Regarding charging fees for cancelling appointment with less than 24 hours notice, this allows patients to call on a Friday at 6PM to cancel an appointment on Monday at 8AM. The reason I charge fees isn't to make money - it serves as a reminder to patients that physicians are not taxpayer employees. Physicians, their staff, and their patients deserve to be respected by their patients. It is not OK to cancel at the last minute or no-show. I would never do that to my family, friends or my physicians. Last minute cancellations and no-shows reduce our ability to care for other patients and contributes to longer wait times. Changing this recommendation is in the best interests of the majority of patients. Fees should be chargeable when patients cancel with less than 3 business days notice. Regarding the section about refusing care for a patient who has outstanding fees, I think this should apply only to urgent or emergent problems. This section goes on to refer to another standard that says we can refuse to book subsequent appointments if we sever the relationship. Some patients just need to be reminded that the physician-patient relationship is a two-way street - it must be respectful in both directions. Charging patients is a tangible reminder that there is a consequence for being disrespectful. But, once that's acknowledged, I am happy to keep caring for them with re-established mutual respect. I shouldn't have to fire them, and a fee serves to help correct the course of our professional relationship. And, remember, at the end the day, physicians can only afford their overhead when they see patients. That is the system in which we work. A standard that facilitates bad patient behaviour is not how one supports and reinforces the need for the relationship to be mutually respectful. While these comments apply to a minority, it is a large enough proportion such that it's not acceptable for the College to compel physicians (and indirectly, their other patients) to suffer the consequences of those that are unwilling to be respectful.