If you want to get a vasectomy in B.C., you’re faced with two choices: sit on a waitlist for months, or pay $2,000 to go to a private clinic.
Advocates with B.C. Family Doctors say the province should increase the amount doctors are able to charge to the Medical Services Plan (MSP) for the procedure so that more doctors will be encouraged to offer the procedure at no cost to the patient.
Dr. Renee Fernandez, chief medical officer with B.C. Family Doctors, says there has been a “significant decline” in the number of physicians providing publicly funded vasectomy care.
She says the province’s fee model is partly to blame and hasn’t kept pace with the standard of care.
“It’s become more expensive to provide the procedure, yet the compensation hasn’t kept up with providing the services that we need in our offices,” Fernandez said.
While some public clinics generate waitlists for vasectomies that fill up almost immediately, some private clinics in B.C. serve thousands of patients per year and charge around $2,000 for a procedure that public insurance only reimburses doctors for at a baseline of about $100.
Huge demand for vasectomies
A vasectomy is a surgically permanent sterilization procedure that cuts the vas deferens, the tube that delivers sperm, according to Dr. Camilla Jeffries-Chung, a family physician with her own practice who also works at Willow Reproductive Health Centre in female and male reproductive care.
Dr. Renée Hall, medical director at Willow Clinic in Vancouver, says she’s been surprised by the huge demand for vasectomies.
The non-profit, dedicated to promoting equitable access to reproductive health care, started providing publicly funded vasectomies in 2021.
That year, doctors at Willow Clinic performed 165 vasectomies. By 2024, they performed 1,230.
“It turns out what we stumbled into was a massive access problem in British Columbia for those who want a vasectomy — and our numbers have gone up and up and up.”
“Now we’re at a point where our waitlist is so full that we had to close it,” Hall said.
The list is capped at 500 people.
“We work our way through it, and as soon as we open it again, it fills again.”
Jeffries-Chung has seen patients come from all over the province to get a vasectomy at Willow: the Island, Osoyoos, northern B.C. She said it speaks to a lack of access outside of Vancouver.
“Just this week, I had somebody from Kitimat travel to have a vasectomy. I think that might be the furthest.”
Dr. Jonathan Follows, who runs a private vasectomy clinic in Sidney, told CBC he performs the majority of vasectomy procedures on southern Vancouver Island.
“When I was doing the procedures on the Medical Services Plan, I was working another job in order to subsidize this,” Follows said. “The vasectomy business didn’t pay for itself.”
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Follows opted out of MSP at the end of December and now charges $850 for the 10-minute procedure.
“I started doing vasectomies in 1991; the fee code was $98. It’s now $104. So over 30 years, it’s gone up six per cent. This is the kind of nonsense family doctors are getting from the Medical Services Plan.”
MSP billing the problem, doctors say
The province’s Medical Services Plan (MSP) currently reimburses doctors about $103.81 per vasectomy.
“There is no way that we can do that without having a loss to the clinic,” Hall said, adding the fee is less than a doctor would bill for removing two benign moles.
Family doctors who perform vasectomies can get a “vasectomy bonus” top-up payment of $45.45 per patient; doctors can also charge a tray fee and a consultant’s fee, depending on their practice.
The B.C. Ministry of Health told CBC that the fee for vasectomies has stayed consistent with the cost-of-living adjustment as part of the 2022 Physician Master Agreement, which governs compensation for doctors.
The ministry says that the fee for vasectomies has increased about five per cent from $98.91 in 2015 to $103.81 now, and the top-up payment for family physicians has almost doubled since 2023.
But the current fee still isn’t a good enough incentive for family doctors to perform vasectomies, according to Fernandez, who noted doctors in Alberta get about $80 more.
Alberta currently charges $187.72 for the procedure, according to Alberta’s Ministry of Primary and Preventative Health Services.
Fernandez said B.C. had 200 physicians who provided a higher volume of vasectomies 20 years ago.
Now, there are only about 100 physicians who currently provide MSP-funded vasectomies in the province, according to B.C. Family Doctors, and of those, only 45 perform more than 25 vasectomies per year.
“There’s one or two clinics on the Island; there’s one or two in the Lower Mainland, and there’s one in northern B.C. So, effectively, three access points in the entire province for a publicly funded vasectomy.”
The lack of public providers means many patients are turning to private clinics.
Private clinic sees thousands of patients yearly
Follows, who has performed 18,000 vasectomies over his career, is retiring at the end of August. The clinic is being taken over by Dr. Neil Pollock, the CEO and founder of the men’s health-focused Pollock Clinics.
His clinic charges $2,000 for a vasectomy. Pollock defended the price of the procedure.
“We charge a fee that’s commensurate with our extensive experience.”
The clinic is likely the largest provider of vasectomies in B.C.; Pollock says he and his team have carried out more than 50,000 vasectomies over 25 years.
Pollock has franchised his men’s sexual health business model, with franchises in Alberta, New Brunswick and Australia.
He said he views his clinic as complementing rather than competing with the public system.
“We’re able to help service very quickly and effectively the large demand for vasectomy, and that’s why we’ve been able to do thousands a year,” Pollock said, adding he supports higher pay for publicly funded doctors.
Doctors say gender equity is key
Hall at Willow Clinic said a lack of access to vasectomy shifts the burden of contraception to women and people who can become pregnant.
B.C. made prescription birth control, including oral hormone pills (“the pill”), implants and intrauterine devices (IUDs), readily accessible through MSP in 2023.
“If the government has put in all this time and investment into providing free birth control to decrease unintended pregnancy, why would you not make vasectomy more accessible when it’s a permanent solution?”
