Newfoundland and Labrador doctors and the province's health minister are butting heads over who should provide flu shots to patients this year.
Last year about 50 per cent of influenza vaccinations were given by family doctors but the health minister wants that to change.
'I have a small army of registered nurses and licensed practical nurses who are all perfectly capable and able to deliver a flu shot.' - John Haggie
John Haggie said highly-skilled doctors should be focusing their energy on services that only they can provide and leave flu-shot clinics to other health care professionals, such as nurses.
"I have a small army of registered nurses and licensed practical nurses who are all perfectly capable and able to deliver a flu shot. It is sensible from a systems point of view to employ doctors to do things that only they can do and let others deliver flu shots," Haggie said.
To encourage that, the province no longer pays physicians a fee just for giving flu shots.
Doctors can still give the shots as part of an office visit but they can't bill MCP for that vaccination. It means doctors can no longer hold flu shot clinics to quickly inoculate a large number of patients.
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The Newfoundland and Labrador Medical Association, which represents doctors, said that means some doctors won't offer the shots at all.
"We have heard from our members that not all family physicians, unfortunately, will be offering flu shots in their office this year," said NLMA president Lynn Dwyer.
Haggie believes physicians should give flu shots to patients who ask for them as part of a regular office visit.
"We supply the vaccine to physicians free of charge. The fact that they have chosen — some of them — to put up barriers in terms of refusing to give it or indeed asking patients to pay a charge for it is really unfortunate and not really something that I think you could justify," he said.
'Not all family physicians, unfortunately, will be offering flu shots in their office this year.' - Lynn Dwyer
Dwyer said the association hasn't heard that any doctors will be asking patients to pay out-of-pocket for a flu shot.
"We have not heard that but certainly when a medical service is no longer insured by government it would be optional for the physician to bill the patient directly. Having said that, we don't think that is going to be an option that our members are going to be pursuing," she said.
Province aiming to increase vaccination rate
Last year about 20 percent of Newfoundland and Labrador residents were vaccinated against the flu, with 109,000 shots administered.
Hundreds of people who weren't vaccinated ended up in hospital after contracting influenza and eight of those people died.
Dwyer said the NLMA expects fewer patients will be vaccinated this year because of the fee change and it fears that will mean more people will be hospitalized and maybe even die.
But Haggie says the province is hoping to vaccinate more people against influenza.
"What we're going to do this year is make a concerted effort to improve vaccinations rates amongst the general adult population and one of the ways of doing that is having clinics open longer. Regional health authorities will have an increase of 25 to 30 per cent in public flu shot clinics. So in terms of access there will be really minimal barriers," he said.
The province's health authorities will start offering flu-shot clinics in late October.