Prescription Renewals

Ongoing challenges we face – high costs and demands on our time

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The last decade has posed great financial challenges for Ontario’s hard-working family doctors. Since 2012, the Ontario Government has cut family physicians’ funding and billings by effectively over 20%. Meanwhile, office expenses including rent, medical supplies, staff salaries, IT, inflation, and taxes have increased and continue to do so. Furthermore, we are using recent advances in technology that improve patient care and convenience, but these also cost money. Accordingly, we have been forced to review our office policies and procedures in order to continue to provide the quality care that every patient expects and deserves. This includes increasing fees for non-OHIP insured services recently.

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Did you know… ?

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• The Ontario Health Insurance Plan (OHIP) pays for most of your medical visits and services. However, there are many uninsured services, which OHIP does not cover. 

• OHIP generally only pays for medical assessments and advice that is given in person, face-to-face, with a patient.

• Medical advice, questions, forms or prescription renewals via fax or email are not covered by OHIP (the physician is not being reimbursed a single dollar by OHIP for these services).

• Every single phone call, prescription request, form, letter, note, email, fax, or other such request requires the time, skill, and resources of the staff and physician. Hundreds of such requests every day amount to enormous costs to operate a medical clinic efficiently.

 • Charging for prescription renewals without an appointment was commonplace prior to the Covid 19 pandemic and was put on hold during the pandemic when in-person encounters were limited.

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What Else Has Been Tried Before This?

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Charging a fee for prescriptions is something we have tried to avoid. 

 

For the better part of a year, we have led meetings with staff and had conversations with some local pharmacies where we have brainstormed and trialed different measures to reduce the number of prescription requests. 

 

We have tried:

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• to synchronize all of a patient’s medications so that they all come due at once;

• to ensure patients have ample repeats on their prescriptions;

• reminding patients to check for repeats through multiple methods before contacting our office;

• to encourage patients to call in for all their medications at once, rather than one at a time;

• to encourage pharmacies to send requests for multiple medications rather than one request per medication on different occasions;

• to encourage patients to get their prescriptions renewed during actual visits, rather than calling in later.

 

Unfortunately, none of these efforts have had satisfactory outcomes. Every day, our office still receives hundreds of prescription requests, even from patients who:

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1. Already have repeats at their pharmacy; 

2. Call in for one medication one day, and then call in for another a few days later, instead of calling in for them all at once;

3. Call in for a prescription even though they just recently saw the doctor and could have asked for it then;

4. Have misplaced prescriptions that were already given. 

 

How Will Charging a Fee help us?

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For years, many physicians’ offices have already been charging a fee for prescriptions without visits. These offices report the following advantages: 

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• Patients take increased responsibility and improve organization of their medications.

• The number of prescription requests drops significantly, from hundreds down to less than a few per day, in most cases.

• This frees-up staff and physician time to care for patients. It also frees up the telephone and fax lines for more urgent matters.

• In many cases, if a patient is running out of medications, it is time for the patient to come in for a visit anyway, which in turn improves patient care.