard some people recommend co-pay systems that work well in other countries. But we shouldn't get too comfortable with how easy it is to get a dentist today, because the NDP and Liberals are conspiring to bring that all to an end.


Private vs public

You can also just take a vacation to a sunny warm country for your annual medical checkup. Personally I'll save the taxes and move elsewhere because this situation will only get worse

Why even pay for OHIP at this point


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## Money172375 (Jun 29, 2018)

Wonder what that billion dollars from the Ontario license stickers would do to help?


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## Spudd (Oct 11, 2011)

I live in a small town in Ontario. I signed up for Health Care Connect when we moved here and it took about a year and a half for them to assign me a doctor. Simultaneously, I signed up for a waiting list at a local clinic and that took about a year to get through. I have a nurse practitioner instead of a doctor now, because I opted for the local clinic. She seems good, but I am mildly concerned she might be less knowledgeable than a doctor.


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## Ukrainiandude (Aug 25, 2020)

*6M Canadians don't have a family doctor, a third of them have been looking for over a year: report








6M Canadians don't have a family doctor, a third of them have been looking for over a year: report


More than a third of Canadians who don’t have a family doctor say they have been searching for one for more than a year, all while their health is declining compared to those with easy family doctor access, new research shows.




www.ctvnews.ca




*


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## Ukrainiandude (Aug 25, 2020)

Government brings in almost half a million of immigrants every year plus issuing 7 million temporary residency permits.
I lived in Canada for over ten years and still don’t have family doctor.
the only solution is to suspend immigration (except heal care professionals) until this problem is resolved.


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## MrBlackhill (Jun 10, 2020)

I wonder if they look only at those on the waiting list or also those who simply don't have a family doctor.

For instance, it's been about 15 years that I don't have a family doctor, but I also didn't add my name on any waiting list.

Maybe my baby's doctor will become our family doctor.


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## Gator13 (Jan 5, 2020)

Walk in and family doctor is attainable in the GTA where I live. I can see my doctor in person or virtually within a couple days max. I believe New Brunswick is the worst in Canada.


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## Eclectic21 (Jun 25, 2021)

Money172375 said:


> Is the doctor crisis nationwide? Or just an Ontario problem. Ours is retiring so know we’re on the (what will be a painful) search ...


I expect pretty close to nation wide. An article from this year listed Quebec as having the most without a doctor then BC. Something like one in ten in Nova Scotia have the same problem.




Money172375 said:


> ... we can’t even use the nearby walk-in clinic once our family doctor retires since you need to be assigned to a doctor.


Odd ... I've never had to have a family doctor to use a walk-in clinic. I've had one of the doctors of the clinic listed as my doctor for getting lab reports etc. but have not been turned away from a clinic when I did not have one.


Cheers


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## Farouk (8 mo ago)

In 2015 Ontario government cut the hospital and OHIP budget by* one billion dollars each to balance the budget*. This was a 7% cut in my speciality fees. I retired in 2017. I have not followed the subsequent fee increases but they have all been below the rate of inflation.

Google search
*The Ministry of Health will temporarily increase physician payments by 2.01% for the period April 1, 2022 to March 31, 2023.Apr 3, 2022 *


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## MrsPartridge (May 15, 2016)

Jagmeet Singh thinks the government should pay for dental. The dentists will refuse just like in the 1960s when OHIP came about. They don't want the govt to set their rates. Looking at the rates the doctors get for procedures like an annual exam - $52. This is insulting and the dentists will have no part of it.
Healthcare isn't as cheap as in the 1960s. Today we have MRIs, CAT scans, robotic surgery etc. So with an aging population and very expensive medical procedures, the Public Healthcare system is under a lot of strain. We need to consider 2 tier healthcare to take some of the load off.

Ohip won't pay for many tests after age 70. No more mammograms etc. because they figure the citizen got to an average lifespan and isn't worth the money.


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## Retired Peasant (Apr 22, 2013)

I haven't had a family doctor since 1996; gave up years ago trying to find one. I had been using walk-in clinics when necessary, however as noted upthread, many/most of these have changed from orphaned patient clinics to after hours clinics for those with a FD. It is strange, as it leaves the orphaned patients with no choice, but to clog up emergency rooms.


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## Beaver101 (Nov 14, 2011)

Gator13 said:


> Walk in and family doctor is attainable in the GTA where I live. I can see my doctor in person or virtually within a couple days max. I believe New Brunswick is the worst in Canada.


 ... family physicians are good for getting annual flu shots, re-fill rxs, checking on a cold (not the flu or Covid!), and or something that can "wait" like "days". O/w it's the hospital / ER that get looked at and "done."


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## AltaRed (Jun 8, 2009)

A bit off-tangent, but this must be becoming a factor in physical relocation decisions, both self-initiated and corporate moves. Why would anyone (other than perhaps a young single/couple with immortality) with a working family doctor relationship move more than 100km away and end up in the 'health wilderness'? This issue does not get any, or minimal, press the best I can tell. 

Spouse and I got lucky 10 years ago in finding a new doctor in our new location but must say we had not given it a significant amount of thought back then. We would give it far more thought today, also being 10 years older in our 70s now, and given our increasing use of specialty services in the health system for which we need referrals from our GP for. I think we are pretty much stuck physically now where we are.


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## Beaver101 (Nov 14, 2011)

^ Because somebod(ies) on this forum says so? 

Hmmm... let me pick which country allow my COLA go down for a few dollars (CDN of course) a day? Mexico? India? Thailand? All warmy over there too.


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## Eclectic21 (Jun 25, 2021)

Gator13 said:


> Walk in and family doctor is attainable in the GTA where I live. I can see my doctor in person or virtually within a couple days max ...


Sounds the same as the late '90's when I was able to get a family doctor in Etobicoke that I couldn't get in Kitchener-Waterloo.




Beaver101 said:


> ... family physicians are good for getting annual flu shots, re-fill rxs, checking on a cold (not the flu or Covid!), and or something that can "wait" like "days". O/w it's the hospital / ER that get looked at and "done."


When I went to the ER, they were great about making sure it wasn't a pressing matter. Since it wasn't with a longer term follow up required - the ER doctor sent me back to the family doctor to access specialists.

I don't know if it's changed but in the past, using a walk-in clinic that set one of their doctors as my family doctor was enough to be able to access specialists.


Cheers


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## Beaver101 (Nov 14, 2011)

Eclectic21 said:


> ...
> 
> *When I went to the ER, they were great about making sure it wasn't a pressing matter.* Since it wasn't with a longer term follow up required - the ER doctor sent me back to the family doctor to access specialists.
> 
> ...


 ...re bolded above - that doesn't sound much like an "ER=Emergency Room" situation. And I don't suppose this "E" situation of yours happened in 2020, 2021 or currently? Currently be prepared to wait 20 hours to be admitted (if indeed a true emergency like a gash in the head). Back in 2020/2021 - I don't think you want to be anywhere near an ER unless you don't mind catching Covid.

Even my "family physician" wasn't willing to see me in-person back then. It was "consult" over the phone unless it was a "true" emergency, then it's the ER you go as he/she can't do anything for me in his/her office. Family doctors no longer do stitch-ups but they do stitch removal AFTER you are more or less healed AT HOME.

Of course, the ER will tell you see your family physician for a "specialist" as a follow up given it wasn't a true "emergency". 

And when you do see your "specialist", where do you think you'll be seeing him/her? In some private clinic with CT/MRI/Xray/Ultrasound machines equipped? Of course, it depends on the "nature of your illness/mishap".


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## cainvest (May 1, 2013)

Eclectic21 said:


> I don't know if it's changed but in the past, using a walk-in clinic that set one of their doctors as my family doctor was enough to be able to access specialists.


Walk-in clinics can definitely book specialist appointments here.

For those that have a family doctor ... what is the real benefit if one has easy access to walk-in clinics?


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## like_to_retire (Oct 9, 2016)

cainvest said:


> For those that have a family doctor ... what is the real benefit if one has easy access to walk-in clinics?


A walk-in clinic is not set up for regular screenings or annual checkups, and so more and more patients without a family doctor are arriving at the ER sick with untreated conditions. These conditions, in turn, requiring more complicated and expensive medical intervention than if they had been under the regular care of a doctor. Additionally, you can't just make an appointment at a walk-in like you can with a family doctor, so you better be ready for a lengthy wait in line along with a lot of other sick people. This adds to those that put off conditions that they may have otherwise gone to a family doctor to take a look at.

add: You don't receive the same level of care at a walk-in that you would with a family doctor. The walk-ins have long lines and are speedy factories to push patients through to get to the next. Your family doctor makes appointments and offers more time to do a more thorough job.
Your family doctor has all your records and knows your history. This is extremely valuable information compared to getting a different GP every visit.

ltr


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## AltaRed (Jun 8, 2009)

In BC, every doctor has access to the electronic health record of an individual, so even a walk-in clinic doc knows the patient's written record....BUT they don't know the ongoing history and interactions an individual would have had with a family doc. With some of the medical issues spouse and I have been dealing with, the 'interactive' history we have with our GP is somewhat priceless. We'd not remotely get that with a walk-in clinic doc.


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## m3s (Apr 3, 2010)

AltaRed said:


> In BC, every doctor has access to the electronic health record of an individual, so even a walk-in clinic doc knows the patient's written record....BUT they don't know the ongoing history and interactions an individual would have had with a family doc. With some of the medical issues spouse and I have been dealing with, the 'interactive' history we have with our GP is somewhat priceless. We'd not remotely get that with a walk-in clinic doc.


I just left the US. My PCP (GP in Canadiana) saw me weekly either in the office or social events.

Their system has changed drastically and it was like peaking into the future. They just got new digital systems that integrate with all the smart devices and wearables. Apple has end-to-end encryption for health data and theirs required 2FA. So much privacy even my Canadian healthcare records can't access it. I've listened to podcasts talking about how these devices will add so much more data to healthcare. My american colleagues were all wearing aura rings but I just used apple healthkit.

Downside at least where I was seeing a specialist was next to impossible. Lots of retired people and the system was overburdened. They have what's called "Urgent Care" for anything that can't wait. It was mostly done by FaceTime or zoom and then you can go to any pharmacy. I had like 3 different health insurance providers and they would all try to make the other pay. My Canadian colleague had a child in the US and still dealing with 5 figure bills.

Healthcare could be a lot more efficient in the next 5-10 years. Private sector will be far more agile than Canada's free system imo


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## like_to_retire (Oct 9, 2016)

AltaRed said:


> In BC, every doctor has access to the electronic health record of an individual, so even a walk-in clinic doc knows the patient's written record


hehe, when my doctor retired, I had been with him for about 35 years. He had all hand written paper records until he retired. I had to pay to get them converted into PDF format by a medical records company so I could have them on a memory stick in a form that a new doctor would accept. 

I'm not aware of any province wide electronic health records in Ontario, so when I go into a walk-in clinic in Ontario, it's a cold call every time.

ltr


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## Eclectic21 (Jun 25, 2021)

Beaver101 said:


> ... re bolded above - that doesn't sound much like an "ER=Emergency Room" situation.


Thankfully, the tests ordered by the ER doc showed it wasn't an emergency but needed follow up.

Either way, my point is that around here, without a family doctor or a walk in clinic doctor willing to be listed as the family doctor - one can't book anything with a specialist.




Beaver101 said:


> ... And I don't suppose this "E" situation of yours happened in 2020, 2021 or currently? Currently be prepared to wait 20 hours to be admitted (if indeed a true emergency like a gash in the head). Back in 2020/2021 - I don't think you want to be anywhere near an ER unless you don't mind catching Covid.


Been in ER for myself or family around three times in late 2020/2021. Never felt at risk for catching covid with the screening questions, forced replacement of the mask one walked in wearing with a brand new one as well as the spacing of the seating.

'Course it varies by location as my sister was shocked when she went in for a chemo treatment in the Windsor area. There was no six feet separation and the staff seemed to be lax about mask wearing and other protocols.




Beaver101 said:


> ... And when you do see your "specialist", where do you think you'll be seeing him/her?


Without a nominal or actual family doctor - I can't get on the list to see the specialist so where I can't see them and how the location is equiped is moot. 


Cheers


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## like_to_retire (Oct 9, 2016)

Eclectic21 said:


> Either way, my point is that around here, without a family doctor or a walk in clinic doctor willing to be listed as the family doctor - one can't book anything with a specialist.


That's right, and a lot of walk-in clinics don't want to get into the rules that apply after a doctor refers a patient to a specialist. Each province would be different, but generally they are responsible for providing appropriate follow-up on test results and must provide or arrange for the provision of necessary follow-up care, including reviewing consultation reports. 

Those complications are a requirement if they do a referral, so they'd rather have you see your family doctor - which of course is difficult if you don't have one. The family doctor is an essential gatekeeper to the entire system, and without one, you're in trouble depending on where you live.

ltr


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## Retired Peasant (Apr 22, 2013)

I have been hearing that more and more GP in Ontario are moving to one issue per visit. So multiple issues that might be related - sorry only one issue per visit - crazy.


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## cainvest (May 1, 2013)

like_to_retire said:


> A walk-in clinic is not set up for regular screenings or annual checkups, and so more and more patients without a family doctor are arriving at the ER sick with untreated conditions. These conditions, in turn, requiring more complicated and expensive medical intervention than if they had been under the regular care of a doctor. Additionally, you can't just make an appointment at a walk-in like you can with a family doctor, so you better be ready for a lengthy wait in line along with a lot of other sick people. This adds to those that put off conditions that they may have otherwise gone to a family doctor to take a look at.
> 
> add: You don't receive the same level of care at a walk-in that you would with a family doctor. The walk-ins have long lines and are speedy factories to push patients through to get to the next. Your family doctor makes appointments and offers more time to do a more thorough job.
> Your family doctor has all your records and knows your history. This is extremely valuable information compared to getting a different GP every visit.
> ...


Many of our local walk-in do physicals and have blood work/x-rays on site. Had a physical a few years back, waited maybe 20 mins for it, no big deal. I've heard others there making appointments, most likely for follow-ups, but I'm not sure how long the wait was.

Also, never had a complaint for a walk-in doc visit yet. They either treat me or set me up with a specialist. All our medical history is electronic here so they have access and they always ask for your current history questions anyways.

Maybe when I get older I'll see more of a need for one.


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## sags (May 15, 2010)

There were a lot of sirens going off around us last night, so I turned on the police scanner app on my phone.

Turned out a microwave fire in an apartment building caused all the commotion so I switched to the ambulance channel.

The first call I heard was the dispatcher telling an ambulance to attend at house that had been waiting for 2 hours for an ambulance.

The next call was to a house waiting an hour.....an elderly woman who had fallen, was bleeding and had chest pains.

Our local hospital has vacancies for 500 nurses........just in our hospital alone.

This is not an acceptable situation, but nobody seems to be doing anything much about it.


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## like_to_retire (Oct 9, 2016)

cainvest said:


> Many of our local walk-in do physicals and have blood work/x-rays on site. Had a physical a few years back, waited maybe 20 mins for it, no big deal.


That's great, consider yourself lucky. I guess the definition of a walk-in clinic must be different where you live - somewhere in utopia. In the world where I live (and just about where everyone else lives), walk-in clinics are to treat problems where the patient can't wait for an appointment from their doctor. They're volume based businesses, where people are processed through very quickly and diagnosed and treated, then move on to the next patient. They're not about to entertain an annual physical exam. I can just imagine at my local walk-in, waiting the prerequisite 4 hours to see an over-worked, underpaid, harried doctor and telling him I want my annual physical exam.

ltr


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## cainvest (May 1, 2013)

like_to_retire said:


> In the world where I live (and just about where everyone else lives), walk-in clinics are to treat problems where the patient can't wait for an appointment from their doctor.


Same here .. doesn't mean they can't do other appointments ... they are just GPs. Where do you think all the people without a family doctor go for checkups?

Also, how long does your physical take? Mine was about 20 minutes ... about the same time as any patient visitng a walk-in.



like_to_retire said:


> They're volume based businesses, where people are processed through very quickly and diagnosed and treated, then move on to the next patient. They're not about to entertain an annual physical exam. I can just imagine at my local walk-in, waiting the prerequisite 4 hours to see an over-worked, underpaid, harried doctor and telling him I want my annual physical exam.


All doctors are volumed based, they all "over book" themselves. Pre-Covid appointment waiting rooms were always packed and you always waited well after your booked time. Maybe your walk-ins don't accept some types of visits or require an appointment?


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## like_to_retire (Oct 9, 2016)

cainvest said:


> Maybe your walk-ins don't accept some types of visits or require an appointment?


An appointment? There's no such thing as a "_walk-in_" that accepts appointments. It's the very essence of the word "_walk-in_ that you simply walk in.

ltr


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## cainvest (May 1, 2013)

like_to_retire said:


> An appointment? There's no such thing as a "_walk-in_" that accepts appointments. It's the very essence of the word "_walk-in_ that you simply walk in.


I gather your Walk-in clinics work differently where you are?

Normally we have 2-4 doctors per clinic. One or two are assigned to walk-ins (on a rotating basis I would guess) while others have appointments, you know ... family doctors. 

There might be "walk-in only" clinics around but I don't have any of those in my area.


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## AltaRed (Jun 8, 2009)

There appears to be a disparity of significance between provinces.


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## livewell (Dec 1, 2013)

The situation re Family doctors in Ontario (Ottawa) is chronically bad and unlikely to get fixed anytime soon with more GP's retiring than being replaced (Together with boomer demographic aging and adding increased burden). The walk-in clinics here are swamped as LTR has described (As are ER rooms.)

I have not tried this (Lucky to still have a GP) but know of a few people who have no GP and use and like it in preference to walk-ins - a virtual doctor service (they send reqs direct to blood clinics and I believe can refer to specialists)









Rocket Doctor: Online Doctors in Canada | Virtual appointments


With Rocket Doctor you will see an online doctor in few minutes. Virtual licensed doctors will do online consultations for medical advice.




rocketdoctor.ca


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## m3s (Apr 3, 2010)

livewell said:


> The situation re Family doctors in Ontario (Ottawa) is chronically bad and unlikely to get fixed anytime soon with more GP's retiring than being replaced (Together with boomer demographic aging and adding increased burden). The walk-in clinics here are swamped as LTR has described (As are ER rooms.)


On top of that they are building more houses and bringing in more immigrants before any of the public services are ready for it

I pay OHIP for what exactly


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## Eclectic21 (Jun 25, 2021)

like_to_retire said:


> That's great, consider yourself lucky. I guess the definition of a walk-in clinic must be different where you live - somewhere in utopia ... I can just imagine at my local walk-in, waiting the prerequisite 4 hours to see an over-worked, underpaid, harried doctor and telling him I want my annual physical exam.


I didn't realise I was in Utopia. 

There are select walk-in clinic locations where one can book third party physicals, in advance. I've never booked one so I don't know how much less than four hours the wait time it is or whether it's more like the wait time at my family doctor.

Speaking of my family doctor ... the office my family doctor works out of has a walk in clinic. Part of my family doctor's schedule is reserved for patients and part of the schedule is for the walk in clinic. 


As well, several of the walk in clinic groups provide on their web site the wait times by location. I've used that to avoid the hour plus wait to go to the clinic with a half an hour or less wait.


Cheers


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## Eclectic21 (Jun 25, 2021)

like_to_retire said:


> An appointment? There's no such thing as a "_walk-in_" that accepts appointments. It's the very essence of the word "_walk-in_ that you simply walk in.


The times ... there are a changing. 

Walk in clinic locations that a decade ago did not allow appointments around here are now advertising appointments. For some, it's because the doctors are splitting their time between being a family doctor and being a walk in clinic doctor. In other cases, it's for specific services.


Cheers


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## cainvest (May 1, 2013)

Eclectic21 said:


> Speaking of my family doctor ... the office my family doctor works out of has a walk in clinic. Part of my family doctor's schedule is reserved for patients and part of the schedule is for the walk in clinic.


Exactly what I have near my place, two clinics with walk-ins all run by family docs.



Eclectic21 said:


> As well, several of the walk in clinic groups provide on their web site the wait times by location. I've used that to avoid the hour plus wait to go to the clinic with a half an hour or less wait.


The larger clinic by me has their wait times on the web, very handy and usually pretty accurate.


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## Retired Peasant (Apr 22, 2013)

cainvest said:


> Where do you think all the people without a family doctor go for checkups?


They don't. I think these 'walkin' clinics you and @Eclectic21 speak of are for existing patients of doctors who work there; not for orphaned patients. Could be wrong, but very few walkin clinics are for orphaned patients.


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## cainvest (May 1, 2013)

Retired Peasant said:


> They don't. I think these 'walkin' clinics you and @Eclectic21 speak of are for existing patients of doctors who work there; not for orphaned patients. Could be wrong, but very few walkin clinics are for orphaned patients.


Well not here in MB. I don't have a family doctor so my normal medical needs are handled via the local walk-in clinic. As mentioned eariler, it appears there are big differences for medical care depending on the province you are in.

Edit: Just looked online at the two closest walk-in clinics to me. One is full but the other is accepting new family doctor patients. Maybe I'll check into this but I'll talk to a few friends (who have family docs) first to get their view on it.


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## Eclectic21 (Jun 25, 2021)

Retired Peasant said:


> ... I think these 'walkin' clinics you and @Eclectic21 speak of are for existing patients of doctors who work there; not for orphaned patients. Could be wrong ...


In my case - you would be wrong.

I used that walk in clinic as an orphan patient several times before finding out that I could sign up with my family doctor.




Retired Peasant said:


> ... very few walkin clinics are for orphaned patients.


I'm not sure what you mean by "for orphaned patients". 

I was an orphaned patient, I walked in and eventually saw a random doctor at pretty much any walk in clinic. The difference with my family doctor is that I can call and book with her instead of going with a random doctor, who may or may not check my history.

What do you envision as a walk in clinic for orphaned patients?


FWIW ... years before I'd signed up at a different walk in clinic group to have what I'd call a nominal family doctor. He'd get test results and arrange for specialists. If I wanted to see him, I'd have to watch the walk in clinic locations that he worked at to see when he was working and line up with the rest of the masses to wait my turn to possibly see my "family doctor".


Cheers


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## like_to_retire (Oct 9, 2016)

Eclectic21 said:


> If I wanted to see him, I'd have to watch the walk in clinic locations that he worked at to see when he was working and line up with the rest of the masses to wait my turn to possibly see my "family doctor".


Your definition of a family doctor is quite different from mine.

ltr


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## Eclectic21 (Jun 25, 2021)

I doubt our definitions are as different as you think.
I did say "nominal" for that one. 

Or are you saying I should have forgone that one so that I couldn't get test results or a referral to a specialist while waiting years for one that fits your definition more closely?


Cheers


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## Retired Peasant (Apr 22, 2013)

You seem to be in a snit today. All of your anecdotes are past tense; like I said things are changing. I also didn't say that _all _walkin clinics are like this. An orphan patient is one without a family doctor.


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## Retired Peasant (Apr 22, 2013)

cainvest said:


> Well not here in MB.


I didn't realize you were in MB. As AltaRed says, things are quite different between provinces, and likely within as well.


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## cainvest (May 1, 2013)

like_to_retire said:


> Your definition of a family doctor is quite different from mine.


Just means you see the same doctor for checkups (and maybe chronic issues) year after year. Might be a benefit to that for some people.


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## Eclectic21 (Jun 25, 2021)

Retired Peasant said:


> You seem to be in a snit today. All of your anecdotes are past tense; like I said things are changing ...


I'm not sure why you'd think me pointing out my experience is different from what you were suggesting for that particular clinic would mean I'm in a snit. 

Yes, things are changing. Years ago, asking at a walk in clinic about a family doctor would result in being given a list of other doctors (i.e. not connected to the walk in clinic) that were allegedly accepting patients. Later the option to have one of the walk in clinic doctors designated as a family doctor was offered (the "nominal family doctor"). The latest is the doctor who has split time between being a family doctor for me and bring a walk in clinic doctor for whomever visits.




Retired Peasant said:


> I also didn't say that _all _walkin clinics are like this.


Neither one of us said it was all walk in clinics where the reference was to the clinic being written about that has family doctors who also cover walk in clinic shifts.




Retired Peasant said:


> An orphan patient is one without a family doctor.


Sorry if I wasn't clear ... what about a walk in clinic makes it "not for orphaned patients" in your area?


Cheers


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## Retired Peasant (Apr 22, 2013)

It was more about your sarcastic reply to ltr. 
The sign on the door says "only for patients of the following doctors...
_A list of doctors_..." .
I ran into this in Sudbury and Orillia and have heard the same from family member in Goderich


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## undersc0re (Oct 7, 2017)

My daughter and I have been on a family doctor wait list for 5 yrs. We live in a city of approx 100,000 in b.c. and we have 2 walk in clinics, one clinic you start phoning at 7am to try and get an appointment that day, the other you start phoning at 10am to try and get an appointment that day. If you are not quick with the phone and they run out of appointments you wait and try the next day. Other option is emergency if you think it can’t wait a couple days. Sucks if you need a doctors note for work, or disability paperwork. If you have a good family doctor, you are lucky nowadays.


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## Johnny199r (May 20, 2014)

I’m 39. Haven’t had a family doctor since I was a kid. I usually have to see a doctor once every 5-8 years. When I do, I just wake up early and go to a walk in clinic, where I’ll usually be at the front of the line when it opens (strep throat, Christmas Day, 2016). I live in Winnipeg now, previously Edmonton. 

No idea whey people care about having a family doctor (any doctor can read your records and I don’t care if he knows what happened to me 15 years ago).You can’t get in to see a family doctor for weeks at a time when you’re actually sick, so what’s the point?

I swear some people aren’t happy unless they’re continually going to the doctor for this thing or that.


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## AltaRed (Jun 8, 2009)

Johnny199r said:


> I’m 39. Haven’t had a family doctor since I was a kid. I usually have to see a doctor once every 5-8 years. When I do, I just wake up early and go to a walk in clinic, where I’ll usually be at the front of the line when it opens (strep throat, Christmas Day, 2016). I live in Winnipeg now, previously Edmonton.
> 
> No idea whey people care about having a family doctor (any doctor can read your records and I don’t care if he knows what happened to me 15 years ago).You can’t get in to see a family doctor for weeks at a time when you’re actually sick, so what’s the point?
> 
> I swear some people aren’t happy unless they’re continually going to the doctor for this thing or that.


It is good and fortunate you are that healthy because it makes room for those that unfortunately have not been dealt that hand of cards and require regular medical attention by a GP and/or specialists and/or occupy hospital beds and ERs. A family GP is a pretty important hub of the wheel to access the specialists needed in this neck of the woods.

No one I know 'enjoys' going to the family doc, waiting days for an appointment sometimes.


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## cainvest (May 1, 2013)

AltaRed said:


> A family GP is a pretty important hub of the wheel to access the specialists needed in this neck of the woods.


So where you are you need a family doctor to get to a specialist?


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## AltaRed (Jun 8, 2009)

I think it has to be a GP referral, not necessarily a family doctor. I suspect a GP at a walk-in clinic would do just fine.

In our case, our GP has referred us to specific specialists when the need has arisen.


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## Farouk (8 mo ago)

There is a "walk-in-clinic" across the street from our condo in North York. Our granddaughter, who has a family doctor in Whitby, needed medical attention and could not drive to Whitby. She went to the walk-in- clinic and they gave her an appointment later in the afternoon. This is a real walk-in-clinic.

There is another type of "walk-in-clinic" which should have been called something else. We have a family doctor who shares the space with 4 other doctors. If we need a semi-urgent appointment we can go to that same office which has clinic called "walk-in-clinic" on Saturday morning. One of the doctors from the clinic will be on call that morning and he/she has acess to all your medical records on the computer. I believe it is one of the agreements family doctors have with OHIP that they would provide coverage for their patients on Saturday morning. There is small financial incentive to provided by OHIP.


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## Eclectic21 (Jun 25, 2021)

Retired Peasant said:


> It was more about your sarcastic reply to ltr ...


It wasn't meant to be sarcastic but a more of a reminder of what would be lost without the nominal family doctor.




Retired Peasant said:


> ... The sign on the door says "only for patients of the following doctors...
> _A list of doctors_..." .
> I ran into this in Sudbury and Orillia and have heard the same from family member in Goderich


Interesting ... I've never been to a clinic that has this sort of list. 
Perhaps this is because of the size of the community?


Cheers


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## Eclectic21 (Jun 25, 2021)

AltaRed said:


> I think it has to be a GP referral, not necessarily a family doctor. I suspect a GP at a walk-in clinic would do just fine.
> In our case, our GP has referred us to specific specialists when the need has arisen.


Not sure if it has changed as I've now got a family doctor to do the referral.
When I had the nominal family doctor, the doctor making the referral to the specialist had to be registered as one's family doctor.

Sounds like other parts of the country are more flexible.

Cheers


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## sags (May 15, 2010)

Walk in clinics aren't the overall solution. The problems go far deeper than that.

_Twelve people on stretchers, including a stroke patient with a brain bleed and a trauma patient transported by helicopter, were lined up in the entrance hallway at Manitoba's largest emergency department on Sunday evening because no beds were available inside, a physician at the hospital said.
*A shortage of treatment capacity at Health Sciences Centre has forced patients sick enough to require hospital admission to wait as long as 170 hours *— more than a week — in the emergency ward for a bed to open up elsewhere in the hospital, the doctor said._



https://www.cbc.ca/news/canada/manitoba/hsc-shortage-beds-hospital-1.6580656


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## sags (May 15, 2010)

The problem is specialists, operating rooms, and hospital space.

They could open up some private surgical or other treatment clinics, but that doesn't magically create more specialists to work there.

Also on the subject of walk in clinics.....GP's get paid a monthly fee for each patient. If you visit a clinic, OHIP deducts the cost from the family doctor's account.

Hence the sign in my doctors office advising patients NOT to go to clinics, but go to the emergency room for care.


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## AltaRed (Jun 8, 2009)

Eclectic21 said:


> Not sure if it has changed as I've now got a family doctor to do the referral.
> When I had the nominal family doctor, the doctor making the referral to the specialist had to be registered as one's family doctor.
> 
> Sounds like other parts of the country are more flexible.
> ...


Anecdotally, I think there is more flexibility in BC, or at least some parts of BC. An elderly relative made a move from Montreal to Vancouver several years ago to be closer to her daughter and family. She started using walk-in clinics for some chronic upper body pain issues. It was via that clinic she was able to source specialists, which opened the door to better diagnosis and treatment. What I don't know is if a particular doctor at that clinic took her on as a formal patient to resource those specialists or not.

Bottom line is the system is broken for those in real need of family GPs and access to specialists for necessary treatments. Plus there appears to be some bigger roles being given to nurse practitioners to help access resources in the system.

To repeat myself, we were fortunate to be able to latch on to an immigrant moving to Canada from South Africa and establishing a practice here. We are also fortunate this individual is about 30 years younger than us which suggests we will die before he hangs up his own spurs and retires. Anyone today who has a similar aged family doctor to themselves are in extreme danger of being without a family GP when they will need it the most in their senior years.


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## sags (May 15, 2010)

People are confusing "walk in clinics" with clinics operated as one office for a group of doctors, sometimes operated for members of a specific employer health group.

Walk in clincs around here are only open for set hours, usually when the doctors are available from their normal duties.

You might have to drive around to several clinics before you find one that is open.

The care there is direct to the problem, and that is it. There is no followup and anything serious they tell you to see your GP or go to the ER.


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## Beaver101 (Nov 14, 2011)

sags said:


> Walk in clinics aren't the overall solution. The problems go far deeper than that.
> 
> _Twelve people on stretchers, including a stroke patient with a brain bleed and a trauma patient transported by helicopter, were lined up in the entrance hallway at Manitoba's largest emergency department on Sunday evening because no beds were available inside, a physician at the hospital said.
> *A shortage of treatment capacity at Health Sciences Centre has forced patients sick enough to require hospital admission to wait as long as 170 hours *— more than a week — in the emergency ward for a bed to open up elsewhere in the hospital, the doctor said._
> ...


 ,... I'm guessing our MOH Jones is doing a fabulous job of either .... kissing her boss' butts or have the "I see, hear and know nothing." expertise. Thanks to Ontario taxpayers!!!!


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## sags (May 15, 2010)

When my son was claiming WSIB, he had no problem getting seen by specialists, getting MRIs or CT scans, getting complete physicals with several doctors.

That is because it is all done by a private company that is operated solely for WSIB patients to assess health issues and benefits paid.

If only everyone could spend a day at a clinic getting checked head to toe at a big clinic, like he did several times.

WSIB paid his costs to drive to Toronto, book a hotel room, and paid all his meals and gas expenses.

If they are trying to find a reason to cut people off benefits......there are no obstacles.


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## Beaver101 (Nov 14, 2011)

sags said:


> The problem is specialists, operating rooms, and hospital space.
> 
> They could open up some private surgical or other treatment clinics, but that doesn't magically create more specialists to work there.
> 
> ...


 ... why would OHIP deduct the cost from the family doctor's account? Unless that "walk-in" is an "additional" office like after-hours for the family doctor. Is it to prevent double-dipping?

Mind you, it isn't unheard of that "some (few)" doctors double-triple-or-whatever-way they can grab an extra nickel dipping out of OHIP. Which basically ruins it for the majority of honest and caring docs.


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## Beaver101 (Nov 14, 2011)

sags said:


> When my son was claiming WSIB.......he had no problem getting seen by specialists, getting MRIs or CT scans, getting complete physicals with several doctors.
> 
> That is because it is all done by a private company that is operated solely for WSIB patients to assess health issues and benefits paid.
> 
> If only everyone could spend a day at a clinic getting checked head to toe at a big clinic.


 ... I think part of that "availability" or "no problem in getting specialists' services" is WSIB want him off their book of claims.


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## sags (May 15, 2010)

Beaver101 said:


> ,... I'm guessing our MOH Jones is doing a fabulous job of either .... kissing her boss' butts or have the "I see, hear and know nothing." expertise. Thanks to Ontario taxpayers!!!!


The Provinces don't want to spend the money necessary to provide adequate healthcare. One exception is Nova Scotia, where the new Premier said healthcare was a disaster and he was going to spend whatever it took to fix it. I don't know how that is going, but we don't hear a lot of bad news from there.


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## sags (May 15, 2010)

Beaver101 said:


> ... I think part of that "availability" or "no problem in getting specialists' services" is WSIB want him off their book of claims.


That is exactly what they want, so they set up a large, private WISB "assessment" clinic.


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## sags (May 15, 2010)

Beaver101 said:


> ... why would OHIP deduct the cost from the family doctor's account? Unless that "walk-in" is an "additional" office like after-hours for the family doctor. Is it to prevent double-dipping?
> 
> Mind you, it isn't unheard of that "some (few)" doctors double-triple-or-whatever-way they can grab an extra nickel dipping out of OHIP. Which basically ruins it for the majority of honest and caring docs.


The GP is paid to have a patient list. If they aren't seeing the patient who went to a clinic, OHIP deducts the clinic fee from the GP account.


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## undersc0re (Oct 7, 2017)

The government should have buildings owned, supplied and run by them. They should employ the family doctors in those building and pay them same way a teacher or rcmp officer gets paid….how hard is that? They show up for their schedule and done.


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## TomB16 (Jun 8, 2014)

Things are oddly OK in SK. At one point, a physician friend (not a GP) had a buddy take me on. It was that bad, a decade ago.

My previous GP is struggling with cancer. He still practice's but only 2 days per week, no physical exams, and there are other restrictions. I hate to lose him but left because the booking wait times would have been impossible in a crisis situation.

I learned there are several GPs with open practice. One is a recent eastern European immigrant who is as good a physician as I've ever had with a beautiful life outlook. I am very fortunate to have him but his practice is still open.


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## Money172375 (Jun 29, 2018)

So I started the process today. Called Service Ontario and had my name removed from our doctor‘s list. He’s retiring in December. Figured I would try and get ahead of all his other patients.

I should receive a letter within 2 weeks confirming my “doctor-less” status. At that time, I can register for HealthConnect which will attempt to find my a doctor. They claim to have a 89% placement rate on our region….but I don’t see any timelines around that stat.

not sure how we’ll get our prescriptions renewed while we’re without a doctor. The walk-in clinics on our region will only see you if you have an assigned family doctor.


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## like_to_retire (Oct 9, 2016)

Money172375 said:


> At that time, I can register for HealthConnect which will attempt to find my a doctor. They claim to have a 89% placement rate on our region….but I don’t see any timelines around that stat.
> 
> not sure how we’ll get our prescriptions renewed while we’re without a doctor. The walk-in clinics on our region will only see you if you have an assigned family doctor.


Yeah, you should probably think in terms of years rather than days in that regard, although I don't know your region.

When my doctor retired in 2021, he graciously removed all his patients from the list, so I was able to register with Health Care Connect right away. Your list position depends on merit, so it seems, and I remember filling out the Health Connect form and bypassing the multitude of chronic illnesses that would have catapulted me higher on the list, but I wasn't able to tick those boxes (fortunately/unfortunately) and I suppose only my 70+ age might have helped my list position. I understand that the list in my city is estimated above 100K. Where am I on the list - who knows.

I spent months and months wasting my time looking and phoning to get a new doctor at all the clinics. Quite a discouraging job. Every single one of them says they are not accepting new patients and do not have a waiting list. They all said I have to register with Ontario Health Care Connect. The reason, it seems to me, that clinics pass all requests to Health Care Connect is that there are kickbacks if they participate. From the Health Care Professionals site it says:_ "New fees and fee enhancements are available to family physicians participating in a primary care physician enrollment model who accept patients through this program."_. Of course they will participate - who wouldn't?

There is a cornucopia of rules among the walk-in clinics it seems, with each one offering different rules, so I consider myself lucky to be able to wait multiple hours in line at my local walk-in to be able to see a random doctor who will refill my prescriptions. I would end up in emergency without this, as many in this country with its failing health system already do. It's particularly galling when people with family doctors stick to the notion that our public health care system is the only way to go. They should lose their doctor in this country and see how they feel.

I already commented in another thread with regard to the fact that a lot of walk-in clinics don't want to get into the rules that apply after a doctor refers a patient to a specialist, so they have a rule of no referrals. Each province would be different, but generally they are responsible for providing appropriate follow-up on test results and must provide or arrange for the provision of necessary follow-up care, including reviewing consultation reports. This is stated fairly clearly in the CPSO (College of Physicians and Surgeons of Ontario) rules regarding Walk-In Clinics under (Managing Tests and Referrals).

These follow up complications are a requirement if they do a referral, so they'd rather have you see your family doctor - which of course is difficult if you don't have one. The family doctor is an essential gatekeeper to the entire specialist system, and without one, you're in trouble depending on where you live.

ltr


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## m3s (Apr 3, 2010)

Ontario is a mess

Not even booking anything that isn't life threatening. I can either go on the cancelation standby list - which will probably come up last minute when I'm not available. Or wait for a new primary care physician. And that is just to get a basic referral to the specialists who are also probably booked out months

My boss waited 5 hours in the ER just to get prescription for heart medicine because his prescription was from another country. There must be a better way


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## MrMatt (Dec 21, 2011)

like_to_retire said:


> These follow up complications are a requirement if they do a referral, so they'd rather have you see your family doctor - which of course is difficult if you don't have one. The family doctor is an essential gatekeeper to the entire specialist system, and without one, you're in trouble depending on where you live.


Yeah, if you don't have a family doctor, you don't have access to health care, and there are no family doctors taking patients.

Best bet, get pregnant, or get your SO/sidepiece etc pregnant so they can get priority, then you might get a doctor.
Otherwise you're SoL

The only people who think we have great healthcare haven't dealt with the problems.
They likely have access to a family doctor, aren't dealing with waitlists, or second rate treatment.


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## Beaver101 (Nov 14, 2011)

^ Are you willing to increase your annual health premiums for that? I mean tax in your case.


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ^ Are you willing to increase your annual health premiums for that? I mean tax in your case.


They could just stop wasting my tax dollars on other stuff, and stick to the basic responsibilities, like health care.


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## cainvest (May 1, 2013)

MrMatt said:


> Yeah, if you don't have a family doctor, you don't have access to health care, and there are no family doctors taking patients.


I don't have a family doctor and have full access to healthcare.


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## MrMatt (Dec 21, 2011)

cainvest said:


> I don't have a family doctor and have full access to healthcare.


You're lucky.

Here you can't access specialists without a referral, and the walk ins don't give referrals.(many don't)

Which leaves the ER, and we're at 18+ hour waits (Google "Code Black ER" for any major center in Southern Ontario)


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## cainvest (May 1, 2013)

MrMatt said:


> Here you can't access specialists without a referral, and the walk ins don't give referrals.(many don't)


So walk-ins in ONT don't give referrals by choice of the doctor?


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## MrMatt (Dec 21, 2011)

cainvest said:


> So walk-ins in ONT don't give referrals by choice of the doctor?


Some don't.
it's intermittent news around the country, I've seen articles out east.

In Ontario I don't think they're allowed to "not give referrals", but from what I've heard, they aren't all that eager to.

Also the lack of consistency is an issue, particularly since Ontario doesn't have shared electronic medical records, so every visit to a walk in (or the ER) is a new experience.

I think just because some people have good experiences (my actual care has always been excellent), and most people don't actually need that much care, the problems are overlooked, not known or not noticed.
Our system is failing, and it's going to take a generation or more to fix.


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## cainvest (May 1, 2013)

MrMatt said:


> In Ontario I don't think they're allowed to "not give referrals", but from what I've heard, they aren't all that eager to.


That would be my first question then if I was to go to an Ontario walk-in. 



MrMatt said:


> Also the lack of consistency is an issue, particularly since Ontario doesn't have shared electronic medical records, so every visit to a walk in (or the ER) is a new experience.


That is scary that a province still doesn't have shared electronic records.


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## MrMatt (Dec 21, 2011)

cainvest said:


> That is scary that a province still doesn't have shared electronic records.


It's a political hot potato.
I think they spent a billion dollars hiring friends to do it, and surprisingly it didn't work out.

Now the various areas use a mix of different systems.
So they're working on it from bottom up, but of course they also have their little kingdoms to protect, and absent leadership from the province it's a mess.

I'm not sure what the current government was doing here, but basically everything they were working on got sidelined by COVID


Looking at how well Ontario got the various health units to coordinate for COVID, I think that given time they'll get it sorted out.
FYI, the healthcare system in Ontario is an absolute mess with many different groups with different funding and priorities.
It's also underfunded and disorganized with ridiculous amounts of waste.


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> *They could just stop wasting my tax dollars on other stuff, and stick to the basic responsibilities, like health care.*





MrMatt said:


> It's a political hot potato.
> I think they spent a billion dollars hiring friends to do it, and surprisingly it didn't work out.
> 
> Now the various areas use a mix of different systems.
> ...


 ... and so why do we need a Health Minister? What's her job other than kissing her boss' axx who happens to be the premier who is doing a spectacular job via your taxes ... according to ya.


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ... and so why do we need a Health Minister? What's her job other than kissing her boss' axx who happens to be the premier who is doing a spectacular job via your taxes ... according to ya.


We need a health Minister to run healthcare in the province, that is her job.

Yes, Ford is doing a good job, and one part of that is listening and getting good people to run the province.
I think he did a great job with his selection of health minister, and then getting out of their way so they can do the job.

Ford understands he's just one person and he needs a team to get stuff done.
The best thing the premier or any leader can do is set a direction, then let the good people under them do the actual work.


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## Retired Peasant (Apr 22, 2013)

There's an interesting (and long) post on reddit from a doctor in ON explaining how the system is set up.

__
https://www.reddit.com/r/ontario/comments/xt3yvr


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## Beaver101 (Nov 14, 2011)

^ Thanks for the post - long but detailed. And I empathize with doctors, nurses and basically all health professionals who are basically burnt out - sped up by the pandemic. That's why long ago, I call those so-called no good "protestors in front of the hospitals (particularly Toronto)" got nothing better to do but just being a bunch of pure "morons.". 

However, I have a simple question for this doctor aka as a self-employed person - do you stop recommending your kids or the younger generation to desist being in this profession? I mean why not be the next Steve Jobs or Elon Musk instead? I'm hoping for an honest answer.


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## MrMatt (Dec 21, 2011)

Retired Peasant said:


> There's an interesting (and long) post on reddit from a doctor in ON explaining how the system is set up.


Just a point.

Physicians do not get paid for anything they do OUTSIDE of a "service". What this means, is any work such as reviewing test results, filling prescriptions, *making/sorting through referrals,* coordinating care with your other specialists/doctors/allied health* is NOT PAID FOR by the government*.

So, if you're a walk in doctor, who may never see this patient again, how many referrals and reviewing results are you making?


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ^ Thanks for the post - long but detailed. And I empathize with doctors, nurses and basically all health professionals who are basically burnt out - sped up by the pandemic. That's why long ago, I call those so-called no good "protestors in front of the hospitals (particularly Toronto)" got nothing better to do but just being a bunch of pure "morons.".
> 
> However, I have a simple question for this doctor aka as a self-employed person - do you stop recommending your kids or the younger generation to desist being in this profession? I mean why not be the next Steve Jobs or Elon Musk instead? I'm hoping for an honest answer.


Do something you somewhat enjoy, you're good is useful, and is paid.

I know people across a lot of careers, some people are energized by the same things that others find draining.
If someone wants to be a doctor, and it's a good fit for them, why not?

If you're in it for status and money, that's not really a good fit for you or your patients.

Sure there are crappy parts, but there are also good parts.


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## like_to_retire (Oct 9, 2016)

MrMatt said:


> So, if you're a walk in doctor, who may never see this patient again, how many referrals and reviewing results are you making?


This is the problem of getting a referral that I have brought up before, in that a lot of walk-in clinics don't want to get into the CPSO rules that apply after a doctor refers a patient to a specialist. Each province would be different, but in Ontario the referring doctor is responsible for providing appropriate follow-up on test results of the referral and must provide or arrange for the provision of necessary follow-up care, including reviewing consultation reports. To me, this is tantamount to being that patient's GP because you have to follow through. Does the walk-in doctor want to do that?

This is stated fairly clearly in the CPSO (College of Physicians and Surgeons of Ontario) rules regarding Walk-In Clinics under (Managing Tests and Referrals). These follow up complications are a requirement if they do a referral.

ltr


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## Money172375 (Jun 29, 2018)

Ford and Lecce handing out more Money for students to “catch up” on their education.





Catch Up Payments


Apply for direct Catch Up Payments to get $200 to $250 to help pay for student learning supports to help fill gaps that may have emerged because of COVID‑19. As a parent or guardian, you can use this one-time funding for things that best suit your child’s needs like tutoring services, supplies...




www.ontario.ca





i plan to set aside the money for when I get my medical services in the US. Can we fix health care and improve classrooms before any more handouts?


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> Do something you somewhat enjoy, you're good is useful, and is paid.
> 
> I know people across a lot of careers, some people are energized by the same things that others find draining.
> If someone wants to be a doctor, and it's a good fit for them, why not?
> ...


 ... I'm not asking you (nor care for your opinions here) as a "licensed medical doctor" in Ontario, so are you?


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## Beaver101 (Nov 14, 2011)

Money172375 said:


> Ford and Lecce handing out more Money for students to “catch up” on their education.
> 
> 
> 
> ...


 ... come on Money#####, you should know by now what's Ford modus operandus is with us taxpayers in Ontario. What's a little bribe? Now his minion Lecce has latched on to that expertise. 

Btw, your response about fixing the healthcare systems here is about the same as MrMatt's of less waste ... works in a dreamworld I say.


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ... I'm not asking you (nor care for your opinions here) as a "licensed medical doctor" in Ontario, so are you?


If you wanted to ask that person, you should have asked them, not this forum.

I have general opinions and guidance, and I'm glad to share it.


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ... come on Money#####, you should know by now what's Ford modus operandus is with us taxpayers in Ontario. What's a little bribe? Now his minion Lecce has latched on to that expertise.
> 
> Btw, your response about fixing the healthcare systems here is about the same as MrMatt's of less waste ... works in a dreamworld I say.


FFS, Ford saved a few million dollars a year cancelling unused phone lines.
There is so much disorganization and waste in the health care system they can save huge amounts of money, if they figure out how.

There would be a massive savings if they could just figure out how to offload patients from ambulances a bit quicker. That's a well known problem that is suprisingly tricky to solve. There are many such problems that can be addressed without a wholesale restructuring.


What's you're solution? Double taxes to 100% of our gross income, then everything will be better?


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> If you wanted to ask that person, you should have asked them, not this forum.


 ... I'm not on Reddit or Twitter or any social media nor forum (other than this one) so how am I gonna to ask 'him' other than asking as a reply to that post?



> I have general opinions and guidance, and I'm glad to share it.


 ... I'm sure you have opinions and would gladly share them as with "guidance" ... LOL. Are you a medical doctor to give him guidance in his field?


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> FFS, Ford saved a few million dollars a year cancelling unused phone lines.
> There is so much disorganization and waste in the health care system they can save huge amounts of money, if they figure out how.
> 
> There would be a massive savings if they could just figure out how to offload patients from ambulances a bit quicker. That's a well known problem that is suprisingly tricky to solve. There are many such problems that can be addressed without a wholesale restructuring.
> ...


 ... I didn't say that about "doubling taxes" nor anything remotely like that. I was asking you that and now you're implying I'm asking that. You're fully aware that it's Ford's usual modus operandus to bribe you with your own money. Latest example is the teachers strike, only it's Leccee's idea now ... LMAO on this minion.

As for saving millions on cancelling phone lines - I haven't heard of that and how many millions can you save on phone lines cancellation? And whose/what phone lines? Cite source please. I hope it's not the 911 - that would save a ton of money - possibly in a billion.

As for "my" solutions - I'm not paid to do that. In fact, I have already paid someone to do that job ... and if she/he can't do - then simply get the fck out and put someone "competent" to do that. Actually "competent" to do "the/aka their" job, other than axx-kissing the boss.


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ... I didn't say that about "doubling taxes" nor anything remotely like that. I was asking you that and now you're implying I'm asking that. You're fully aware that it's Ford's usual modus operandus to bribe you with your own money. Latest example is the teachers strike, only it's Leccee's idea now ... LMAO on this minion.


I disapprove of the "education catchup" just like the 'carbon tax rebates".



> As for "my" solutions - I'm not paid to do that. In fact, I have already paid someone to do that job ... and if she/he can't do - then simply get the fck out and put someone "competent" to do that. Actually "competent" to do "the/aka their" job, other than axx-kissing the boss.


Ford is that competent leader, I'm glad we have him.


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> I disapprove of the "education catchup" just like the 'carbon tax rebates".


 ... but do you disapprove getting $250?



> Ford is that competent leader, I'm glad we have him.


 ... I don't particularly disagree considering he openly said "I stand shoulder to shoulder with the (current) PM". I'm just waiting for the fall out or how much flack he's gonna get from "his" peers. 

But then we're not talking about Ford's job here - are we? Why are we paying for a Health Minister? Or are you saying, you're fine with her performance or your tax dollars or our health systems is fine as it is under her expertise (whatever that is)?


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## MrMatt (Dec 21, 2011)

Beaver101 said:


> ... but do you disapprove getting $250?


yes, I disapprove of this handout.



> ... I don't particularly disagree considering he openly said "I stand shoulder to shoulder with the (current) PM". I'm just waiting for the fall out or how much flack he's gonna get from "his" peers.


Hopefully a lot, because he's wrong.
That being said, it's his job to balance the various interest groups.



> But then we're not talking about Ford's job here - are we? Why are we paying for a Health Minister? Or are you saying, you're fine with her performance or your tax dollars or our health systems is fine as it is under her expertise (whatever that is)?


Asked & Answered. We're paying for a Health Minister to run the Ministry of health. How can I make that answer more clear for you, you seem to not understand it.

Yes I am very pleased with her performance. I think she's doing an excellent job. 

Our health system is in crisis, I don't expect everything to be fixed in just a few years, the system has decades of problems to fix.
I am glad that we have a team in place which is trying to address the problems. When you look at the LTC problems during COVID19, you have to realize that there were already plans in place to address some of these issues, they just didn't get implemented in time.

But in summary, I'm fine with her performance, but our health care system is not fine.


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## Beaver101 (Nov 14, 2011)

MrMatt said:


> yes, I disapprove of this handout.


 ... so are you returning the cheque(s)? [In case you're wondering about me, I have no cheques to return as I ain't getting any.]



> Hopefully a lot, because he's wrong.
> That being said, it's his job to balance the various interest groups.


 ... so now he's wrong ... man, must be super-tough being a member of the CPC. Or that Ford is trying to change or camouflage his spots.



> Asked & Answered. We're paying for a Health Minister to run the Ministry of health. How can I make that answer more clear for you, you seem to not understand it.
> 
> *Yes I am very pleased with her performance. I think she's doing an excellent job.*


 ... like? What has she done actually other than the usual kept her mouth shut or saying "yes, yes, yes yes, yes ... to Ford"?



> Our health system is in crisis, I don't expect everything to be fixed in just a few years, the system has decades of problems to fix.
> I am glad that we have a team in place which is trying to address the problems. When you look at the LTC problems during COVID19, you have to realize that there were already plans in place to address some of these issues, they just didn't get implemented in time.
> 
> But in summary, I'm fine with her performance, but our health care system is not fine.


 ..if our healthcare systems is not fine (other than burnout doctors, nurses, and hands-on health professionals), then whose job is it to make it fine? And exactly what is the job of the Health Minister who you think is doing so fine, warming up a chair paid by you and me? Make up your mind.

And never mind about the LTC fiasco - there's a seperate Minister for that, ain't there?


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## MrMatt (Dec 21, 2011)

MrMatt said:


> Hopefully a lot, because he's wrong.
> That being said, it's his job to balance the various interest groups.





Beaver101 said:


> ... so now he's wrong ... man, must be super-tough being a member of the CPC. Or that Ford is trying to change or camouflage his spots.


yeah, he's wrong.
What does the CPC have to do with any of this?
I thought we were talking about Ford?



> .if our healthcare systems is not fine (other than burnout doctors, nurses, and hands-on health professionals), then whose job is it to make it fine?


The minister of Health.


> And exactly what is the job of the Health Minister who you think is doing so fine, warming up a chair paid by you and me? Make up your mind.


They're running a wide variety of initiatives. Look at the plans they had for LTC before COVID hit.
I also think they did a good job with handling COVID.

It's possible for the system to be in crisis, while the people working to fix it are actually doing a good job.

What do I have to "Make up your mind" about? That the system is broken and they're working to fix it?
Isn't that what they were hired to do, and what they SHOULD be doing?



> And never mind about the LTC fiasco - there's a seperate Minister for that, ain't there?


Uh no, the Minsiter of Health and Long Term Care is actually responsible for both Health and Long term care.


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## Money172375 (Jun 29, 2018)

MrMatt said:


> yeah, he's wrong.
> What does the CPC have to do with any of this?
> I thought we were talking about Ford?
> 
> ...


I believe the ministries were split in 2019.


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## MrMatt (Dec 21, 2011)

Money172375 said:


> I believe the ministries were split in 2019.


Yes, I see that they were. 
Though they are still quite tightly linked.




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www.health.gov.on.ca


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## Retired Peasant (Apr 22, 2013)

Retired Peasant said:


> There's an interesting (and long) post on reddit from a doctor in ON explaining how the system is set up.
> 
> __
> https://www.reddit.com/r/ontario/comments/xt3yvr


Geez, sorry folks. I did not copy/paste the whole post. I just copied a link; CMF software changed it to the whole thing.
One thing that stuck out for me, was that when a rostered patient goes to a walk-in clinic, OHIP will charge that patient's doctor for the visit. In other words, OHIP doesn't actually pay in some circumstances. Some rostered patients end up being fired by their doctor if they go to a walkin clinic. Meanwhile, they might wait weeks for an appointment with their dr. No wonder people go to emerg for non-emergencies.


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## MrMatt (Dec 21, 2011)

Retired Peasant said:


> Geez, sorry folks. I did not copy/paste the whole post. I just copied a link; CMF software changed it to the whole thing.
> One thing that stuck out for me, was that when a rostered patient goes to a walk-in clinic, OHIP will charge that patient's doctor for the visit. In other words, OHIP doesn't actually pay in some circumstances. Some rostered patients end up being fired by their doctor if they go to a walkin clinic. Meanwhile, they might wait weeks for an appointment with their dr. No wonder people go to emerg for non-emergencies.


There is a reason some people in the Windsor area simply pay US health insurance and get a family doctor in Michigan.


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## cainvest (May 1, 2013)

Retired Peasant said:


> One thing that stuck out for me, was that when a rostered patient goes to a walk-in clinic, OHIP will charge that patient's doctor for the visit. In other words, OHIP doesn't actually pay in some circumstances. Some rostered patients end up being fired by their doctor if they go to a walkin clinic.


Wow ... if true, that is totally messed up! 

How is healthcare not the highest priority when voting comes around in Ontario?


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## MrMatt (Dec 21, 2011)

cainvest said:


> Wow ... if true, that is totally messed up!
> 
> How is healthcare not the highest priority when voting comes around in Ontario?


The teachers union is much stronger.

Also healthcare is loaded with political appointees,
Look at the brief summary of the attempt to make electronic health records. Half a billion dollars with nothing to show for it.




__





Loading…






en.wikipedia.org





removed overly political statement.
Suffice it to say that political appointees are rampant in healthcare.

Also many parts of the health care system consider "advocacy" part of their job.


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## MrMatt (Dec 21, 2011)

cainvest said:


> Wow ... if true, that is totally messed up!


It makes sense though.
Family doctor offices are ideally the first point of care and should coordinate patient care.

So they get a bonus to provide that continuity of care. 
But if they're not actually providing that care, they lose the bonus

The thing is that the Ontario health care system has evolved and is very complicated and if you look honestly at the pieces you can understand how they came to be... what to do with it is a much harder problem.


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## sags (May 15, 2010)

cainvest said:


> Wow ... if true, that is totally messed up!
> 
> How is healthcare not the highest priority when voting comes around in Ontario?


Yes it is true. I have posted before that my GP has a notice in her office that tells patients NOT to go to a walk-in clinic, but go to the ER instead.

When I asked the secretary what that was about, she told me OHIP takes the money away from the GP to give to the clinic.

GPs get a fee for every patient on their patient list. If they see them or not. If you go to a clinic too much.......the GP gives you the boot.


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## sags (May 15, 2010)

Our GP doesn't even have all the current medical information in her database online.

I had appendicitis twice and she didn't know until I told her. She then updated my medical records and medications herself.

The history of some past Conservative governments, including the Ford government, was the instinct to cut spending on healthcare.

Ford eliminated automatic inspections and full audits of LTC homes, and cut funding for a variety of programs, when he first took office.

Ford also froze the number of new LTC homes that could be built, because he didn't want to fund their ongoing operations.

My wife's employer has retirement homes and had one LTC home. They wanted to expand it and build more but couldn't get approvals.

So they sold the LTC home and built more luxury retirement homes.

To claim that Ford fully supported healthcare is pure folly and fiction. He cut, cut, cut.........when he was first elected.


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## sags (May 15, 2010)

Look no further than the right wing conservative government of Liz Truss in the UK.

Their first order of business was to cut taxes on the wealthy and corporations. They chose to inflate the debt to give rich people more tax breaks.

It is a keystone part of the right wing conservative ideology and will never change.


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## cainvest (May 1, 2013)

MrMatt said:


> It makes sense though.
> Family doctor offices are ideally the first point of care and should coordinate patient care.
> 
> So they get a bonus to provide that continuity of care.
> But if they're not actually providing that care, they lose the bonus


It doesn't make any sense to me, I see it as ...

Walk-in clinics should be for acute (non-life threatening) issues, gives faster response and if needed, referrals.
- Gets paid per visit

Family doctor for chronic issues, checkups, perscription refill/adjustments, referrals, etc.

Gets paid set amount for each family patient they retain
Also gets paid per visit

Scheduling a family doctor appointment weeks out for something like strep throat or a sprained ankle is silly. A walk-in clinic is much better suited for that. Now I can understand if someone doesn't go to their family doctor for 2 years or so that they may get booted out so someone that does need it gets in.

Of course much of this depends on eletronic access to medical history.


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## MrMatt (Dec 21, 2011)

sags said:


> Ford eliminated automatic inspections and full audits of LTC homes, and cut funding for a variety of programs, when he first took office.


That's not the full story, we've been over this.
The inspection requirements haven't been followed for decades. 
They set new priorities to address the most urgent problems, while they reviewed and prepared a new inspection regime. 

Previously the "suprise visits" were pre-announced, or simply didn't happen, because they never had enough inspectors anyway.



> Ford also froze the number of new LTC homes that could be built, because he didn't want to fund their ongoing operations.


It's more complicated than that.



> My wife's employer has retirement homes and had one LTC home. They wanted to expand it and build more but couldn't get approvals.
> 
> So they sold the LTC home and built more luxury retirement homes.
> 
> To claim that Ford fully supported healthcare is pure folly and fiction. He cut, cut, cut.........when he was first elected.


Ford put a freeze on several initiatives, which is completely normal for a new government.


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## Beaver101 (Nov 14, 2011)

^ And the (current) Minister of Health under father Ford is doing a FINE JOB. Right, until she and her family needs medical help. And then I suggest she go to the USA and look for that.


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## MrMatt (Dec 21, 2011)

cainvest said:


> It doesn't make any sense to me, I see it as ...
> 
> Walk-in clinics should be for acute (non-life threatening) issues, gives faster response and if needed, referrals.
> - Gets paid per visit
> ...


For urgent issues I can see my family doctor within 1-3 days, possibly same day. They leave holes in their schedule specifically to achieve that target.
If the issue can't wait till the next day, go to the ER.
If it can wait, call your doctor.

Since we don't have electronic records, it's good for the doctor to know that I've had strep throat 5x in the last 2 years. That might be indicative of something else.

It is better for patients to have continuity of care and a relationship, and the government offers a small incentive to create and maintain that. Not a perfect solution, but considering the situation it's not too bad.

Remember the previous government spent over half a billion dollars and failed to make electronic health records (which is insane since they could have simply copied from another jurisdiction, or used a free solution Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review)
I think this was not done by the Ontario government because of the previous high profile failure.


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## cainvest (May 1, 2013)

MrMatt said:


> For urgent issues I can see my family doctor within 1-3 days, possibly same day. They leave holes in their schedule specifically to achieve that target.
> If the issue can't wait till the next day, go to the ER.
> If it can wait, call your doctor.


Sure, not all people can get in quickly and honestly there is no reason for family/walk-in doctors to fight over patients. Many family doctors here are the walk-in doctors as well, not sure about Ontario.



MrMatt said:


> Since we don't have electronic records, it's good for the doctor to know that I've had strep throat 5x in the last 2 years. That might be indicative of something else.
> 
> It is better for patients to have continuity of care and a relationship, and the government offers a small incentive to create and maintain that. Not a perfect solution, but considering the situation it's not too bad.
> 
> ...


And that is likely the biggest failure for Ontario ... I surely hope those responsible got fired and/or not voted in again. I mean if someone goes into an ER unresponsive and the doctors don't have a medical history ... wow, that's bad. Still, a previous failure doesn't mean they shouldn't proceed ... other provinces have it, how about copy the one that is working the best?


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## MrMatt (Dec 21, 2011)

cainvest said:


> And that is likely the biggest failure for Ontario ... I surely hope those responsible got fired and/or not voted in again. I mean if someone goes into an ER unresponsive and the doctors don't have a medical history ... wow, that's bad. Still, a previous failure doesn't mean they shouldn't proceed ... other provinces have it, how about copy the one that is working the best?


E-health was just one of the provincial Liberal scandals. The GTA gas plant & coverup scandal was a billion dollars or so.
Ontario votes Liberal, they kept re-electing the same Liberal government until they got Ford.

Due to the political fallout electronic health records were toxic. So the Ford government went to work on a lot of things that were less politically charged.
There are a lot of problems, and they generally chose to try and focus on lower visibility things, with less political risk, that could still make a difference. 
They actually pursued a huge number of smaller initiatives. I believe the idea was to make things better, and avoid the big headline scandals that would be politically costly.

Sure I'm a Ford supporter, so go ahead, take my opinion with a grain of salt, but it's hard to look at the situation in Ontario and see a big mess, with no clear way to solve it. Due to Ontario voting, I think the idea of trying to get as many small changes cleaned up in a single term is a good idea. 
I think the expectation was that they'd be a single term government, so if you really care about the people of Ontario, you fix up as much as you can in that limited window.


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## cainvest (May 1, 2013)

MrMatt said:


> Due to the political fallout electronic health records were toxic. So the Ford government went to work on a lot of things that were less politically charged.


If it is a big issue people really care about (and want to see fixed) then they need to bring it to light before the next vote. Otherwise, just like you stated, the current gov will side-step it.


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## Money172375 (Jun 29, 2018)

Behind a paywall, but the headline says it all.









Almost 20 per cent of Toronto doctors are considering closing their practice in the next five years


Of 439 family physicians in Toronto who answered a survey question about their plans for the future, 77, or 17.5 per cent, said they were thinking of winding down their practice




www.theglobeandmail.com


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## Beaver101 (Nov 14, 2011)

Money172375 said:


> Behind a paywall, but the headline says it all.
> 
> 
> 
> ...


 ... are you surprised? I'm not. 

What I am surprised is - why do we need a provincial Health Minister (along with that fake CMO) for anyways? [And don't forget to include that other minion supposedly responsibile for the Education system.] Why are Ontarians wasting their tax dollars? I mean we only need one main mouthpiece, father Ford.


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## Beaver101 (Nov 14, 2011)

Jones defends Ontario’s handling of health care as hospitals overwhelmed with sick kids

10:00 AM "ANNOUCEMENT" for Ontarians ... this is the "best" she can do?  Do we need further proof of another jackass "hard" at work? 

Money#####, does the above tactic sound familiar to you?


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