Healthcare Rant

I had a disturbing realization the other day. My doctor has no bloody clue who I am. Now, to folks who have always lived in a big city, this might not be so shocking. I, however, grew up in a small town and went to a family doctor – who, incidentally, made house calls. He knew who I was, all my past ailments, and often knew just by looking at me (without poking and prodding) what medicine to prescribe. Now, however, I have to go through a whole song and dance every time I see my doctor, reminding her of past illnesses, while she rifles through my file. The other day I made the mistake of saying to her “Remember when I was in just before Christmas?” Blank stare. No. Right. Of course. Silly me. I’ve only been with this same doctor for over 7 years.

Now, I’m not one to complain much about our healthcare system. For the most part, it’s pretty good. A hell of a lot better than the American one. But as the years move forward, I am starting to see that certain things have been lost. Of course, I guess you could apply that to many sectors…like customer service in department stores…but when you think about it, going to the doctor is one of the most personal things you can do. I don’t know…am I crazy thinking that maybe they could work on a little more personal attention? On the flip side, I know that doctors have an enormous number of patients to see in a day. But is that another problem? My doctor, in particular, runs her medical clinic but also has an esthetics clinic which, frankly, I think she’s more interested in focusing on. You think she might be overloaded a bit?

Normally I don’t get too worked up about the doctors. I’m a pretty easy going patient. I go only when I’m really sick and sometimes not even then – much to the dismay of my family members. I often use walk-in clinics for less important stuff and see my own doctor for physicals and things of that nature. Why is this? Well, normally I can’t get an appointment with my doctor for about 4 or 5 days after I call. If you’re like me and leave thinking about going to the doctor until things are on the verge of critical, this scheduling poses a bit of a problem. So walk-ins are the convenient choice. Sure, sometimes you have to wait for a couple of hours to get in, but then I’ve sat in my own doctor’s office waiting for over an hour for a scheduled appointment. Really, what’s the difference?

And scheduling is what got me all heated up the other day. There’s a rule here. I think it applies all across Ottawa, maybe Ontario, and maybe Canada…but I don’t know for sure. If you make an appointment and you later need to cancel that appointment, you must give the office 24 hours notice or you get charged $25. I get it. A lot of people skip out on their appointments and it screws up the scheduling in the office. But does it really? Whenever I go in to an appointment, they’re not waiting for me. They don’t even have my file out. It only gets pulled when I hand over my OHIP (Ontario Health Insurance Plan) card. The day is so packed, I’m not sure they would ever miss me. But anyway, let’s say it’s necessary, is 24 hours notice reasonable? I don’t think so. I had a situation where my son came down with the flu on the weekend and since the doctor’s office wasn’t open on Sunday, I couldn’t call to postpone my appointment. I called at 8:30 Monday morning (my appointment was at 11:30) and got no sympathy. “Fine.” I said. “I’ll bring my son with the flu to your office.” Ok says the receptionist. OK? What is wrong with you? And what does this all boil down to to me? They don’t care. They don’t have time to care. You’re just a number on a file. That’s it.

Now, I can make some comparisons for you. It’s not all doom and gloom out there in the medical clinic world. I was lucky enough to get my kids in with a pediatrician basically the moment my oldest was born. The personal attention I get from that office is like night and day from my own doctor. First of all, they always recognize us. They know who we are. Second, I can call in the morning and make an appointment to bring in the kids an hour or two later. Third, I’ve missed an appointment, and got scolded (rightly so) but wasn’t charged. And forth, we are never made to wait long to get in. If we’ve had to, the doctor has personally apologized for the wait. So I ask, if some doctors can provide this level of service why can’t others?

Now you might ask…well, if you don’t like the service from your doctor, why not switch? It’s not that easy anymore. Many doctors aren’t taking new patients. For instance, it took my sister three years to find a new family doctor after the previous one retired. Three years is a long time to go without a doctor, especially when you have children. So really, they have us over a barrel. After all this rant the question that comes to me, where does one lay the blame for this? The doctors? I can’t fully blame them. They are trying to work to their best benefit under our system. The government? Perhaps. I wouldn’t want an entire system re-haul or to trash the system completely but I think some improvements could be made so that it is better suited to the requirements of today. In my opiniion, doctors are, in general, too busy. How can we fix this?

For more on Canada’s Healthcare System and its history see here.

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12 thoughts on “Healthcare Rant

  1. I think you said it when you mentioned your doctor’s Aesthetics clinic. In Ontario that’s private, uninsured by the provincial health plan. She can charge whatever she wants. And she doesn’t have to deal with sick people; just people who want their bikini line trimmed. She probably makes more money from that part of her “business” than she makes from actually treating sick people.

    My dad once went to visit his family doctor for a specific purpose, but while he was there asked that the doctor look at something else as well. The doctor said my father would have to make another appointment for that because the doctor would only be paid by the health plan for a single visit. Of course my dad blew up at him and scolded him severely!

    To me the problem is because we’ve stopped being “patients” and we’ve become “health care consumers”. We’re no longer “citizens”, we are now “taxpayers” and when we seek government services, we are “clients”. Corporate ideology and Corporate-speak have permeated every aspect of society. Especially in North America.

    But still, I would hate to live in the US and have to suffer through US HMO’s. That’s probably infinitely worse, unless you have a lot of money.

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    1. I think, Brigand, you hit the nail on the head when you said we have stopped being patients and are more like customers. So true. Even though we don’t pay directly, doctors are still paid per visit and so the more visits they get per day, the more money they make. I know the two-tiered system is very attractive to doctors, particularly those in it for the money, and I think by running the esthetics clinic, my doctor is dipping her toes in the two-tiered waters and she likes it.

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  2. Took me 4 years to get a doctor after coming home to Canada after a life overseas. I was using walk in clinics, but then I got cervical cancer – and had the most amazing gynecologist look after me. When it was finally over and all was well again he asked where he should send my file. I told him I had no family doctor. He let out a massive sigh and said “not an option”. See he believes that if you’ve had one cancer – it’s because your predisposed to it. He made some calls, pulled some strings and – yep I have a doctor. I was so grateful that it never occurred to me to be angry that this GP had this strict “one problem at a time” rule. One day when I realized I DID have more than one issue I called the office and said “I have 5 issues I wish to discuss – I will come in and I will be talking about all 5 so give me the time needed for that”. They argued I listened. I said “now that your done giving me the party line just book the time for 5 issues back to back – enter it as 5 different patients if the paper work amuses you – but I will be there and I will not leave until I have had the service my tax payer dollars entitle me too.” They argued again and yes THEY HUNG UP ON ME!!

    I called back – was put on hold – again – and again – and again. But I got my appointment. I did wait a week, and I did wait for 25 min to see my doctor on the day. As we finished talking about the first issue he got up to “shoo” me out and I said “Not so fast doc. sit your ass down we aren’t done here – I’m your next 4 patients”.

    Yep – he was pissed, then laughed about my strategy – but now when I call – I get service (bet they have a note “careful – insane bitch just comply with wishes”). They know me and they know I mean business. Sometimes you have to snap them out of their bubble and remind them why they wanted to be doctors in the first place.

    I think in same cases (not all) they get away with it because we let them.

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    1. Well, good for you, Fantasia. Sometimes you do have to take the upper hand. Persistence and knowledge are a necessity when dealing with the system. I always go to my doctor with as much knowledge about my symptoms as I can…and have an idea in my head as to what the problem might be. My father went through a horrible ordeal. He was sick for years, mostly lethargic and sometimes feverish, but no one could diagnose him with anything and he was pretty much pushed off to the side as being a hypochondriac. Even after he had a series of 22 (count ’em) strokes he was still told to go home and take aspirin by the docs at emerg. But, when my sister pulled some strings through someone she knew at work who’s sister runs a clinic, she was able to get someone to take a serious look at my dad. Turns out he had a bacterial infection in his blood! He was finally admitted to hospital, a series of tests and an intense round of antibiotics and he’s finally on the mend. So ya…you can’t be complacent at all.

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  3. My dad was a doctor, but died too young. My beloved uncle Jorge was a doctor, too. Our family doctor. Always at hand, until he passed away.
    So, luckily enough, there a few doctors to call whenever needed. But what you describe here sounds very much alike to the Peruvian public health system. The poorest people have to suffer from it. If you can afford private health services, most likely you can live your whole life without even stepping in a public health facility.
    Not something I can say I’m proud for…

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    1. I’m so sorry to hear about your father, Gabriela. It is nice to have a doctor as a family member or friend. I have neither so I don’t have that advantage. The nice thing about Canada’s system, is that there is no private health service. Rich and poor, alike, are provided with the same quality and level of services. The only option would be to go down to the United States for private treatment, which many wealthy people do. I should mention that, until my father’s ordeal, I have never really had a problem with the quality of healthcare itself. I, personally, have always been given accurate diagnoses and the appropriate prescriptions. My complaints are more on the doctor/client relationship side of things.

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  4. I need to thank you for what I consider an informative article. I always wanted to learn more about the Canadian Health System and this post shed a light on the subject.

    Like Gabriela I come from a family of doctors. I’m fortunate to have 3 doctors from 3 generations taking care of me and my family in most instances.

    Although healthcare is entirely free in Syria the similarities with what Gabriela described about Peru are exact.
    The poor get inferior service while the rich can pay whatever it takes to get the best care available.

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    1. Well, you are very welcome, Abufares. I could have gotten a lot more in depth, but I figured this rant was long enough this time! 🙂

      Many Canadians are salivating for a two tiered system but I don’t think they realize the negative effects it will have on the public part of the system. Or they don’t care because most of those who want it are the ones who can afford to pay for private healthcare so they would never have to use the public system.

      I guess, like with anything, there is always room for improvement. My hope is that the Canadian government will continue with improvements to the system without altering the basic and important foundation of our system…being free and quality healthcare for all Canadians.

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  5. I’ve always had great care with my HMO providers in the US, but then I wasn’t often sick either.

    Living in Austria and the UK gave me a taste of this kind of medical care, and I would never want it. Rich and poor get terrible care, rich and poor pay for private. My brother lives n the UK and has never used the national system.

    The best deal is in Jordan. A middle class American can get great care, and although the poor get an inferior form of care, it exists. A friend of mine has set up a clinic for Pali and Iraqi refugees who fall through the cracks!!

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    1. I’m sure there are some Americans who have never had a problem with their system like you, Kinzi. But statistics show there are many who have a huge problem. Did you know that medical bills are the leading cause of bankruptcy in the US? That’s scary. See this article for more – http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/

      Good for your friend setting up the clinic! Ideally one would think a doctor is, by choice of profession, naturally a humanitarian. But I think that part of it has been largely left behind. It is nice to see that there are still some doctors out there who aspire to uphold this and who are doing great things.

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    2. With Obama’s health care reform initiative, there has been alot of Canada bashing from the US right-wing. They like to grab one or two extreme cases and use that to support the claim that the US system is better. But the numbers don’t really back them up. They use anecdotes, because the statistics aren’t on their side. Here are some statistics, in addition to Isobel’s citing of bankruptcy:

      A peer-reviewed comparison study of health care access in the two countries published in 2006 [http://www.pnhp.org/canadastudy/CanadaUSStudy.pdf] concluded that
      – U.S. residents are one third less likely to have a regular medical doctor,
      – one fourth more likely to have unmet health care needs,
      – and are more than twice as likely to forgo needed medicines.

      Not surprisingly then: “The death and disease rates for patients in Canada are the same or lower than those for people with similar diagnoses treated in the United States — even though per capita health-care spending is higher [in the US], a study suggests.

      Read more: http://www.cbc.ca/health/story/2007/04/18/health-canada-us.html#ixzz0hKsGs3IW

      We’ll always have the rich skipping south to the US, like Danny Williams (premier of Newfoundland) did a few weeks ago, even though the procedure was available in Canada. There is a mentality among many (especially the rich and conservatives) that better health care is available in the US. But what they are really seeking is “Cadillac Health Care”, not better health care.

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  6. kinziblogs – interesting – I lived in Austria (3 years) and the UK (4 yrs) and got amazingly good care – for free. Same in Switzerland (3 yrs), France (4 yrs), Germany (2 yrs) and many others – goes to show how sometimes it isn’t the system.

    The only place I have gotten truly horrid care was the US and Turkey but at least in Turkey I wasn’t charged an arm and a leg for the privilege.

    What your friend is doing is wonderful!! Proves to me – it’s about the doctor.

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