It’s One thing for disgruntled “orphans”—medical speak for the five million Canadians who don’t have a family doctor—to accuse GPs of cherry-picking their patients; it’s quite another for the Canadian College of Family Physicians of Canada to accuse itself. But that’s just what’s happening in the June issue of the organization’s magazine, Canadian Family Physician, which is published this week.
In a commentary called “Casting Call,” Kenneth Kirkwood, an assistant applied health ethics professor at the University of Western Ontario in London, Ont., writes that family physicians are “auditioning” prospective patients in order to “balance” their workloads. The problem is, they’re doing it by turning down the severely ill, the elderly, the overweight and the drug addicted—the very people who are most in need of care. This audition process, where doctors ask prospective patients to fill out complicated medical histories and then go home and wait for a call, has been going on for the past few years, Kirkwood says, but now “it’s brazen.”
Kirkwood says patients too are auditioning doctors, especially in big cities where they shop around walk-in clinics hoping to find GPs who will write prescriptions for painkillers like OxyContin or sign forms that help them fool their insurance companies into paying for sick leave they don’t deserve.
Both sides are clearly trying to play the system, but Kirkwood points out that patients have no duty to their docs, while doctors do have a moral obligation to treat everyone equally.
“If you are a doctor,” he says, “you are going to deal with sick people; that’s what you signed up for.”
Turning down patients who are likely to be time-consuming is “corrupt,” Kirkwood concludes. And although the practice isn’t widespread yet, he predicts it soon will be. “Somebody needs to stop this,” he says.
But will his words fall on deaf ears? “Well,” he says, “the Canadian College of Family Physicians does run this journal.” Now if only their members would read it. M
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