Ontario Patient Enrollment Model

February 25, 2010 3:49 PM

Ontario Patient Enrollment Model. Can anyone elaborate as to what this program is all about? My doctors office is really putting the pressure on me to sign this thing, but it seems rather restrictive. Apparently it's voluntary, but they seem rather adamant that I register as a patient, and won't stop calling me about it. Am I just being unreasonable here, or is my doctors office just being a pain in the arse?
posted by anonymous to health & fitness (4 answers total)

You know something? Googling for "Ontario Patient Enrollment Model" gives four results, all of which point back to this very AskMe. I live in Ontario, I've never even heard of this, and my wife who has many specialists that she sees regularly has never heard of it either. This smells fishy to me.
posted by the dief at 4:14 PM on February 25, 2010

Wait, is it this thing (pdf)? I've never heard of it before, but it looks like they're trying to make sure that you don't switch doctors, and maybe so they can get the Ministry to give them information from your specialists if you have them. Weird. Where I live, there's a shortage of doctors and trying to lock patients in so they can't see other doctors easily seems sort of laughable.
posted by the dief at 4:21 PM on February 25, 2010

I filled out one of these when I acquired a new family doctor, who was part of a shared practice, a few years ago. From what I can see, its like being part of an American HMO, but without the heavyhanded restrictions. It is entirely voluntary on the patient's part, and you aren't locked in to a doctor permanently. You do agree not to switch family doctors more than twice a year, which seems fair enough.

The doctor gets some money for each patient, which may explain at least part of their eagerness: "Family physicians are also encouraged to take new patients into their practices. A premium is available to physicians when they enrol new patients. In order to claim this fee, the physician, in addition to formally enrolling the patient, must co-sign with the patient a New Patient Declaration form.

There's a lot more info on the Ontario web site here.
posted by maudlin at 4:42 PM on February 25, 2010

I'm a family medicine resident in Ontario. My knowledge on this not all-encompassing by any means, but this is not a scam, as suggested above. It is likely that your family doctor is part of a family health organization/network/team.

To try to get away from the patient-mill feeling that a fee-for-service style practice tends to encourage, the province introduced alternate models of compensation. Instead of getting paid for every single patient visit, and only for visits, the new models involve being paid a lump sum for each patient in the practice. This is called capitation. There are bonuses for doing preventive health-type measures (paps, immunizations) and chronic disease care (diabetes) for one's patient population. Your physician is required to provide some after-hours care. There are monetary penalties to your doctor if you go to the emergency room for less urgent things, or to another family doctor, as they are expected to provide your care for the scope of less urgent problems.

This doesn't mean your family doctor can't refer you to a specialist. This also doesn't mean that, if you're unhappy with your family doctor, that you're stuck with them. Your doctor wants you to sign this so you'll agree to go to them for primary care, you'll be on their roster of patients, and they don't have to rely solely on your visits as fee-for-service visits to fund their practice. Most patients sign on to it, but you don't have to. In fact, if you go to the ER too often for niggly little things, your doctor will probably switch you back to fee-for-service billing because they'll be tired of getting penalized for those visits.

A few links for more information are here and here (from Australia, strangely enough).
posted by flying kumquat at 5:01 PM on February 25, 2010 [2 favorites]