Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN

User menu

  • Subscribe
  • My alerts
  • My Cart
  • Log in

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JPN
  • Subscribe
  • My alerts
  • My Cart
  • Log in
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Med Life with Dr. Horton
    • Podcasts
    • Videos
    • Alerts
    • RSS
    • Classified ads
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Activate online account
    • Look up login
    • Earn CPD Credits
    • Members Corner
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
    • Activate subscription
    • Look up login
    • Manage account
    • Manage IPs
    • View Reports
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Features

Preferential treatment for WCB patients angers some MDs

Eleanor LeBourdais
CMAJ October 05, 1999 161 (7) 859;
Eleanor LeBourdais
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Some physicians are questioning the ethics of giving Workers' Compensation Board patients preferential treatment. They argue that the practice essentially undermines the equal-access provision of the Canada Health Act (CHA).

Canada's WCBs, which are funded by employers, are exempt from the Canada Health Act and are allowed by legislation to purchase health care services, either publicly or privately, for injured workers. The idea is to get workers back on the job as quickly as possible.

But that argument doesn't wash with Dr. Philip Berger, a family physician and assistant professor of medicine at the University of Toronto, who insists that medicare and workers' compensation are all public funds. "Workers' compensation is an employer tax, a government-created institution with a duty imposed upon employers by governments as a cost of their doing business. Given that it's all public funds, if we're going to have officially sanctioned queue-jumping in the public system, it should be debated publicly in the legislature, with committee hearings to see what the citizens feel about it."

Berger suggests that the social costs of WCB queue-jumping for anyone not covered by workers' compensation must also be weighed. "If a worker happens to get injured away from work, should he be made to wait longer just because it wasn't an occupational injury? What about the quality of life of an elderly person who has to wait while employees get more rapid service? I think the social benefit of decreased cost to society has to be weighed against the prolongation of reduced quality of life for those not employed, and even those who are employed but get injured off the job."

For now the current legislation holds, although the Workers' Compensation Board of BC is taking an innovative approach that meets both its needs and the needs of non-WCB waiting patients.

"We have public facilities that have unused capacity and closed-down operating rooms," explains Dr. David Blair, executive director of medical services for BC's WCB. "We saw it as more cost-effective and accessible for workers if we could acquire some of that unused time in those facilities and put them to work."

This past year, for example, the WCB paid the Dawson Creek District Hospital to provide 1 day of operating room time per week for WCB patients. It later added another half-day. "WCB cases definitely get in more quickly than they did before," says orthopedic surgeon Dr. Carel Ackermann. "If I see a WCB patient with a [meniscus-related problem], for example, I can usually get him on the slate within 2-3 weeks. If he was not a WCB case, it would take perhaps 6 months."

But the arrangement also benefits the area's 70 000 residents, because Ackermann is allowed to add on Medical Service Plan patients after WCB patients have been treated. It also ensured that the part-time service he offers in the area remained financially viable after funding cuts affected his OR time.

In addition to Dawson Creek, the WCB has made similar arrangements for expedited surgery with hospitals in Trail, Vernon and Campbell River, and is negotiating with other communities.

Blair says WCB funding may be a welcome alternative for hospitals when requests for extra public funding are turned down. "We have a sort of understanding with the ministry that we're going to be focusing our efforts on areas where there's an acknowledged wait-list problem."

Still, Ackermann wonders how the arrangement would work in a larger context. "My gut feeling is that it's a more friendly system in a small setting. In a big setting, I just wonder whether more WCB would get done and there wouldn't be time for the [medicare] cases. Then it would take time and energy away from the rest of the public."

Dr. Jim Lane, past president of the BC Medical Association, says the situation in British Columbia simply emphasizes that the medicare system is in crisis and facing chaos. "Politicians have to start to debate seriously how we're going to have a publicly funded health care system survive into the future. Our present system is failing because of wait lists; the WCB wouldn't be doing this if our system was adequate."

Dr. Michael Rachlis, a well-known medical commentator, offers similar criticism, but at the same time he has some sympathy for the WCB's position. "My view is that we're getting these initiatives from the WCB because the health care system and work-related injuries are so poorly managed right now. It just highlights that the real answer to all these problems isn't to try to make a better system for a small number of Canadians but to make a better system for everyone."

PreviousNext
Back to top

In this issue

CMAJ
Vol. 161, Issue 7
5 Oct 1999
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Preferential treatment for WCB patients angers some MDs
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
Citation Tools
Preferential treatment for WCB patients angers some MDs
Eleanor LeBourdais
CMAJ Oct 1999, 161 (7) 859;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Preferential treatment for WCB patients angers some MDs
Eleanor LeBourdais
CMAJ Oct 1999, 161 (7) 859;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • Scopus
  • PubMed
  • Google Scholar

Cited By...

  • The silent payer speaks: workers' compensation boards and Canadian physicians
  • If the WCB can do it, why not others?
  • Scopus (1)
  • Google Scholar

More in this TOC Section

  • Dr. Krop gets knuckles rapped, but vows to fight college's "Inquisition"
  • Staffing crisis looms, radiologists warn
  • Ball rolling on research into heading injuries
Show more Features

Similar Articles

Collections

  • Topics
    • Patient safety & quality improvement
    • Occupational health
    • Health care coverage
    • Canadian government

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Videos
  • Alerts
  • RSS

Information for

  • Advertisers
  • Authors
  • CMA Members
  • Copyright and Permissions
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact

Copyright 2019, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire