Medical Offices Policies in Canada

I decided to write about my experience that is currently ongoing with my specialist.    My reason is the policies for cancellation of appointments, long wait times, bad medical advice or just plain making something up to get you out of the office.

A little back history:

All my life I’ve been pretty healthy, I had a knee injury in my 20s and had my tonsils out when I was 20.   Other than that, I was healthy.   I went for regular check ups with my doctor and that was that.    Then in 2009 things started to change.   I noticed my eye sight was getting bad and I was getting pain behind my left eye.   I went to the eye doctor who, informed me these were signs of a brain tumor and sent me to my family doctor to run a battery of tests.    After three months of searching for the cause, my doctor ran a simple blood test and found out that I have, Graves Disease.   Most likely it went un-diagnosed for over 25 years or so.   So, for the next year, I was sent to an endocrinologist for diagnoses and treatment.   She prescribed all sorts of medications to try to get  the thyroid under control (Hyperactive thyroid), and the side effects of those drugs sent me into an emotional roller coaster of hell.

After a few months of this, I went to my Endo, and asked when would I start getting to normal.  She told me it would take over two years to get the thyroid under control with drugs.  This to me was unacceptable.  I was newly married and didn’t feel it fair to my spouse or that my new marriage could handle that kind of strain.   So she suggested what they call RAI, which is a radiated pill and it kills the thyroid and you go on a hormone pill for the rest of your life.

Now that doesn’t sound bad on its face.  However, after doing my research and finding out that this pill is served to you by someone in a lead lined radiation suit, in a lead cup and that afterwards if you vomit, they have to call a hazmat team to clean up the mess.  Well, that made me uninterested in that treatment.    So I asked my endo what other options.   She said surgery.   I said no problem, and I underwent surgery and had my thyroid removed.

Here it is approximately 4 years later, and I’m on my second Endo and here is what recently happened:

With an Endocrinologists, they are considered specialists.   With these doctors, when they schedule your appointment they book them anywhere from 3 months to a year in advance.  And like most doctors in Ontario, Canada, they have a policy that if you don’t give 48 hours notice to cancel or change your appointment, you will be charged a fee of fifty dollars ($50.00).

I understand this policy and agree with it to a point.   After all there are exceptions to rules and one of those is a contagious illness.    I contracted pink eye the day of my previous appointment date last month.   I woke up with my eye swollen and oozing juices like a tap.  I didn’t want to infect anyone else, so I called my doctor’s office to inform them and reschedule.  Not cancel.   The receptionist was very apologetic and understood but insisted the doctor would charge me the cancellation fee anyway.  I didn’t like it but I agreed.  Since i was cancelling the appointment without 48 hours notice.   So I was rescheduled for yesterday.   (Feb 2nd, 2015).

Now, here is where it get’s interesting.   I live in Southern Ontario and we got hit with a snowstorm the night before.   30 cm of snow got dropped on us and the southern Ontario people seemed to think this was a huge thing.  (I grew up more north, so to me this is normal winter weather).

Schools, government offices, banks and many business’s closed for the day.    I didn’t get any call from my Doctor informing me my appointment was cancelled so I assumed it was still on.   Did I mention my husband had previously booked the day off so he could drive me to and from the appointment as well?

So off we went to the appointment.  We arrived at the medical building 20 minutes before my appointment time.  Paid for an hour and a half of parking and went in.  And when we got to the doctor’s office, it was locked.   No one came in.

This is where I have the issue.   We as patients are expected to call them when we cancel the appointments.  We are expected to give 48 hours notice as well otherwise they charge a fee.  Yet, the same courtesy is not applied to us as patients.   I’m a photographer by trade, and I consider my time just as valuable.  I know how to write a proper business letter, and how to create an invoice.   I thought about it and discussed it with my husband and decided to bill the doctor for my inconvenience.  After all, they didn’t give me 48 hours cancellation notice, and they didn’t call me to cancel at all.   As well, today I received a phone message advising me I had two choices, to call and reschedule or to find another Specialist on my own since mine is retiring in April.

I wrote up the letter today and below is the body (I took out names to protect privacy),

Dear Doctor Endo

You did not show up for the appointment which was scheduled for Monday February 2nd, 2015, at 2:00 pm.

Regretfully, I must charge a cancellation fee of $50.00 (Fifty Dollars CAD). plus a $6.00 (Six Dollar CAD) for parking, as well as an Administration fee of $20.00 (Twenty Dollars CAD).

Also, as per the phone message we received on Tuesday February 3rd, 2014, There will be an additional $100.00 (One Hundred Dollars CAD), finders fee to find another Endocrinologist due to your retirement.

However, if you wish to refer me to another Endocrinologist in the area, then that fee can be waived.

Kindly contact me if you wish to reschedule the missed appointment.

Now for my reasons.    First, they expect us patients to call them and to give them at least 48 hours to cancel an appointment.  If you call to reschedule, they consider that a cancellation and will bill me $50.00.

I have no issues with this, but the street goes both ways.  I did not receive a phone call informing me my appointment was cancelled, so as a business man I feel I can charge them back for the missed time.   After all time is money.  And in my case, I charge a fee of $100 for an hour portrait session, I had to pay for parking, and my husband had to miss a days pay to drive me.

On top of this, I only got this Endo last summer.   Less than a year and he is retiring and I have to go through the hassle of finding a new one myself, instead of him referring me to another Endo.

So, here is how it breaks down:

$50.00 Cancellation Fee

$6.00 Parking

$20.00 Admin Fee.

$100.00 Finders Fee (Waived if they refer me to a new Specialist).

Total $176.00

Doctors in Ontario have the ability to retire without giving any notice to their patients.  None.  My mother who has severe spinal arthritis had her specialist retire on her and they didn’t even bother to send her a letter.  She showed for her appointment and found a new doctor in that office that informed her the previous doctor had retired 3 months before.

It’s time we start billing back for our time on these bad billing practices and treatment by doctors in Canada.   If more Canadians started to bill back for Cancelled appointments, long wait times, then maybe, just maybe doctors would change their policies to reflect a fairer and compassionate practice.

The current billing policies create distrust, anger, and resentment.   Billing for small things like a note scribbled on a piece of paper for your employer costs $20.00 in some offices.  It’s getting out of hand and I am fighting back.

So I wrote up the letter and the invoice today and then after I called my Endo’s office, and as soon as the receptionist answered, she put me on hold.  Then a few minutes of waiting she came back and I informed her who it was, she happily offered to reschedule my appointment, or I had the choice of going to another Endocrinologist.

So, I proceeded to inform her that because the doctor was billing me for rescheduling my previous appointment, and that I had received no such call from them to cancel the one that they missed, that I would be sending them a bill for the cancellation of the appointment.  At first the receptionist thought I was joking, but as I listed my reasons, her tone became angry.  ( After all, how dare I, a mere patient bill for my time.)    I calmly explained that my time is just as important and as a courtesy at least, if my doctor cancels my appointment, for any reason I expect a phone call.   I didn’t receive one and told her that because I did not get that call, I assumed that the appointment was on.   I told her I even checked the newspaper for the cancellation as well since many business’s will post their closures due to weather there.

She became livid and started shouting, saying “what did you expect me to do, I was snowed in my home” etc.   My response was, that is not my problem what you do.  The doctor expects me to call him to cancel my appointment if I have to cancel, he didn’t do me the same courtesy and so I braved the weather and made it for my appointment.    I told her, that maybe should could pass on to him that he should call his patients as a courtesy if he cancels their appointments, and then stated I would be sending the bill out within the next few days.

(Many companies will try to come up with excuses that have nothing to do with their customer.  For example I ordered something for Christmas and when I ordered it, it was in stock and it didn’t ship.  After calling the company about the order they informed me that the warehouse was out of stock on the product.  This isn’t a problem for the customer, nor is it one that solves the problem, so I told them that was their problem, and not mine, and that I wanted the product.  And I was right.  The same goes with the doctors office.   I don’t care that they were snowed in.  That isn’t my problem, it’s theirs.  If I used that excuse they would still charge me the fee. )

I will post a follow up on the saga as it continues…

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2 thoughts on “Medical Offices Policies in Canada

  1. While I understand your chagrin at being charged $50 for a 24 hr cancellation, I don’t think you’re fair in billing your doctor, or taking it out on his receptionist, and here’s why….

    You make a direct reference to the snowfall and things closing….throwing in a shot about how this much snow wasn’t a big deal “in the North”…..I’ll point out, that having lived in ‘the North”….not only in Ontario, but in Cold Lake Alberta, Yellowknife NWT, and even Alert NWT I can tell you that 30cm of snow in such a short period of time is a big deal….especially when there are 100’s of kms of streets that need to be cleared..

    But, back to my point….you knew the weather was bad and many businesses were closed…but you went to your appointment anyway….without calling ahead.

    Right there your actions fail the test of “a reasonable person”.

    In addition to this, its unreasonable….and illegal for an employee of any medical organization to have their patient’s files at home….which is what would’ve been required to contact you.

    Some organizations do give employees the ability to access their networks remotely, but in my experience (15 years in healthcare IT), doctors offices don’t typically have the ability to do that.

    In pushing this issue you are guaranteeing that the staff at your doctor’s office won’t help you.

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    1. While I get your point, you missed mine. Not all business’s were closed. Most in fact were open with the exception of Schools and banks and government offices and a few mom and pop places. Besides that. If the roles were reversed and I was snowed in and I didn’t called in to them, they would charge the fee. As well, other doctors were in fact in their offices in the medical building.

      First, I’m not attacking his receptionist. She answers the calls, and deals with the patients. The doctor doesn’t take calls. It might be different were you are, but the reception is the go to person for everything. They are even the ones who do all the filing and send out those letters saying they are charging a fee for cancelling appointments. I wasn’t blaming her or attacking her. I’m against that policy and being charged the fee and yet they can cancel without notice and not pay anything? Really?

      A doctor’s office is a business. As such, I am the consumer. It is not unreasonable to expect a phone call from the doctor’s office if THEY cancel the appointment, no matter what the reason. It is not my job to ensure the appointment is still on if I have made it and they confirmed it was still a go. It is theirs. I’ve had specialists do this constantly as well. My previous Endo would go on vacation without changing or calling the scheduled appointments until after they got back. Or they would be called to the hospital and not bother to call to reschedule on the day of the appointment. Or even not show until 30 minutes past the time my appointment was scheduled.

      “Medical files are not allowed to be brought home” – That isn’t my problem. That is trying to push the problem back on the patient. I don’t care what they can or cannot do. In this day and age they have the ability to remotely connect to the servers at work and make those calls. So the excuses are just that. Excuses not to do something.

      I won’t accept that from any retail business, I won’t accept that excuse from a business that offers a service either.

      “In pushing this issue you are guaranteeing that the staff at your doctor’s office won’t help you.” – Actually by doing this and if more people did this, then these types of policies would go away and better service would happen. Many people I have spoken with are fed up with long wait times, cancellations without any notice, being billed for notes, rescheduling etc. So your in the minority in your thinking. Also if you read the blog post in full, you would have seen the doctor is retiring in April. That is another part of the issue. I spent three years having to look for this doctor myself and in less than six months he is retiring. If I had been told that there was even a chance he would decide to retire in less than 6 months, I would have found a different doctor.

      If you do some research, many people in the United States are billing their doctors for long wait times, and the doctors are paying them. Some are providing little gifts for waiting longer than 30 minutes for the poor service. It’s about time Canadians starting pushing back and getting better services as well.

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