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Patients, doctors say private clinics will survive

Demand will continue despite Romanow views

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Nov. 30, 2002. 01:56 PM
Canadian Press
Halifax

As she sat anxiously awaiting diagnosis on whether she has multiple sclerosis, Patricia Viscount had few doubts the demand for private clinics will continue whatever the views of Roy Romanow.

"Here, I can find out if I'm sick in a matter of weeks," she said in an interview Thursday at a private Halifax clinic.

Viscount was awaiting an MRI scan, a technology that uses a powerful magnet to produce a detailed picture inside of the body.

"This is a significant point in your life. Whether or not you have MS can drastically change your life."

The health commissioner's historic report stopped short of banning the for-profit, private diagnostic clinics like the one that Viscount was in.

Instead, Romanow recommended a flood of $1.5 billion in cash for public diagnostic services across Canada creating potentially tough competition for private clinics that charge between $400 and $725 for the service.

Brian Lee Crowley, a co-author of a critique on the Romanow report, calls the recommendation a poorly disguised attempt "to put the privates out of business."

Romanow also said the use of MRI units should be part of the ``insured health services" under a new Canada Health Act a move that would mean private clinics couldn't continue directly billing patients for the scans.

At one point in the report, Romanow flatly states, "direct health-care services should be delivered in public and not-for-profit health-care facilities."

But at the Canada Diagnostic Centre clinic in Halifax, Viscount said public demand for private clinics in Nova Scotia where waiting times are weeks rather than months at hospitals will remain.

In her case, the MRI scans of her brain could show telltale fissures and reveal multiple sclerosis, an unpredictable neurological condition that in extreme cases causes blindness and paralysis.

With early treatment, the disease is easier to combat. That's why patients eager to relieve anxiety will keep paying for private-clinic results, said Viscount.

"I think it's another option for the public," the woman, in her 20s, said before her test.

"You have a choice of where you want to eat, where you want to drink. This is the same.

"I think competition is always the answer. Like any product you buy, it's better to have choices."

In a neighbouring office, Norman Gosse, the co-owner of Halifax's first private MRI clinic, said he isn't worried about being put out of business by the Romanow report's recommendations.

He expects the appetite for the service will grow across the country.

In Nova Scotia, there are only about 7,000 MRIs carried out a year. He expects that will triple over the next few years.

"If we go from 7,000 to 18,000 or 20,000 scans there's lots of room for us," he said.

The clinic is in its fifth month and is starting to break even with about 25 patients per week.

Elsewhere in Canada, private operators said the impact of the Romanow report remains hard to discern.

Dr. Bruce Forster, the medical director for Vancouver's Canada Diagnostics Centre, agrees with Gosse that the $1.5 billion still won't be enough to satisfy public demand.

"It seems like a lot of money in the short term, but the question is whether it will be enough?"

As the number of MRI units increase, more physicians will order them, he argues. "And as new types of imaging tools become available the question remains whether the government has the money available to meet the needs of today and tomorrow."

Operators of private think-tanks also have their doubts provinces will agree that MRI should become an insured health service under a new Canada Health Act.

Forster said if provincial health ministers go along with that recommendation, it will soon mean there will be demands for a similar status for dozens of other services.

"If it's deemed a medically necessary service it opens somewhat of a Pandora's box into what other services will be considered medically necessary," said the radiologist.

But Crowley said he's worried about the future of the clinics and argues Romanow's views could undercut a crucial option.

"If you look to the province with the shortest waiting time it's Alberta. It also happens to be the province with the most developed private MRI clinics," he said.

"The question is whether private-sector providers could provide better service and free up public health-care dollars. I don't think Romanow's tried to answer those questions."
 

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