I was recruited to join a private health centre as a doctor. Here is why I said no

Posted on November 11, 2025 in Health Debates

Source: — Authors:

TheStar.com – Opinion/Contributors
Nov. 10, 2025.   By Danyaal Raza, Contributor

Years ago, I received an unsolicited recruitment letter inviting me to join a “private health centre” in another province. I was struck by how enticing it sounded. The recruiter promised an “unhurried practice environment” with a small roster of 500 patients instead of a typical size of 1,200. The pay for this work approached half a million dollars per year.

For an overworked family physician, this felt like a dream. But as I asked questions, the catch became clear — every patient would first have to pay an annual fee of $4,000, before I could see them.

Today, clinics like the one that sent me this offer, continue to proliferate. Marketed to the wealthy and well-off, they promise so-called “comprehensive” and “personalized” care along with faster access and longer visits. Proponents call them innovative. In reality, they are an example of system failure, not a solution.

It is illegal for doctors to ask patients for money in exchange for care that is already considered medically necessary and is publicly covered. Journalists and advocates have repeatedly documented that these clinics often restrict access to visits by asking patients to pay for medically necessary care that should be publicly covered.

Often referred to as “double-dipping,” these clinics bill privately for care that is publicly covered. In practice, this creates a two-tiered system: one for those with means and another for everyone else.

During my conversation with the recruiter, I asked what would happen if someone approached me who couldn’t afford the fee. The answer was blunt: I’d have to see them “somewhere other than the clinic.” In other words, patients without means would be turned away from the very family doctor who was otherwise available under the public plan.

These business models are often justified as partnerships with the public system or even with employers as part of employee benefit packages. Yet, as family doctors and researchers will attest, many of these clinics have high-priced “annual assessments” that include unnecessary or even risky tests that do not follow best practices.

When an abnormal result does occur, including false-positives, they are often followed up in the public system. Far from easing the burden on care, these private schemes can add cost and confusion to an already-strained system by privatizing profits and shifting costs onto public, not-for-profit care.

There are better ways forward, ones that strengthen rather than fragment the foundation of our system. Publicly funded team-based care like Family Health Teams and Community Health Centres are proven, scalable models. Many of these clinics already deliver the same continuity and coordination that private-pay clinics claim to do, but without the same price shock.

In my own practice, a Family Health Team in one of the city’s most diverse communities, patients face multiple barriers to care, including economic insecurity, housing precarity and language barriers.

Yet our inter-professional team of social workers, nurses, nurse practitioners, pharmacists and others achieves measurable improvements in chronic disease control and preventive screening for a community of patients that includes nearly every slice of the city.

Patients struggling with addictions, bankers working on Bay street, food-delivery workers and new Canadians all receive care under the same roof.

Compassion, time, and teamwork are what make good care possible. Scaling up team-based care, guaranteeing access to a neighbourhood clinic like your neighbourhood school, improving digital tools for patients and providers, investing in centralized referral pathways between primary care and other specialists and improving working conditions for health-care workers would do far more for access and sustainability than normalizing private-pay clinics.

Health care in Canada was built on solidarity, on the idea that access to care should be based on need, not ability to pay. Every doctor and nurse diverted to private-pay clinics is a resource taken away from the collective effort to rebuild universal primary care. There is no justification for pawning the family dishware, so that a lucky few can eat with silver spoons.

The recruiter who first reached out to me was right about one thing: primary care should be unhurried and personal. That vision doesn’t require $4,000 membership fees.

It does require the political will to invest in the type of primary care that gives every Canadian the same promise of timely, high-quality care.

Dr. Danyaal Raza is a family physician and the primary care and health policy scholar at St. Michael’s department of family and community medicine.

https://www.thestar.com/opinion/contributors/i-was-recruited-to-join-a-private-health-centre-as-a-doctor-here-is-why/article_73207d2a-327f-4ce5-a33e-8cc9808eb59f.html?source=newsletter&utm_content=a06&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_25009

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