A private business on P.E.I. says it can provide international visitors to the province much faster access to some health-care services than Island residents can expect to receive — for a price.
PEIdoctor.com is also pitching for-pay health consultations to Canadians, raising concerns from advocates of Canada’s universal health-care system.
The website says it can provide international visitors and Quebec residents with same-day, non-emergency access to a physician, including weekend and evening visits, even house calls to their hotel, cottage or AirBnB.
Those come at a cost ranging from $229 for a virtual consultation to $900 or more for house calls.
“We believe more visitors will come and longer-stay visitors will come and people who, for instance, are in their retirement age may come for longer stays,” said Marius Croeser, CEO of EndWell Management Inc., the P.E.I. company behind the website.
Dr. Janine Karpakis is one of the two doctors listed on PEIdoctor.com. She is a family doctor who works from a clinic on St. Peters Road in Charlottetown. (Aaron Adetuyi/CBC)
Dr. Janine Karpakis is one of the two doctors listed on the website. She’s a family doctor who works for Health P.E.I. from a clinic on St. Peters Road in Charlottetown.
She said the appointments she keeps with paying international customers fall outside her regular duties with her patient panel from her family practice.
“It’s all about convenience,” she said about the tourist appointments. “It really is about not having to wait in urgent care or [the] ER.”
According to a Google review posted on the website, a woman claiming to be a U.S. resident wrote: “We received better care from Dr. Karpakis than any care we’ve received in YEARS in the US… If you’re a visitor to P.E.I. avoid urgent care 12+ hour waits and book a 30 minute visit here!”
Karpakis said patients are “mostly people who’ve forgotten their medication at home and need a quick prescription or, you know, a bladder infection or a little rash, an insect bite, that sort of stuff.”
Those appointments aren’t available to P.E.I. residents because the Canada Health Act stipulates medically necessary health-care services have to be provided to insured Canadians without charge.
Dr. Janine Karpakis said her international tourist patients are “mostly people who’ve forgotten their medication at home and need a quick prescription or, you know, a bladder infection or a little rash, an insect bite, that sort of stuff.” (Aaron Adetuyi/CBC)
But PEIdoctor.com does have a service it offers to Canadian residents, including Islanders.
On its website, that’s billed as a type of medical information session — 45 minutes with a doctor to explain existing diagnoses, specialist reports, lab and imaging results at a cost of $195.
Karpakis said it’s something all patients should receive through the public health-care system, but often, there isn’t time.
“Because the health-care system is so strained, you can’t really get back to see that provider in a time period, or sometimes never. That’s why I’m saying this consultation is inviting you to come sit next to me, as if we’re talking in my living room.”
But Tracy Glynn with the Canadian Health Coalition said this is not something that Canadians should have to pay for.
“The description of that service sounds like it’s medically-necessary health care, that it’s part of the intake process,” she said.
“For us, that would be considered a violation of the Canada Health Act and something that our provinces and the federal government should take action on.”
CBC News reached out to Health P.E.I., which in turn provided a response from the P.E.I. Department of Health and Wellness. That response focused on the international appointments but not the for-pay offerings for Canadian residents.
For us, that would be considered a violation of the Canada Health Act and something that our provinces and the federal government should take action on.- Tracy Glynn, Canadian Health Coalition
“Under the Canada Health Act, provinces are required to provide insured health services to residents of the province. Tourists and visitors are not considered residents of the province and are therefore not eligible for publicly funded insured health services,” the statement reads.
“Physicians and nurse practitioners can provide health care to individuals who are not eligible for Medicare, with those patients responsible for the cost of their health care, whether accessed through a HPEI facility or otherwise by way of private agreement.”
CBC also reached out to the P.E.I. College of Physicians and Surgeons, which also provided a statement.
“All members of the College are expected to abide by the College’s Policies and Standards along with the applicable legislation for their profession,” that statement reads.
“The two physicians listed on the website are both active members of the College. They must abide by our policies and work within their clinical scope.”
Regarding the consultations for Canadian residents, Croeser told CBC: “We’re very cognizant of the rules around what is a medical consultation and what is not. We’re asking a simple question: are they services that are outside the scope for private pay?
“We believe they are and we believe there’s a need.”
In a follow-up email, Croeser told CBC, “PEIDoctor does not offer P.E.I. Medicare-insured physician services to insured Islanders on a private-pay basis. We have deliberately structured our services around this boundary.”
He also explained how he believes private, for-pay health care can work in support of P.E.I.’s public health-care system.
‘We believe more visitors will come and longer-stay visitors will come and people who, for instance, are in their retirement age may come for longer stays,’ says Marius Croeser, CEO of EndWell Management Inc. (Aaron Adetuyi/CBC)
But Glynn disputed that, saying a lack of clarity in the Canada Health Act has led to “grey areas,” including in the provision of virtual health care, where private companies are finding ways to profit.
That, she said, is “further starving the public system of resources and health-care workers, and then making the waiting periods for scans and surgeries even longer.”