Calgary clinic replaces sterilization fee with new patient charge
Last Updated: Wednesday, April 29, 2009 | 8:50 PM ET
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Instruments are sanitized at the Richmond Square Medical Centre, which is trying to offset the cost of tougher provincial standards by charging a new fee to some patients. (CBC) A Calgary medical clinic will no longer be charging patients for sterilizing instruments, but will be introducing a "tray fee" instead, says the centre's owner.
In March, the Richmond Square Medical Centre began charging podiatry patients $5 if fewer than five sterile instruments were used during their visit and $10 for five or more, to offset the cost of following new provincial standards.
On Tuesday, the College of Physicians and Surgeons of Alberta (CPSA) ordered the practice stopped after inquiries by CBC News. Clinic owner Gary Mummery said the 50 to 70 patients who paid the fee will be reimbursed.
"The college of physicians doesn't appreciate the term sterilization fee. So we have dropped the sterilization fee," Mummery said Wednesday.
Instead, the centre plans to introduce a tray fee, which is a charge for supplies and equipment used for a procedure done in an office setting, rather than in a hospital.
The Alberta Health Care Insurance Plan reimburses doctors a tray fee — typically $7.71 for minor procedures and $22.83 for major ones — for insured procedures. Mummery said his clinic plans to institute a tray fee for equipment used for services that are not covered by the province.
"It's only where we don't get a tray free from Alberta Health and Wellness that we'll be charging the patient," he said.
The southwest clinic stopped charging a fee for sterilizing medical instruments on Tuesday, after inquiries to the College of Physicians and Surgeons of Alberta by CBC News. (CBC) The province introduced tougher sterilization measures on Jan. 1 after health officials discovered improper cleaning of medical equipment in a Vegreville hospital in 2007, and the reuse of syringes in a High Prairie hospital in 2008.
Mummery said buying new equipment and instruments cost the clinic $8,000, and that extra daily work related to sterilization amounts to $240 per week.
"It's a cost that we're eating to this point. We would rather not eat it for very long because it's like any business, costs are costs and if you don't cover your costs, you're not long in business," said Mummery.
"[The] medical profession today is strapped as it is. Doctors are vastly underpaid in relation to what they make and the responsibility that they take."
Dr. Brian Ward, the CPSA's deputy registrar of standards of practice, said some clinics have switched to disposable tools, but Mummery said that's not possible for podiatric procedures.
Fees for uninsured services are at doctors' discretion
Ward said clinics have the right to charge extra fees for uninsured services, such as cosmetic procedures.
"They can charge fees as they see fit to their patients for those services, and if that includes the cost of purchasing equipment or cleaning that equipment then that can all be bundled into those fees," said Ward, from Edmonton.
Ted Woynillowicz, Calgary chair of the Friends of Medicare, said he welcomed the more stringent sterilization rules, but not the charges.
"Charging people for that, it's unfathomable. And my question is when will these add-ons actually stop. When will this nickel and diming actually stop?"
Mummery said he won't have to download the cost of sterilizing equipment if the province announces it will be reimbursing medical centres.
"We do not know at this point and do not have an active voice as to how quickly they'll make that decision," he said.
Mummery said he's not sure yet how much the tray fee will be, but he said it will be waived if a patient says he or she can't afford it.
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