Local children's clinic restricted by government: director

Tiny Tots Medical Centre will return to its regular opening hours in July after rejecting about 3,000 patients this month, but its director warned problems are not completely resolved. The children's clinic, which is located in Dollard des Ormeaux, could not operate on evenings and weekends due to government-regulation imposed staff shortages.

"On any given day, the demand (by patients) is always greater than the supply," said Tiny Tots' director Dr. Benjamin Burko. "And if a (special) Activités Médicales Particulières (AMP) situation were permanently accorded to us, then more patients would be able to seen."

The AMP designation, governed by the provincial Ministry of Health and Social Services, calls for general practitioners in Quebec who work at private clinics to put in 12 hours a week of work at a different location, whether at a hospital emergency ward, or by helping out "vulnerable" populations, such as seniors.

Burko, who says his staff of approximately 25 to 30 paediatricians and GPs sees up to 300 patients a day, has previously tried to gain an AMP designation for Tiny Tots several times, arguing that their usually extended hours and large flow of patients practically means they act as an emergency service for children. "The work that goes into our centre is as important, paediatric emergencies are as important," Burko said.

Though previously rejected, he appealed again in June after yet another government regulation, a ceiling for billing that would have meant his paediatricians would only get paid 25 cents on a dollar until the end of June, had most of them elect to stop working beyond 3 or 4 p.m. on weekdays, and completely during weekends.

"We asked, 'hey, listen, our paediatricians are going to be out because of the ceiling issue and if you don't let us have AMP (status) so that our doctors can stay and work their 12 hours a week at our place, we're going to be closed," said Burko, but it was to no avail.

According to Burko, Quebec lowered the billing ceiling for the period of January to June 2009, and only informed his clinic of this change on May 1st. "We were already too far into the game," Burko said.

Patients at the clinic had mixed reactions to the reduced opening hours today.

"It doesn't affect me personally, I can understand it affecting other people," said Joanne Cooperman, sitting in the waiting room with her teenage son. As a resident of Hampstead, she said, she could easily see another doctor in Montreal somewhere else if Tiny Tots was closed in an emergency.

For Dalia Hanna, who sat in the same waiting room with her newborn quietly grinning on her lap, the situation was slightly different. "Right now, I'm on maternity leave," she said, "but once you're working, it's harder to come during the day." She added restrictions on clinics would only worsen hospital waiting times as people would elect to go there instead.

"Sometimes we come in the evenings when we have to, but usually we don't," said Christine Mallette, seconds before hearing her number called up for her and her children's appointment.

Burko said part of the reason his staff went beyond billing ceilings this year was because of a number of extra patients who came to them due to H1N1 fears. "Normally, a doctor sees 30-35 patients every day, most of us were seeing an extra 10 or 16 everyday," he recalled.

He said Info-Santé, a Quebec-run health help telephone line, has been a little too eager to emphasize parents take children who exhibit flu-like symptoms to a doctor in case it could be H1N1. "They're not particularly good about listening to the facts and saying: 'it sounds minor, sit at home for another day," he said.

In the West Island, several cases of H1N1 were reported at local schools, both public ones belonging to the Lester B. Pearson or Marguerite Bourgeoys school boards, as well as the private Collège Chalemagne in Pierrefonds.

"Students and staff have been advised that if they show flu-like symptoms, they should stay at home for seven days," a Pearson school board press release reads. Over at Marguerite Bourgeoys, a statement on its website advises "individuals who have flu-like symptoms to keep their distances from contacts with others, particularly by not showing up at school […] The presence of flu-like symptoms does not automatically mean consulting a health professional is necessary."

Provincial health ministry officials did not return requests for comment as of press time.