Travel medicine is not formally recognized as a specialty in Canada. Travel medicine consultations aren’t included on provincial lists of reimbursed services. Does that mean travel medicine doesn’t deserve your attention? Far from it.
Because travel medicine consults are uninsured, you can charge patients directly and name your price. Administering all the various vaccines can bring in a fair-sized chunk of additional revenue, too.
Because it’s not a specialty, says Dr. Jay Keystone, a longtime travel medicine expert and professor at the University Toronto, “any practitioner can call him or herself a travel medicine practitioner without any training or certification whatsoever.” (There’s one exception: your clinic must get a special Health Canada licence to give the yellow fever vaccine.) So there are no major bureaucratic hurdles to jump over to get into travel medicine.
And — best of all — according to GP/FP travel medicine practitioners, travel medicine can be an enjoyable and satisfying aspect of your practice.
“Would I recommend it?” says Dr. Ken Gamble, a Toronto FP who does travel medicine consults for aid workers heading overseas. “Yes, if you want to do it well. If you’re in it to make extra money, there is a risk that your practice will be skewed. Anyone can give a vaccine. Not everyone can give risk-benefit counsel that’s appropriate if we want to keep the standards high.”
In other words, just because you’re not required to get special training doesn’t mean you shouldn’t. McGill offers an annual, three-day CME class (in May this year) that’s popular with local family docs. And the International Society of Travel Medicine gives a certification exam based on its influential travel medicine tome Body of Knowledge. They also offer occasional two-day review courses.
You can also read the updated practice guidelines from the Public Health Agency’s Committee to Advise on Tropical Medicine and Travel (CATMAT), released in December. In addition to advising on what kinds of office supplies you’ll need, including what kind of fridge you should get — an important consideration, according to Dr. Gamble, who upgraded after a fridge failure once ruined a whole load of vaccines — the CATMAT guidelines also recommend that, to maintain competence, physicians do a minimum of five to 10 consults per week and keep up with the literature.
The extra income can be nice; Dr. Gamble’s rate is $40 per consult. But travel medicine isn’t for everyone, he warns. “One, it can get very repetitive when you do it on a regular basis,” he says. “Two, it can change in an instant and you can be out of date very quickly. Three, drug companies can put a lot of pressure on you to prescribe products that aren’t absolutely necessary.”
But if you think you’d enjoy the work all the same, then travel medicine isn’t too hard to pick up and it might even give your bank account a bit of a boost.