Health application forms must not be used to screen prospective patients

Another article in this edition, Patients with chronic pain need family physicians—it’s unprofessional to turn them away, describes the experience of a patient with a chronic pain condition who was rejected by a number of clinics based on answers he provided on an application form that was largely a health questionnaire. The patient was certain it was because he was taking opioids for his pain disorder.

The College has also received reports of physicians advising clinic staff and prospective patients that they will not see new patients with open claims with WorkSafeBC or ICBC.

The use of application forms to screen patients and refusing patients with insurance claims both contravene the College standard Access to Medical Care. Under the subheading Discrimination, the standard says in part:

[Prospective patients not meeting the definition of discrimination in the CMA Code of Ethics] may be vulnerable and marginalized, and also deserving of respectful and fair access to medical services. These individuals may have communication challenges, complex medical problems or medical conditions related to aging where extra time for assessment may be necessary. Some may be dealing with insurance claims, which require a physician to complete lengthy forms on their behalf. Others may have difficulty complying with recommended medical treatments as a consequence of active addictions, limited education, involvement in the criminal justice system or social problems. Refusing to treat anyone in such circumstances violates the medical profession’s ethical principles.

Allegations of discrimination are carefully investigated on a case-by-case basis and may be sustained by the College where impact is demonstrated even if the physician did not intentionally discriminate.
Physicians should note that allegations of discrimination may not only result in complaints to the College, but also to the BC Human Rights Tribunal.

Physicians must not use the health information provided on application forms to determine whether to accept a patient. Prospective patients naturally regard that as discrimination and, as noted above, have recourse to the College complaints process and the BC Human Rights Tribunal. Patients who are turned down by a physician are owed a legitimate reason, as determined by law. 

Questions regarding patient access to medical care should be directed to the College or the CMPA.