Recommending that patients exercise more is definitely a worthwhile venture, as Dr Anne Pousette outlined in her article, “Re-embracing physical activity after COVID-19: What is the physician’s role” [BCMJ 2021:63:298]. In fact, she says, “Physicians can play a crucial role in promoting a societal return to physical activity.” But by recommending that family physicians take on this task, and giving time-consuming examples of how they might do that, I am wondering if Dr Pousette is aware of what province she practises in.
BC MSP does not allow family physicians, or any physicians, to bill MSP for such counseling or for any lifestyle or preventive counseling. This is clearly outlined in the Doctors of BC revised fees for uninsured services document (www.doctorsofbc.ca/sites/default/files/uninsured_services1apr2021_421287.pdf). Patients are to be billed under code A00054, which states: “Preventative medicine counselling all forms, e.g.: health maintenance, assessment and counselling to include physical examination, smoking withdrawal and other harmful habits, weight and/or diet control, exercise programs (planning and management), stress management techniques, social support systems, establishing normal sleep patterns and other forms of lifestyle counselling - per half hour $158.00.”
Dr Pousette’s recommendations clearly fall under the above uninsured fee code, meaning MSP cannot be billed for such a visit. That means family doctors are left with the impossible choice of either doing the work and not being paid, which is clearly untenable, or saying sorry to patients who want advice for weight loss, smoking cessation, or exercise guidelines. Please, Doctors of BC, consider requesting coverage of such services in your next round of fee negotiations. Our patients, our families, our communities deserve it.
—Lesley Horton, MD, CCFP
This letter was submitted in response to “Re-embracing physical activity after COVID-19: What is the physician’s role?”
Read the author’s response in “Re: Re-embracing physical activity after COVID-19. Author replies.”
Read BC Family Doctors’ response in “Re: Re-embracing physical activity after COVID-19. BC Family Doctors replies.”
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