Thursday, March 08, 2007

Just a flesh wound sir...

Ranting time.

The Canadian medical system: what's happening and why are we in this handbasket?

I was in Nashville last year and a cabbie there chose to lecture my husband and I on how superior the American medical system is to the Canadian one. I had to work hard to hold back the snarky laughter. Since America doesn't seem, in fact, to have a medical "system" per se. At least not a state-sponsored one like ours.

Oh, how superior I felt. Poor little American cab driver, thinking they have it so much better with their pay-per-use hospital visits and people going bankrupt from lack of insurance.

Well, the smirk has been slapped from my face.

In Canada today, the only way to get to see a doctor quickly is to 1) go to the U.S., or 2) go to a clinic and wait for an hour to see a physician who knows nothing about you or your medical history.

In my experience, "family" doctors are a thing of the past. We recently moved from Ontario to Quebec and my husband happened to get in with a local family practitioner. When I called to book an appointment with the same physician, they refused.

Me: "Huh?I thought he is a 'family' doctor?"
Snarly secretary: "He is."
Me: "Well, my husband's one of his patients, and I'm my husband's family."
Snarly secretary: "That's not what family doctor means."
Me: "Excuse me, I'm holding the Oxford Canadian right here...let's see...D...E..F...fairyland...fairy tale...fake...fall behind...fallacy...ah, here it is: family. 'A group of people related by blood, legal or common-law marriage. Or adoption.'"
Snarkretary: "M'am, I'm very busy..."
Me: "Well, by that definition, wouldn't a 'family' doctor be one who treats....families?"
Hellion: "He's not taking any new patients, m'am."
Me: "But...but what if one of us has cancer? What if we have a venereal disease we're passing back and forth? What if we had a kid or were trying to get preggers? Wouldn't it make sense to have the same physician?"
Jerkass: "[dial tone]"

That has been the pattern for my relations with the Canadian medical community for the last decade or so. I know someone who couldn't get an appointment after she miscarried, for God's sake. They promised to call her back with a time-slot, and just never did.

Now I've got a bit of a skin condition that I'd rather treat sooner than later (don't worry, nothing contagious), and I'm told I need a referral. But can I get in to see my physician (yes, I eventually found one...*) to get a referral? No. I'll have to go to a clinic, wait for 2 hours, see someone for five seconds who will look at me, see that I obviously have the skin condition, and set up a referral. Meantime, I've wasted HOURS of my time--not to mention precious moments of theirs.

And what, I ask, is the point of a "medical file" in such a system? Why waste the trees? My medical file is rotting in the back of some forgotten drawer, attracting dust mites.

*My search for a "family" physician has been a bumpy ride. First there was the time I got booked in at my mom's doctor, who made me wait an extra hour (standard in this "superior" medical system), then walked into the (cold) examining room, looked me up and down, and said "I'm not taking new patients. Why are you here? What is the problem?" To which, gobsmacked, I replied, "....?"

She: continuing to glare. Me: continuing to stand there in shock with my mouth opening and closing, trying to articulate something along the lines of "...but doctors...they're supposed to help people...they're healers...they're heroes...nice to people...make booboos feel better...mommy don't let the bad lady put the bigneedle in me!!! mommy!!!! mommeeeeee!!!!"

I picked up my bag, blinked at her once, and left the room. I asked the secretary why she had booked me in if the doctor wasn't seeing new patients. To which she replied, "....?" So I told her they'd better not submit for OHIP funding (that's the way it works in our state-sponsored system...the doctor sees you, then submits a bill to the government instead of to you. The government uses your tax money to pay the doctor. See the potential for turnstile-like patient treatment there?). She said they would. I said I'm going home to report you to OHIP immediately. Which I did. And they never ended up getting paid, or so OHIP told me.

Finally, I found a new doctor. And by new, I don't just mean new to me. I mean "new" as in the stench of medical school is still hanging on his yet-unwrinkled doctor's coat. I mean about 28 years old. Male. Doing physicals. On me. Gawping at my bits and pieces. My first sexual experience was less awkward than my last pelvic exam. Let's just leave it at that.

Now, part of me feels guilty for complaining. Because we Canadians by nature don't want to 'rock the boat.' But you know what? We are taxed more exhorbitantly than every other people on Earth except the Swedes. I pay forty-two percent of my income back to the government. FORTY-TWO PERCENT. So screw guilt. I want some goddam results, here.

It's easy to run a medical system when you don't actually have to deal with those pesky patients. I've paid for the service, and I want what I paid for.

Now if you'll excuse me, I have to go to the clinic. I hear the line-up's still pretty short.


Blogger Ann-imal said...

Wow. I really feel for you! I too had to find a "new" doctor a few years ago since my GP (the best damn doctor EVER!) decided that he would rather join a group of researchers who use alternative medicine to save those who have cancer. How can I be mad about that? BUT I was. I knew I would never find anyone like him - and I didn't. I was, however, referred by his nice medical assitant, to the "run-of-the-mill" Wal-Mart type group of doctors I go to now. See, the new "in" thing is to have a whole lot of them open up a clinic where you have your doctor but if he/she is not there (probably off spending our bucks on a 5-star all-inclusive somewhere) another medic can take you and has access to your file... Yippee! The service sucks and the facilities are dirty... Way back in October I called my GP to see if he was taking family members (Peter needs to have his arm looked at), I am still waiting for an answer...

11:25 AM  
Blogger kim. said...

I got one for ya. Went to Shoppers to get my birth control prescription that my doctor's office was supposed to have called them about 2 months ago - Shoppers pharmacy had no record. This was a Friday night - needed the damn pills the next morning. Started calling doctor's office/Shoppers first thing Monday morning. It took until 4 pm TUESDAY (and literally about 25 phone calls later) to get my goddamn prescription. UNREAL. I even drove around Kanata the Monday night to get into a walk-in clinic and all were full. Found out after missing pils for 3 days you have to start all over again - so my 15 year schedule has been broken by these arseholes. I'd rather stab myself with a dull spoon than ask my doctor to do something for me.

12:16 PM  
Blogger whyioughtta said...

Ann-imal: "Wal-Mart doctors"!!! Ha hahaha I love it. But dirty medical facilities? Gaaaag. I heard the other day that something like 1,200 people a year in Canada die because they visited a hospital where some lazy-ass medical personnel didn't wash something properly. And a 6-month call-back lapse? WTF??? That's terrible.

Kim: The sad thing is that we have all been there with the pills/doctor/pharmacy nightmare. I've been there too. Had to start the month over.

I can't believe you had to drive around Kanata, though. That just adds insult to injury. Shudder. ;^)

2:32 PM  
Blogger kim. said...

What's funny is my "brother-in-law" is a pharmacist in PEI. I should have just called him and got him to get me a prescription somehow. Would have been faster.

2:40 PM  
Blogger Mairéad said...

Jeez!! I thought we were bad here in Ireland! Although, nah, we're still worse! We just wait and pay (anywhere between €45 and €80!!) for the pleasure of seeing our GP. Pay again at the chemist (pharmacy) - VERY expensive. Our taxes DO NOT cover it (I pay 42% tax!!!!). Our private health insurance DOES NOT cover it either!!

4:25 PM  
Blogger whyioughtta said...

Kim: Pro'lly would've been there in a day! It's sad when your mail is faster than your doctor.

Mairead: Slainte! (Or is it dia duit?)(I can never remember...) I never realized how highly taxed Ireland is until I started reading the Swearing Lady's rants, which I can fully appreciate. I guess it's the price we pay for being citizens of such wonderful socialist states.

We pay for our pharamcy stuff too (although it is sometimes partially deductible via insurance)--I can't believe you have to pay that much tax plus pay to see your GP. That's highway robbery!!!

8:39 PM  
Blogger Gizzy said...

[me too post with one god, one bad experience]

I was at my optometrist on Dec. 28 to see if my prescription had changed (had budget left in the insurance for a new pair of specs), when she couldn't get a proper reading in my left eye. Had to see a specialist. That appoinment took a few weeks to get (OHIP). An appointment for another specialized test at a private company took no time at all (pay-per-use). Two and a half months later, it's still ongoing, with more tests needed, but things are moving fairly quick. That's the good experience.

Now the bad... last week I felt so sick I thought the appocalypse was imminent. Called my family doctor (my mother was a nurse and had pulled some strings to get me a G.P.). Now, I only go to the doctor maybe once a year; I'm not one of these go to the doctor with every sniffle. The G.P.'s office says no appoinment for 4 days. So, I went to the local clinic. It was a 3 hour wait, plus they close twice a day for an hour at a time where you can't even get in the queue. The doctor finally saw me. I described my symptoms. He pointed to a nice, pharmaceutical-sponsored relief poster of the human respiratory system and described what was going on. I walked out of there with a prescription to the antibiotic brand on the poster!

A friend who used to work at one of Ottawa's most prominent restaurant's told me that their "private" room was almost always booked by big pharmaceutical companies trying to woe their clients (doctors).

I sure am glad that doctor had that poster; otherwise I doubt he would have been able to decide what prescribe me!

I'm lucky and thankful to have insurance...the pills were $50 plus dispensing fee.


9:49 AM  
Blogger Gizzy said...

Whyioughtta: I wouldn't be quick to refer to medical personnel as "lazy-ass" -- they're generally underworked and overpayed.

I used to hear all from my [nurse] mom about how the hospitals are understaffed and much so that nurses don't have time to be friendly anymore, which was one of the best aids to convalescence.


9:55 AM  
Blogger Ann-imal said...

Phone call for family referral updated... I just called the doctor's office again to ask if my GP is taking family in... The nice lady at the desk (probably the same one from September) said she would ask and get back to me... Let's see if it works this time!

Gizzy - totally understand that hospital and clinic staff are underpaid and overworked... In my hospital stays, it pays to be nice to them!

10:36 AM  
Blogger whyioughtta said...

Gizzy: I'm not "quick" to refer to medical personnel as lazy-asses. I'm referring to the ones in hospitals who don't hand-wash properly, and then make people get sick and die, as lazy asses. Maybe it's because they're overworked/underpaid. Or maybe it's the basic human instinct to cut corners (lazy-assedness). Or maybe it's because they're not trained properly. Either way, people are dying from it and that's just wrong.

IMO, the medical profession, like all professions, is not composed entirely of long-suffering saints. There are doctors who are just in it for the money and shouldn't be practicing. My grandmother was diagnosed with cancer way too late because of a doctor like that. That's not to say they're all like that, but some are. As for other medical people (nurses, receptionists), I don't really know what their situation is like, just that I've seen a LOT of good ones and a lot of bad ones too.

We mostly hear a lot of bitterness from them, though, and I'm torn over that. On the one hand, they've taken on very tough jobs--let's face it, it'll never be easy to be a nurse. On the other hand, they don't always get the credit/pay they deserve.

Obviously there's a systemic problem here. But on yet another hand, Canada is POURING money into our health-care system right now, right? So why are things getting worse instead of better? That's my question. Is part of it maybe just a bitter attitude that's become entrenched within that community? Or are things actually getting worse for them too?

12:15 PM  
Blogger Mairéad said...

The Irish cost of living is very high. Our Gov tell us that we have a low taxation system (low rate is 20%ish and high is 42%) but the sneaky taxes are massive, e.g. on food, clothes, electricity, petrol, books, insurance, everything! My motor tax is €400+ for a family saloon, and yet the roads are incredibly poor. Potholes are endemic. Our best road in Cork county (largest county in Ireland) is a dual carriageway of about 10 miles. We pay for all school books etc..., dr, dentist, chemist. Facilities are rubbish. No playgrounds, swimming pools, gym halls etc... unless in hotels! We have no rubbish collection, water mains or sewage system. We live in the countryside, ya, but we pay the same taxes as the city dwellers. I'll stop now before I burst a blood vessel!
P.S. Dia dhuit is God be with you, or hello. Sláinte is short for sláinte mhaith - good health, or cheers.

4:20 PM  
Blogger Ann-imal said...

Doctor referral update... The doctor's office ACTUALLY called me back with an answer! Peter goes in for a "meet and greet" in a couple 'o' weeks...

Still in shock...

10:32 AM  
Blogger nicole said...

i need to see a doc. my blood. boiling. i could barely wait to get to the end of the post 'cause it was already teeming over my being, this valiant, tragic camaraderie (wrong term, whatever) team feeling (again, poor choice) but you know what I mean.. goddam, does it make it any better that we're all in this together? is this why we're not collectively more outraged? then i did get to the end and realized that's why you have 12 (mine 13) comments on this post. no one realizes how bad the system is until you need to even skirt it.
it's desperate.
then i feel bad when i am seemingly prioritizing this mere human basic need over the more permanent calamity of the general. oh sigh..

1:06 AM  

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