Reduced Access to Our Healthcare

November 7, 2021

Reduced Access to Our Healthcare System

On the last day in Myrtle Beach, my wrist started swelling and became painful. What made it more painful was changing a flat tire on the road trip home on Interstate 40 going towards Raleigh. I heard a pulsating noise from the back tire: I thought it was a rock caught in the tire grooves. But the noise increased and came closer and closer until I told Kathy it sounds like a helicopter that was about to land on the roof of the car. I stopped and exchanged the flat tire mostly without using my left hand, which has become quite weak from the pain in the wrist. I suspected it was a spider bite and considered going to an urgent care clinic in North Carolina but delayed it, knowing that we’ll be at home in a couple of days and then I would see my family doctor.

We arrived back home on Friday night. Early Saturday, when I called, I discovered our clinic was closed on the weekends. The mission statement of the clinic claims the provision of a: “patient-centered approach that ensures access promptly”. This must be creative writing, since there was no service on the weekends. In response to my subsequent inquiry, they advised I should go to a walk-in clinic or the emergency ward of a hospital when they are closed. OK. My recently retired family doctor always had a backup.

Since by then my hand was extremely painful, my next task was finding an open clinic. So I went on the internet and searched for area walk-in clinics. I found out that some required appointments altho they were called walk-in clinics. Doctors were on duty at different times, but not on this Saturday.

Carlingwood shopping center had a clinic that I visited previously and drove over there. They told me they deal with only “their” patients, the clinic had capped their clientele and they would not see me. At the next walk-in clinic, I saw no receptionist. One other patient was waiting for consultation; he told me he saw no one when he came in but there was a doctor behind the walls. I was not sure how he knew that, but I waited, so together we waited and waited. Other people came and left after seeing no one at the reception desk. After an hour, I left as well for the next walk-in clinic at College Square where I was told they were fully booked for the day, but they took my contact info to have a doctor call me after 4 pm. He did and prescribed an anti-inflammatory. It took the entire day to get healthcare.

With the swelling gradually going down but still concerned, and afraid a walk-in clinic would not alert my family doctor about my treatment, I contacted my family doctor on Monday. They informed me she was fully booked that week but offered a virtual initial appointment with a substitute. The virtual consultation was very difficult: trying to describe a swelling verbally. I could not understand why they would not see me in person, but the remote consultation was the best they offered that week. It resulted in a requisition for an x-ray for arthritis and a prescription for an anti-inflammatory. The anti-inflammatory worked its magic in over a week, but I never heard back on the results of the x-ray! Some healthcare.

My access to general healthcare has changed substantially over the last few years, starting with the retirement of my family doctor and my switch to a group practice. The retiring doctor had a paper file on me over an inch thick and he had known me for decades and could just about to see what was wrong with me when I walked in to see him. My new doctor at the group practice had an introductory meeting with me when we met. I was surprised to learn that she was not interested in my files; No, she said, she does not need my previous history. She sat behind a computer and was typing on it more than looking at me sideways.

This new relationship with my family doctor is via the receptionist at the group practice: I write a note to the reception desk that I need an appointment and specify what my problem is such as pain. Reception transmits the email to my doctor, who responds sometimes a week later. The response could be to arrange for a virtual or physical meeting or I receive a requisition for tests or an x-ray. It may be a week or weeks before the results of the tests are in and I receive an email from reception telling me how the doctor wants to follow up.

If the follow-up is a physical meeting, a fifteen-minute consultation is arranged. I found these meetings are too short; by the time the doctor logs into my file on the computer and catches up on my situation, the useful time is less than ten minutes.. There is no time to discuss lifestyles or bring up other medical issues. The tone of these meetings is transactional and specific: I should follow this or that diet, monitor my blood pressure, and report back to her. Until a few years ago, the government paid for an annual check-up which provided the opportunity to have a wide-ranging discussion about my health. I find these new consultations limiting, leaving no opportunity to discuss issues that I have. When I brought up some other potential problems at one of these meetings, she advised me to set up another meeting. The fifteen-minute consult is to review and solve one problem. This way of working may result from how doctors get paid by the government. But is this “patient-oriented” care? When do we get an overall view of my health?

I mentioned to a hematologist friend my belief that the quality of healthcare in Canada is going down. She said that may be true for the general practitioners since Covid appeared a couple of years ago: family doctors have had to develop safe systems to deal with infected patients that limited access to them. The same theme was echoed by friends who all expressed frustration with accessing medical care in recent months. Access to healthcare has been reduced over the last couple of years. Just my opinion. What do you think?