In the July Bulletin, physicians were invited to provide commentary regarding various aspects of access to a physician's practice. A small number of responses were received and are being considered by Council. On reviewing this matter, Council noted one area which appeared to be causing some confusion. This was the question of whether it is appropriate for physicians to close their practices to any new patients and what impact that would have.
First of all, it should be clear that any physician is free to determine that their caseload is sufficient such that they generally are not accepting new patients. The determination of this is obviously a very individual matter, but this should be considered when physicians feel that their ability to serve their current patients would be significantly compromised by taking on a number of additional ones.
Thus, it is now common, and acceptable, for physicians to simply respond to any inquiries by stating that they are not accepting new patients.
Having said that, some physicians believe that, once making that determination, it would be improper for them to accept any patient at all into their practice. This is to advise that such need not be the case.
In other words, even if a physician has a "closed" practice, and is advising that new patients are not being accepted, the physician is free to make exceptions to this. If physicians wish to include a new patient into their practice, for whatever reason, they are free to do so; notwithstanding they have previously said that new patients are not being accepted. As examples, these may be patients they have encountered in another context such as the Emergency Room, may be patients who are relatives of current patients, patients who are new to the community and have particular needs, or patients seen at the request of a colleague.
It is trusted that this point is now clarified. It should be noted that this commentary does not yet address the issue of physicians who have not yet closed their practice, but who are selective regarding the patients they are willing to accept.
11/99