Let’s start by explaining what a public clinic is, which will help us better understand what a private clinic is.
Medical care provided by physicians in a public clinic are covered by public health insurance. You don’t have to pay for the physician’s work; rather, the physician submits and charges these fees to the RAMQ (Régie de l’Assurance-Maladie du Québec).
The Régie, however, allows public clinics to charge patients for some procedures that aren’t covered, such as cosmetic medicine. Also, a physician that does joint injections, for example, may charge the patient a reasonable amount for the medication and equipment used during the procedure. However, these costs exclude the medical procedure, which he remains covered by the public plan.
Conversely, in a private clinic, such Cliniques Médicales Lacroix, all medical activities, appointments, and others, are billed to the patient directly and cannot be reimbursed by the Régie. To this effect, the RAMQ requires that private clinics display a document indicating that the physicians in that clinic are non-RAMQ and that the any fees cannot be reimbursed by the public plan.
Moreover, the RAMQ does not allow joint practice, which means that a doctor must exclusively practice in one field or the other, either 100% in the private sector or 100% in the public sector. This goes for all clinics, whether public or private. As required by law, there can be no hybrid under any circumstances. Some clinics say they are private when they are public, which causes confusion for patients. The growing popularity of private medicine in Quebec contributes to this trend. A recent investigation by the RAMQ showed that a well-known Montréal clinic gave privileged access to public doctors for patients who had received a private check-up at that clinic. They had quicker access, more time with and greater attention from the doctor, and benefited from additional perks, such as a more spacious waiting room and other small advantages to which only those who had paid for their check-up had access. In this example, paying patients from the same clinic could obtain appointments more quickly as benefit from multiple perks when they met with public doctors in the clinic. The RAMQ ordered the full reimbursement of the fees collected by the private division since it was a total violation of the law. The RAMQ therefore recommends that anyone who notices this type of illegal practice should report it immediately.