PRACTICE PARTNER
OFFICE CONSULT
The purpose of this column is to answer questions about issues that we either hear about frequently, or
that have a wide applicability across the profession. If you have any questions or topic suggestions for this
column, please email them to feedback@cpso.on.ca.
When your
Rostered Patient
Seeks Care
Elsewhere
Conversation key to understanding
reason why
W
hen your rostered patient decides to
seek medical care outside your practice,
it can be a source of frustration.
But keep in mind that your patient
may simply not understand their obligations within a
rostered relationship.
Most patients aren’t familiar with the intricacies of the
different physician funding models and may simply not
appreciate that their visit to a walk-in clinic has a finan-
cial consequence for their doctor, said Dr. Keith Hay, a
medical advisor at the College, and a family physician
practising in rural Ontario.
That’s why, he said, it’s important that patients be told
of their obligations before entering into a rostering agree-
ment and then be reminded of them if and when issues
arise.
“Do they understand their obligations under the roster-
ing agreement? Are they unable to access care during the
hours available from their regular family doctor? These
are some of the questions that need to be discussed with
a patient to determine whether the rostering relationship
remains a good fit,” he said.
Dr. Hay says that he used to pour over the monthly
Outside Usage reports from the ministry, examining each
and every patient that may have sought service outside
his rostered practice. He explained that he eventually
decided that it was an inefficient use of his time and only
served as a source of irritation.
“What I realized over time is that as a physician, I
needed to exercise a bit of flexibility and understand that,
from time to time, patients may seek care outside of my
practice,” offered Dr. Hay. “It may have been because
the patient was travelling, or perhaps going to school in
another community or another reason that may only be
clear to the patient.”
Dr. Hay said that he did not think it was appropriate
for physicians to de-roster or even terminate a patient
after a single infraction without understanding why the
patient felt the need to seek outside care. “If there are
issues, you should work with your patients to understand
and address them. The relationship begins by consensus
and when it needs to be ended, that should ideally be a
mutual decision, as well,” said Dr. Hay.
MD
ISSUE 2, 2019 DIALOGUE
43