If you’re like most Canadians, you often have trouble getting to see your family doctor. But some Canadians don’t have any trouble at all. Quebec government data indicate one patient saw their family doctor 362 times in 2024. You have to wonder: which three days didn’t they meet with their doctor? Christmas? Easter? The Super Bowl?
Patient confidentiality means we’ll probably never know what was going on. What is clear, however, is that all provincial governments should review cases of excessive doctor appointments more closely, for government data obtained by SecondStreet.org shows Quebec’s experience is not unique. No doubt most doctors and patients are completely ethical, but we should all be concerned when the system is abused. Over-use costs taxpayers and takes resources from those with legitimate needs.
Quebec’s super-patient isn’t a one-off. The province’s other “top 10” users ranged from 295 to 346 general-practitioner appointments that same year. Manitoba’s top patient had 252 appointments in a single year, while B.C. and Saskatchewan topped out at 209 and 199 visits, respectively. In Alberta, the government reports, 9,331 patients had 100 or more appointments in 2024. It has already promised to look into these numbers.
The big question is, of course: how many of the high-volume cases in each province are legitimate and how many involve either patients taking advantage of “free” health care or doctors abusing their ability to bill the system? The evidence suggests abuse is happening, it’s just a question of how much.
Late last year the Ontario government’s auditor noted that “one physician billed more than 24 hours of services on 98 days between May 2021 and April 2022. On one of these days, this physician billed 114 hours of services.” Who is this mysterious doctor who can bend time to squeeze in so many hours in a single day?
The report went on: “the Ministry’s post-payment audit found that the physician’s clinical records failed to show start and stop times for services provided. The Ministry identified almost $1.4 million in overpayments.” The same report also noted: “Another physician billed over 24 hours of services on 15 days within a six-month period in 2020-21.”
On the other hand, several social media posts about SecondStreet.org’s research allude to abuse by patients. For instance, one person on Facebook commented that at a clinic she worked at in Edmonton “there are patients that come in once a week to see this doctor. The doctor went on medical leave and they still come in once a week. And when u (sic) ask why they are there … they shrug and say they just come in every week to ‘check in.’”
All this is happening while an estimated six million patients do not have a family doctor. Curtailing over-use and abuse could free up resources to help these people.
Some have called for user fees to deter abuse by patients. A small fee almost certainly would lead to some patients being more judicious in how often they use the system. They might wait an extra day to see if a cold clears up before running to their family doctor’s office. Or those just “checking in” regularly for no reason might reconsider, as even a fee of $10 for each visit would add up over time.
User fees are a political non-starter, however. A 2025 poll commissioned by SecondStreet.org found that 59 per cent of Canadians oppose paying just $10 for an appointment. With the high cost of living the top political issue in the country and taxes to fund health care already high, politicians aren’t likely to implement such a change.
In terms of improving the system, however, Ontario’s auditor report includes straightforward solutions: use data analytics to flag when patients are piling up bills, audit those cases and then follow up to make sure the physicians involved change their behaviour. It also wouldn’t hurt if provinces like Alberta and Quebec that do have higher case volumes spoke with those like Saskatchewan that have far fewer cases of extreme use.
To repeat, most patients and doctors are almost certainly ethical when it comes to using and billing the system. But a nation of over 40 million people is bound to include some bad apples. For the sake of taxpayers and genuine patients who have trouble accessing the system, they need to be tracked down and rooted out.
Colin Craig is president of think tank SecondStreet.org.
This column was originally published in The Financial Post on May 12, 2026.
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