Mind & Body

Dermatologist to work through health centre

 | January 11, 2013

Another medical specialist will be joining the physicians at the Sun Peaks Health Clinic this year.

Dr. Richard Lewis, Kamloops’ only dermatologist, hopes to offer his services at Sun Peaks twice monthly for the ski season.

“What’s different (about Dr. Lewis) is he’s de-enrolled from the Medical Services Plan (MSP) so that he may bill,” explains Marg Kosolofski, manager of the Health Clinic.

De-enrolling from the medical system means a doctor can no longer bill their services to the government; instead they charge patients directly. The physician retains all of his or her licenses and qualifications.

Lewis de-enrolled from the medical system because of the problems he believes are associated with it, namely the low fee schedule. In B.C. a dermatologist can charge a new patient $60 for an initial consultation, and $20 per repeat visit. An equally qualified specialist in Alberta will make 50 per cent more to do the same job.
This low fee structure, Lewis contends, has resulted in a lowering of the quality of services provided to patients.

“The only way you can make a living in B.C. as a dermatologist is to see more and more patients to make up for the low fee schedule. Well, seeing more and more patients means the patients get poorer service, the patients sometimes might get 5 minutes of your time to be able to look after conditions that properly should take 15 or 20 minutes of your time. I’m billing the patient directly, I use the fee schedule that I feel is warranted,” says Lewis.

Dermatologists in B.C. and Quebec are the lowest paid in Canada. Lewis believes this is a major reason one third of B.C.’s graduating dermatologists leave the province.

As an alternative, people seeking medical advice for skin conditions can visit their family physician for consultations, but that actually costs the health system more than if they visited a dermatologist. A general practitioner charges MSP $80 to $110 per initial patient visit rather than the $60 a dermatologist can charge. Compounding Lewis’ argument is the extended wait and processing time a patient encounters going through a family physician rather than through a specialist such as himself.

But charging higher amounts to patients directly can sometimes result in inequality, so Lewis, in limited circumstances, offers pro bono consultations. Lewis asks that his pro bono patients make donations to the Kamloops Food Bank.

Lewis explains that his pro bono work is driven by a desire for equal access to medical services despite economic status. Pro bono assistance is commonly provided by law firms, marketing, technology, and strategy consulting firms.

Lewis’ services at the Sun Peaks clinic will focus on non-cosmetic skin conditions including “mole patrol,” examining moles for signs of skin cancer.

For scheduling info visit: sunpeakshealth.com