Most visits to the family doctor’s office in Canadian provinces result in the same basic fee. That fee is paid to the doctor, who then takes a portion of it – often as much as 40 per cent – to pay office rent, employee salaries and the cost of equipment, supplies and maintenance.
Some provinces have modified fees for visits that can take more time, or that involve the use of office equipment that must be discarded or cleaned afterward.
The cost of your medical visit might not be limited to the doctor’s office, however. Lab tests, mammograms, bone density tests, x-rays, counselling visits, and prescriptions all add costs to the system. Some of these costs are partially or fully passed on to the patient, others are covered by insurance, and some are covered by health care.
Consider the associated costs of various situations that might prompt a visit to your doctor.*
You wake up with a fever and the worst sore throat of your life. It does not get better in a couple of days. You visit your doctor, who spends a few minutes asking questions and examining you, including taking a throat swab. This is a quick visit and is generally not complicated. The doctor receives a basic fee of about $32. The throat swab goes to the lab, where it costs approximately $30 to analyze the sample and produce a report, which goes back to your doctor. You might be prescribed antibiotics, which cost approximately $25 for 10 days. Part of this medication cost may be covered by insurance and you may pay for some of this yourself.
Total cost: approximately $90.
You notice burning with urination, need to urinate frequently, and feel generally unwell. You visit your doctor and provide a urine sample. The sample suggests infection and is forwarded on to the lab for a culture.
The doctor receives a basic fee of about $32.
The lab cost for the culture and report is $30. Cost of treatment is approximately $15, some or all of which you may pay.
Total cost: approximately $75.
Your four year-old son is due for a check-up. Also called a preventative health visit, this is where your doctor will measure your son’s height and weight, and asks questions about nutrition, exercise, habits, behavior, development, safety, and immunizations. Your doctor does not recommend any routine tests, but reminds you that your son needs a set of immunizations. The doctor receives a basic fee of about $80. In Alberta, immunizations are administered by the public health office and cost approximately $120 for the vaccines themselves, in addition to the cost of the public health nurses’ salary and overhead, which is about $50.
Total cost: approximately $250.
You are pregnant and have a routine pre-natal visit with your doctor at 26 weeks. You are due for routine mid-pregnancy laboratory tests, including a gestational diabetes test. You are also scheduled for a follow-up ultrasound in about a month for a low-lying placenta. The doctor receives a basic fee of about $32. The cost of the laboratory tests is approximately $80. The cost of the ultrasound is $150.
Total cost: approximately $165.
You are a 65 year-old woman seeing your doctor for a periodic health examination. Your doctor assesses your general medical condition and makes suggestions for lifestyle and medication management of those conditions. Screening tests like a pap test and a mammogram may also be suggested. The doctor receives a basic fee of $70 to $80. A pap test adds another $20. If the doctor spends 30 minutes working with you alone (including writing notes and reviewing your file), there is a top-up to the fee. The office visit adds up to approximately $110. Your lab tests, such as cholesterol and diabetes tests, cost $60. A fecal occult blood test for colon cancer screening costs $7. The mammogram costs approximately $100. The Pap test interpretation costs $20. The bone density costs $140.
Total cost: approximately $430.
You are a 20 year-old man who comes in for tests to rule out a sexually transmitted infection. Your doctor indicates that a few tests, including HIV, should be done now. Repeating the HIV test twice in the next few months is also warranted. The doctor receives a basic fee of $32. The cost of the lab tests for chlamydia/gonorrhea testing, syphilis, hepatitis B, and HIV is approximately $100. The repeat HIV tests cost $40.
Total cost: approximately $172.
You are a 32 year-old man who falls while skiing. You feel a pop in your knee. It is swollen and painful, and you cannot put weight on it. The same day, you visit the emergency department in the mountain town near where you were skiing. It is a weekday. The cost of visiting the hospital for any reason will vary depending on the size and location of the hospital, but in this mountain resort town, the foot-in-the-door cost is $275. The on-duty doctor receives a basic fee of $40. (The cost of an emergency room visit varies with the time of day. A visit at midnight on a weekend will cost more than a noon-hour weekday visit due to the added cost of calling in physicians and technicians during non-working hours.) The doctor recommends an x-ray to rule out a fracture: $40. You purchase crutches and a brace: $60.
Total cost: $415.
You are 60 years old and have hypertension. During your office visit (usual fee $32), your doctor discusses lifestyle measures that may help control your blood pressure. He also considers medication options for your condition, choosing from many different classes of drugs. He prescribes hydrochlorothiazide, a diuretic drug (often called a water pill) proven to be safe and effective. It is also the least expensive option, costing only about $15 for a three-month supply. Other common first-line medications for hypertension are amlodipine, which costs approximately $55 for three months, and ramipril, which costs $45 for three months. Your doctor may not tell you that he considers the cost of medication in making his decision. If you do not have insurance to help cover the cost of your medications, tell your doctor, as this information may factor into what medication your doctor decides to prescribe.
Total cost: $79.
The cost of an office visit should never prevent you from getting the care you need. Getting care before serious complications develop is also necessary. However, it is important to remember that costs are involved. These include the fees paid by the health care system for your visit, the equipment and supplies used, the follow-up tests, the cost of the physical space where the services are provided, and the salaries of those providing services. Being aware of potential costs is one more excellent reason to protect your health.
* As actual costs vary from province to province, the amounts used are only approximations.