Medical retainer ‘withdrawn’ while under review

A local doctor has walked back her plan to offer a $125 a month “retainer” program after outrage from the community and a review from the province.

Last week we reported that Dr. Perpetua Nwosu had sent a letter to her patients advising them of the coming program. The details were unclear, including whether patients who decided not to pay the optional fee would be able to remain under the doctor’s care.

We received dozens of comments from readers, and hundreds more were posted online.

“If I was suddenly forced to pay $125 a month for basic medical care, that money would have to come out of my food budget,” one reader wrote. “I am very aware that we have an extreme shortage of doctors on the Island, all over BC, and across Canada. Despite this fact, we can't allow any doctors to bully or blackmail anyone—especially seniors.”

Another wrote he’d be glad to pay $1,500 a year for his wife to have one doctor treat her heart condition. “Sixty percent of Victorians don’t have a family doctor. I don’t know what you would call it, but I wouldn’t call it a health care system,” he wrote. “Canadians are so proud of the “health care system” we have. What is there to be proud of? My plumber makes more than my doctor. It’s no wonder they’re all leaving. Their expenses are skyrocketing, and their income is capped. Optometrists make money. Dentists make money. Veterinarians make money. Family doctors? It’s a joke and I don’t blame them for finding alternatives.”

Then, on Sunday evening (Aug. 14), Dr. Nwosu emailed her patients telling them that “the scheme as it was originally stated is withdrawn while it is under review.”

She did not specify whether the scheme was withdrawn under direction from the Medical Services Commission, which is reviewing the situation, or whether the review she referenced is internal to her clinic.

“Perpetual Health Centre is committed to providing safe and efficient medical services for all patients,” the brief email continued.

Dr. Nwosu did not reply to multiple requests for an interview with Capital Daily, but did post a response on Facebook a few days after we published the initial story. She wrote that her idea to charge $125 per month was an attempt to provide patient-centered care that would provide access to a team of professionals, under her supervision. Her vision was to provide “family medicine that stays with you from birth until you take your last breath.”

The scheme wasn’t a two-tiered system, she wrote, and never planned to cut any patients.

“A good number of my patients are happy to be part of it. It is sad that the original plan has been derailed by lack of proper information. My clinic will now restructure to give us the opportunity to provide care that is well intended and patient-centered,” she wrote.

“I wanted to show for once that a system can work in Victoria, one that carries everyone along, one that I did not want to do secretly. I wanted something open that can face scrutiny.”

It’s unclear whether the $125 retainer payment is allowed under the current policy and agreements. Health Insurance BC allows for an annual non-medical fee, to support administrative aspects of the business, but it has to be optional. Dr. Nwosu’s letter to patients called the fee non-medical, but most of the services it listed were medical.

The Medical Services Commission, which is investigating the matter, said in a statement through the Ministry of Health that it's "pleased to hear that this practitioner has communicated to her patients her plans to suspend the proposed fee." The BC College of Physicians and Surgeons also said it would not comment until a full review is complete.

One of the Westshore-based patients we interviewed in early August, who we called Hayley, was relieved when she saw the email.

“That’s going to make my life easier, because we do still have a GP,” she said. “It seems to be getting a lot more press, and I think that’s good. I think it will put pressure on politicians to get busy and come up with solutions so it’s not just me who’s fortunate to still have a GP, and that everyone can have one.”