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A Canadian healthcare advocacy group is warning patients that a Kelowna medical clinic offering paid memberships may be in a legal grey zone.

Pandosy Village Medical Clinic offers a few different paid memberships. The Concierge Membership is $3,750 for the first year, and then it’s $2,750 annually after the first year, and the Snowbird Membership is $2,000 a year. 

Audrey Guay with the BC Health Coalition, an organization that advocates for the public healthcare system, said although clinics are legally allowed to sell memberships for services outside of the medical services plan, people may be paying for services they are freely entitled to. 

“I would want people to be cautious on the personal level so that they know that they're not entering into any illegal situations where they're being taken advantage of,” she said. “Be aware that the growth of these private clinics is actually hindering our access to primary care overall as a province.”

Other clinics in B.C. like the Harrison Healthcare clinic and Telus Health clinics ran into legal trouble because they were extra-billing patients for services covered by the public plan, according to the Coalition. Those cases were resolved allowing the paid memberships to continue for services outside of the medical services plan. 

Medically required services like diagnostics are covered by the public plan, but other non-essential services like some follow-up care might cost patients their own cash. For example an X-ray is covered by MSP, but a person may have to pay for follow-up physiotherapy through private benefits or out of pocket.

The Pandosy Village Medical Clinic's Concierge Membership includes things that are clearly not covered by the medical services plan like an assessment with a dietician, a fitness assessment with a kinesiologist and canine therapy assistance. The membership also includes 24/7 access to a physician by phone for easier access instead of booking an appointment.

The clinic said the doctors were too busy to speak to iNFOnews.ca.

The memberships description on the clinic's website includes this disclaimer: "some of the above services are in some circumstances considered to be medical service plan covered benefits. The Concierge membership fees are not for any medical services plan covered benefits but for those that are outside medical services plan coverage. Medical services plan covered benefits will be billed to the medical services plan in the usual course for those patients who have medical services plan coverage."

Guay said a potential legal grey area in the clinic's membership is the advertised 24/7 access to a physician via phone or email.

“That's the grey zone that we currently live in where a clinic could make the case that they're also offering medical service plan insured services to non-members, but is it truly equitable access or equal access?” Guay said. “From what I'm seeing, really quickly, warrants an investigation from the medical services commission."

Telus Health and Harrison were subject to legal action, but the settlements were a weak deterrent, she said.

“In both cases, the companies settled with the government and agreed to clarify that the member fees don't in any way go towards faster preferential access towards seeing your doctor or any medical service plan's insured service,” she said.

The College of Physicians and Surgeons of BC said in an emailed statement that doctors can choose to opt out of the medical service plan and bill patients privately for medical services otherwise covered by the provincial plan.

If patients have concerns about a doctor's billing practice they can report it to the Ministry of Health's Billing Integrity Program here.

“I do think that there is a legal grey zone in these memberships that's currently existing. And I think companies are finding ways to take advantage of those legal grey zones," Guay said.

“We need those laws enforced and a clear message to be sent to clinics that, you know, in Canada, we have access to healthcare based on need and not the ability to pay."

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