A private clinic that recently opened in Ottawa's Kanata district is offering patients a thorough five-hour physical checkup if they agree to pay $1,200 out of their own pockets.
But critics, including at least one doctor, say the clinic's business model is also costing the public health care system a bundle.
La Vie Executive Health Centre, run by Dr. Hassan Sannoufi, opened in the luxury Brookstreet Hotel a month ago to provide services that it says the public system doesn't cover, including a five-hour physical exam that includes:
- Electrocardiograms at rest and under stress conditions.
- Eye and hearing tests.
- A diet assessment by a nutritionist.
- A report in digital and paper format that includes personal medical and family history.
Sannoufi said he opened the clinic because the public system didn't allow him to take the time and care he wanted with each patient.
"As a family physician, you become more volume driven rather than quality driven," he said. "I cannot ethically provide … proper health care by seeing my patients for five or ten minutes or doing a quick physical for 20 minutes. This is not what I would want my career to be."
He added that he thinks the public system is a great concept, and would bill his services to the Ontario Health Insurance Plan (OHIP) if they were covered.
Patients seek prevention
Patients such as Michelle Knight said they go to the clinic because they want to find problems before they become serious.
"What we're paying for privately is the prevention," Knight said. "We feel we're creating less of a burden on the health-care system."
The services she receives include access to Sannoufi in the evening, and the ability to talk to him by phone or e-mail, she said.
Her husband, Dean Henderson, said that thorough blood work and other testing done by Sannoufi detected a condition that a regular physical missed just months earlier. He is now on an exercise regimen to manage the condition, he said.
"You're paying the doctor to go the last mile on this information," he said.
But critics such as Dr. François-Gilles Boucher said a five-hour physical would likely produce more questions than answers, leading to unnecessary publicly funded tests and specialist referrals.
Boucher, who teaches family medicine at the University of Ottawa, thinks everyone needs a blood pressure test, which is a standard part of a checkup in any doctor's office.
But for most people, the extra tests offered by La Vie clinic offer no benefit, he said.
Sannoufi also promises referrals for publicly funded chest X-ray and abdominal ultrasounds for all patients who haven't had them recently.
The Canada Health Act, the law intended to protect the public system, makes it illegal to charge patients for any service covered by the public system, including chest X-rays and abdominal ultrasounds.
Clinic lengthens wait lists: Boucher
Boucher said tests and referrals generated by private clinics should be paid for privately, because otherwise they make wait lists longer in the public system, in which other patients are undergoing tests for specific reasons.
"And yes, if it becomes more widespread, then that will necessarily build up the lineups for testing, for CT scans, for angiograms, for MRIs, for X-rays, for colonoscopies, every imaginable test, for no benefit in the short or the long term."
Groups such as the Council of Canadians are opposed to the clinic's business model for similar reasons.
"Where you allow a physician who is operating in that way to provide preferential access to some patients, including to insured health care services, we're all, in a way, subsidizing the cost of that preferential access," said Ottawa lawyer Steven Shrybman, a board member for the council, which describes itself as a lobby group working to protect Canadian independence by promoting policies such as public health care.
Sannoufi stands by his services. He said he can think of cases in which the preventative tests found health problems that could have been missed. In one patient, he said, the abdominal ultrasound found an aortal aneurysm, an expanded blood vessel that can rupture, causing death.
As of Tuesday, the government of Ontario had sent the La Vie clinic a letter asking about its billing, but so far has not taken any steps against the clinic.