The head of a new Ottawa clinic warns cuts to doctor fees could put patients at risk or prompt another public health scare.

Dr. Mark Reimer, who runs an endoscopy clinic in Kitchener and is opening a second in Ottawa, said the province’s decision to cut fees for colonoscopies could make struggling clinics close down or the quality of care may diminish.

Ottawa Public Health notified the public about an infection control lapse at Dr. Chistiane Farazli’s clinic last November. Public Health did not link the lapse to funding.

Reimer said without proper funding, the chance of another infection scare is higher.

“Underfunded care increases the risk of bad outcomes,” said Reimer. “No matter how hard to you try to be efficient, in the end, you get what you pay for.”

Health Minister Deb Matthews said the suggestion the fee change could lead to compromised safety is “unacceptable.”

“Facilities must be clean, they must be safe and the fee absolutely must not affect the safety and cleanliness of any facility,” she said.

Reimer said physicians are ethical and responsible, but he is concerned that if doctors close clinics for economic reasons, patients who need routine procedures such as colonoscopies will be forced to go to hospitals, where the procedure is more costly and there are longer waits.

Matthews said fee changes were based on evidence doctors are more efficient and perform more procedures more quickly. Reimer argues the process has become more costly due to regulations.

Reimer said the scare in Ottawa cost Ontario $700,000 as Ottawa Public Health had to notify and test about 7,000 patients  for HIV and hepatitis.

COLONOSCOPY COSTS

-Doctors at clinics and hospitals are paid $190.80 per colonoscopy

-Clinics also get $22.35 in “office fees” to pay for nurses, equipment and all other office costs

-In hospitals, those other expenses are covered by government funding, Reimer estimates at $300 per colonoscopy

- Reimer says doctors are using about 50 per cent of their own fees to pay the true costs of maintaining their clinics