As many of you know, I’ve been running group therapy sessions for chronic pain since 2005 and began offering them virtually in 2020. These sessions are considered medical treatments according to OHIP regulations and therefore covered just like any other medical visit to a doctor.

In December 2022, the Ministry of Health put new rules in place regarding virtual care, making it mandatory that a patient must be seen in person before submitting any bills for virtual care and be seen in person at least once every 24 months thereafter. At the end of November 2024, OHIP will automatically stop paying for anyone who has not come to an in person session since December 2022.

If not enough people show up for at least one in person session between now and the end of November, there is a possibility I will have to shut down the group sessions. Although my overhead is low, I still have to pay for space rental, tech support, licensing fees, insurance, etc. Without enough people attending, I would not be able to pay for these things.

I do not want this to happen and I plan to keep going as long as possible. I do not think the rule makes sense in the context of group sessions as opposed to individual care. Assuming my virtual sessions are valuable for people with chronic pain, the rule seems to create an unfair barrier to treatment for people who live out of Toronto where access to specialized pain care might be limited or non-existent. If a person’s ability to travel is severely compromised by pain, it seems doubly unfair.

For now, I ask you all to continue attending as usual. I know it will be out of the question for many of you to travel to Toronto but I would still like you to attend the virtual sessions whether I can bill for it or not. However, if you might be able to make it to one in person session between now and the end of November, your attendance would be invaluable help in keeping the sessions going.

I have already been in touch with OHIP and the Ontario Medical Association to see if I can find a work around or some way to bend the rule. I like to think that the service I offer is a useful and cost-effective way to provide continuing care for people with chronic pain, especially since it doesn’t seem like anyone else is providing a comparable service. If you agree, please let me know and feel free to discuss this with anyone you think might be interested.

As soon as I hear back from the people I spoke to at OHIP and the OMA, I will let you know what else might be done to keep the sessions going. In the meantime, if it is not too difficult to come to an in person session, I would greatly appreciate it. Regardless, I wish you all well and hope you will keep working to get better.

Thank you,

Jan Carstoniu MD FRCPC