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health care in canada... you decide.

technodoll
May 2nd, 2006, 11:13 AM
Two patients limp into two different Canadian medical clinics with the same complaint. Both have trouble walking and appear to require a hip replacement.

The first patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week.

The second sees his family doctor after waiting a week for an appointment, then waits eighteen weeks to see a specialist, then gets an x-ray, which isn't reviewed for another month and finally has his surgery scheduled for a year from then.

Why the different treatment for the two patients?

The first is a Golden Retriever; the second is an elderly man. :pawprint:

Rick C
May 2nd, 2006, 11:40 AM
What if the Golden Retriever was poor and couldn't afford it?

I just paid $3,000 to get Skyler's hips fixed . . . . appointment for assessment in the morning, surgery in the afternoon.

But not everyone could do that for him.

I'm in favour of a two-tiered system where doctors are required to work in the public system but can also work privately.

In your example above, the man, if he was wealthy enough, would fly to Costa Rica, India or the USA and have the surgery in the same time frame as the Golden Retriever. When you think about it, that's rather nuts since that money should be spent in Canada to help the overall system.

My thoughts.

Rick C
www.goldentales.ca

LavenderRott
May 2nd, 2006, 11:49 AM
Well, he had better have plenty of money if he is coming to the States for treatment equal to that of the Golden!

I don't have a lot of money so neither me, nor my pom would get treatment as fast as that Golden.

technodoll
May 2nd, 2006, 11:57 AM
when you go to the emergency room at 4am because you are sick like a dog... and are told the wait is 16 hours minimum... and the room is packed with coughing sick people... and ONE doctor on staff... then you would WANT to be a dog cuz emergency vets would take you in less than 5 minutes! :mad:

(based on true life experience - i would PAY to get health benefits if it would mean i could actually see a doctor when i need one!) grrrr

happycats
May 2nd, 2006, 12:09 PM
Our health care system was supposed to get better, now that some of us have to pay for it! (it's funny how it gets deducted with the TAX on your cheque though)

Emergency rooms are based on urgency, (the most sick get served first) and I don;t think anyone with a runny nose should be in the emergency room!!!

If it's not critical stay the heck out of emergency!! EMERGENCY means just that!!

I think it would run much smoother, and faster if non-emergency patients weren't there.

I think the old OHIP system worked much better, maybe they should look into a system more like that.

technodoll
May 2nd, 2006, 12:22 PM
OK where are you supposed to go when you have a fever, an allergic reaction to an antibiotic and an erratic heartbeat? at 4am? all the clinics are all closed and anyways, most won't see you unless you have a family doctor there, and if you find one that WILL take you and the ONE doctor on duty starts at 8am and you arrive at 10am and his schedule is full, well too bad, come back tomorrow - that is just insane... i really do not feel either safe nor supported in this healtcare system that is full of holes big enough to swallow a whale :(

happycats
May 2nd, 2006, 01:28 PM
OK where are you supposed to go when you have a fever, an allergic reaction to an antibiotic and an erratic heartbeat? at 4am? all the clinics are all closed and anyways, most won't see you unless you have a family doctor there, and if you find one that WILL take you and the ONE doctor on duty starts at 8am and you arrive at 10am and his schedule is full, well too bad, come back tomorrow - that is just insane... i really do not feel either safe nor supported in this healtcare system that is full of holes big enough to swallow a whale :(

Sorry T, that post wasn't aimed at you. I have been to the Emergency, and seen people with runny noses, someone with a broken toe, and one person wanted a note for work!!!:rolleyes: . I have no problem if people NEED urgent care, but I think about 80% of the people there are not urgent! JMO;)

cpietra16
May 2nd, 2006, 01:43 PM
:rolleyes: I wonder if my vet takes human clients?

Luvmypit
May 2nd, 2006, 02:14 PM
That is why they created Telehealth Ontario where you call and a RN will help you decide if you should go to a doctor, hospital or walk in.

I have called a couple times and its really helpful.

happycats
May 2nd, 2006, 02:47 PM
That is why they created Telehealth Ontario where you call and a RN will help you decide if you should go to a doctor, hospital or walk in.

I have called a couple times and its really helpful.

I've used it many times for my son!:) I love it! They were great, very knowledgeable. friendly and helpful!

Writing4Fun
May 2nd, 2006, 03:32 PM
I've used it many times for my son!:) I love it! They were great, very knowledgeable. friendly and helpful!
LOL! Yup ... TeleHealth and Poison Control - two very important numbers to have on-hand when you have children! :eek: In case anyone is wondering, Chlor-Out isn't terribly toxic to healthy children. Even if they swallow a considerable amount, they might get an upset tummy at the worst. ;)

meb999
May 2nd, 2006, 04:14 PM
I'm in favour of a two-tiered system where doctors are required to work in the public system but can also work privately.
www.goldentales.ca

I don't know.....it's a slippery slope..............

rainbow
May 2nd, 2006, 05:28 PM
I think we should have nurse practitioners (sp?) that are just one step below a doctor to take care of all the minor emergencies. :)

Skryker
May 2nd, 2006, 07:33 PM
I think the practise of "notes for work" ought to be abolished! I do understand the employers point of view, it's just that it takes up so much time in the clinics and especially in ERs. Terrible practise. Waste a doctor's time to certify that yup, you've got the flu or a cold and should be at home or should have stayed at home.

divinecalamity
May 3rd, 2006, 01:33 AM
I think we should have nurse practitioners (sp?) that are just one step below a doctor to take care of all the minor emergencies. :)

I think this is a great idea!! I think Nurse Practitioners (NP's) should be the first step to health care. They should be in medi-clinics, they can treat common ailments, and a MD would be used for more serious issues.

As for having an allergic reaction to medication, if you went to the ER and your reaction was severe they would place you at the top of the list ie if you were having issues breathing...ABC's right. The reason ER's are soooo backed up is cause of people going cause of runny noses and coughs. I had to wait 6 hours before I got asthma treatment...it wasn't tooooo bad..but that is an A on the ABC's imagine how long a broken toe had to wait.

I do not believe in tiered medical systems, ours just needs to be worked on. like the idea of NP's

Melei'sMom
May 3rd, 2006, 02:50 AM
How ever they do it, our system really does need to be fixed.

Last summer my husband had a pretty nasty accident and had 2 rather large and very deep gashes on his head. after 15 minutes we could not get the bleeding to stop, so we went to the ER. they put us in a room right away, and then we waited for almost 2 hours for a dr. to see him. He was bleeding the whole time! the doc walks in, looks at the cut and says...yep, you are cut to the bone and need stithes. So he pulls out the tray for that and cause they are so understaffed, I had to play nurse for him or we could wait for another hour.

So after he is sewn up, we go home and find out very early in the morning (5:30am!) that the dr did have time to call the police and say that my dh had been assulted and the dr wanted it checked out, apparently thinking I had whacked him with something. Why didn't he just ask how it happened when we were there? dh explaining what happened as I walk in. Police started laughing about anyone thinking I could do that damage to him (size difference) oops...when waaaayyy ot with that story.

main message there...I think we used 2-3 towels and a whole roll of papertowel to keep the blood outta his eyes while we waited and the dr. didn't even have time to be concerned about the lose. everything turned out ok but that could have been a disaster because of overused ERs.:mad:

Rick C
May 3rd, 2006, 09:38 AM
Some Calgarians have figured out the fastest way to get service in an emergency ward is to go to one of the satellite communities surrounding the city - High River, Black Diamond - and use the ER's at the hospital's there because there is, generally, zero waiting.

Rick C
www.goldentales.ca

SarahLynn123
May 3rd, 2006, 10:03 AM
Another problem is those who get free ambulance services. They call the ambulance and head into the ER for a bite to eat and some time to sober up. Its cheaper then a taxi home!

(My Mom works in the ER)

badger
May 3rd, 2006, 10:24 AM
Not in Quebec. 250 smackers, bill in the mail.
When I collided with a car on my bike and someone called an ambulance (which I did not need; in fact the guy in the car, who seemed to be withdrawing from something, could've used a hand - or maybe a drink), they checked me out right there and gave me a dossier number, which would have been good for a free ambulance ride later, if I started having seizures or blacking out.
But my neighbour had to call an ambulance one Christmas; he was recovering from cancer surgery and in very very bad shape. He got a bill.
Ambulances are a private affair here in Quebec. Lotsa problems.

SarahLynn123
May 3rd, 2006, 12:07 PM
Not in Quebec. 250 smackers, bill in the mail.
When I collided with a car on my bike and someone called an ambulance (which I did not need; in fact the guy in the car, who seemed to be withdrawing from something, could've used a hand - or maybe a drink), they checked me out right there and gave me a dossier number, which would have been good for a free ambulance ride later, if I started having seizures or blacking out.
But my neighbour had to call an ambulance one Christmas; he was recovering from cancer surgery and in very very bad shape. He got a bill.
Ambulances are a private affair here in Quebec. Lotsa problems.

Its not free for the average person in Alberta either, but some do get the service for free and many who do, abuse the system.

Crazy expensive if your not one of the lucky few who get it free hey!

Prin
May 3rd, 2006, 01:29 PM
I think we underestimate the system a bit. I think that if you are really in trouble, you can get help. The only thing that makes it get a bad reputation is what "really in trouble" means to most of us. To an ER doc, it's something life-threatening, not a small cut, a cough or a broken toe... If you really need it, they give you the help you need.

I got into my public specialist for my thyroid the day after I got his number. He wasn't even supposed to be taking new patients. I told his secretary the symptoms I had and he called back and told me to be there at 7:30 AM the next day. Now he tells me that I was on my way to a heart attack at 25.

And when I went to the ER in BC, I was seen right away (broken nose) and I had my xrays within a half hour of arriving.

And when I went to the ER in Banff, I was seen within an hour too.

If it's serious, they treat you.

(Too bad hip surgeries and knee surgeries don't count as serious- I'm not saying it's a perfect system.)

meb999
May 3rd, 2006, 01:43 PM
Two patients limp into two different Canadian medical clinics with the same complaint. Both have trouble walking and appear to require a hip replacement.

The first patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week.

The second sees his family doctor after waiting a week for an appointment, then waits eighteen weeks to see a specialist, then gets an x-ray, which isn't reviewed for another month and finally has his surgery scheduled for a year from then.

Why the different treatment for the two patients?

The first is a Golden Retriever; the second is an elderly man. :pawprint:

I think, honestly, that the outcome would rarely be as stated. If the two are elderly...one of them will eventually get the surgery, the other will get PTS....

badger
May 3rd, 2006, 01:54 PM
You have put your finger on it, Prin. If it's critical, this is where you want to be. However, I think the gods were smiling on you when that specialist picked up your file so quickly and agreed to see you.

It's like we have too much knowledge from the media (have you noticed, on the CTV news, there's a medical piece EVERY night. I am so sick of that woman, I want to send her anthrax) and yet, compared to doctors, not nearly enough. And we are fast losing the wisdom of our forefathers and foremothers, some of which are now being reclaimed by the medical establishment (ex leeches for cleaning wounds).
OK, some of them died, but never mind :).

I think the health system has to get very serious about prevention. I don't know how you do that without pissing off the drug companies and it would cost plenty, but it would pay off in the end, perhaps reducing our national health bill by as much as a third. Wait for the statistics on the reduction in smoking, lung cancer rates are already dropping and we're only really into the first few years of the 'non-smoking revolution'.

If I had the power, I would BAN drug advertising from Canadian TV. Not enough knowledge, therefore too much. Just selling.

Prin
May 3rd, 2006, 02:06 PM
You have put your finger on it, Prin. If it's critical, this is where you want to be. However, I think the gods were smiling on you when that specialist picked up your file so quickly and agreed to see you. lol funny how our points of view are different.. In my head, at that moment in my life, the gods were pissing on me, but whatever, tomato tomahto.:D

technodoll
May 3rd, 2006, 02:07 PM
oh btw...guys... i had gotten that email from my jokes list... didn't think it would stir up such a debate, LOL! :sorry:

happycats
May 3rd, 2006, 02:24 PM
oh btw...guys... i had gotten that email from my jokes list... didn't think it would stir up such a debate, LOL! :sorry:


Debate is healthy!! and fun, if done in a respectful manner!! It's all good, I don;t think anyone's feathers got ruffled.

Thanks for bringing up this topic, it's interesting seeing different points of view:)

Another point, they have to get tough with health care fraud, last I heard is there is 15 thousand more health cards then there are people here:eek:(thats ontario only)
There are sometimes 15 or more family members sharing one card!!
Photo Health cards should be made MANDATORY!! I'm sure it will save millions when all these extra cards are put out of use!!

meb999
May 3rd, 2006, 05:10 PM
I know this isn't a strong argument, but we still have it better than the States.

My sister lives in the States and their health care is ridiculous. She has to call her insurance company everytime she wants to go the doctors office (and a few times it's been an emergency -- like when her husband stopped breathing :eek: --- and they told her to wait a few days before going!!)

Plus, she only got like 6 weeks off after giving birth :eek: :eek: :eek:

Our system isn't perfect, far from it, but we're better off than most countries....

OntarioGreys
May 3rd, 2006, 05:45 PM
Our health care system was supposed to get better, now that some of us have to pay for it! (it's funny how it gets deducted with the TAX on your cheque though)

Emergency rooms are based on urgency, (the most sick get served first) and I don;t think anyone with a runny nose should be in the emergency room!!!

If it's not critical stay the heck out of emergency!! EMERGENCY means just that!!

I think it would run much smoother, and faster if non-emergency patients weren't there.

I think the old OHIP system worked much better, maybe they should look into a system more like that.


It would be nice if we did not have to burden emergency rooms, but what do you do when it take 2 weeks to get into to see your family doctor if you are lucky enough to have one. The waiting list for a family doctor is 2 to 3 years locally, many people are forced to use ER's for non emergency care as many small cities and towns don't have walkin clinics available
Then there are the work places like mine that require substantiation of any medical related absense otherwise you are fired, the wording in the labour act regarding absences changed in the labour act a few years ago, that allowed companies to demand proof of absenses, I work for one of those companies, many local doctors refuse to write a note for less than a 3 day absense, so if I have a migraine or a gastric upset which prevents me from working for 1 day I have no choice but to go to the hospital, so I can get a note to explain my absence, otherwise I would lose my job, because my company has 2500 workers that policy put a huge strain on healthcare, but the goverment allowed the clause for absense substantiation into the labour laws a few years ago and many large industries are taking full advantage of it. When I have a migraine the last place I want to be is in a hospital waiting room with bright lights and little children shrieking and visiting their public washroom clutching and praying to their porcelain god, but what choice so I have when my job is on the line

I'm in favour of a two-tiered system where doctors are required to work in the public system but can also work privately.

Do you think the doctor would provide the same level of care for each patient? , especially if they can charge different fee structures, right now doctors have a cap on their wages which is where the nightmare problem started which caused many to quit or move out of the country, I already have a 2 week wait to see my family doctor. If the doctor has paying clients they will take priorty and be treated first , which means waiting times will incease that are publicly funded, and how many doctors while the shortages remains will except publicly funded patients if they can have those the are will to pay the costs out of pocket, And once it starts more tests and procedures will becomes cut from public funding at a much faster rate than what has already occured. I still remember that days when anesthesia was not covered by ohip. I was making a little more that minimum wage was single raising a child who was a toddler at the time, needed 2 surgeries one being for cancer (abdominal surgery) each bill was $150(this was 25 year ago) and to be able to pay I had to drop my phone and cable and restrict my groceries budget to meals every third day and babysitting after work till I could pay it off. My doctor was not happy that I was not resting and eating well but I did not have other options available I was just fortunate I had youth on my side, I know I could not do the same today if my finances like they were then. Imagine what it would be like for the senior who is has only a small pension, who has to give up having lifesaving surgery simply because they cannot afford the cost of anesthesia. Today general anesthesia costs would probably be around $500 which would be more that the monthy CPP.

Lise
May 3rd, 2006, 05:53 PM
Over the last two years I have had more experience with our health care system.Ali our six year old had a small bump on her leg that was really bothering her so we took her to her doctor after a week with no improvement.He thought maybe a reaction to an insect bite,but could not locate any center,so he sent us to CHEO for more test,meanwhile it is getting larger and there are two more bumps.Doctors at CHEO also think maybe a reaction,but they want to do ultrasound,by this point I'm asking maybe they should biopsy?no they want to MRI okay.Still no firm diagnosis but they think possibly a vascular tumour and send us to Ste Justin's to another specialist who does another MRI and ultrasound still no biopsy,confirms diagnosis and schedules surgery.She goes in for surgery Doctor comes out the diagnosis was wrong,they don't know what it is and want to BIOPSY it while she is under.We went through a few days of hell waiting to hear if it was malignant or not.Doctor calls and it is a benign tumour of the nerve sheaths.These type of tumours are usually benign and once removed do not usually grow back,but Ali had a ten cm tumour remved from her leg last thursday two years after the initial visit when it was less than two cm.The Doctors and nurses are absolutely fantastic they are wonderful people who are incredibley overworked and doing their best in our system.Sorry if this is off topic it's been kind of a long few weeks.

happycats
May 3rd, 2006, 06:13 PM
Yes Ontariogreys I know there are problems in small towns, and many have no choice but to go to emergency, but I still think it's crazy and somethig needs to be done about it.
The emergency room experience I was talking about was in the city with MANY walk in clinics available!

I thought the Max CPP was $800.00?, I know the Old Age pension is close to $500. (my parents are seniors:) )

Rick C
May 3rd, 2006, 06:25 PM
I'm in favour of a two-tiered system where doctors are required to work in the public system but can also work privately.

Do you think the doctor would provide the same level of care for each patient? , especially if they can charge different fee structures,

Are you saying all doctors lack ethics? :highfive:

That's simplistic frankly. You have no idea what system might ultimately be negotiated. You're also presuming such motivations don't exist already in the public system among physicians.

As an example, a doctor might be required to work certain billing hours within the public system and charge the government specific rates for services THEN, after meeting that requirement, work outside the system billing privately. That's off the top of my head.

right now doctors have a cap on their wages which is where the nightmare problem started which caused many to quit or move out of the country,

As I've said a few times in the "oil" debate, its simply a fact of economics that price fixing creates shortages because entrepreneurship, risk-taking and innovation is stifled.

So long as we continue to cap - out of fear - what these highly trained professionals can do, we will continue to frustrate obvious solutions to waiting times.

I already have a 2 week wait to see my family doctor.

I'm always puzzled when someone says that to me because I can see my doc within a day or two so long as I'm willing to show up first thing in the morning . . . . . and this guy has a full practice in Calgary and isn't taking new patients.

I've never had to wait for a doctor and I don't pay anymore than any one else as far as I know.

If the doctor has paying clients they will take priorty and be treated first ,

Again, you're simply surmising something based on . . . nothing. You have no idea of the eventual dual system that might be negotiated if we were given some room to dance. One that requires doctors to work, say certain hours in a month within the public domain is an easy answer to your concern.

I believe an average doctor in Canada works 53.8 hours a week. If you required that doctor to work 35 hours in the public domain and whatever he wanted privately, you might see a great number of efficiencies develop out of it.

And once it starts more tests and procedures will becomes cut from public funding at a much faster rate than what has already occured.

It seems to me the opposite would occur as per my note above about price controls and rationing leading inevitably to shortages. Why on earth are we in a lather about having private cat scan and other diagnostic facilities in this country where they have to bill a certain percentage of their business to the government but can also take on private bookings?

The problem with BOTH sides of this debate is the scare-mongering the extremists engage in, trying to scare the crap out of Little Old Ladies.

For the record, I'm a big fan of public healthcare. Although I can afford any procedure outside of the country I might require these days, I also remember in about 1963 a doctor in a small prairie town coming to treat me for mumps in our decrepit small house that we later turned into a one car garage. That was only a few years after public health care was introduced and I always wondered if my parents could have afforded that visit without it.

http://www.ecmaj.com/cgi/content/full/167/5/521

Rick C
www.goldentales.ca

technodoll
May 3rd, 2006, 08:56 PM
all i know is...

-i got a bad cold a month ago
-after 2 weeks, it turned so bad, i went to a walk-in clinic to see a doctor because i had not slept in 5 days due to fever and deep, painful coughing. I waited 2 hours, it was a slow afternoon. he said to come back in 48 hours if the antibiotics did not help my lungs.
-i waited 4 days to return, thought it would get better, to no avail. by then i was deaf in one ear due to sinus infection. i tried a clinic close to my home, it was full and besides they would not take me since my family doctor did not work there. they referred me to another clinic down the street. it was also full, i got refused. i had to go to the original walk-in clinic far from home to find a spot.
-after 3.5 hours of wait, finally saw a doctor who sent me for chest & sinus x-rays in another clinic. there goes another 3 hours. then back to the clinic, another 45 mins wait to see the doctor with my x-ray results.
-changed antibiotics (acute bronchitis), got a spray for the sinuses, by the time i went home i had wasted an *entire* day waiting here, waiting there. in pain the whole time.
-i am still coughing, i am still deaf in one infected ear, i am not well and my family doctor can only see me JUNE 27th.
... is this a ******ing joke??? :mad: how many more days do i have to miss work to wait in clinics to see a doctor who doesn't give a crap and only spends 3 minutes with me, writes a prescription and shoves me out the door?
:sick: :sick: :sick:

Prin
May 4th, 2006, 06:32 PM
I think you need a better family doctor then. Not all family doctors are that bad.

CyberKitten
May 7th, 2006, 08:25 PM
Is that something that you know for a fact actually occured? I can see it maybe in a small town where a GP would have to refer her or his patient to a specialist and that might take some time but I know from my own experience and our own wait times lists - posted publicly - that this is simply not the case in the Maritimes. There are exceptions of course in certain areas but I have never had any of my patients wait.

I do often tell people who live far from a major tertiary center to bring their child to that center directly if they do not feel they have rec'd the care they felt their child needed. (I am a pediatrician so I think of that population obviously.) Most hospitals now have Patient representatives as well and these ppl will respond to complaints - tho I don't mean yelling at a triage nurse in the ER!! There are 2 for ex at the QEII in Hfx and 2 at the Women's and Children's Hospital.

That man in that case needs to find another surgeon and be assertive about his health care. Perhaps it is beacuse I studied in Boston but often we Canadians are a little too laid back - I do not mean we have to complain and whine but there are constructive steps that can be taken.

And anyone who is needs urgent or emergent care will be seen asap where I work. I do realize there are probs in some provinces and our population is smaller. If this person needed the same surgery in the US, he also would have to wait (They never tell you that in the studies) - I work with and have also been a patient in the US and the wait time for me was longer in the US than Canada.

It depends on so very many variables that no one can ever make a judgement based on the kind of observation made here. My dad was going to go to the Mayo Clinic - since he was in Fla where there is one - but he rec'd a faster appt and even faster minor surgery at home in New Brunswick. It was also much cheaper - just his taxes.

Anyway --- I saw both these past few weeks and I am very very happy with our medical system. I do like the fact I can choose to go elsewhere if I choose but we need to maintain and improve (I do realize it is not perfect) our own system that allows EVERYONE the care they deserve - regardless of whether they have medical insurance or are rich or poor.

Gazoo
May 7th, 2006, 09:12 PM
Some Calgarians have figured out the fastest way to get service in an emergency ward is to go to one of the satellite communities surrounding the city - High River, Black Diamond - and use the ER's at the hospital's there because there is, generally, zero waiting.

Rick C
www.goldentales.ca

shhhhhhhh if ya keep blabbin everyone's gonna do it!!;) :D

CyberKitten
May 8th, 2006, 07:04 PM
HaHa Gazoo, that is what Maritimers do too - if they do not not want to wait (if their prob is minor) at an ER in a city, they visit a smaller clinic and wait maybe a half hour. I thought most Canadians did that, lol