For the first 9 years of Magenta Health, approximately 400,000 incoming emails were received, read, and handled by our amazing team. These emails covered everything from ordinary administrative questions to complex medical requests. We stopped accepting emails in late 2023 for reasons discussed here.
Since then, we have continued to accept patient-initiated medical messages - patients could send written messages to their physician through their physician’s homepage.
There’s still an elephant in the room though. OHIP does not compensate family physicians when they provide care in writing. Instead, for the past 10 years, Magenta Health physicians have reviewed and responded to messages without compensation, driven by a shared desire to provide accessible care and to support the health and well-being of patients.
However, given the option of virtual care, physician shortages, and an ever increasing administrative workload, the status quo is no longer sustainable. It’s driving physicians to burnout and to leave family medicine altogether. It’s time to make a change.
What’s the change?
In select circumstances, patients will need to subscribe to an annual uninsured services subscription to initiate new conversations with their physician. This fee will cover services not compensated by OHIP, including electronic messages. Alternatively, patients can choose to pay on a per-message basis.
We will be implementing this policy strictly. In some cases, messages may be returned to the patient without being forwarded to a physician if they fall under the new guidelines.
There will continue to be situations where messages cannot be sent at all, even with payment, as well as situations where payment is not required.
When Will Payment Be Required?
While the specifics will vary slightly between physicians, here are some examples of situations where payment will be necessary in order to send a request in writing instead of an appointment:
Requesting adjustments to an existing prescription
Following up on a previously discussed medical issue
Requesting replacement prescriptions while traveling
Asking for insurance-related notes (e.g., for massage or orthotics)
When Will Messages Still Be Free?
There will again be slight difference between physicians, but patients will likely be able to initiate certain types of messages for free, such as:
Responding to direct messages from your physician when a response is requested
Requests for routine screening tests (e.g., mammograms, other preventive screenings)
Requests for lost prescriptions
Providing information about care received elsewhere
Administrative messages that do not need physician review or input will also continue to be free.
When Can’t Messages Be Sent?
One of the key challenges with enabling patients to send written messages is that inappropriate, unnecessary, or potentially dangerous messages are sometimes sent. For example, if someone is experiencing an urgent medical concern, sending a message and then waiting, in lieu of proceeding directly to see a medical professional, can lead to potentially catastrophic consequences.
We have worked to configure our systems so that in certain circumstances, messages cannot be sent at all. Instead, in those circumstances, patients will be provided advice as to a more appropriate next step, such as booking an appointment with their family physician.
Just like whether payment will be required or not, there will be some slight differences between physicians.
Why are there Differences Between Physicians?
Physicians are individuals with varying educational and work backgrounds, family life, schedule, personal preferences, and tolerances. There will therefore be edge cases where different physicians can reasonably disagree as to how best to handle the situation, inclusive of whether sending a message should be free, payment required, or permitted at all.
We have worked to configure our systems so that these physician nuances are automatically handled. Patients only need to proceed through their physician’s homepage to search for and proceed via appropriate options.
What If I Can’t or Don’t Want to Pay?
This change will not affect anyone’s ability to access OHIP-covered care. Patients will always be able to book an appointment with their physician or, in urgent cases, a covering physician. These appointments are covered by OHIP, so there is no charge for in-person or virtual appointments.
Will Paid Messages be Prioritized?
Absolutely not. They will be processed and reviewed by physicians in the ordinary course. Patients should not send urgent medical concerns in writing; urgent medical concerns should be addressed by appointment. Magenta Health does not offer executive health or concierge care.
