Dialogue Volume 15, Issue 2 2019 - Page 43

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