Medical specialists overcharging – study
As newly trained doctors in the specialty have hit the job market in the last year or two, however, they have faced an almost bizarre quandary; most cannot find work in a field that seems to urgently need them. The oncologists are not alone. Medical organizations say physicians in a half-dozen or more specialties are facing unemployment or underemployment, despite the countrys continuing shortage of doctors and long wait lists for many medical services. Its really frustrating, said Dr. Shaun Loewen, 36, who recently finished his five-year residency in radiation oncology. I want to start working and treating patients. Thats what the public has paid me to do and thats what I want to do. Unfortunatley, if I cant find those opportunities in Canada, Ill have to look elsewhere. Some of those stymied in their job search are trained in areas like oncology and orthopedic surgery where governments have invested hundreds of millions of dollars in recent years to expand services and reduce patient delays. But while provincial governments have paid to train more specialists in those high-demand areas, hospitals and health regions often lack the money to hire them once they hit the job market, experts say. Others argue there is a disconnect between the divvying up at medical schools of specialty training positions, called residencies, and the real-world patient demand for the graduates various services. The Royal College of Physicians and Surgeons which oversees and sets standards for medical specialties has already catalogued a list of high-unemployment specialties. It includes not only oncology and orthopedics but cardiac surgery, nephrology, neurosurgery, plastic surgery, otolaryngology the ear, nose and throat field and public health and preventive medicine. We thought, Wow, this is a really surprising list, said Danielle Frechette, the colleges health-policy director. Its paradoxical to have ongoing issues with wait times and cancelled surgeries and able-and-willing bodies to meet those unmet needs (who cant find work). The Royal College is currently surveying recently graduated residents on the issue and has so far discovered that one in five have failed to find full-time work, prompting them to take locums temporary fill-in jobs for absent doctors work part time, or return for further, sub-specialty training. Half the 1,500 respondents to a recent survey by the residents association reported they were moderately to extremely concerned about finding work, said Dr. Adam Kaufman, president of the Canadian Association of Interns and Residents. The group has even started a program, Transition into Practice Service (TIPS) to help get positions for newly trained specialists.
According to the medical schemes act, your medical scheme must legally cover: Your benefit conditions in full, as per the invoice submitted by the healthcare provider. Your scheme is not allowed to use your personal medical savings account to pay for benefit conditions. The diagnosis, treatment, and care of roughly 300 serious and costly health conditions fall under benefits, including 270 diseases such as tuberculosis and cancer; and 25 chronic conditions including asthma, epilepsy and hypertension. Your scheme is entitled to nominate a designated service provider such as a doctor, pharmacy or hospital as the first-choice provider when you need treatment or care for the benefits condition. If you choose to use a nondesignated service provider and it is not an emergency situation, you may have to pay a portion of the bill. If you have a condition that is classified as a benefit, most schemes require you to register for a benefit before they will start reimbursing you as per the benefits requirements. Schemes avoid payments Gantsho notes that medical schemes are not dealing with benefits in a uniform manner and different complaints bear testament to this: Some schemes have deliberately programmed their systems to fund members benefits accounts at scheme rates and then pay the balance only after the council investigates a complaint. Other complaints related to instances where schemes underpaid claims or made no payment owing to the fact that members did not use the services of the designated service providers of the scheme, whether voluntarily or involuntarily. Some members did not qualify for benefits as their treatment did not form part of treatment protocols, but some protocols were contravening the (act) in that they were not evidence-based. This means members had been offered an incomplete package, he said. Calls for price regulation Raath says while the benefits are absolutely necessary, he takes issue with the draconian way in which they are applied, as well as the lack of consultation about which medications and services should fall under this description.