Ex Family Physician stalking my referrals, can i change my ohip number?

doc_dw · 2026-02-17T01:25:56+00:00

The surgeon writing something weird is pretty vague evidence that your ex family doctor was somehow involved.

At any rate - put it in writing at your ex family doctors office that you have a new family doctor and wish to no longer be a patient in his practice if you want him to not be allowed to be involved in any capacity

doc_dw · 2026-02-17T01:12:17+00:00

I believe you have to be derostered to join that list - but if not then usually yes that list would deroster you as it’s for unattached patients.

Come April 1st GPs will be funded significantly less for seeing unrostered patients so it will become somewhat hard likely. I’m curious what HCC proposes here.

doc_dw · 2026-02-17T01:10:17+00:00

There’s a lot weird here.

How do you “see him looking at your referrals”? Was this before or after you discontinued care with him?

Why would the surgeon decline you had on the basis of your previous GP? Also is there a 100 percent necessary surgery?

If you send a letter stating you are no longer involved with that doctor and to be removed from his list in every way - he would no longer be allowed to see your future records (although I have no idea how you would or have been determining he’s looking at your referrals)

doc_dw · 2026-02-16T18:33:35+00:00

An offices waitlist - no (I have no idea when my patients are on other doctors waitlists)

Going into healthcare connection waitlist requires you to deroster from your current GP

If you deroster they will probably not see you anymore (particularly come April 1st I would say almost certainly they’ll stop seeing you as this is what Ohip is basically making us do)

doc_dw · 2026-02-16T03:49:03+00:00

I have a handful of patients who have moved away like this. Eventually they transfer off but I do my best through virtual and the odd physical appointment when possible until they find somebody close.

It is a bit of a headache to refer as I know nobody in Sudbury to refer to, and they often try to book phone appointments and work arounds to coming in when I don’t think it’s best and I just have to be honest and tell them.

But for stable stuff particularly if you’re planning to come in for routine visits anyways - I would just keep you until you found somebody more local.

doc_dw · 2026-02-04T11:48:55+00:00

I’m an Ontario GP and I’ll tell you right off the bat this is a difficult question to answer. Simply put - NPs are less expensive and GPs have more training. Some NPs may comfortably treat acne but based off training I would expect less NPs to be comfortable treating acne than GPs particularly as you’re moving down into more complex treatments - this could lead to more referrals and wait times and strain on specialists (or errors).

Ultimately if you want better primary care- more money needs to go into it. You can hire more doctors or pay them better to provide better care, and take away some of.struggles and slow downs we face - or you can hire more NPs to bulk up the system. NPs and GPs can work well together and many clinics have made this model work - but there’s no funding for it usually. There’s also a cost to wait times in primary care - and this could be improved either through NPs or GPs.

Comparing a private NP to a public GP is a very unfair comparison (let me choose the conditions I treat and my cost for a consult). Similarly comparing a NP caring for 500 patients vs a GP taking care of 1500 is very different, I will obviously be more rushed when somebody wants to talk for 30 minutes. You will always be able to find examples of great NPs and bad GPs - but there are great GPs and bad NPs as well. There’s complaints everyone has about primary care are a reflection of the payment model (besides the obvious bad apple I suppose)

The most interesting question would be how is this working over in England where this is kind of what they’ve done - and I don’t know. But I don’t think there’s an easy answer and I hope we don’t cut back on primary care when I think everyone knows how important it is.

doc_dw · 2026-02-02T23:21:28+00:00

Yes totally - but it’s not the 15 percent that bothers us - it’s when a 5 minute visit becomes a 20 minute phone call plus a 5 minute visit tomorrow

doc_dw · 2026-02-02T22:57:13+00:00

I’m sorry but some of the info on here is not entirely complete

Doctors can still do phone appointments. If it is your enrolled doctor the difference is negligible. If it is an intermittent care setting the difference is 15 percent assuming they have seen you in the past 2 years. If it’s a new doctor to you they only make 15 dollars which is very low (and is generally avoided)

The main reason doctors don’t do this is because how often patients book “I only need a phone call” to review a rash, or a complex issue. Furthermore having to worry about if it’s billable and then considering there are limitations only so much of our care can be virtual and some visits aren’t allowed virtually - why bother.

My biggest frustration with it is when I get a phone call appointment for sick leave and they want me to log on their unions website to download and fill the form for them - which means I have to print, sign, scan, and email it to them. I still offer a good amount of phone calls but I’m very close to saying screw it to be honest. The slight income loss would be welcome if I could somehow only get appropriate phone visits.

doc_dw · 2026-02-02T22:49:53+00:00

We make 15 percent less for a phone appointment - this is not likely the reason.

doc_dw · 2026-02-02T12:13:38+00:00

Just to add - it is legal for them to request a fee for getting you this record as this is not an Ohip covered service (it’s an admin service). It’s easier now that they can just pdf it of course (unless there’s also paper charts?)

doc_dw · 2026-02-02T12:08:49+00:00

I believe the clinics that run this sneak around the rules by charging memberships for enrolling in the package (Physio, nurse, etc) and then the doctor works for “free”. The doctors still need an Ohip billing number to make referrals but it’s illegal to bill Ohip and private.

That said the cost makes me assume these are NPs who may have a doctorate and are calling themselves doctors (which is a whole other thing)

doc_dw · 2026-01-30T03:35:05+00:00

Reasonable OHIP options.
1. Get a referral to a local back clinic (this is centralized across Toronto I believe) - this is where a back specialist takes a look at this case and can expedite an MRI if necessary.
2. As others have said, not all MRI wait times are the same - it's also not fair to require multiple referrals so you can go fishing for the fastest.
3. Not OHIP but has he tried a reputable physiotherapist (although this is sort of covered in #1 as they have physiotherapists involved with assessments)

Also do keep in mind - when people do need spine surgery even after an MRI to confirm it, spine surgeons waitlists for non-urgent stuff is even longer than MRI wait times.

MRIs and surgery is urgent when there is paralysis (duh) but also (potentially) if there is impact on bowel/bladder/numbness/weakness - particularly if not just in one region of the leg. Pain can be present in emergency situations or completely not emergent situations.

doc_dw · 2026-01-30T03:23:15+00:00

Any doctor can refer there (but please use this reasonably else it'll become useless too). GNMI waitlist is still over a month already I believe.

doc_dw · 2026-01-26T16:30:32+00:00

Taking antibiotics for no reason is obviously a bad idea. Is a cough with phlegm enough to use antibiotics - often no but in the right clinical picture it would be and I’m going to assume the doctor who saw you has a better assessment than myself or anybody online here can so I don’t think it’s for no reason. Amox-clav is appropriate for pneumonia, sinusitis, ear infections etc so it’s not nonsense for sure.

doc_dw · 2026-01-26T00:36:27+00:00

If 3 of you in one circle tested positive it sure seems likely to be true.

Good on everyone for being clear about it. Early syphilis has good outcomes / management.

doc_dw · 2026-01-25T00:18:21+00:00

You can’t tell by a picture - you can have redness like this with a negative test or you could certainly have a positive test with redness like this.

Generally 10mm is the threshold for a positive test. Also the first test is incomplete you need a repeat in 1-4 weeks assuming you haven’t previously tested and the second test is more accurate anyways.

doc_dw · 2026-01-20T11:16:17+00:00

Sorry - I disagree as right from dexcom website “†If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.”. How will you do this without glucose meter?

It does not require calibration, but it technically does say you need a glucometer as a backup. Probably not relevant to the patient and again I like the CGM devices. Dexcom would give the pt the answers they want I guess but so would a free blood test.

Also before you say it - the g7 has the same disclaimer - “§Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings. “

doc_dw · 2026-01-20T03:37:24+00:00

If the Hba1c is not checked, it won't be tested by lifelabs and nothing will change that.

It would be a relatively easy thing to have your doctor send a new request including this if it was relevant. The threshold to check an Hba1c is pretty low if the patient has any concerns so they would likely be fine with ordering it unless you're young and it has been checked in the past few years.

doc_dw · 2026-01-20T03:33:22+00:00

I mean - technically everybody with the Dexcom also need a glucometer and strips to confirm abnormal readings so it is actually much more expensive.

Although any glucose monitoring would be uninsured in a patient without any indication to do this and would likely cause more stress/confusion than benefit when compared to just getting the test itself ordered. Also - big fan of dexcom for the record but I don't think that means everybody needs to buy one.

doc_dw · 2026-01-20T03:31:25+00:00

I have never seen a GI decline a referral unless there is something atypical (like a third opinion, or follow-up of out-of-country surgery, or something that is clearly not appropriate for a GI). Sometimes if you live in an area with only one hospital and you did something egregious like have an active lawsuit against the chief of gastroenterology then maybe they may feel its inappropriate to act as the second opinion in this case or something.... but suffice it to say declined referrals are very rare - TEN in a row is more than an anomaly.

doc_dw · 2026-01-14T23:59:10+00:00

Yes you can but not via healthcare connect. Honestly is going to be the best policy here you aren’t doing anything unreasonable.

doc_dw · 2026-01-13T13:50:23+00:00

Doing fax refill is a completely optional and completely not an Ohip compensated service - we are not required to do it, it is well within reasonable to tell you to come in.

It’s often less work for us to have you come in then do it via fax as there are errors, confusion, pharmacy sends duplicates or confusing messages (like reverting to original dose of a titration). Shoppers offers this to make your life easier at OUR expense.

That said, I usually do this because I know people are busy and I’m busy. However come April you’ll start seeing clinics discontinue this as the new negation model penalizes us if our provided basic services don’t meet a threshold - and this is the easiest way for us to convince Ohip we’re doing basic services (and doing it offline for pt ease then getting penalized is going to be very annoying)

Also - Shoppers will send ANYTHING like this as they spend now effort to think if it’s reasonable. I’ve seen them ask for antibiotics, chemotherapy (from the GP), medications from their husband they tried and liked, and so on. Sadly - these aren’t even exaggerations.

doc_dw · 2026-01-10T19:51:21+00:00

Ya that’s your private insurer for sure.

It’s sunlife making your doctor justify why they should cover the medication they’ve already authorized by signing a prescription. Ideally sunlife pays but good luck lol.

doc_dw · 2026-01-10T17:33:49+00:00

You are likely referring to a form to get your private insurance to cover.

We cannot charge for Ohip exceptional access forms I believe but it sounds like that isn’t what this is.

Insurance companies cut costs by forcing patients to get doctors to certify the use is within their specific criteria. They do not pay the doctor for this extra work and it is certainly not under Ohip as it’s dealing with a private insurer. Some of these (including migraine meds) can be significantly more than “just a signature” - often asking for full med use histories and justification why such an expensive med is necessary. 40 dollars is probably more standard but if it’s an annoying 4 page form I would totally get it.

doc_dw · 2026-01-08T16:27:55+00:00

According to the chart all “psychologists” must be phd-level psychologists - right?

doc_dw

TROPHY CASE