June 18, 2019

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Eye doctors dominate list of top billers in Manitoba

Ophthalmologist says fees justified

Colin Corneau / Brandon Sun files</p><p>Dr. Guillermo Rocha says busy Manitoba doctors use funds wisely.</p>

Colin Corneau / Brandon Sun files

Dr. Guillermo Rocha says busy Manitoba doctors use funds wisely.

Hey there, time traveller!
This article was published 7/7/2017 (710 days ago), so information in it may no longer be current.

Thirty-five Manitoba doctors each billed the province for more than $1 million in 2015-2016 — and four of them submitted invoices totalling more than $2 million.

Ophthalmologists dominated the ranks of high billers, occupying the top three spots, according to a Free Press analysis of the most recently available provincial data. Eight eye doctors billed Manitoba Health for $1 million or more — tops among specialist categories.

The highest-billing physician was Dr. Richard Leicht of Winnipeg, who was paid nearly $2.5 million.

Brandon ophthalmologist Dr. Guillermo Rocha, president of the Canadian Ophthalmological Society, said it would be wrong to assume physicians are pocketing these high amounts. The fees paid to physicians have to cover overhead expenses and staff costs, said Rocha, who himself billed the province for more than $1.2 million that year.

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Hey there, time traveller!
This article was published 7/7/2017 (710 days ago), so information in it may no longer be current.

Thirty-five Manitoba doctors each billed the province for more than $1 million in 2015-2016 — and four of them submitted invoices totalling more than $2 million.

Ophthalmologists dominated the ranks of high billers, occupying the top three spots, according to a Free Press analysis of the most recently available provincial data. Eight eye doctors billed Manitoba Health for $1 million or more — tops among specialist categories.

The highest-billing physician was Dr. Richard Leicht of Winnipeg, who was paid nearly $2.5 million.

Brandon ophthalmologist Dr. Guillermo Rocha, president of the Canadian Ophthalmological Society, said it would be wrong to assume physicians are pocketing these high amounts. The fees paid to physicians have to cover overhead expenses and staff costs, said Rocha, who himself billed the province for more than $1.2 million that year.

He said his costs include advanced diagnostic equipment plus the salaries of four full-time and three part-time certified technicians and a part-time research associate.

"In my case, I work five, sometimes six days a week to cover an area where I’m the only ophthalmologist in... a 180,000 (person) catchment area," he said, adding that he’s on call 11-13 days a month.

Rocha, who grew up in Mexico and was trained at McGill University in Montreal, said he takes only three, maybe four, weeks of vacation a year.

Five years ago, when the Free Press last analyzed physician billings (for the year 2010-2011), 16 doctors made the million-dollar list — including eight ophthalmologists — but nobody cracked the $2-million mark. The 2016-2017 list is due in October.

There have been calls in some parts of the country to re-examine the fees paid for certain medical procedures, such as cataract surgery, given that technological and professional advances have allowed ophthalmologists to perform far more in a week or month than in the past.

But Rocha rejects that argument, noting patient outcomes have also improved and system costs have been greatly reduced since cataract patients, for instance, no longer need to be admitted to hospital. In fact, he said he knows of a number of physicians who have received the procedure and gone to work the same day.

Just because physicians can perform certain surgeries more quickly, Rocha said, doesn’t mean they require any less skill. "If (tennis professional Roger) Federer can put (away) an opponent in three sets instead of five, is he worth less?"

Reducing fees might also discourage physicians from seeing greater numbers of patients and make it more difficult to recruit specialists to Manitoba, Rocha warned.

It took about two years for the province to recruit a glaucoma specialist to Winnipeg, he noted. No Canadians applied for the job. In the end, the province was lucky to find a "formidable" specialist who had trained outside the country.

"So, we have to be really be careful, I think, about how physicians are treated in this province because not even some Canadians have been willing to come out here to explore the opportunities...," he said.

Manitoba, meanwhile, has had some of the longest waiting lists for cataract surgery for several years now.

The issue hasn’t been a shortage of ophthalmologists, but restrictions on the amount of operating time that is allocated to them, Rocha said. Regional health authorities will only pay for so much operating time. "You can double the number of ophthalmologists and still the bottleneck will be the resources that are provided by the government."

Health Minister Kelvin Goertzen was unavailable for comment Friday, a spokeswoman said.

In the past, the minister has stated that cataract surgery is one of the "priority procedures" being examined by the Progressive Conservative government’s wait times task force.

larry.kusch@freepress.mb.ca

Larry Kusch

Larry Kusch
Legislature Reporter

Larry Kusch didn’t know what he wanted to do with his life until he attended a high school newspaper editor’s workshop in Regina in the summer of 1969 and listened to a university student speak glowingly about the journalism program at Carleton University in Ottawa.

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