Another private MRI clinic is set to open, this time in Montreal, letting those willing to pay out of pocket avoid lengthy hospital queues, in what is becoming a growing health-care trend.
The magnetic resonance imaging clinic, expected to open in December, will also house a CT scan, ultrasound and other diagnostic machines and is being set up by about 25 radiologists from the McGill University Health Centre.
"There's not enough MRI units right across Canada," said radiologist Dr. Larry Stein, one of the owners of the as yet unnamed private MRI clinic in downtown Montreal.
Health Minister Allan Rock's vow a few months ago to spend $4-million a year on extra staff to monitor the Alberta health system and to crack down on any infringements of the Canada Health Act hasn't stopped clinic owners from opening private MRI units.
The Ottawa Valley MRI Centre, currently a mass of rubble and concrete, is to open in Hull, Que., some time in October, and is only a six-minute drive from Parliament Hill.
When one of Ottawa Valley MRI's partners, Lorne Paperny, was asked whether he was concerned about what Mr. Rock might do, he said: "What's he going to clamp down on? It's an uninsured service. I think he should look at it more as an interesting test study on private health care in Canada."
Questioned by reporters last week in Edmonton, Mr. Rock said he'd been provided with information that people are paying cash for MRI tests.
"The question then arises: Were these medically necessary and were they required to pay cash, and if so, is that a barrier to access under the Canada Health Act?" he said.
Neither the Co-ordinating Office for Health Technology Assessment nor Health Canada had so far tracked the number of private MRIs. Estimates range from a low of 14 to a high of 20, all in the provinces of Quebec, Alberta and B.C.
Robert Hecht, one of the partners in the Ottawa Valley clinic, calls the MRI "the diagnostic tool of choice." In Edmonton, where there are three private MRI clinics, price wars have broken out. A body-part scan is available for as low as $475. That compares to Vancouver, where an MRI can cost as much as $875.
Private-clinic owners say the MRIs, which produce images of organs, tissue and bones through powerful magnet and low-frequency radio waves, are not insured under some provincial health plans when done in private clinics.
"I think we're doing good for patients; we're helping people," Dr. Robert Ouellet, director of the Reso-Concorde clinic in Laval, Que., said in a telephone interview.
Despite operating his clinic seven days a week, Dr. Ouellet said he opened another MRI clinic, called the Reso-Carrefour, to meet the demand. He added, "Some hospitals are even sending them to our place."
Indeed, Cité de la Santé Hospital in Laval has sent roughly 100 patients a year since 1998 to Dr. Ouellet's Reso-Concorde clinic. Hospital spokesman Jean Garneau said the hospital has paid $500 to $800 per patient, depending on the type of scan needed.
"We don't have an MRI, but we would like one," Mr. Garneau said.
Even though McGill University Health Centre operates its MRI from 7 a.m. to midnight, seven days a week, adults must wait as long as five months for a scan, Gillian Ross MacCormack of the centre said. She said emergency cases are seen right away.
Norman Laberge, chief executive officer of the Canadian Association of Radiologists, said private MRIs are "becoming a business because the government got out of the business, unfortunately."
His group has called for governments to invest $1-billion in diagnostic technology, saying Canada looks like a developing country when it comes to accessing high-tech equipment, falling behind Korea, Iceland and the Czech Republic. Canada, he said, needs 91 new MRI machines.
The shortage, Mr. Laberge said, has put extra pressure on radiologists, who are lobbied by patients who don't want to queue for several months for the diagnostic test.
"It is reported to me from a lot of radiologists that they are under a lot of pressure from high-profile people to political personalities, to have people jump the queue," he said from Montreal.
Christine Burdett, chairwoman of the Alberta branch of Friends of Medicare, said private MRI clinics should be banned because they allow patients with cash to get faster access that those without.
"One of my fondest hopes is that we'll see MRIs go at fire-sale prices. We could use them in the public sector," Ms. Burdett said.
Despite their growing popularity in Canada, some patients still travel south of the border for MRIs.
"The bottom line is that patients are willing to pay for it," said Kevin Burns, chief operating officer of Buffalo MRI in New York State. A scan there costs $465 (U.S.).