MONTREAL — The Quebec College of Physicians has launched an official investigation two days after the Montreal Gazette revealed patients in Montreal routinely bribe doctors in exchange for speedy services.
The College of Physicians is also pleading with patients and doctors to step forward, warning that without formal complaints about the practice, black market medicine will never be eradicated, college secretary Yves Robert said.
The Montreal Gazette reported Saturday that patients who want to be bumped to the top of waiting lists often slip doctors envelopes stuffed with thousands of dollars to jump the queue. Patients said they paid for preferential access to the operating room and for obstetricians to show up for deliveries.
One high-ranking physician who works with doctors at several Montreal hospitals said the systemic practice is an open secret.
Hush-hush payments run from $5,000 to $7,000 to jump the wait list into the operating room, and between $2,000 to $10,000 to guarantee an obstetrician' presence at a delivery, the physician said.
One doctor even gave his answering service a list of expectant mothers who paid, and those who didn't.
"It's not only illegal but unethical. It's totally unacceptable," Robert said. "You cannot overbill the patient for a service that is publicly funded."
The practice contravenes the board's code of ethics, he said.
Led by the board's main investigator, Francois Gauthier, the investigation will initially target doctors at two hospitals named in the article.
"We were made aware of names involved and we will focus on them in particular. We were told a physician has been doing that since 1990. So our (investigator) will get in touch with him to get answers," Robert said.
Meanwhile, a Quebec patients' advocacy group is polling its 400 member user-groups across the province.
"We've launched an investigation. We're doing an inventory, we want them to tell us about patients offering money or that have offered money in exchange for services," said Paul Brunet, head of the Conseil pour la protection des malades.
When their mother got sick, Vivian Green and her twin sister, Ora Marcus, say they slipped a doctor at the Jewish General $2,000 to bump their mother to the top of the waiting list. "It was cash incentive, to buy our place ahead of everyone else," Green said.
But the doctor returned the envelope within days, saying the operation was beyond his expertise. That's when Green went to a doctor at the Royal Victoria Hospital. He also took the money — but he never showed up for the operation, Green said.
The only time bumping a patient is permitted is to make way for a more pressing medical emergency, Robert said. "That's the only reason it is accepted to make a change on a wait list — surely not for a kickback."
The board is taking the allegations seriously and its investigator "will take every action necessary but it's hard to go forward without names," Robert said.
"To do his job properly he needs complaints by patients or colleagues. Any person who is aware of this kind of practice, should — and I would say must — inform our (investigator)," Robert said. "He can't go on a fishing trip and investigate 20,000 doctors."
The investigation should be handled by the provincial police, said federal Liberal health critic Ujjal Dosanjh.
"I could never in my wildest nightmare imagine this happening here," Dosanjh said. "It's very very unsettling and disturbing. If it's happening in health care, where else?"
Bribes to jump the queue for medical care clearly violates the Canada Health Act, he added. "I'm urging an investigation by the police — and quickly."
Critics also raised the issue during question period in the House of Commons Monday.
"Allowing illegal cash payments to continue will endanger the health of those Canadians who cannot afford extra billing, and the health of Canadians generally," said New Democrat health critic Megan Leslie. "When will the government stop allowing two-tiered health care and stop letting those with enough cash to jump the queue?"
Health care is a provincial and territorial matter, replied federal Health Minister Leona Aglukkaq.