Tuesday, April 14, 2009

Doctor, Doctor

For the most part, I have been very pleased with health care in Canada. Having worked in hospitals in both Texas and Virginia, I saw how horrendously unjust the American health care system is. Immediately upon beginning my work here in Canada, I realized that I was not counseling a single patient or family member who was afraid of going bankrupt or losing their home due their the escalating costs of their care. I saw this ALL THE TIME in the States. Canadian health care is not without it's problems. I have heard stories of long waits in emergency rooms, shortages of physicians, and problems with standardized assessments. But everyone here has access to care. Everyone here will be treated, eventually. And your place in the health care system is not determined by your ability to pay.

I have been particularly impressed with the focus on preventative medicine. It makes sense, when you have the same entity, the province, both paying for service AND providing the service, they are more likely to see the long-run cost benefit of preventative medicine. Whereas, if you have two separate entities paying for service (insurance companies) and providing service (physicians, hospitals, et al), both are trying to make/save money, so the insurance company is going to try to avoid payment for treatment for as long as possible, and the physician isn't likely to provide treatment unless s/he is certain of payment. Thus, illness, ailments, conditions, etc go untreated until they become life-threatening (or until the life is taken and treatment is no longer needed, which seems to be the insurance companies' ultimate goal). In my role as a chaplain here in Canada, I have seen people hospitalized for conditions/symptoms that would never warrant a hospital stay in the States (simply because no insurance company would cover it). The reasoning of the Canadian hospitals is that treating the person now will save money down the road. Even if the focus is still on finances, at least here, the patient is treated.

As a patient, I've had no complaints about the health care system, with the one exception that it's extremely difficult to find a primary care physician. Canada has a doctor shortage, so most physicians are not accepting new patients, and one doesn't go to their PCP for immediate concerns (colds, broken limbs, stitches, infections, etc.). People go to their PCP for physicals, paps and the like. For any immediate need, you go to a walk-in clinic (for non urgent medical needs) or the emergency department of the hospital (for the urgent concerns).

My first experience at the walk-in clinic (for an infected cut on my finger) involved absolutely no wait; I was home with my prescription of antibiotics within an hour and a half of walking out my door. I had about a 30-minute wait on my second visit (for a sore throat). Nothing like the rumours of 30-hour waits that fearmongers spread throughout the States to warn people about the "horrors of socialized medicine".

Seriously, the only complaint I have is the doctor shortage. I needed to go for my yearly physical and pap smear. With the shortage of physicians here, you only go to a gynecologist for gynecological problems; you go to your PCP for your routine examinations. Only I didn't have a PCP yet. And with the shortage, I didn't have many options. So I went with the one closest to my home. And he was terrible. He wouldn't look at me when asking me questions. He seemed disgusted at my body and the thought of having to actually touch me. And he answered my questions is a condescending tone as if I know nothing about health, anatomy, medicine, etc. (I am the daughter of a physician. I do work in health care. I am an intelligent woman. And I do know a thing or two about medicine and my own body.) It was such a dehumanizing experience. I refuse to go back to this doctor.

Luckily, I don't have to. For most concerns, I will go to a walk-in (there are about six within a 10-minute walk of my home). And for anything more serious, I will go to a specialist. And I won't have to go to another PCP for a year.

I won't let a bad experience with a bad doctor become an anecdotal justification in support of privatized medicine. The States has bad doctors, too. I have been to a few. (And worked with many more.) While I would prefer a doctor who would actually look at me and treat me as a human being, I will accept a system that actually looks at everyone and treats all people as human beings. Dr. R is just a jackass. And I would rather be abused by a single jackass than an entire jackass system.

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