Physicians across Ontario are increasingly using third-party online vendors to arrange for patient services like referrals and prescription renewals.
However, in using these vendors, patients are being charged extra fees to access services that were previously free.
The fairly new trend in northern Ontario is meant to be a convenient method for patients to access vital services, but it’s got some complaining of sticker shock.
Judy Medina, 79, is from Sudbury. She has several chronic health issues that require multiple prescriptions to manage them.
Medina said she recently became unhappy with her physician when they directed her to Sparrow Health — a third-party vendor that allows patients to renew their prescriptions and process referrals online, for a price.
I felt I had no option, which means that I felt forced.— Judy Medina, patient in Sudbury
Through Sparrow Health, patients can make requests for prescription renewals, sick notes, or referrals to massage therapy and other services without making an appointment. Patients can pay per service or purchase a monthly or annual subscription. Those who choose to subscribe aren’t charged every time — they pay a flat rate.
When Medina sat down to use Sparrow Health and input her prescription renewal request, she was charged a fee. This had never happened before, she said.
“After three phone calls and having to wait in line on the phone at the doctor’s office, I finally decided I had no other options. So with a lot of difficulty again, because I am not computer savvy by any means, in any way … my husband and I got online and contacted Sparrow Health,” Medina said, “And finally got enrolled there and ordered the prescription or the renewal and I was charged with tax $9.26.
“I felt I had no option, which means that I felt forced.”
Extra fee gaining traction
While the extra fee was a shock for Medina, the Ministry of Health said the practice is legal. And it has only become more common over the last several years, particularly in southern Ontario.
Although the practice is just beginning to gain traction in northern Ontario, some family doctors in Sudbury have been using these services for the last 15 years.
But in using these third-party vendors, some patients are unwittingly being charged for services that are not insured by the Ontario Health Insurance Plan (OHIP).
While the legislation around insured and uninsured services has not changed, it is up to the physician whether to charge the patient for the service.
Many are starting to charge.
Ripple effect of a doctor shortage
When patients ask for a prescription renewal at an appointment, that service is covered under OHIP. However, if that request is made over the phone or online without a scheduled appointment, the service is not covered.
The issue becomes even more complicated amid the growing doctor shortage in northern Ontario. Fewer doctors means longer wait times for appointments, so people are using third-party services more often.
We need to find a way to stop burning-out physicians. So if I’m able to save four hours a week, I have to do that.— Dr. Samuel Peters, Sudbury
In the past, Medina said she would sometimes ask her pharmacist to Fax her doctor’s office for a renewal. But that’s no longer an option as health services across the province are phasing out Fax communication.
For people like Medina, there are fewer options. Some include accessing an after-hours clinic, waiting for an appointment at the doctor’s office or paying for the use of a third-party vendor.
Dr. Samuel Peters is a physician with Boréal Family Medicine in Sudbury, which uses Sparrow Health.
Peters said the online vendor was implemented at his office as a solution for several challenges increasingly facing doctor’s offices in northern Ontario.
“We need to find a way to stop burning out physicians, so if I’m able to save four hours a week, I have to do that,” he said, “Often physicians are working well into the evenings doing things like these prescription renewals.
“The other thing is the office sustainability — 1,500 prescription requests a month coming into our office, about four hours of staff time that we’ve eliminated by going through this service.”
‘Trying to encourage the right behaviours’
Peters also said introducing the third-party vendor has sparked helpful behaviour from patients, such as ensuring they bring prescriptions to appointments to avoid additional fees.
“We’re trying to encourage the right behaviours that actually allows patients to not have to pay anything, which is booking regular appointments, seeing their doctors and getting their blood work and all the stuff that we’re happy to do for our patients,” Peters said.
While the new fees have been a shock for some patients, Peters said he notified patients several times over about a year, before the third-party vendor came into effect this January.
For people like Medina who struggle with computer literacy and reliable internet, being notified wasn’t much help.
The Ministry of Health said that in Medina’s case, her physician is following legislation and the charges are under doctors’ discretion.