Examining compensation models for walk-in clinics

ABSTRACT

Positioning primary care as the cornerstone of the health system and establishing primary-care providers as the gatekeepers and coordinators of care has been a long-sought aim of health systems around the world. Further, a main aim of this goal in Canada has been to have a primary-care provider that is responsible for the health and well-being for each insured patient. However, ensuring that all citizens in a province are registered with a primary-care provider who is responsible for their care and can provide timely access to care when needed has proven difficult to achieve. This is not surprising given that primary-care providers in Canada are confronted with many challenges in their practices, including one or more of having to serve large geographical areas, providing care to uninsured populations, and managing high workloads as well as a mismatch between provider availability and the need for timely access to services (particularly after-hours and weekend care). When coupled with the policy legacies of how physicians in Canada have traditionally delivered care and been remunerated (e.g., as private business owners with public fee-for-service payment), the result is a patchwork of primary-care models.