The doctor is out: How proposed MCP change could affect your flu shot

More than 30,000 people in Newfoundland and Labrador went to a family doctor just for a flu shot last year, but proposed changes to MCP coverage would eliminate that.

Fee-for-service physicians concerned about negative health impacts of cost-cutting measure

Under a provincial government proposal, fee-for-service doctors who see a patient solely to administer a flu shot would no longer be able to bill MCP. (Chanss Lagaden/CBC)

More than 30,000 people in Newfoundland and Labrador went to their family doctor for the sole purpose of getting a flu shot last year, but proposed changes to MCP coverage would eliminate that service.

The provincial government wants to remove the fee code for influenza immunization from the MCP payment schedule, so a trip to the doctor's office for a flu shot wouldn't be covered.

Doctors would still be permitted to administer flu shots as part of normal office visits, but wouldn't be allowed to bill for it. They can currently bill a separate charge of $17 for each vaccination.

The NLMA Board of Directors. President-elect Dr. Lynn Dwyer (front row, right) will take over the position on June 3. (NLMA)

"Our understanding is government sees this as a cost saving measure, but there has been no cost analysis done that we're aware of," said Lynn Dwyer, a family doctor and incoming president of the Newfoundland and Labrador Medical Association (NLMA). 

"And we have grave concerns that this will actually cost more to our health care system."

Half of flu shots last year given by doctors

According to Dwyer, of the 124,000 flu shots administered in the province last year, 65,000 were done by family physicians.

"So our patients will either need to be accommodated in community health clinics, or if people are not vaccinated, we can see higher healthcare costs through more people being sick and higher hospital admissions," said Dwyer.

"We don't know how government is planning to accommodate potentially 65,000 extra flu shots if those are not being provided by family doctors." 

"Doctors place high value in providing flu shots as a preventative service," says NLMA president Dr. Christopher Cox in a letter to the health minister. (Jeremy Eaton/CBC)

The current president of the NLMA, Christopher Cox, has written a letter to Health Minister John Haggie outlining the association's contractual and legislative issues with eliminating the fee.

"De-insurance or de-listing of a service normally occurs only when it is not medically necessary. This proposal is a major policy break with past practice that needs to be evaluated carefully," wrote Cox.

The letter also covers the NLMA's concerns about the impact on patient care, equitable access to flu shots and cost issues.

Will free up time says government

In a statement, the Department of Health and Community Services said the decision to remove the MCP fee code for flu vaccines is being discussed with the NLMA, and the flu vaccine remains free of charge to everyone in the province.

"The regional health authorities run successful clinics in communities across the province and if required, capacity will be added to this system to ensure anyone who wishes to get a flu vaccine can do so," said a spokesperson in an email to CBC News.

The department also said the initiative will, "allow physicians to free up their clinic time to improve access for patients needing primary care services, rather than administering flu vaccines."

'Not just a flu shot'

For some, the annual flu shot may be the only time they see a doctor, and Dwyer said that's an important part of preventative patient care.

The NLMA says rural fee-for-service physicians have expressed concern about lack of access to community clinics for flu shots. (CBC)

"Maybe that patient hasn't been seen in a year, maybe they have blood pressure taken and it's noted to be elevated, or they have other health concerns that come to attention and are then followed up on," Dwyer told CBC Radio's Central Morning Show

"So it's not just for a flu shot, it's part of preventative ongoing health care and the circle of care that we are trying to provide to our patients." 

Low immunization rate 

"We already know that in 2014, Newfoundland and Labrador had the second lowest immunization rate in the country [at] 24 per cent, the Canadian rate was 31 per cent," said Dwyer.

"Government is looking at de-listing a fee code for physicians that could potentially mean even less of our patients will be immunized, so from a community and public health perspective this is a very grave concern." 

With files from Central Morning