By Denise Paglinawan
Students now face a higher fee for missing an appointment at the Ryerson Medical Centre, as new rates for services not covered by health insurance, including certain lab tests and vaccinations, have taken effect this semester.
Fees for missed psychiatric appointments at the medical centre have increased from $65 to $100 for follow-ups and $130 to $150 for initial assessments.
Meanwhile, fees for missed “mental health visits” with a family physician remain $65 for intermediate visits, such as obtaining prescription refills, and $130 for initial mental health assessments.
The fees were increased to align with the Ontario Medical Association’s (OMA) suggested rates, Allan Macdonald, director of Student Health and Wellness, said in an email to The Eyeopener.
OMA, however, told The Eye that they have no specific recommended rates for missed appointments. Rates are set by the clinic or physician and there is no minimum or maximum amount they can charge.
Macdonald added that the increase was also made to keep in line with other fee-for-service clinics. “We compared the fees and settled on an amount that seemed appropriate given our circumstances.”
“Fees are reviewed on a regular basis and were last updated three to four years ago,” said Macdonald.
He also added that the increase was not caused by the cuts in public health or education funding made by Ontario Premier Doug Ford’s government.
“The rate reflects the appointment time reserved for a particular client,” said Macdonald. “Appointments that are 50 minutes are billed at $100. A small proportion of appointments would incur a $100 no-show fee.”
He said the medical centre charges late and no-show fees to help ensure that patients show up for scheduled appointments.
According to the medical centre’s website, patients’ failure to give sufficient notice of cancellation “take away the opportunity for other patients to access services.” In addition, no-shows “result in a loss of income to the clinic and physicians.”
If a patient is unable to go to an appointment, to avoid paying a no-show fee, they must give at least 24 hours notice for appointments with family physicians and 48 hours notice for appointments with psychiatrists.
First-year nursing student Liv Andrews said she thinks the increase in fees is “pretty reasonable” for the allotted time given to cancel before a psychiatric appointment.
“48 hours is quite a long time,” Andrews said after her initial appointment at the medical centre. “I don’t know how much money [the medical centre is] losing. If they’re losing $100, then I would say… it’s pretty reasonable.”
Macdonald said his department does “try to be mindful of emergencies and patient financial situations, and have adjusted [the rates] as indicated or appropriate.”
RyeACCESS coordinator Adam Asmar, however, said the increase in no-show fees is “just another way to siphon money out of the cash strapped pockets of hardworking students.”
Asmar notes that the fees are another cost students have to deal within a year of OSAP funding cuts, elimination of grants and the rising cost of living.
“Students who are unable to make their appointments due to unreliable transit, bad mental health days or any other preventive circumstances will now have to deal with an additional cost that many will not be able to afford,” he said.
Sam Abuhard, a fourth-year mechanical engineering student, also thinks the fees are “a little bit too much” and the medical centre should charge students less.
“If they charge for a smaller amount of money, that would be more acceptable,” Abuhard said after leaving the medical centre.
While charging for missed appointments may help with a health service’s trims to budget, Judith Friedland, retired University of Toronto professor and current chair of Public Health Ontario’s ethics review board, said it seems “short-sighted” to raise cancellation fees when “so many students [are] struggling with mental health concerns.”
“Instead of encouraging someone who has taken a first step to getting help by making an appointment, it is almost punishing them for doing so,” said Friedland. “It’s not that unusual that someone seeking help changes their mind [and] gets worried about reaching out.”
Friedland said both the university and the government, “will need to be confronted with their mistakes in not providing more [mental health] resources.”