Common questions about doctors, non-insured
services, prescriptions
and medical records

How do I find a doctor who is accepting new patients?

To find a family doctor who is accepting new patients, call the Nova Scotia Department of Health Physician Information Line at (902) 424-3047 or visit www.gov.ns.ca/health/physicians.

Can a doctor interview me before accepting me as a new patient?

Doctors who are accepting new patients into their practices are expected to use a first-come, first-served approach. While initial appointments and health status questionnaires are acceptable for them to get to know new patients and to learn about patients’ health concerns and medical history, these may not be used to select “easy patients” or to screen out those with more difficult health concerns, such as chronic or terminal disease. In addition, doctors cannot refuse to accept patients based on their age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status.

Some doctors focus on treating certain types of patients, such as women, children or elderly people. Doctors with these specialized practices are permitted to deny access to other types of patients.

Does a doctor have the right to stop seeing me as a patient?

Doctors have the right to stop seeing patients. However, they are expected to be sure that patients can get medical care somewhere else, and they are expected to tell patients in writing why they have decided to stop seeing them. Doctors most often stop seeing patients who:

• Continue to miss appointments without telling the doctor or the doctor’s office well in advance
• Continue to ignore the advice or treatment on which the patient and doctor have agreed
• Say rude, insulting, or threatening things to the doctor, patients, or staff
• Are violent with the doctor or with patients or staff
• Cause trouble in the doctor’s office
• Insist on being given prescriptions for drugs that the doctor does not think are needed

Can a doctor stop seeing me as a patient if I ask for a second opinion?

A doctor should not ordinarily stop seeing a patient who asks for a second opinion. The College supports the Canadian Medical Association Code of Ethics, which requires that doctors respect patients’ reasonable request for a second opinion from a doctor of the patients’ choice.

Why do I have to pay for some things when I visit the doctor?

Most of the services provided by Nova Scotia doctors are insured by Nova Scotia Medical Services Insurance (MSI). When doctors provide these services, they submit a claim to MSI and are paid in return. However, certain services and materials are not insured by MSI. Doctors are entitled to charge patients a reasonable fee for these services. Each doctor decides whether to charge for a non-insured service and sets the fee. Common non-insured services in Nova Scotia include: Completion of forms, undertaking medicals and examinations required for a driver’s licence or other licence; certain medical supplies, missed appointments and transfer of medical records.

Are doctors required to return patients’ phone calls?

There are no rules that require doctors to communicate with patients over the telephone. Busy schedules often prevent physicians from phoning patients back. In some cases, doctor may prefer to discuss a medical situation with a patient in person rather than on the phone. Time spent on the phone with patients is a “non-insured service”, so some doctors may charge patients a nominal fee for this. Patients should be informed of this fee before the conversation.

Can a doctor renew a prescription over the phone?

Doctors are not required to renew prescriptions over the phone. However, in situations where the patient is known to the doctor, or where the doctor has a good knowledge of the patient’s health, the prescription may be renewed over the phone. This decision is up to the doctor. Telephone prescription renewals are a non-insured service for which doctors are entitled to charge patients.

When prescription drugs have to be taken for a long time, why do doctors sometimes prescribe such small amounts?

Before writing a large prescription or automatically renewing a prescription, doctors often want to follow up with patients to see whether the drug is working as it should. In other cases, doctors will limit the size of prescription refills to ensure that the amount of medication dispensed each time is covered by the patient’s insurance plan.

Does a doctor have the right to change my medication if I am happy with it? Can the College make the doctor change the prescription?

Doctors and patients are encouraged to discuss changes in medication or therapy and agree on a treatment plan. Patients who want to have their doctors change or maintain particular prescriptions should approach their doctors with these concerns.

It is not the role of the College to tell doctors how or what to prescribe for their patients.

Can I look at my medical record?

Upon request, patients are entitled to examine and/or receive a copy of their complete medical record compiled by the doctor who has given them advice or treatment. This includes records or reports from other doctors. Patients are not permitted to remove their file or any reports in their medical record from their doctor’s office or from their hospital medical record. Doctors are permitted to charge a reasonable fee to cover the costs involved in allowing patients to view or get a copy of their medical record.

Medical records are the property of the doctor, hospital, or clinic that compiled them. However, patients have a right to examine and obtain copies of all information in their record, including records prepared by other doctors. The following exception applies: Doctors are not required to release information if they believe it could harm the patient’s physical, mental or emotional health or if another person could be harmed by the patient having access to the information. If doctors refuse patient access to records for this reason, they may have to justify this refusal in a court of law.

Patients will be asked to provide written authorization to release copies of their medical records. Doctors are not required to produce medical records on demand, so patients should request in advance to review or receive a copy of their file. The doctor or an office staff member may be present when a review of the file takes place. The time it takes to make a copy depends on the amount of information in the file.

Who can look at my medical record?

Apart from doctors and patients, the following groups and people can see medical records under certain conditions:

• A person to whom the patient has given written permission
• The College of Physicians and Surgeons if asked
  to investigate a complaint (the College must have an Authorization and Consent for Release of Information)
• A court of law when it is examining a legal case
• Nova Scotia Medical Services Insurance (MSI) when it is examining a doctor’s billings
• Other health care workers involved in the patient’s care (such as nurses and other doctors)

How long are doctors expected to keep medical records?

The College advises doctors to keep medical records for at least ten years after the date of the last visit, or in the case of a minor, ten years after the patient reaches legal age, which is 19 in Nova Scotia. After this time, the doctor may destroy the medical record in a confidential manner.

Can a doctor charge me to see or to get a copy of my medical record?

Doctors are permitted to charge a reasonable fee to cover the following costs involved in allowing patients to view or get a copy of their medical record:

• staff time needed to prepare the record
• staff time to supervise the patient’s inspection of the medical record
• the doctor’s time to review or explain the record if requested
• copying charges

Can a doctor charge me for completing legal or insurance forms?

Yes. The completion of many forms is a “non-insured service” for which doctors are permitted to charge patients a fee.

Can a doctor charge me for a missed appointment?

Yes. Doctors are permitted to bill patients for missing appointments when patients have not given sufficient notice. Doctors are expected to inform patients about their policy on missed appointments.

What are my rights as a patient?

Patients have the right to:

• be treated with respect
• expect confidentiality be maintained, unless their doctor explains why it has to be broken
• expect their doctor not to take physical, emotional, sexual or financial advantage of them
• refuse an examination or treatment or withdraw consent without obligation or harassment
• be kept informed, if possible, of major delays in obtaining consultations or treatments
• know if there are colleagues with whom their doctor will discuss their case
  receive appropriate referrals
• request a second opinion
• be listened to carefully and supportively regarding their concerns
• have another person present during examinations

What are my responsibilities as a patient?

Patients are expected to:

• respect the privacy of other patients, doctors
  and staff
• ask the doctor for further information if they do not understand
  let their doctor know if they feel uncomfortable during an examination or treatment
• cooperate and follow recommended treatment as long as they agree, and inform their doctor when they don’t
• notify their doctor or staff if they are unable to keep an appointment
• allow their doctor to have a staff member present during an examination

How do I contact the College?

College of Physicians and Surgeons of Nova Scotia
5005-7071 Bayers Road, Halifax, NS B3L 2C2
Telephone: (902) 422-5823
Toll-free in Nova Scotia 1 (877) 282-7767
Fax: (902) 422-5271