Private health care in Ontario?

[npd]

I am totally confused about how private health care works.

I spoke to a private health care place today (the only one i know in ottawa..they are actually in Gatineau but also have an office here on bank street) In any case, I told them I had to wait possibly six months for a specialist appointment after being referred by my GP.. and they told me they do specialist referrals(they do the searches to find the quickest one) the fee is $100. The doc would be in the private sector but appointments can be as quick as couple weeks.

My question, what does this all mean? Do I have to pay this psychiatrist because he is private or are all psychiatrists covered under Ontario health care?

 

[Retired]

My understanding is there are no physicians or medical services opted out of OHIP in Ontario except for one specialized hospital doing surgical procedures near Toronto. However there are numerous private (opted out) medical services in Quebec, and based on your description of this facility, the referral you would receive would be to a physician in Quebec.

Therefore if you chose to consult one of these physicians, you would have to pay the physician directly with cash or whatever other direct pay method that phsyican accepts. You would not be able to claim from OHIP and if you happen to have supplemental group health insurance through your employer,the payment would not be eligible for compensation. Seeing a private pay physician would come out of your pocket.

This also applies to diagnostic services such as MRI or other diagnostic imaging in one of the private pay labs in Quebec.

A few years ago my doctor requested an MRI for me. The wait time in the local Onario hospital would have been between six months to a year, however I could get an MRI done in Quebec in a day or two. That MRI cost me $1000.

Where on Bank Street in Ottawa is the referral service you went to?

 

[npd]

Your explanation makes sense based on one article I read (it seems very hard to get info on the private system) But I heard about the ideas you are describing - i.e., physicians in the private system having to opt out of funding from the public one to receive direct payments from patients, etc

I should have been more clear. This place is in Gatineau but they have an office also on Bank Street. In fact though, when i called about the specialist referral, they told me to call the Gatineau number. Here is their website. Sentinelle Health Group - Health Services - Private Clinic - Health your priority - Ottawa - Gatineau - Outaouais -

 

[Retired]

Your description was clear, and I understood the clinic was in Gatineau with a representative office located on Bank Street. Thanks for the link.

Of course if you choose to consult a psychiatrist using this service, if your first language is English and you feel more comfortable expressing yourself in English, you would want to specify your preference to the referral service. The clinic in Gatineau may well have psychiatrists who have had training in an English speaking system.

This is not to imply a French speaking physician could not treat you, but there are language and cultural nuances that must be understood by one's physician, especially in a didactic specialty such as psychiatry.

 

[npd]

Yeah, i doubt i can. I would think its very expensive. But maybe at least one session to see if he believe I have sufficient issue for an assessment etc?
Do these doctors tend to be better/worse in your opinion?



---------- Post added at 08:03 PM ---------- Previous post was at 08:02 PM ----------

Oh..and i should ask..for ODSP purposes is it ok to use these private docs for assessment? since ODSP is a government program?

 

[Retired]

I believe you will find a cross section of competence among private pay physicians just like in any other environment. You can ask for information about the training and clinical experience of the person to whom you are being referred. Perhaps you would have even more justification to "vet" your prospective physician in this situation than in the OHIP system.

Many very well qualified physicians in Quebec have opted to work in the private pay system, and in some cases are seen by people from all over the world. Your own research will be your best guide.

 

[Retired]

for odsp purposes is it ok to use these private docs for assessment? since odsp is govt program?

I don't know, as I have not had experience with this. Perhaps Dr. Baxter could offer some insight.

 

[npd]

Perhaps you would have even more justification to "vet" your prospective physician in this situation than in the OHIP system.

The lady said they do the search for $100. As you say, i hope that includes my feedback. I would like someone with a certain specialty, experience, someone who is more non-medication oriented, and who has experience with ODSP cases.

If they allowed that type of stuff in private system, i think it be well worth. Save you a lot of time, which in turn is a lot of money.

---------- Post added at 08:41 PM ---------- Previous post was at 08:25 PM ----------

I am kinda confused though why they still need a referral sent from my gp..if they are independent.

 

[David Baxter PhD]

for ODSP purposes is it ok to use these private docs for assessment? since ODSP is a government program?

More specifically, ODSP is an Ontario program. I don't know how they would react to recommendations from out of province, or even if they have a policy that applies to that issue. Your best bet would be to ask someone at the ODSP office.

If they allowed that type of stuff in private system, i think it be well worth. Save you a lot of time, which in turn is a lot of money.

How does seeing someone in a private health system save you money if seeing the equivalent professional in the public system will cost you nothing (other than taxes you have to pay anyway)?

I am kinda confused though why they still need a referral sent from my gp..if they are independent.

The referral from a family physician or general practitioner is standard in psychiatry and has nothing to do with OHIP vs. private. The rationale is that the psychiatrist will see you for consultation but will often want medical history from the family physician, and will refer you back to the family physician for followup (e.g., continuing scripts for any medications) later on.

 

[npd]

More specifically, ODSP is an Ontario program. I don't know how they would react to recommendations from out of province, or even if they have a policy that applies to that issue. Your best bet would be to ask someone at the ODSP office.

I will check on that, thanks.

How does seeing someone in a private health system save you money if seeing the equivalent professional in the public system will cost you nothing (other than taxes you have to pay anyway)?

I'm referring to the efficiency of a system, which in the end costs us more money through taxes. We spend 10% of GDP on health-care.

If we allowed people to choose their doctors based on experience, their specialty, a "profile", if we knew the doctors process going in, etc I think we would save a lot of time, create less strain on the system, and get quicker and better results.

I believe there is a lot of "buyers remorse" in the public system. Again, while we aren't directly paying..we are paying through taxes..same thing imo. We are often stuck with Gp's, specialists, and a whole system of people who don't really get us or what we are trying to accomplish. For example, many people on ODSP go to GP's that are against ODSP because of their personal opinions on psychiatry and what they personally view as a "real" disability and not. Some don't want to reffer. On the other hand, others do it too much. When it comes to specialists, what if I could choose to go to a psychiatrist that shared my view on more natural therapy as opposed to drugs? We don't control these things. So we have a system of frustration where you are randomly going to people and often these people don't have your interest at hand.


Furthermore, when it comes to psychiatry specifically, and diseases that you can't test for physically, its of utmost importance to solve these cases as fast as possible. Why? I don't have figures here but I would think that because there is no real concrete tests for most mental illness, and you need a specialists advice, people in this area tend to have a tough time functioning. This affects the economy. A lot of people are on social assistance and not working. Or are missing many days of work due to stress, depression, and other issues.

If I could go see a psychiatrist tomorrow, and he can diagnose me in a few sessions, start me on medication, I can get to work sooner. If I can go see him tomorrow and he says that my issue is minor..I can rest easier and possibly go to work knowing I am not crazy. And even if he decides its chronic, long-term disability, well maybe it gets me off assistance...and "categorizes" me properly.

 

[OntarioCarLover]

Private vs. public, English vs. French, sometimes I feel our life's becoming too complicated.