After the controversial Copeman
Clinic, a partly private, executive health centre in
Vancouver, was found innocent by the BC government of
any billing misdeeds, public and private healthcare
activists across Canada perked up.
The ruling, according to founder
Don Copeman, is a green light for him to expand his
hybrid, semi-privatized model across the country. But
not everyone agrees. Is Canada about to see an explosion
of such clinics, or is Mr Copeman's entrepreneurial
spirit outpacing the reality of Canadian law?
UNCLEAR
DECISION
The answer to that question is, counterintuitively,
perhaps more unclear now than before the BC decision
on the Copeman Clinic. That's because the government's
Medical Services Commission (MSC) has refused to release
the reasoning for its decision.
"It's a two-edged sword. By not
releasing the reasons for the decision [the MSC has
created a situation where] anybody wanting to copy the
model also has to be concerned that, while Copeman made
it through the test, they might not," argues David Schreck,
a retired BC NDP legislator.
'ELITE'
MEDICINE
The Copeman model is a divisive one: 'elite' members
are promised — after an enrollment fee of $3,900
— quick access to doctors and a cadre of attentive
healthcare professionals, even some who will help members
with their golf swings.
The centre, established in 2005
by Don Copeman, has doctors on staff who bill the province's
Medical Services Plan for publicly insured services.
The enrollment fee covers the extras — like fitness
programs and other services not reimbursed by the MSP.
Critics argue the clinic's doctors
are freely taking from the public purse, but, through
the enrollment fee, the clinic is only tending to its
well-heeled subscribers. Nonmembers can ask to see a
doctor at the clinic but those enrolled get priority
and it is the doc's decision to attend to more patients
or not.
The Copeman Clinic is poaching
doctors from a system already starved for GPs, say critics.
But Mr Copeman argues that offering a sweeter deal to
family physicians is what's needed to inspire more med
students to think twice before choosing to specialize.
"We do have a doctor shortage. How do you solve a shortage?
You have to make the job better," he argues. Copeman
Clinic physicians, billing the province for insured
services and maintaining a stable of about 500 enrolled
members, should be able to earn around $275,000, Mr
Copeman estimates.
After over a year and a half of
deliberation, the MSC has declared that Mr Copeman's
clinic isn't doing anything illegal.
PLANS
TO EXPAND
With the MSC's decision behind him, Mr Copeman is pressing
ahead. A Copeman Clinic in Calgary is slated to open
this coming spring.
Staffing doesn't appear to be a
problem. By collaborating with other healthcare practitioners
onsite, he says, "doctors get to practice the kind of
medicine they have always dreamed about." The five physicians
at the Vancouver clinic currently see between 10 and
12 people each day.
Plans to expand to Toronto are
on hold but not because Ontario's Ministry of Health
has been hostile to Mr Copeman's model — he said
the Ministry has been "very reasonable" in discussing
how Ontario clinics could conform to existing legislation
— but for the more mundane reason that he just
hasn't found the right piece of real estate to accommodate
a clinic there. Mr Copeman's ambitious five-year plan
is to have 12 clinics established in the country's largest
urban centres.
PLANS
TO EXPAND FuRTHER
In the long term, Copeman wants to turn what is now
one clinic into a franchise of 40 throughout the country.
"It is the key to sustainable public healthcare," he
says.
But Dr Danielle Martin, an Ontario
GP and member of Canadian Doctors for Medicare, isn't
buying it. "We shouldn't overestimate the potential
of a model like [the Copeman Clinic]. I think they will
find most Canadians don't want to pay twice for their
healthcare. It's probably not a model that is going
to have a big impact and it's certainly not a model
that is going to offer a significant solution or a way
forward for the majority of Canadians."
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