Officials with Royal Inland Hospital are suggesting a 23-year old man from Quebec – who says he was denied surgery due to his being from that province – did ultimately get the care he needed.

Citing privacy concerns, RIH Chief of Staff, Dr. Todd Ring, did not comment on the case of Patrick Bélanger, who fell and broke his jaw, cheekbone, and a bone around his left eyeball in Sun Peaks on June 10.

Bélanger says he had presented his provincial health card and offered to pay for the surgery with private insurance but was told by Dr. Peter Stefanuto to go back home for the operation within 10 days or his bones would start to fuse.

Dr. Ring told NL News people who show up for emergency care at RIH will always be treated but he said not all situations fall into an emergency category.

“In these situations, oftentimes it is actually better and I would say fairly routine, for patients to actually go back to their home, whether that is another community within in B.C., Canada, or even across the world,” Ring said.

“We have lots of patients that come and enjoy the Interior of BC who injure themselves and ultimately would be seen in our emergency department or even have a consultation with a specialist and then be advised that their options may include going back home to have their surgery where they can have the appropriate follow-up.”

Bélanger did end up getting the surgery he needed seven days later.

Dr. Bobby Rishiraj, who did the surgery, says he had no concerns about billing for physician fees in Quebec, noting he was concerned that Bélanger could have gotten addicted to the opioids he was prescribed to manage the pain.

All provinces have reciprocal billing agreements allowing Canadians to be treated anywhere in the country, but Quebec doesn’t have an arrangement for physician fees, only for costs related to care in hospitals. Doctors who treat Quebecers can either bill the province or bill the patient, who then can get reimbursement from their government.

Ring told NL News that interprovincial payments with Quebec are a known problem.

“And I think it does set up situations that potentially happen in instance where you are trying to work though some of those issues and I think ultimately that can contribute to some of the delays that could happen in care,” Ring said.

Bélanger, who had trouble speaking because his jaw was wired shut for six weeks following surgery, said the emotional toll he has suffered is “incalculable,” on top of the physical pain, which still includes migraines.

His family paid Dr. Rishiraj $2,563 and will apply for reimbursement from the province of Quebec.

– With files from Paul James and The Canadian Press