Are family doctors cherry picking patients?

When Anne Lyddiatt’s family doctor retired, she went looking for a new one.  The Ingersoll, Ontario resident thought she’d found one for herself, her two daughters, and her granddaughter, and they filled out application forms with their health information. But only one of the four was accepted: the daughter who had no chronic conditions.

“When we went back [to hand in the forms], the receptionist said ‘I’m sorry, she’s the only one who fits our profile,” says Lyddiatt. “I knew [cherry picking] went on, but I didn’t realize the extent of it until then.”

Family doctors are allowed to screen patients based on their scope of practice. But they can’t refuse people because they’re low-income or have complex health problems.

Lyddiatt isn’t the only patient who feels she’s been treated improperly: in a 2011 discussion with 25 members of the Toronto Health Policy Citizens’ Council – led by Andreas Laupacis, Healthy Debate’s editor-in-chief – some members believed they personally, or friends and family members, had been inappropriately screened out of a doctor’s practice. A recent study in Canadian Family Physician spoke to 18 Ontarians who had lost their family physicians, and found that many were frustrated with the process of getting a new family doctor. One said “I felt like I was applying for a job …. I knew already that there could be issues in terms of if you have too many problems, or … the burden that you’re going to put on the practice.”

The College of Physicians and Surgeons of Ontario has received 90 complaints since it began tracking them in 2008, after developing its policy on the issue. That only includes those who’ve come forward officially; the actual incidence is probably higher. Ken Gardener, assistant registrar at the College of Physicians and Surgeons of Alberta, says, “I don’t think we get lots of complaints [about cherry picking], but I know that if you go down and talk to a number of physicians practicing at the front line, they’re certainly aware that some clinics do not comply [with the rules around it].”

The issue has caused a debate over the common introductory meeting – is it a way for family doctors to present their practice and look for fit, or an invitation for some doctors to screen for more time-consuming patients? And new funding models may reward cherry picking more than old fee-for-service ones did. So how pervasive is the issue, and what can we do to counter it?

Who does it affect?

Trevor Theman, registrar of the College of Physicians and Surgeons of Alberta, says he’s also heard complaints about cherry picking, often against those with complex medical issues. “Commonly it appears to be the more difficult patients, patients with multiple chronic diseases, with chronic pain, those who may have some drug seeking behavior, or patients with mental health conditions,” he says.

Research has also found discrimination against a different category of patients. Last year, Stephen Hwang, a physician and scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, studied the issue (Healthy Debate is also run out of the institute). Hwang looked at the effect socioeconomic and health status had on access to primary care physicians by having researchers call 375 family doctor’s offices in Toronto. They said they worked for a bank and had just been transferred to town, or that their welfare worker had told them to get a doctor, and also asked for regular check-ups or care for diabetes and back problems.

Contrary to popular perception, he found doctors actually were more likely to accept patients who needed more care, with 24% of those who said they had diabetes and back issues getting an appointment, versus 13% of those who only needed checkups. But there was a difference when it came to socioeconomic status: 37% of the callers who pretended to be bankers were accepted by family doctor versus  only 24% of welfare recipients. Often, the ones in a lower socioeconomic status would be told the doctor wasn’t accepting new patients.

“Working with people who are marginalized or disadvantaged, what they often say is, ‘I think I got treated differently because I’m poor,” says Hwang. He suspects physicians may turn down lower-income people because of the perception that they take more time and energy.

The guidelines

Both the Canadian Medical Association’s code of ethics and The Ontario Human Rights Code prohibit discrimination based on things such as age, race or gender. The College of Physicians and Surgeons of Ontario’s 2009 policy on new patients is even more explicit, stating that patients should be accepted based on who’s first. “Physicians who are able to accept new patients into their practice should use a first-come, first-served approach,” it reads.

The policy does make exceptions for doctors who have decided to limit their practice to a certain specialty, such as sports medicine, or patients doctors don’t think they have the skills to treat (though the Toronto citizens’ council raised concerns this might be used as a loophole). Another exception: physicians can prioritize the sickest. “You can choose on the basis of picking someone who is more urgent than the person in front of them,” says Marc Gabel, president of the College of Physicians and Surgeons of Ontario.

The College of Physicians and Surgeons of Alberta has similar guidelines. “A physician who is accepting patients on anything other than a “first come first served basis” must establish criteria for patient selection, based on matters relevant to the physician’s scope of medical practice,” it reads.

Screening meetings

The Ontario college’s guidelines recommend against introductory appointments, where family doctors meet with patients, explain the practice and hours of operation, and get a sense of the patient’s background. Hwang’s study looked at the rates of these introductory meetings – which he’s heard called “patient auditions.” It found in 9% of cases, patients were invited to one. “To me that’s kind of concerning, because [the CPSO] says in no uncertain terms you shouldn’t do that,” he says.

Those appointments are often where patients are rejected, says Theman, saying the College of Physicians and Surgeons of Alberta has had patients say they were explicitly told told they were too old or had too many conditions. However, he does believe meet-and-greets can be legitimate, when they’re used for a doctor who has a limited scope of practice or to clarify expectations between the physician and the patient.

Others also believe they have merit. The College of Family Physicians of Canada doesn’t have a policy surrounding patient screening, but believes that all family doctors need to be socially accountable. But Francine Lemire, executive director and CEO of the organization, believes that doesn’t mean they shouldn’t have introductory meetings, though they’re often precipated by an acute situation. “It offers an opportunity for us to communicate how the practice works, what our after-hours situation is, what the coverage for the practice is. We get appraised of their situation and can think through how is this practice going to be able to support them, and then they can also assess the same thing,” she says.

The College of Physicians and Surgeons of Alberta doesn’t discourage initial meetings, but believes that only the patient, not the physician, can look for fit (beyond the accepted exceptions). “If you have a meet and greet with a patient, then that is now your patient. You have established your relationship with that individual,” says Gardener.

Issues of compensation

The payment models for doctors may not be helping in Ontario, either. Capitation was introduced and has proven popular, with 4,000 of Ontario’s 9,000 family physicians on the system, which pays doctors per patient, per year, rather than per visit. “In the old traditional fee for service way of doing business, there wasn’t nearly as much incentive to cherry pick as there is with primarily capitation funding,” says Mark Dermer, a family doctor in Ottawa and author of Healthcare Insighter.

Under capitation, doctors get paid an adjusted rate depending on the patient’s age and gender – but not for how sick the person is. That means that physicians would be paid the same for a 40-year-old who came in once a year as for one who came in every month. “A payment system that creates sufficient incentive to cherry pick is flawed,” says Dermer.

Rick Glazier, senior scientist at the Institute for Clinical Evaluative Sciences, studied compensation and patient mix in a 2012 analysis. It found that doctors paid through capitation are more likely to be in suburban or rural areas, with patients who are healthier and richer. Those on fee-per-service are more likely to have lower income, less healthy patients. But those differences don’t necessarily mean doctors are cherry picking – rather, Glazier thinks those offices who would have benefited from capitation made the switch when it became available, and those who would have lost money stuck with the old fee-per-service program.

And the gap means the financial incentive to cherry pick is there. “The [patient] who never comes in is a winner financially, and the one who comes in all the time is a loser, financially” under the current system, Glazier says. He also has colleagues who began building practices from the ground up with Health Care Connect, which helps Ontarians find a family doctor and prioritizes those with complex health problems. “They’ve realized you can’t have an entire practice of those people, or you’ll have a third or half of the number that everybody else has [and make a lot less money],” he says.

The government has tried to address this problem by providing additional payments for illnesses such as diabetes, as well as services like prenatal care and smoking cessation. “They have recognized it as a problem… they are paying an acuity payment,” says Glazier. “They are attending to it, but so far it’s not anything like the size of the payment that would make you want to take on those patients.”

In the meantime, hopefully the ethical requirements of the profession are enough to keep doctors from screening out unhealthy or poorer patients. It’s important to treat everyone to maintain the public’s trust, says College of Physicians and Surgeons of Ontario’s Gabel. “Professionally we go into medicine to take care of people. Not to take care of only x or y, but to take care of the entire alphabet,” he says.

The comments section is closed.

  • Judith C. Seli says:

    My situation is difficult because I had no problem to get a family Dr in Stratford, ON, but the Dr.’s Nurse didn’t communicated to me details of test results clearly, I was applying for a new life insurance and my family Dr. Sent my whole medical records to the Insurance Co. which denied the life insurance coverage, I asked for a copy of my Dr.s report and I received it, that’s the way I knew some of my test results and also some tests that had to be repeated hadn’t been done. Last week, I called Apr. 28/21 for an appointment and the receptionist told me they weren’t giving appointments, that I was going to be called by the nurse to give me an appointment. Two days passed without the nurse calling me, so I called again and I told them that the Dr.’s nurse hadn’t called me. The receptionist said “she is very busy, she will call you”. Today is May 4 and I haven’t heard from the nurse, I have a pain on my heel, and I need to see a Doctor. What can I do? I feel neglected.

  • Jeny Jones says:

    Discrimination against the elderly during COVID-19. My parents are aged 90 and have been seeing their physician for over 14 years. He recently found out that they attended a walk in clinic in another town because during COVID they were afraid to leave their home. After finding this out, their family doctor asked them to come in and had them sign paperwork March 10, 2021. He informed them at first that this paperwork was to get their file back from the other doctor at the walk in clinic who apparently according to his statement had taken their files from him. Eagerly (both in their 90’s) to return to normalcy my parents signed to consent from to return their files to their longstanding family doctor who they believe was sincere and helping them. My parents called for an appointment on March 11, 2021, with their family doctor only to be told by him that they were being transferred to the doctor at the clinic where they were seen during COVID and the consent they signed was to send their information to him. They were tricked, their doctor refused to treat them and sent them on their way. I don’t think that is fair and I think this trick is mean and unethical! What can I do to help them? Where can I complain about this unfair treatment??

  • Anne says:

    This happened to me today my doctor made me feel that I was the problem and dumped me as his paitent

  • Betty Ann Sanderson says:

    My name is Betty Ann Sanderson I have questions I have seen this doctor name Dr. P Dhanjal at st. James medical clinic 1600 portage Ave Winnipeg Manitoba 1204.774.1868
    I received a letter from him stating I will no longer be able to be your regular physician he said his downsizing my practice all of sudden he wrote me this letter i received in the mail as of July 22. 2020 I have this doctor for seven years he knows my health issues I have blood cloth in my leg as he treated me two times for the same problem and some other issues in my health it’s hard to find a doctor specially this covid-19 I’m regularly Patient to doctor DR P. Dhanjal I had some some issues with his secretary she won’t let me talk to him she suggested the doctor no longer going to take you as patient she was very rude and disrespectful towards me awhile I was sick what can I do with this matter ? I’m very hurt and devastated by this … yours truly Betty Ann Sanderson 215 Kinver Ave Winnipeg Manitoba 1204.647.6622

    • Anne says:

      I thought about my family doctor cherry picking today and when I got off the phone with him realised he did me a favor I Don’t want to go to a doctor with a ignorant bedside manner

  • Cathy Wilson says:

    My doctor actually refused to treat me after I caught the receptionist living to me as to her reason for not allowing me to come for my appointment 10 minutes later due to a dental appointment.She wrote me a letter…this was particularly hurtful as I had been her patient for nearly 10 years and got along well… I struggled to find a new GP and am very jaded now.

  • Charlene Fielding says:

    I have found 3 doctors taking patients myself and phoned my telehealth care connect to be connected to one of them. She tells me to call back in the fall 2 more doctors are coming closer to me . I call back, oh they aren’t coming now. I find another one now that is taking patients and have them update my file with her name and my husband gets call next day saying DR not in our district . I’m going door to door and phoning Dr s. Was told I need to find Dr that isn’t excepting from telehealth by my health care connector . Feel like I’m going in circles.

  • Shauna says:

    I live in Alberta, and I have experienced this first hand!! While searching for a new doctor, I was mortified at how I was treated at these “meet and greets!” It has left me emotionally scarred, feeling hopeless, frustrated, and angry. I was told that I had too many issues, the government regulates how many “complicated patients” they can accept, and that I wasn’t a good fit for their clinic. Before this, I was with the same doctor for almost 10 years. I only went to that clinic, I only had one pharmacy, and I had legitimate issues backed up by tests, and documents from my Spinal Surgeon. I was so shocked that this was happening to me, proud to be a Canadian, but feeling like I was living in the states where I wasn’t good enough for proper health-care. I had no idea there was an actual name for what I have been experiencing. Knowledge is power, I am going to do more research on this because it is a situation that desperately needs to be addressed by our society for our well-being.

  • Dennis Brunet says:

    I am 61 male. Seems every young doctor wants to change my prescriptions that have been working perfectly for the last 20 yrs. End up trying their new crap with terrible side effects and going back to what has been working for me all along. Makes me want to slap some commen sense into them.

  • Patient Disgusted says:

    I do not believe a comment will affect this form of insanity that has gripped the medical community in this country.
    Doctors of all types tend to be all about their ego anyway, and this is just one more tool for them to play “God”, as in:
    “I will pick and choose only the people I like for treatment” Whatever happened to honor and service? To the Hippocratic oath? To the human quality of compassion and empathy?

  • old sam says:

    They have ways of getting rid of you. Making appointments and then when you show up there’s no record of your appointment.
    The younger doctors are not good listeners. I know this near 70 old body pretty well and know what medications I react. I don’t want a flu shot so that I would imagine goes against me.
    They just have their ways, they’re subtle but you know what they are doing.
    I like to be involved in my treatments and usually have a lot of questions but now doctors don’t have the time. I honestly think they prefer not to take anyone over 60-65 because we know a lot about ourselves and will question them.
    No handshakes anymore. Seem detached and busy imputing information into the computer or looking something up on their cell phone. It’s all about tech, no personality, and feels much like taking my car in for testing.
    I picture a building with a drive-thru , BP station, Blood Testing Station, Swab Station, EKG, and so on, no people just machines…
    I’m dreading my later years for this reason.
    and the lies…mis-truths sounds nicer but it’s lies. Falsehoods in previous doctors records have hurt me…and are so wrong. Near death so will leave a trail of those behind to be reported on facebook or You Tube

  • Mercedes T says:

    “Capitation, Money incentive for Cherry picking patients” should not be allowed.
    What kind of medical ethics is this that government actually allows this discriminating behavior by doctors.
    Thus, descriminatory practice by doctors, leave s a patient feeling not worthynof medical care. Which is every human being rights. When a doctor has given the power and incentives to reject patients. There is something very wrong with the medical system. Get rid off “capitation”

  • DUSTY H says:

    hi my feelings a long term care aid this is wrong since when do we have drs to play God and allow a paitent not to have care they think they have rights maybe so but the fact they are to stick to there promise just like i had to when working in a mental hospital i had to put my patient first had to protectt the paitnet from harm or therates i was not there to just them this not waht a medial staff are to do its wrong since when do we become God i m sure he is really ticked off in the end its time the laws are no racism should be allowed or picking and choicing paitents nor should interview the patients with out a social worker or family member i know i had one treat me with his games and he is dr out of bc and at at training center confidentail rspv to my addres please urgent my heath is at risk i m dibetic 2 rspv newmanp this is confidential to the person that recieves this i hope that your team can improve this note many people are right tick off and fed up correct it before people gather to change things lol DUATY APN

  • Donastria says:

    I live on ODSP, and have been attempting to get a family doctor for over 5 yrs just to be told each time I either don’t qualify or they are not taking new patients. Though 1 I caught in their lie of ‘not taking new patients’ by tricking them. They were not happy. Just because I am disabled I do not deserve to be taken care of? I am less then? Somehow to me this does not seem right, and quite backwards. Should the sickest not be taken care of first? Is that not the policy they use in hospitals? You go to emergency and they take you first come first serve, unless someone comes in that is let’s say having a heart attack. Then they take them first. Why then is it so damn hard to hold GP’s to that same standered? Why are they insentified to pick and choose only the healthier options? THEY ARE NOT THE ONES WHO NEED YOUR CARE!

    • Margaret says:

      I agree!!!! These doctors took an oath, to help all. This type of discrimination, YES I SAID It!!! must stop!! Everyone deserves good medical care! So my question is who is going to stand up for all of us in need of good medical care? What is the college of physicians and surgeons going to do about this? Att the family doctors out there you asked an oath to heal now honour it!!!!

    • Emily says:

      I know how you feel, it is hard to get a doctor and just as hard to get a dentist accepting patients on odsp too. It is so sad to know people on odsp are discriminated because our financial situation. Try putting yourself in our shoes for a change. How would you like to be treated this way because of your financial and health situation? You would not like it so, do not treat us like that because we did not choose to be on odsp, we did not choose to have certain and sometimes complex medical issues!! Think about that!!!

  • Katharina Bartsch says:

    My Family Dr. retired from his practice. So I needed a new family Dr. I have been diagnosed with AnkylosingSpondylitis, so I use pain medication. My family Dr. gave me a list of doctors that were accepting new patients. The first Dr. office aks a list of my. med. As soon as I said that I was on pain med. I wouldn’t even get an application. The secretary said the Dr. in this office don’t prescribed pain med.

  • R says:

    I had a horrendous experience with one clinic that definitely does cherry picking.

    A doctor named “Dr. L” dropped me as a patient after I had a panic attack during an appointment I had with her, last year. I started to hyperventilate during the appointment – I was not rude, I didn’t misbehave in any way; I explained that I have a medical condition that makes it hard to control my anxiety. Instead of being understanding or caring like a doctor should be, she dropped me as a patient – I learned that today when I called the clinic and tried to make an appointment. When I called and tried to make an appointment, the receptionist asked me to hold. When the receptionist picked up the phone again, I was told that Dr. L would not see me anymore. I then asked why Dr. L wouldn’t see me anymore; I was calm and polite when I asked. The receptionist didn’t answer me, she hung up on me! When I called back (giving the benefit of a doubt and thinking she might have hung up by mistake) she hung up on me again! I was not rude to the receptionist nor was I rude to Dr. L nor did I ever miss an appointment with Dr. L; it is because of these things that I can only come to the conclusion that Dr. L to see me because I have a challenge that can make it extremely difficult to control my anxiety. I do not try to make anyone upset; in fact, after I had the panic attack, I tried to talk to Dr. L but was told by the receptionist that Dr. L would be busy the rest of the afternoon and would be unable to speak to me, even though it was only two minutes after I left the exam room! (Dr. L did not tell me not to come back or anything like that when I had the panic attack either.)

    Fortunately, I have someone who is willing to be my family doctor – Dr. L was my doctor for less than one month. I met with the new doctor the same day that I called Dr. L’s office and was told that she wouldn’t see me anymore and told them about what happened (Dr. L won’t see me anymore, I told them about the panic attack I had at the last appointment, I also mentioned the fact that the receptionist hung up on me – TWICE). They think that Dr. L dropped me because she can’t handle the fact that I am “different” – I have anxiety that can be hard to control, and I do try to control it! However, they said it was wrong of her to drop me, it was also wrong of the receptionist to hang up on me, and that she and the receptionist should be ashamed of themselves and that they were guilty of cherry picking.

    It seems that if you have a mental health condition, you’re screwed, I know of people that are dropped by doctors because of this. My family doctor works in this walk-in clinic (that I have used in the past) and I hate to say it but I have Post-Traumatic Stress Disorder due to another doctor that works in the clinic (that is actually the same age as me – we’re both 29 years old). The doctor that I developed Post-Traumatic Stress Disorder from was rude; he made comments that no doctor should ever make – he criticized me for frequently visiting the clinic (I had been due to a medical problem I had been having), plus he personally attacked me and said other things. I have not told my own doctor about this since I know that would be pointless as this doctor that was rude to me is apparently “nice” to other patients. I really like my family doctor but my family doctor is only in two full days a week and the other three days is in only for the mornings – I could see someone else in the clinic (and I obviously tried) but I have had bad experiences (not just with the rude doctor that gave me Post-Traumatic Stress Disorder). I am looking for a new doctor again and if I find a new doctor and it works out with the new doctor I will be going back to the walk-in clinic (where my family doctor works – my family doctor doesn’t have a clinic outside the walk-in clinic) and telling my “current” family doctor what happened and that I have been treated like dirt several times but the last time, from the doctor that is the same age as me, was like the final brick – it has broken me. This happened in November 2018 and I’m still really upset about it – I still have crying spells and even nightmares, that’s why I have Post-Traumatic Stress Disorder from this – this incident with the rude doctor gave me Post-Traumatic Stress Disorder.

    Bottom line: We need better doctors – both Dr. L and the rude doctor were rude and cherry picking; I think the rude doctor was cherry picking since he was nice to other patients (as I heard other patients say) yet completely rude to me for no reason at all.

  • Louise says:

    My Dr has discriminating against me, because I’m a Canadian

  • Behare says:

    I dont understant finding a falily doctor near your area should be a problem.
    I am calling several clinics near my area and they are not accepting new patients, Isnt that bad?
    What is the point driving far and find a family doctor? It should be in your area
    When you call them they give no reason why dont accept.
    We are e new family we work everyday and of course we want to find a family doctor near our place. Actually they are dicriminating in all ways without explainin the reason. but there is no reason not to accept new patints. They really picking cherries up.
    I think this must be very actual in media.

  • Tammy says:

    My family doctor told me strait out not to tell specialists that I was on ODSP. That I would be treated differently. so yes this goes on all the time.

  • Mr D says:

    I had one Dr who moved and never told me when I found out and left messages for an appt no one ever phone me back. when my regular walk in Dr asked me to get family Dr I told him I can’t find one and he gave me no contacts like he knows what’s going one

  • Amy Carolyn Budway says:

    This is happening to me right now I have lost everything My friends family money job apartment all because I followed my Dr’s orders – 10 years ago. I was born with loradosis and cystitis so I had chronic pain and major back issues. 2008 My GP(whose now retired) referred me to an Orthopedic Dr, 3 failed instrumental fusions L3,4,5 S1 later and Baker cysts – I know there are no guarantees in life but NOW! I’m now blacklisted cause I was asking questions about my future and not knowing what REALLY goes on – (We are the “No hopers or parasites) Quality of life -is what I see now on TV as walking is scary cause when a cysts birsts I fall and not wanting to be treated like a victim but I am SUFFERING in silence with a Depression I never thought I would experience -Suicide! I am so grateful for the good guys but I am losing the right light at the end of the tunnel. Please what else can I do when I have been told what to do and did it and so on and so on. I was never a “difficult” patient but our Dr’s are stigmatizing and sterio typing us to the point of no Hope – Why are you a Dr if you don’t want to help? That is my scenario I hope it gets better but I am losing hope.

  • Lois says:

    I just got told today that the dr wanted to interview me. I just moved from Saskatchewan to Langley BC. I have never been asked before now. They are definitely cherry picking and please respond to what they are looking for in BC in a female patient.

  • Victor says:

    Look Linda. Doctors have the best of both worlds; the goverment pays (no need to bother handling money, bounced checks, etc).

    The set high tariff for services (that is why such high incomes).

    Have control over who practices with the ruse of “qualifications”. It is as if restaurant owners had the exclusive authority to decide who is qualified to open a restauran and forced anyone who wants to open a restauran to pass a very tough exam on health laws, microbiology, communicable disease, stove technolgy and on and on.

    Same for car mechanics, nurses, engineers, lawyers, etc. Any profession can have an exam as tough as you want.

    It is a medical scam thas is costing lives because many people can not access a doctor and wait too long.

    Any doctor who comes from a country with proper training standards for doctor, and there are many countries, for example all of Eastern and Southern Europe, should be allowed to immigrate to Canada. Only requirement should be 6 months in a hospital or clinic to familiarize him or her with Canadian laws, interpersonal skills, etc.

    Doctors should be on salaries, normal civil servant salaries without hard incentives to see as many patients as possible ane to have as few doctors as possible.

    Doctors Canada have set up fake barriers to make more money, the res is distraction

    Victor Lopez

  • Ms. Lynne Poirier says:

    I don’t treasure anyone like myself being discriminated against in such a way. to me it appears that we will never ever be able to get or have any drs out there accepting us. therefore, it’s like they don’t honestly care. to me this shows irresponsibility on their part, as chronic conditions make up a lot of patients’ health histories, etc. my son will not accept any that will accept him but won’t accept me. this shows that my son supports me and would risk his own health for mine as he knows it is unfair. I wonder what happened to the people mentioned here whose
    only person was accepted did, etc. it would be interesting to know. did they do what my son does and he/she pull out in support of those who didn’t get accepted or did he/she stay with where they did get accepted? for those of us who never will get accepted we are left with trust issues, frustrated, no medication renewals when they run out of repeats, anger, feeling like the drs are hoping we will die so no more needing any of them, etc. The College of Physicians and Surgeons support their own 99% of the time so don’t bother writing to them to complain. I don’t even trust or even go to the Walk-in Clinics anymore. a lot more to this than meets the eye, etc. but I’ll stop here as I believe most of you will get what all I am saying. Health Care Connect is a very sad joke and really don’t help as much as they should. don’t fall for anything they say when they tell you they may have a dr. for you, you will still get turned down if your anything like me. I didn’t ask to be the way I am and I shouldn’t be blamed/faulted for it.

  • East West says:

    They work for the people and are paid by the gov’t. I am a teacher and I cannot cherry pick my students..I have to to teach whoever I am given…from the rich to the poor, from intellectually gifted to autistic, from behavioural issues to kids with chronic illness…you name it I have to deal with it-and most times, all in one class! This is absolutely insane a doctor can cherry pick….unless they run their own private pay practice, this is unacceptable.

  • irene carlson says:

    I am unable to find any medical Dr..willing to accept my chromatically ill body and felt to die BC CANADA

  • Juston says:

    I have applied at several doctors who supposed accepting patients here in sarnia…They are cherry picking here for years,,,I have serious back problems cant find a doctor, you find me 1

  • Sarah says:

    In my experience in Northern Ontario, physicians can fire you as their patient for any reason at all. Patients don’t have any rights. I just received a letter from my family doctor firing me as a patient for no good reason at all. The only reason I could possibly come up with is that I have chronic pain and could possibly be considered “complex”. I thought we were moving forward with treatment, but then I received this letter and am dumbfounded. It certainly takes a tactless and tasteless practice to make such a decision, without even calling me or speaking to me in person about any issues. Canadians are really kidding themselves if we think we have a better system than the Americans. I can’t even get primary care, specialty care, or decent pain control in this poor country.

  • Peter Clark says:

    I am and I have experienced this problem, first hand, it’s systemic and most Doctors seem to think they have every right to ignore their Hippocratic Oath!; They even limit Doctor/Patient meetings to discussing “one issue” at a time!

  • Just think of me as 'Can't get a doctor and tired of giving up my medical spot to less responsible Canadians' says:

    Yes. Cherry picking is a problem. But not totally without merit.
    Should a physician have to offer advice and due diligence to a person who is (for example) ill due to smoking or an otherwise irresponsible lifestyle after being told multiple times to stop??
    Some people are putting undue burdens on the doctors limited time. Making changes to their own lifestyle would offer:
    a) immediate better health and
    b) more time for other people to see the doctor.
    So yes, it’s a problem. But its not 1960. Why should our taxes support people who don’t care enough about their own health to stop smoking & drinking alcohol when both are long-proven burdens on the Canadian Health Care system?

  • Shanon says:

    It should be against the law and the doctor should lose their license. You become a doctor because you love the job and love helping people and If your only doing it just for the money become a lawyer instead, nobody’s life is on the line that way. Doctors should not refuse to help anyone nor should they be allowed to cherry pick or refuse being the family doctor for that patient that asks unless that patient becomes a problem for them and not medically. I feel the worst thing to happen in Alberta is the privatization of clinics Albertans are worse off because of it, doctors no longer work together to solve problems everything is now on a individual basis when it comes to problem solving, thats why so many people are misdiagnosed all the time. It’s hard to find a good doctor but with no choices available your stuck with whoever is taking patients at the time.

  • Bruce says:

    What to do doctor give me no hope plus I had a fall I don’t know if I have disfigure by fall or emergency doctor?

  • Bruce says:

    I’am being miss treated doctor flu shot no rubbing alcohol reaching pic, no pain receive after head injury, bullied from waitress and partner throwing something at me now I have m.r.s.a. doctor won’t cure he said everybody has it I read 3% pop.does what’s he talking about senior being bullied again!

  • Erich Walther says:

    My wife is Pregnant. Due this March. My Family doctor has told me, with her in the office with me, that he will not take her or my child on as patients, because he “has too many patients, and needs to maintain a schedule where he can see his patients without having to book them weeks in advance”…

    But I am left wondering, If my “Family” doctor won’t see my wife and child too, how can he be allowed to use the title of Family Practitioner? When he is in fact an Individual Cherry Picker.

    I am freaking out trying to find a doctor for my child. In Canada, I never imagined this would be an issue for me in my life. I just pray my baby doesn’t die because I can’t find a real Family Doctor in time…

  • Gordon Gauthier says:

    I am a 71 years old male, retired professional, who moved to Thunder Bay to help with my 90 years old mother. I am an only child. I had health problems when I moved here but I did not expect to be treated so poorly by medical professionals. I have submitted an untold number of “applications” to become a patient. Not one called back. Not all but most receptionists were downright rude. To give them their due, I am sure they take the brunt of the anger and distrust that has exploded since health care and doctors ethics have taken a plunge. Anyway, when I call them back they suddenly are no longer accepting patients. Out of desperation I went to a walk in clinic where I was referred to a specialist but told not to return to the walk-in clinic. That is, if I had any other problems I should go to the hospital emergency room. Even though I was finally getting treatment I still had other health issues that needed addressing. A friend told me she had heard a certain doctor was taking on new patients so I immediately drove to the clinic and was indeed told the doctor was taking on new patients. I submitted the requisite “patient application form”, waited a week before calling to find out my status, I was told that the doctor was almost finished “selecting” his new patients and that he chose not to take me on as a patient with no other explanation. I seemed pretty clear to me that he felt he couldn’t make enough money off of me do I get to suffer despite paying my share of the provincial medical expenses for the last 55 years.

  • Brenda Jensen says:

    My husband and I moved from BC to Saskatchewan so I could offer care for my 91 year old Mum. We had had the same doctor in Kelowna, BC for the 44 years I lived there. Great doc, wonderful care and never hesitation to recommend when he was accepting new patients. His take on recommending new patients was “I want to know firstly, that they are invested enough in their health care personal health that they are seeking a doctor who works toward that same end and not someone seeking health care to enable them to continue with issues that have been ongoing and they’ve not done anything to improve themselves….as related to critical care”. I like that approach and only recommended them as a probable patient if they wanted the truth, as he was known to hand his patients, and what they had to do themselves to assist in their personal care. Here, in Saskatchewan, pasted on the wall of the doctor that was referred to us (from a girlfriend [moved to Vanc Island from SK]) were the words ‘only one issue per visit’! I did ask him if this meant that I had to leave and come back the next day if I had more than one medical issue to discuss with him during the visit…to which he pointed to the sign and said ‘can you read that?’. My husband, who had lived healthily thru an Angina attack 10 years previously, was told that he would require ‘too many reports to be written, therefore could not continue to be his patient’…wherein, I looked for the Hippocratic Oath on his walls and found none! Insult after injury! I continued to see this doctor only to refill my one prescription for high blood pressure (insuring he would not get a mortgage payment from my visits) and found myself at a local emergency hospital unit for a brief bout of sciatica. Cherry-picking at it’s finest…and this doctor went to great lengths upon our initial visit to tell us both how he had walked out of Iran to Russia to go to medical school, then to the US and now residing in Canada for 25 years. What if, just what if, we had discriminated about his ethnic background and told him that we weren’t going to continue seeing him for medical care because he was from outside of Canada!! I get we have a shortage of doctors in Canada. I get that they are all taxed to the top with patients. I just don’t get that they want to make their 30-50 quickie patients to pay for the house they are living in nor the car they are driving while posting ‘one issue per visit’ and rejecting patients based on their medical needs. (PS – my husband was not seeing him with heart related issues as there hadn’t been any since the 10 year period had passed) We were simply introducing ourselves to him SHOULD we need a family doctor. I wished I was still in BC with the doctor who took the time to address any health related issues we had or were to encounter. I am 69 years old, husband is 66 years old. It stinks to high heaven and we are helpless to report this guy for this abusive words…too many reports, too much time….I don’t have time for that!!

  • Faith Conners says:

    I know this is old, but I decided to leave a comment anyhow. I finally got a family doctor today. I literally set myself up to the fact that he wouldn’t accept me as a patient, so I wouldn’t get let down again. The first few times I tried, the only reason I got turned down is because I am Transgender. I know it makes me a bit different from your average patient, but it’s not THAT complicated! I was even willing to help educate these doctors, but they didn’t want to hear it. My new doctor was so chill about it all that I was legitimately shocked.

  • J McFadyen says:

    Too many Doctor’s will dispose of patients who disagree with their long list of unnecessary pills. Trying to quite smoking on your own, is not even considered now, by most family Doctor’s. If you’d like to try quitting on your own, first, you are quickly dismissed and told your next appointment will be with a different Doctor. Doctor’s also base their practice on their religious belief’s, and will not treat you, according to their belief system. Most Doctor’s seem not to care, are there to make as much money as quick as possible.

  • Terminated says:

    I wasn’t screened out but I was kicked out of a practice once I made a few more visits than usual and requested additional blood tests. I was too ill to work at this point. I was NEVER disrespectful or demanding. I was left without a family doctor when I needed it most. My point is that unfortunately we can’t expect doctors to do the right thing, sadly, we need some oversight to prevent these types of things from happening. Any overview of my case would have seen I was mistreated, not to mention I know now misdiagnosed. My new doctor did have an introductory meet and greet, though I don’t know if his intention was to screen or to simply explain policies, etc. He has been great, I am doing well now, thank god. I’ve always suspected my old doctor was paid per patient (capitation model), I was clearly a burden to her, in fact she yelled at me that she had a busy practice and was terminating a “long list” of patients. If I yelled at a patient at work (I work in a hospital), I would be disciplined at the very least, if not fired.

  • Daniel Belanger says:

    Ontario health care is failing us the family doctors use patient as rat lab prescribing their pills of choice even if it is harmfull to the patient but good for thepharmaceutical and the doctors plus the college of physician which only cause problem when you call them.Time to let go of these doctors and replace them with docbot like the bank atm machine. Save money and better service for the patients.

  • Noca says:

    I have encountered many cherry picking physicians. Once I found out the rules stated in the CPSO policy #1-09 I started to report them. I have several open complaints with the College. Ontario doctors have put me through hell in the past 5-6 years and I have had enough.

    I will list some of the most notable cherry picking physicians below:

    One physician was accepting new patients, I got an appointment and went to see her. I started off by going through my medical history with her, and then listing off my medications I was on. It wasn’t until I mentioned “Dilaudid” did she mention that “her patient roster was full” and that she “was not accepting new patients”. Does she honestly think I believe that? The secretary didn’t tell me when I checked in, and the doctor didn’t mention it until I mentioned I was on a narcotic. Doctor’s can choose who they want right? They can refuse patients depending on which medications they are prescribed right regardless of documentation? WRONG.

    Some other dishonest Ontario physicians aren’t as straight forward about their discrimination and will try to make up elaborate baloney cover stories, some during the appointment, and some only AFTER you report them to the College. This one physician was on the Hamilton Academy of medicine, with an ad that he was accepting new patients. I called his clinic, and asked if this was the case, and the secretary said “yes” he is accepting new patients, so I booked an appointment. I go to the appointment, I check in with the secretary, and go into the doctor’s office about 10 minutes later to meet with the doctor. I again start by going over my medical history, and eventually I got to my medications, and it wasn’t until I mentioned “Dilaudid” did the doctor interrupt and tell me that he was accepting new patients, but only patients who were “formally with Dr. B”.

    Of course I called him out on it and told him he just made that up, that it was a load of baloney. His advertisement on the Academy made no mention of that he was only accepting patients formally with “Dr.B”, nor did his secretary mention it when I inquired about an appointment and booked one, nor did either secretary mention it when I checked in for the appointment, nor did the doctor mention it when I entered the room. It wasn’t until I mentioned “Dilaudid” did that trigger him to come up with his bs cover story about this fictitious arrangement with a doctor who may or may not even exist. I left the room before the doctor did and I stopped to ask the secretary if the doctor was only accepting patients who were formally with Dr. B. Do you know what the secretary said to me? “Who’s Dr. B”. Hahahah. The dishonest family physician exited his office moments later, locked eyes with the secretary, who then turns around, looks at me and says “ohhhh yeah, Dr. B, of course we are”. Pathetic!

    Another cherry picking Hamilton physician, that I saw years later who also had an ad on the Hamilton Academy of medicine that they were accepting new patients, I ended up getting an appointment with him and seeing this doctor. First appointment I went over my medical history with him (mind you I was off Dilaudid by now) and he asks me to get a copy of my medical file so that he could review it. Normally transfers of medical files from previous family doctor’s would be free, but since he told me that he “hasn’t accepted me as a new patient yet” that it would be $50 that have to come out of my own pocket from my ODSP check, to book another appointment with him to see him in another couple weeks.

    On the 2nd appointment, by now I have invested 6 weeks of waiting with him just to try and get a family physician, he tells me that he has talked over with his members of his healthcare team and that they have decided that “he has been taking a on a lot of patients lately”(a common excuse from cherry picking doctors, and “that patients with my diagnosis require a lot of work”. Literally two sentences later he says that he won’t be taking me on as a new patient. Of course I have been nothing but polite and patient up until this point. His “has been taking a lot of new patients” excuse is not an acceptable reason to deny a patient. If you are a family physician in Ontario, either your practice is “open” which means you are accepting new patients, or it is “closed”. This physician’s practice was still “open” and accepting new patients as his ad remained on the Hamilton Academy website, even now, months later. You have to see patients first come, first serve. You cannot discriminate based on patients who you see as difficult cases either.

    I was fed up by this point and began to report every cherry picking, dishonest physician I come across. Their true colors become known when you report them, because they go to great lengths to make up these ridiculously bogus stories and excuses to try to cover their butts.

    Other physicians have been honing their cherry picking skills for much longer. They don’t care how many rules they break. Many will attempt to screen patients over the phone by having you answer these survey’s, which if they find an answer they want to discriminate against, they will simply never call you back with an appointment. They are NOT allowed to do this, report them immediately.

    Other physicians when you ask them whether they are accepting new patients will reply “well he may be accepting new patients, but he may not be”. Either you are accepting new patients, or you are not. This is not an acceptable tactic, again report the physician. One physician knew that if he saw a patient in his office, and decided to cherry pick that he would be breaking the rules, so his secretary said “oh no, you don’t have to book an appointment, just drop by and the doctor will talk with you in the hallway”. Again just another sleazy tactic by these dishonest Ontario physicians to cherry pick. Report them.

    Some physicians will advertise on online advertisements that they are accepting new patients who are “not on narcotics”. Again, they are breaking the rules of the College, make sure to take a screenshot and print that off to include in your report to the College.

    Cherry picking is not an isolated incident as the Ontario Health Association would have you believe, it is actually quite a common occurrence. The College of Physicians and Surgeons themselves are willfully ignorant and complicit by not proactively policing these doctors. They wait for patients to complain first, and only a fraction of patients will ever step up and complain because of how unfair the complaints process is. Any physician you complain about to the College has the right to refuse to see you as a patient, and can drop you without any other cause you are already their patient. They can do this EVEN if your original complaint was that the physician was cherry picking. The doctor who broke the rules can now cherry pick simply because you reported them for cherry picking. The College is made up of physicians themselves, who are likely just as dishonest as the physicians they are policing.

    In order to catch these doctors and bring about change, the public needs to stand up and report these physicians. Canada has a one party consent law when it comes to recording. Simply record all conversations that the doctor’s office has with you, including those on the phone and in person. You can simply hit record either audio or video on your phone and lay it in your lap, as long as you are in the room, and a party to the conversation, you do not need their consent or knowledge to record them. This way you will have the evidence when you go to report these cherry picking physicians to the College. The cherry pickers weren’t going to take you on as a patient anyway, so might as well make sure they have formal complaints on their records as physicians.

    Read up on the College’s policies posted publicly online, because chances are, doctor’s haven’t actually ever bothered to read them themselves.

  • MICHELLE says:


  • A. Rendon says:

    I was just refused service from a walk in clinic. I found his behavior discriminatory, unethical and down right offensive, after 2 hours waiting to review my test results. I discover I had many problems to work on. He only read it, said something on the line of ” keep seeing the doctor you talked to before” and left the room, like he was in a hurry. He shouldn’t be permitted to practice if he doesn’t respect the patient’s needs. Time is important to me to star healing or get worse. Please help!

  • Dr. P says:

    Part of the problem is that as a doctor it is difficult to discharge a patient. If I do I run the risk of a college complaint and/or human rights complaint. Besides I don’t like firing a patient I only do it about once every few years. The other thing is difficult patients interfere with taking care of other patients. For me a difficult patient is one who misleads me or seems to be seeking things I cannot give (inappropriate medication for example) or doesn’t trust my judgement always asking for unneeded tests etc. I have been in practice for about 30 years so I have a practice that is pretty big so I don’t need extra income. However I loose patients regularly because they pass away or move away. So what I do is take on new patients who come to local rest homes and don’t have a doctor that does housecalls. Sick patients, complex patients as far as I am concerned bring them on. They seldom complain and they are grateful for good care. Not only that it is fun to be engaged in your job trying to figure stuff out. Thats what I went to med school for, to take care of sick people. But to open up my practice to everyone who calls up some of whom have been fired by other doctors by the way seems to be the path to despair. I think if you gave doctors the freedom to discharge a patient without consequences and set up the compensation mechanisms properly (it can be done) we all would be better off. It seems these days like we have to insert government into all our daily interactions and are we really better off for it?

  • Zoran Pejcinovic says:

    My docter will spend half an hour with a shall we say a young lady and if he’s with me for two minutes he becomes rude and my complaints or reason for coming are always the same. He has a wry bug case load in nursing homes has his own FP clinic financial interest in the pharmacy told me shoppers won’t honor his pain med scripts after emergency sent me to him with specific MRI referal since hospital already has current x ray of my lumbar region wich I have disintegrating disc disease he demanded an x ray that took me a long time because I am mobility limited and now after the x ray he demanded for no reason I had to make a appointment to see him. At wich point his nurse asked me why I was there waited 35 minutes in the waiting room while listening him schmooze with a young attractive women. Then finally comes in asks what he can do for me doesent even remember why I’m there and spent 2 minutes going over my broken wrist and minimized my serious chronic back pain and o had to remind him I need a MRI requisition gr said oh we will get back to you he wasted 4 MN the for no reason emergency gave me a requisition form to take to him for an MRI now 5 months later no correspondence from his office still waiting to get a referal for MRI and MRI take 6 months to a year so he’s preventing me from getting proper and urgent health care by being maliciously negligent still waiting said his office would call .it’s been 6 months and I’m nowhere closer to getting an MRI and losing sensation in my lower extremeties as a result f the first 2 spinal surgeries. What to do. He also has a very big ego problem. Flirts with the ladies and gives them far too much unessarry time, at the expense of other patients and treats his own kind better than a regular Canadian person if you know what I’m getting at.

  • Ashley says:

    There is a place for cherry pick just not based off of medical need of financial status, but because of the patients attitudes. I am not a doctor, but I have worked at a doctors office at the front desk. All three doctors I worked with never would or did deny a patient because of their medical conditions or their financial status. There were some patients who did not get into our clinc even if we were accepting new patients and I was glad some of the people I encountered were refused. I’ve been sweared at, called unspeakable names, and threatened simply because they thought it was stupid that they could not see a doctor that second. The patients were not in any medical distress or in need of medical attation at the time. There is no excuse for that kind of behaviour and hopefully the lack of appointment makes the people think twice about their behaviour.

    • Trish says:

      Good response, punish a sick person, that you don’t have the people skills to deal with, by denying them the medical help they require and paid for in their taxes???? Perhaps you need to find another job that doesn’t,t involve people that get upset?

      • M says:

        The funny thing is that the majority of the patients who are the most unjustifiably demanding pay little or no tax. So the doctor, who pays a great deal of tax, in, a sense, paying for the privilege of being abused by that patient.

  • Mark & Alice says:

    Just experienced this today at a meet and greet appointment. Husband was automatically accepted, but the doctor termed me more “complex” so the doctor cut me off, talked over me, and said I needed another meet and greet whereby I would have to give a more valid reason for wanting a family doctor before she would accept me. I did give her a valid reason, but for her, it wasn’t valid. Also, after berrating me, she said I looked tense and told me I had issues (though I continued to remain silent because she wouldn’t let me get a word in edgewise to defend myself), and she gave me a speculum to take home so that I could practise inserting it so that maybe when I get my next pap, it would not be so painful. Well, if she hadn’t have cut me off, she would have found out that it was painful because of an underlying physical condition, not because I am tense after being emotionally abused in her office.

    • Mark and Alice says:

      I just wanted to add that this was in southern BC. And getting a family doctor is near impossible, even for pregnant women (which I am not, btw).

  • Clarissa says:

    I live in Northern Alberta and have found doctors cherry pick here. I have a complicated case. The rest of my family does not Husband and my children. The doctor took all of us on a patients at first. I saw then doctor 3 times and then he said I was to complicated and kept the rest of my family and discharged me as a patient. This is not right. He new my medical conditions when I went to him on the meet and greet. I told him I was complicated. He said I was out of his realm of practice. He is a general practitioner. How was I out of his realm. What recourse does some one have. Now I am with out a doctor to help me with my medical problems. This is unfair and unjust.

  • Lillian Lee says:

    Now that health records are being computerized, the best solution would be to have patients go to any walk in clinic, the doctors would be able to access the records, and have all the information at hand. What need is there to stick with one doctor, who is too busy, or doesn’t have the interest to take care of sudden problems. Let’s hope that day comes. I am tired of waiting 2 hrs. past scheduled appointment, being told I can’t talk about more than one problem, and then only have 5 minutes of the doctors time. The medical society has deliberately kept admission rates down, so we have a shortage of doctors, and those who do practice, make a more lucrative living. Time for changes and more efficiency.

  • Discouraged says:

    Capitation as currently practiced is problematic, even without initial screening. My former family doctor became upset with me when I came in more frequently one summer, told me she had a busy practice, and that she had a list of patients she was terminating, including me. I’m sure she took too many patients, waited to see who was high versus low need, and terminated the ‘needy’ people who were less financially rewarding for her to keep in her practice. I was left searching for a new doctor at a time I needed it the most. Morality and ethics should prevent this type of behavior, sadly, you can’t rely on that, the system has to have strategies in place to prevent this type of behavior, or the healthcare system will be poorly serving those who need it the most.

  • Whocares says:

    Yes they do cherry pick! I tried for years to get a family doctor but had to go to screening appointments and every time was rejected. Why? Because they either didn’t take people on disability or they didn’t take people with complex needs. I now go to a family health team, I see a new resident every two years, when I asked to see the supervising doctor I was told she was not there! I get exactly 10 minutes per appointment to deal with one issue only. My health is suffering. I was supposed to have follow up after an abnormal breast biopsy and that was 5 years ago! Follow up for a nodule in my lung? Hasn’t happened either! Go in for a repeat prescription for my antidepressants but the computers were down so I leave with nothing and they wont fax it in either so I ended up with no meds for 3 weeks! Suffered hell for 3 weeks because writing a prescription by hand is too much work, it’s bs.

    • James Pookay says:

      Take some ownership over your own health issues.

      It’s unfortunate that there was a computer glitch that prevented you from getting your prescription refilled on the day of your appointment, but these things happen and can bring things crashing to a halt since a lot of clinics are completely dependent on the computers these days.

      But it’s hard to blame your doctor for you not taking your pills for 3 weeks. I can see this glitch causing a problem for a day or two, but you made the decision not to try another way to get your medications from a walk-in clinic, emergency department, asking your pharmacy for an emergency supply or following up with your doctor’s office the next day once the computers were back online.

      • whocares says:

        Easy for you to say when you are not in my situation and obviously have zero understanding of my disabilities.I have a disability caused by child abuse, a traumatic brain injury and PTSD. I have cognitive problems and my memory sucks! I use wheeltrans so getting a ride for the next day is impossible and her office will not fax in antidepressants.
        I was off my meds for two days when the weekend arrived, I was feeling fine so I figured I was ok and didn’t need them and then I was far from ok, I was apparently suffering withdrawl symptoms that had me on the verge of psychosis and suicidal, I would love to see you think clearly in that state.
        My doctor knows my situation including my limitations both cognitively and mobility wise, my doctors knows what happens when someone like me ends up off their meds, it was her responsibility to write the bloody prescription! and the issue wasn’t that she couldn’t write it it was that she chose NOT to!

        Kinda funny that she admitted to her serious error but you blame me.

  • Jane says:

    I had to get a new doctor as my doctor relocated. I am a very healthy woman physically my issues are emotional and social. I met her this week and I had to fill out a few papers. Its 45 mins with 2 buses to get to this clinic for me and the bus is only every 30 mins coming back. They locate for cheaper rent so many have to suffer who do not have cars. Its a 10 minute walk or so after getting off the second bus it was very hard for my good friend who was visually impaired as well. So she told me that if I need to see her to call for an appt but at times I may have to wait a few days to get in up to a week. She also told me that I am not allowed to go to any dropin clinics as they would be charged. I find this hard to believe. The odd time I have to go to a dropin clinic for two reason, one is its very cold like -37 and I am too sick to go to my regular dr plus the waiting. I had a bad bladder infection in February so that is why I went to the dropin clinic who sees you right away and got a prescription. I would prefer my doctor to me out of that clinic but its dropin and hard to get a doctor there. Also on the way there are no bathrooms at all with 2 buses and a 10 min walk that takes 40 mins or more, very uncomfortable for a sick person. Now I am in a dilemna but I feel she is pigeon holing me because I am low income at the moment. She asked me some strange questions like Why am I in ottawa and why am I in this situation of not working…which I did not appreciate.

  • Patti says:

    We patients with multiple chronic issues NEVER asked for their health problems. If one of those is mental illness, God Help Us!

  • Erin Mulrooney says:

    Help…advice highly sought as I am living proof of cherry picky in Ontario in the worst way!! I moved from Vancouver, British Columbia last summer to Sarnia, Ontario. I was unfamiliar with the application process in Ontario yet I did not panic, my physicians prescribed me 3 months worth of prescriptions. (One of those being Clonazepam, not at all aware it was listed as a narcotic/or high risk in Ontario and my troubles began.) I believed I had “time” with my supply and was obviously very trusted to be prescribed 3 months worth, being on it for over 15 years for a few controlled issues, a “clean record” in my chart and by my physicians back home…NEVER having abused it, ever. I have now been turned down by countless physicians who ARE accepting patients to this day. If I received a call back at all, I was told in an unpleasant manner, “Dr. _______ is choosing to not select you as a patient”. Disheartened and becoming fearful, I began going to walk-in clinics, ranging from London all the way to Windsor and everywhere in between. Approximately 1 in 10 clinics would offer assistance for a short time, some were kind and understanding with my years worth of receipts and prescription bottles showing my regular dosage, meanwhile others have been down right cruel, even kicking me out of their office to my complete shock! I’m 38 years old, definitely do not present as someone who has addiction or misuse problems but this is the only cause I am able to find to be rejected by this amount of physicians. Mind you, who did not offer me the opportunity to meet me face to face, to have my file transferred and to see I’m actually a rather easy, proactive and pleasant person to deal with even on my worst day…it’s just who I am.

    NOW however, only less than a week ago; I was in the ER with suspected pleurisy (which I had 4 years ago). Long story short (this is the shortest version, believe me), it turns out I have pleurisy but with an unknown cause, I have multiple bilateral pulmonary emboli…aka “many” blood clots throughout both lungs as well as extremely swollen nodes throughout my chest and around my heart and it nearly killed me. I was in the ER for less than 24 hours…mostly awaiting test results, was prescribed a few days of antibiotics and 6 months of a newer blood thinner that requires follow-up but not weekly like the older ones. The ER staff was aware I have no follow-up after care but what could they do, they discharged me? So here I sit with very few answers, unsure if another clot is on it’s way to my heart, brain or lungs at any moment (maybe it doesn’t work this way, I do not know despite researching all I possibly can on my own), I do not know what I’m permitted to eat (a normal diet for me is Paleo but vegetarian since I have Celiac, also 100% controlled) where most foods I usually ingest are leafy greens but these can be “danger foods” with high Vitamin K, I logically know I should not be sedentary yet I’m fatigued beyond words but more so, I have chest and back pains which intensify with exertion but also exist 24/7…not at the same level (that brought me to the ER after a couple of days because I did not wish to be a bother and stupidly felt I could push through the pain) obviously but what is “normal” pain to push through to remain active or when or for how long, etc, etc?? Only a physician can tell me and can refer me to a hematologist, a cardiologist, regular blood work-ups, CTs, X-Rays, etc.

    I went to the MP’s office prior to this occurrence, he and his office were outraged as I had a list of every physician who had rejected me. He pulled up and printed out an exert from the College of Physicians and Surgeons site in Ontario clearly indicating a first come, first serve basis for selection of patients. He also highly encouraged me to follow-up with complaints to the College yet what could he or his office personally do…nothing.

    With ONLY a prescription that was not desirable before, NOW to have a scary condition…am I really going to possibly lose my life at 38 years old because “Dr. _______ does not wish to select me as a patient”? A simple phone call to doctors who had me as their patient for over a decade would only prove, I am more than an easy, considerate, patient and proactive person to deal with who is both respectful and attentive in what guidance and instruction I am offered.

    Terrified in Sarnia (to put it mildly)

  • Purpledolphin says:

    Here is something to think about. I understand that everyone has to make money to eat and survive. However, how much does a doctor make that takes patients as they should meaning in order of application received? Are doctors so worried about padding their pockets that they are willing to let patients die? Is the money and glam why the doctors are in the profession? I’ve seen a lot of comments thrown around about money and maybe some doctors in the system need a reality check. Not saying it is any of you here but if you know a doctor that does these things then they do need one!

  • Arlene Miles says:

    After my family doctor had retired in March 2014, I have been denied medical treatment from over 30 doctors in the GTA.
    I didn’t choose to become sick, I was born this way, and after my accident, my illnesses became much worse. I went to the CCAC, Ontario’s Health Care Connect and they did nothing to help me. The response I received after searching, and being denied was “to open a phone book and find a doctor on my own.”

    Now, my health is failing, and there is nothing I can do because GTA doctors don’t want to see me. I’m looking forward to dying, at least when I’m dead, I won’t have to worry anymore.

  • Boles says:

    A relative of mine in Alberta was informed by the family doctor that she could only “bring” two health issues to the appointment. What a terrible thing to be told – especially when having to drive distances and/or having to rely on someone else to drive you to your medical appointments. And, this is only going to get worse with an aging population.
    I am totally disgusted with our Health Care System. It is not a Health Care System that works anymore and the College of Physicians and Surgeons are as much to blame as the government. They could be a lot more proactive in repairing and improving, in what I believe is , a badly broken system. Perhaps The College and the governnent have forgotten that they provide a service which is paid for by the taxpayers.

  • Carol Nowlon says:

    I moved from London Ontario to West Lorne Ontario when I purchased a home in West Lorne at 114 Main Street (paid cash for the house, therefore, as can be noted, I was NOT poor woman). I attempted to find a local family doctor for my 12 yr old daughter and myself (this was in 2001). I was told in the office, by receptionist that the doctor was accepting new patients, I completed and submitted the required paperwork. I was never called back so I stopped into the doctor’s office, which was in Dutton Ontario, the town over and in close proximity to West Lorne. I was told the doctor would accept my child but NOT me. I have to many medical issues that have issues related thereto. I was APPAULED and did not accept this answer as fair or just and did not accept the offer of having only my daughter accepted as his patient. I was forced to seek out a family doctor that would take on both me and my child as patients.
    Thank you for accepting my comment on this subject.
    Respectfully, Carol A. Nowlon Email: Cell: 226-926-6337

    • Wonder says:

      I just wondering WHY human beings now in the 21 century need to fill out “forms” Applications. Too get a medical professional (family doctor) and met the medical professional NEEDS.

      Wires have been crossed, some where along the lines of doctors meeting patients health care NEEDS

      Reformation of technologies needs. Views on the subject at hand.

  • A. Reader says:

    Of course they’re cherry-picking. As long as there’s more need than supply, most doctors operate their own private businesses, and as long as the provincial government keeps kow-towing to them with financial incentives like captitation payments (monthly $ for having 1000-1500 patients on their “roster”, regardless of whether or not they even see these patients) the businesspeople will naturally try to attract those healthy young people for whom they can get paid without working for those payments. Who wouldn’t want to get paid every month per person regardless of whether or not one is doing any work for that person? And since most younger doctors have been raised to think they’re pincesses and princelings, many actually believe they’re entitled to continued privileges throughout their lives because they somehow “merit” them by virtue of graduation.

    Some family doctors are not just requiring resumes from prospective patients; they want extensive documentation packages that amount to entire portfolios that could take weeks and lots of $ to assemble – all before you even get to meet the doctor perhaps 3 months after the application. I had one reject me after his second question, which was “are you employed?” as he was filling out my “profile”; I chatted with a hospital administrator who said another had told her straight out that she was “too old”. One young princess whom I thought I was rostered with never told me she was refusing to take me on, as I found out from ServiceOntario after I phoned to get de-rostered, and they sent me a letter that showed she’d never rostered me at all. And yet she still expected me to behave as though I were, and never see another doctor of any kind outside that Family Health Team, and only use hospital ER as a last resort. As this doctor explains, it’s because these FHTs and other family physicians can get financially punished by OHIP if their patients see other doctors, but don’t get dinged if you go to ER:

    So it is not even so much as cherry-picking for healthy patients; it is actually trying to select the most obedient people. By asking you to jump through all sorts of hoops and fill in so many forms, many are actually assessing your probable behaviour. That’s certainly why employment agencies and most other businesses require that you fill in forms and an “application” (if you” apply” to someone, they can always reject that application) : to see how detailed or brief you are, how easily and well you follow directions, etc. Some doctors probably rationalize this very-dsiciminatory process by thinking to themselves that “it’s not that they’re poor; it’s their behaviour that’s likely to be a problem…”, and those copanies where I worked and used such forms argued that those who follow written directions well will also be more likely be cooperative with any contracts we want them to sign, too. Of course, those contracts were never exploitative, oh no……Those contracts were in their best interests….

    Be wary of those family physicians who are constantly “accepting new patients”. Many are charging “block fees”, too, and not just in Quebec as this article makes clear:

    Finally, as to Dr. Hwang’s study, which showed some doctors were more willing to take new patients on based on medical need, that may be true but I find it hard to believe, as 99% of the doctors’ offices I called said they weren’t accepting and the initial conversations never progressed to the poiint where medical need/details were discussed at all. The very few receptionists who said they were accepting were more interested in explaining about the portolio/application process.

    After a lot of research on my part as to what was happening (I hadn’t searched for a doctor in over twenty years) I finally learned to say the magic word, “diabetes”. which should have indicated that I couldn’t wait to fill in all the forms and then wait for 3 months or more for a first meeting (that condition requires frequent blood testing). Some were more interested in me after that magic word, and other launced into an explaination to the application process…

    Lucky for me, I just met a highly-regarded, salaried doctor at a Community Health Centre. It’s a registered charity, and not just a “non-profit” FHT where the doctors are mining the grant system to pay for the investments from which they’ll be able to harvest their patient list for their eventual private corporation.

  • Georgena Sil says:

    Perhaps in 5 years time, doctors will install a MediCull door at clinic entrances, to automate the process of cherry-picking. This and other points made incisive through satire at Medi-Caper (Staticus Satiricus) URL:

  • Reg says:

    Canada does not have a health “system”, it has a publicly funded lottery. Doctors, for a guaranteed payment, can choose to provide fantastic or minimal care & no-one holding them accountable. The level of service that individuals receive can vary from (effectively) none – due to lack of access; through to world-class, if your situation happens to benefit from the random lottery of conditions.
    Expecting each province to organize and delivers its own services, without some national baseline and support is a recipe for unfairness. The patient’s best option: move to the location that increases your odds in the lottery.

    • Gerald I Goldlist says:

      Please do not denigrate our whole profession for the failings of the Canadian Health Care System.

      The duly elected representatives of the patients created this health care system. Physicians are not responsible for it, but just doing the best we can.

  • Arron Service says:

    Put family physicians on a salary and specify a panel size based on complexity. Move all family medical practice into healthcare team models and provide incentives to ensure the team practices to full scope. Allow patient/client self-referrals to the healthcare team. Keep the physician scope of practice to medicine and leverage the expertise in the team with non-medical issues (e.g., system navigation, social, economic and behavioural determents of health).
    Reining in physician practice within the context of a multi-disciplinary team will reduce costs since the healthcare professions are the experts in their respective non-medical areas (more effective) and demand less in the way of compensation (more efficient).This would ensure that individual healthcare needs are addressed by the most appropriate healthcare provider, improve patient/client centeredness and reduce the tremendous variability that currently exists in Ontario family physician practices.
    The Americans and NHS have been moving in this direction for the last 10 years.

    • Dr. J says:

      Family medicine is the least competitive and least sought after branch of medicine in the US. It is nearly impossible for patients in the States to get a good family doctor. The quality of trainee and of the training programs is suspect in many cases.

      Physicians do not like working on salary. Can you blame them? With independence, a physician has the obligation to advocate on the patient’s behalf. With a salary, the physician serves two masters, and often times the needs of the patient are not in line with the “mission” of the paying organization.

      Reducing physician independence in the name of cost cutting hurts patients.

      • Dr AS says:

        The prestige of one medical specialty versus another is not something that should drive the design of our primary care system.
        The article is suggesting that some physicians are cherry picking clients which completely contradicts the suggestion that the only thing on a physician’s mind is what is best for the patient.
        Finally, to suggest that salaried physicians working in organizations will have less of an obligation to advocate on the patient’s behalf is completely false. In fact, the most publicly accountable PC services in Ontario are being provided today by organizations where physicians are staff, on salary and patients are rostered to the org, not the MD.

      • Julia P says:

        that’s not really true – I lived in the U.S. and I never had a problem finding a good G.P. – I’m not sure what area you would be referring to – maybe in the middle of nowhere Wyoming?

        Also, U.S.-trained family physicians have another year of training (residency) and I would exponentially chose a U.S.-trained family M.D. over a Canadian one. Exponentially.

  • Paul Webster says:

    There’s reasonably good empirical evidence some Toronto psychiatrists cherry pick their patients:

    Kurdyak and Goldbloom

    Can’t find a psychiatrist? Here’s why

    “What we found, in fact, was that as the supply of psychiatrists increased, the total number of patients that each psychiatrist saw decreased. When supply is plentiful, psychiatrists opt for maintaining smaller practices of patients who are seen more frequently. Full-time Toronto psychiatrists, on average, saw half as many outpatients, and half as many new outpatients, per year compared to psychiatrists in regions with fewer psychiatrists. To put this in perspective, 40 per cent of Toronto-based psychiatrists saw fewer than 100 unique patients per year (and 10 per cent saw fewer than 40 patients), whereas only 10 per cent of psychiatrists in the lowest supply regions saw fewer than 100 patients per year.

    It’s difficult to explain why this is happening, but the current provincial fee schedule pays for ongoing psychotherapy with no limits on visit frequency or duration of follow-up, and with no definition of illness severity or complexity – so it certainly plays a role. Such a fee schedule permits psychiatrists to tailor their practices in a way that suits their preferences, but does not necessarily align with greatest public need.”

    Paul Kurdyak is a psychiatrist and clinician scientist at the Centre for Addiction and Mental Health (CAMH), lead of the Mental Health and Addiction Research Program at the Institute for Clinical Evaluative Sciences (ICES), and expert advisor with; David Goldbloom is a psychiatrist and senior medical advisor at CAMH and chair of the Mental Health Commission of Canada

  • Dr Z says:

    Elizabeth, Dr W is talking sense. He is not giving an opinion. Its a fact! I get paid a lot more to do a five minute procedure than a 20 minute consultation.

  • Peter G M Cox says:

    Speaking as a (former) caregiver to a close relative with chronic health issues which exposed us to extensive experience of Canadian healthcare, I cannot say whether WE encountered “cherry picking” but we DID suffer (quite literally) the effects of being left without a family doctor for extended periods – in one case FIVE YEARS and in the other TWO periods of TWO YEARS.

    I believe both issues are symptomatic of the same problem – “rationing” of healthcare. According to “OECD Health Statistics 2013”, Canada employs far fewer healthcare professionals than comparable countries (those with similar GDP per capita and universal healthcare systems with average spending per capita similar to Canada) – 33% fewer specialists, 20% fewer general practioners and 10% fewer nurses per capita than the average of these 12 Continental European countries. (This, of course, begs the question of where we DO spend our healthcare dollars – another issue!)

    Given this “resource” handicap, it should be (even more) imperative that the financial incentives to healthcare professionals are designed to achieve (what should be) the objectives of the organisation – the welfare of patients. Clearly, they are not. WE did have some very favourable experiences of family doctors and specialists who devoted considerable time to resolving problems (that would not have occurred with prior, adequate primary care). However, they were not remunerated for much of this time. Such altruism should be rewarded – not penalised! And it should not be assumed that doctors’ and nurses’ “vocations” should be sufficient motivation (alone) for them to do “the right thing” (a view I have heard articulated on more than one occasion). I have learned from extensive senior management experience (in the private sector) that, to get the “best” out of employees, remuneration practices need to be designed to reinforce the (innate) motivations of employees to achieve the organisation’s objectives.

    “Empowering” patients to be responsible for paying for their medical care also seems to work in the Continental European countries referred to above. All have a social insurance foundation where (universal) insurance arrangements (often through state, “single payer”, not-for profit providers) are organisationally independent of healthcare providers. Such arrangements appear to function far more smoothly. From some personal experience, one does not have to “beg” for a family doctor and patients can select specialist care on general practioners’ advice.

  • Gordon W Stewart says:

    n 2007 I was seeking a new doctor in London Ontario for myself and two daughters after leaving BC to do research for one year, The application to be a patient concerned me. My two daughters aged 9 & 11 and myself after filling out forms were accepted. We had no health issues, and would only visit a doctor for regular checkups, As a civil liberties advocate I was concerned about others with health issues who may not be accepted as patients. Sure they could go to walk in clinics, but no single doctor gets to know them. I believe this is a problem that the medical profession was allowed to create by creating private walk in clinics. Without walk-in clinics doctors would not have the luxury of cherry picking who they want as patients.
    If ever you ask the question about mental health patients and doctors/hospitals cherry picking, I would be more then ready to give my views and opinions as mental health detentions is at the core of the research I’ve done.

    • A. Reader says:

      “Without walk-in clinics doctors would not have the luxury of cherry picking who they want as patients.”

      Sorry, but have to disagree here. When I started with one practice in TO 30 years ago, these clinics didn’t exist. That was when I was 23. At age 30 I found another one when I moved to London, no problem, and again when I moved at age 36, to Hamilton. In between those moves to smaller cities, I always returned to that TO practice, which was sold in late 2013 when the last family physician ceased practising. Now, at age 53 and with a few problems, I’ve been having no end of trouble at being screened out. That wonderful TO practice was FFS, but the two doctors really wanted to control their schedules, so I soon learned they were only appropriate for things that could be scheduled weeks in advance. You see a fly enter your 6-year-old’s ear at his school, and the teacher expects him back the next day without that fly? The doctor’s office would tell you to go to a walk-in clinic for anything urgent, so they were cherry-picking the kinds of appointments they wanted to deal with amongst their patients. And I have no idea if I wasn’t “picked” to begin with due to that lovely age of 23…Everybody likes young, leadable people too shy to say ‘boo’ and ever-so-ready to be cooperative and steady with regards to annual paps, vaccinations, tests, you going to whomever and wherever they referred you…

      Somehow I think that, even if walk-in clinics never existed, any businessperson can tell their receptionist to avoid booking appointments for some people they don’t like, or discourage you from returning through any number of techniques…Heck, I was 17 or 18 when our family doctor (literally the only one in the small town) yelled at me for bothering him “when there are people who are really sick in my waiting room!” Obviously he thought I was malingering, which is why the school was insisting on a note from him. Do you think I bothered to tell him of my depression and suicidal thoughts? Do you think I went back to him when I had a sore throat that lasted 6 weeks? (It turned out to be strep, as the hospital in another town eventually told me, and they were amazed that I’d been too scared to even try and see the family doctor, as they warned me of the dangers of untreated strep turning into something way more serious.) It turns out almost the whole town knew that family doctor had a drinking problem, and boy! that town needed another doctor or a walk-in clinic! I won’t relate the saga of how he neglected my mom, and how she died of a superating, externally visible cancer that could have been treatted if he bothered to do any kind of exam (absolutely zero in over 17 years!) instead of constantly doping her up with excessive dosages of valium…

      No, walk-in clinics are not the problem. They arose in populous cities to meet needs that weren’t being addressed by private businesses, the Ministry wanted to divert patients from hospitals, and even if you had/have a family doctor, that didn’t mean you had/have access to care when you need it. They’re only being run down since the private businesspeople started resenting them for the competition they represented, and taking away from them the “easy” and more lucrative fee-bearing services that can be accomplished in a few minutes. Now, since the “rostering” system has been widely implemented in family practices, and OHIP is financially dinging those doctors if their rostered patients go to a clinic, they’re resented even more. Since you do research, you might find this article interesting, as it discusses walk-in clinics and is entitled “All the Right Intentions but Few of the Desired Results: Lessons on Access to Primary Care from Ontario’s Patient Enrolment Models “:

      The “continuity of care” you allude to is an important good, but you might want to be more careful before you blame walk-in clinics for the selectivity family physicians have been practising for as long as I can remember. Selectivity will continue; doctors have always been led to believe they are autonomous professionals and superior to the rest of us, and it is their rights that must be protected. Heck, every profession and worker would like to control how they work and for whom, and the most effective way to ensure this is to have your own business with an endless supply of clients who have no other alternative but to beg for your help, at your location, your convenience, according to your preferences, etc., and with guananteed payment and no competitors (or the ability to punish patients who break “their” rules of behaviour and seek out a competitor).

      So please forgive my defence of walk-in clinics. My now-adult son and brother use them all the time, and I’ve been forced to myself at different times. I’ve generally had good experiences there; logic tells me they have an incentive to treat all people well – or they don’t come back. Yes, continuity is good – but only if the care is good to begin with. Not all “care” is good care.

  • Donna Wright says:

    We are very lucky to have an excellent family physician now, but it wasn’t always so. Our son has severe, multiple disabilities and is medically complex. When I asked our current family doctor why he said ‘Yes’ and others said ‘No’, he replied, ‘Family doctors do not like uncertainty in their patients. I’m OK with it.” I thought that statement was very telling.

  • Scott Wooder says:

    A few stories and some expert opinion are clearly enough to develop an opinion or a political position. They are not enough to disparage the ethics of the 10 thousand family physicians who provide primary care to 13 million people.

    Since 2008 the CPSO has received 90 complaints. Or put another way, in the last 6 years the CPSO has only received 90 complaints! That sounds like good news to me. After all during that time hundreds of thousands of Ontarians have rostered with a family doctor.

    I am also concerned that people continue to demonize capitation as having some special incentive to look after well people. Every single compensation model contains the same incentive. Fee for service practices have a much higher through-put with well people presenting with simple problems than they do with people who have multi-system illnesses presenting with complex or multiple problems. Despite these economic realities, family physicians continue to provide care to those most in need.

    Kanterivic and Kralj published an article in Health Policy which supports this admittedly superficial analysis.

    I’m sure we can all find examples of individual physicians who fail to live up to the high ethical standards of our profession and I’m afraid that most of us ( me included) occasionally fall short, but before physicians are painted in such a broad based negative light I ask for a more balanced presentation of the facts.

    • Duff Sprague says:


      I support fully support your statements.

      When I had the privilege of being the executive director of a Family Health Team our physicians were compensated through capitation payments, the rule was that the FHT administration collected all of the new patient forms and when team physicians had room to take on more patients they would contact the office, let us know how many and they would receive their new patients in the order that the forms came in.

      In fact, there were situations with people requiring urgent need for physician care – a palliative patient re-locating from another community to be with family; a new community member with a serious chronic disease; a mental health patient living in his car – all of whom had no doctor. In each case I sent an email to all of the physicians detailing the immediacy of the situation. It never took more than 24 hours to hear from a physician willing to take the patient and I can’t recall a time when there wasn’t multiple offers of care.

    • Gerald I. Goldlist says:

      15 complaints per year!

      Dr. Wooder says it very well:

      “Or put another way, in the last 6 years the CPSO has ONLY received 90 complaints! They are not enough to disparage the ethics of the 10 thousand family physicians”

      We are a very honourable profession with very high ethics and the vast majority of us work diligently to manage the healthcare of our patients. We should be quick to stand up to those who denigrate us. Well put, Dr. Wooder

      • A. Reader says:

        The reason they’ve received so few complaints is becuase patients know the odds are stacked against them (after they run a huge risk by identifying themselves) and essentially volunteer to help the CPSP discipline their own members in a legal process that’s geared to protecting those members. Not work the risk or effort.

        The above is the same logic that a disempowered person comes up against when they consider a harassment, rape, or discrimination complaint: the accused has all the protection and benefit of the doubt, as well as lawyers and insurance companies behind them, and the complainant often has none of those protections. Besides, the time and financial resources we’d be expected to expend on the complaint could be better used in the time-consuming and very frustrating search for a new doctor.

        I used to think well of doctors as a “very honourable profession with very high ethics…” Unfortunately, as my medical records and recent search has shown, doctors capitalize on this perception and few live up to it. I thank the heavens that I can point to a few that meet this standard, or otherwise I wouldn’t be debating at all.

    • Ron McKinnon says:

      Old article but for every complaint made 100 complaints are not made due to fear of repercussions, loss of doctor etc.

      • Linda Lat says:

        I agree Ron. Folks need to all start putting e-mails together and send in these concerns to the Prime Minister’s office(where transfer payments come from) and to the Premier of Ontario to end this barbaric system. This system has the most detriment to the elderly and chronically ill. Shameful.

  • Dr. Frances Leung says:

    Cherry picking definitely exists. I also believe that capitation encourages it intrinsically.
    I think that all general practitioners should be mandated to take on patients and all residents must be served by a doctor by rule. Walk-in only practices should be discouraged as they allow disjointed care.
    I think that the funds should reside in the patients rather than the government. In other words, let each resident be allotted a certain amount of funds for their health care and they can take it to a doctor when they need the care. Doctors will then have to work efficiently to compete for this money. The power will reside with the patient. If a person comes down with a more serious condition requiring more care, s/he can apply for increase in the health credit limit so that universal coverage is still there. Having both the consumer and the care-giver being aware of the money involved will help to encourage more efficiency.

    • Elizabeth Rankin says:

      You have a good point! Let the patient have the power and choice of using their tax funded dollars to find the right doctor that is willing to listen, think and be part of a team that welcomes diversity among their clientele.

      Doctors have removed themselves from the category of being a professional when they don’t perceive others as having value beyond themselves and only regard their own perceived opinion of the patient has value. Patients and other professionals need to work together as part of Interdisciplinary Teams. We need more collaborative efforts & as part of a process it begins with valuing what the patient has to offer &, that they are the most important part of the team.

      For interested readers of this column I recommend you consider joining the SOCIETY FOR PARTICIPATORY MEDICINE. Go online to read more. The Mayo Clinic Chief Residents have invited Dave deBronkart, a patient, to a five day series on the value of patients and what they have to offer.

      • Patti says:

        I feel I can’t win!!! I am a 53 year old woman who has a number of health issues (most, truly are controlled by medication) and want to be empowered so I can take care of my health. I thought that that’s what doctors wanted. However, when I have approached doctors in my adult years including my current one (who is a good person), I find that I face irritability and sometimes smirking. I don’t go to the office a lot and I’m always courteaous but it seems no matter what I do, I’m not taken seriously. I deserve better. I know it’s human to act on the stigma attached to a person but I should be able to count on a doctor.

    • Lorraine says:

      I agree with Dr. Leung’s comments. I do hope there are teams working on the implementation of this idea. Canadians/Ontarians need to be fully aware of the costs of various procedures – the cost for their yearly check up and its components, the cost for a trip to the emergency department, the cost for a bed at the hospital, etc. Awareness will help each of us stop and think before going to see the doctor. Awareness will help each of us work at making achieving a healthy weight a lifetime goal, staying away from cigarettes and other vices a lifetime goal, maintaining a healthy diet a lifetime goal, staying actively involved with community and volunteer activities a lifetime goal, being there always for family a lifetime goal. Knowledge and awareness should help each of each resolve minor issues on our own (without visits to the doctor), while leaving the good doctors time to work with all those patients that have chronic issues. These are people that need the doctors; and the doctors need them. And that is another way for the cherry picking (I speak from experience) to stop.

    • Ruby says:

      We need more Drs like yourself. Wish you could be my Dr.

      Thank you

    • Julia P says:

      This would be brilliant, but it seems like such a complicated process (a.k.a., to request additional funding) that I don’t see how Canada could do this. Also, I appreciate you bringing up the problem of the “Walk-In Clinic” Wow. I can tell you some stories. I think they can be “profit mills” for some (unethical) physicians – I was told by not 1 but 2 clinics in my area, “You can do walk-in only” which sent a chill, A CHILL! down my spine. The first is – after I had a “new patient appointment” the physician was trying to “weed me out” as I had a serious condition. (herniated disc – work injury) You can’t imagine the shock that I had…I mean, for a physician to do this. Aren’t they supposed to be the more ethical people in society – better than lawyers at least! Lol.

      But do you understand the message that it sends. $We’d$ $love$ to $see$ $you$ as a $Walk-In$ $Clinic$ recipient only. Not actually help the patient heal up! Sick.

  • Dr. Willis says:

    Doctors are paid to DO, not to TALK and not to THINK.

    A family doctor office visit for complex disease management pays approximately 10 to 20% of that of other surgical procedures that take about the same amount of time to complete.

    Physicians are trained to be able to critically think and evaluate a patient so that they can arrive at the most appropriate diagnosis and start the most appropriate care plan; this might be the most important link in the chain. Unfortunately, this isn’t valued. When physicians get into the real world, they’re paid to cut, sew, drill and shoot. Thinking and listening are means to the big end of CUTTING!

    Until evaluation and management fees are on par with procedural ones, we will not see an end to cherry picking.

    • Elizabeth Rankin says:

      You should be fired from the profession! Any doctor who can’t or “won’t talk and doesn’t think” has no place having the privilege of seeing patients.

    • Dr W says:

      Reading comprehension is certainly not your forte.

      Nowhere did I say that I do such a thing, or that I’m even a family doctor. If anything, I think its pretty clear that I condemn the practice but see it as something that’s due to the misvaluation of services than from any inherent lack of ethics. Any change we want to see needs to come from a reappraisal of the value of complex care.

    • F says:

      So , in other words , Dr’s are drones

      “Doctors are paid to DO, not to TALK and not to THINK.”
      “Physicians are trained to be able to critically think”

      It’s rather pointless to be trained at something you don’t do

      You are a disgrace to your profession


Vanessa Milne


Vanessa is a freelance health journalist and a form staff writer with Healthy Debate

Andreas Laupacis

Editor-in-chief Emeritus

Andreas founded Healthy Debate in 2011. He is currently the editor-in-chief of the Canadian Medical Association Journal (CMAJ)

Mike Tierney


Mike is the Vice President of Clinical Programs at Ottawa Hospital.

Republish this article

Republish this article on your website under the creative commons licence.

Learn more