Canada: 'It's insane': Patient Told She'd Have To Wait 4.5 Years To See Neurologist

a reply to: infolurker

Hey, it's a lot better than not having insurance and never being able to get checked. That's the reality for many, many people.

originally posted by: dfnj2015
a reply to: infolurker

An in the United States it takes about that long to save up enough money to pay the doctor!

Assuming you dont have actual benefits from your job.

originally posted by: Subrosabelow

originally posted by: rickymouse
Well, maybe that specialist is booked up. There are other specialists around, the person may have had to travel to another town to see one sooner, just because one is booked up doesn't mean you can't try another one. Here the doctors just tell you they are not taking new patients, go find someone else.

Really depends on where you are in Canada. In Alberta, specialists will not even take your appointment without a direct referral from your doctor. Meaning, your doctor has to make that appointment. You can't do it.

I didn't have as much of a bad time as this patient, but I still was forced to hobble around with an uncasted broken ankle for 5 days while waiting on the ortho surgeon to get back to me about my referral from the doctor. Come to find out, the doctor I was supposedly referred to was no longer even a surgeon at that clinic and they claimed they had zero record of anyone calling to schedule me. Four days of a broken ankle and orders to stay off my feet and it took multiple calls to the referring doctor and the uncooperative clinic (who didn't want to deal with us, much less give us the new phone number and office address of the specialist I was supposed to see.)

The health care system is broke as hell in some areas of Canada and we're paying for it with our taxes.

We have the same problem here, you have to wait a week or more some times to get to see a surgeon. I live in the Upper Penninsula so we do not have as good a selection here. It is getting better, but conflict between the doctors and nurses here seems to cause a lot of problems. You call for an appointment and get it five days later because the one scheduling things just looks at the schedule, you tell them it is bad and they do not even go talk to the doctor, they just schedule you in. Then you see the doctor and mention you had to wait five days and he says that he should have been contacted, he would have worked you in. The next time you have a problem, the same thing happens. So you go to the ER where they do it right away at great expense to the insurance company and a high copay, like three hundred bucks.

The problem lies in that if someone does come in for an emergency, the nurses and scheduler do not want to discriminate so they consider anyone who wants an immediate appointment an emergency. If one gets away with going in, they feel anyone can. Then the doctor gets mad because he is overworked with things that are not really emergencies. This is a quirk with humans, the workers should ask the doctor if something is bad and let him make a decision. They also need to try to identify non emergencies of regular patients. When you have been a patient of a doctor for twenty years, you should be able to get in when needed.

Doctors used to schedule a couple of hours at the end of the day for walkins, now they book the whole day. I liked it better when you could just go in and see your doctor without an appointment like that. Now they have walk in clinics and you do not know who you will see, your regular doctor knows you, knows how you perceive pain and illness. I was never a complainer and knew what I probably had from experience, I have susceptability to microbes that Augmentum takes care of so the doctor usually prescribes that. Amoxycillin does not work. But the combo in augmentum does for many lung issues and infections when I get them. I also do not go in unless I can't kick the bug and my doctor knew that. I did have one doctor, my last one, who was a pill pusher and when I would tell her augmentum seemed to work, she would give a different antibiotic. So four days later I would go to the outpatient clinic and they gave me the augmentum because my sickness got worse. I dumped that doctor, if you tried to tell her what worked, she would do the opposite. I have a good doctor now, he has straightened out my records and listed my stuff like life long hypoglycemia and tachychardia on the charts, the other doctor sent me for testing and she did not write it in my charts that all testing showed the tachychardia and that was related to hypoglycemia somehow. I had three conclusive heart stress tests that showed this from that doctor, she kept sending me back every couple of years, I had been diagnosed and I had had many tests verifying this for many years before. I just could not take the meds for it regularly as my first two doctors who diagnosed me back in the seventies told me I wouldn't be able to do, it is hereditary and they learned from my uncles and dads treatment.

originally posted by: TheConstruKctionofLight
a reply to: infolurker

meh..come to Australia...we have Medicare and Private Heath Insurance - usually get to see a specialist within about 6 months if not "dire" urgent under the free system.

To hell with that!

Now, I understand the possibility of a small wait but when weeks turn into months.... or years... that is not healthcare I want.

Here in the US there is an artificial doctor shortage caused by a trade union called the AMA. If we could break that monopoly, it would be even better.

Who or what controls the number of medical doctors in the U.S.?

Government licensing, regulations, and funding are the greatest controls on the number and types of medical doctors, with those policies effectively being set by trade unions, most notably the AMA (American Medical Association).

Trade unions like the AMA and the AAMC (Association of American Medical Colleges) are not only powerful lobbyists and influence their members to conform, but they also appoint the members of accrediting agencies (e.g. LCME, ACGME), as well as members of task forces and advisory councils (e.g. RUC which sets prices).

While they have not set an explicit quota for the number of doctors (wink wink), their policies create shortages.

For the past quarter-century, the American Medical Association and other industry groups have predicted a glut of doctors and worked to limit the number of new physicians. In 1994, the Journal of the American Medical Association predicted a surplus of 165,000 doctors by 2000.

To give a flavor of the specific controls, here's an overview of the requirements for becoming a medical doctor (based on A Primer on Medical Education):

(1) A 4 year pre-med college degree, then register with AMCAS (American Medical College Application Service) and take the MCAT (Medical College Admissions Test) which is designed by the AAMC.

(2) Graduate from 4 years at an LCME (Liaison Committee on Medical Education) accredited medical school. Note that, according to the LCME directory of the 141 programs currently in the US, there were no programs accredited between 1982 and 2002.

(3) Pass the USMLEs (US Medical Licensing Examinations) during medical school which are designed by the NBME (National Board of Medical Examiners) and the FSMB (Federation of State Medical Boards of the US). There are per-specialty national board examinations after residency as well.

(4) Up to 5 years of hospital residency (and then possibly a fellowship) accredited by the ACGME (Accrediting Commission on Graduate Medical Education) which is controlled by the trade unions.

In practice, residency is also largely limited by government funding:

Residencies are funded through hospitals. Through Centers for Medicine and Medicaid Services (CMS), the federal government pays hospitals for each resident (known as direct medical education funding, or DME). Hospitals with residents also receive slightly more reimbursement from Medicare for their patients (indirect medical education funding or IME). In most cases, CMS will only pay for a limited number of residents per hospital. States may also contribute to residency education, often through Medicaid programs that are partially funded by CMS.

How Medicare Subsidizes Doctor Training:

This means hospitals used to have incentives to create new residency slots ad infinitum so they could keep on getting higher and higher payment rates from Medicare. Congress decided (perhaps understandably) that this was financially unsustainable; there was also some concern about creating an “oversupply” of doctors in the 1990s. So in 1997, Congress capped the number of positions that Medicare would underwrite, freezing the total at what it was the year before.


(5) Earn a living through payment for services which is controlled by a market that is heavily distorted by government regulations, including those favoring insurance and price fixing via the AMA RUC's (Specialty Society Relative Value Scale Update Committee) recommendations to CMS (Centers for Medicare & Medicaid Services) that favors specialists.

See also:
- Does the AMA limit the number of doctors to increase current doctors' salaries? (Skeptics StackExchange, 2011)
- Warnings of doctor shortage go unheeded (Seattle Post Globe, 2011)
- Solving the Shortage in Primary Care Doctors (NY Times, 2013)
- The Shortage of Medical Residency Spots: A Failure of Government Control (Forbes, 2013)

- Special Deal: The shadowy cartel of doctors that controls Medicare. (Washington Monthly, 2013)
- How the AMA’s Price Fixing Distorts Health Care Delivery and Pricing (Naked Capitalism, 2014)

- The Case Against Medical Licensing (Dr. Wilson, 2014)
- Capitalism and Freedom: Chapter IX: Occupational Licensure (Milton Friedman, 1962)
- The AMA and Price Discrimination in Medical Care (Thayer Watkins)
- Antitrust Enforcement in the Medical Services Industry: What Does It All Mean? (Havighurst, 2005)
www.quora.com...


www.theatlantic.com...

American Medical Association President Robert Wah recognizes this residency bottleneck. “U.S. residency program positions have not increased at an adequate rate to accommodate the expanding number of U.S. medical graduates and the current IMG [International Medical Group] applicant pool,” he said in an email.

Even if the AMA were to magically produce a few thousand more residency slots, it would barely make a dent in 91,500 projected doctor shortage.

Whittling down the shortage will likely take a combination of measures.

A third fear is that loosening regulations would negatively affect U.S. medical schools. If coming back to the U.S. were easier, Americans might be more likely to study in places like England and Israel because becoming a doctor would be both cheaper and faster overseas.

Further, an influx of doctors could impact a more sensitive matter—with an increased doctor supply, salaries among America’s white-coats would almost certainly go down.

“Nobody wants to share their pie,” Alomran says. “This is the same everywhere and is not unique to medicine, in my opinion.”

originally posted by: Caver78
The wait times are no joke north of the border.
In the Toronto area I had a good friend wait 10 months to get into a specialist for liver disease, and no they didn't drink.
Another friend died of a heart attack waiting to see a cardiologist.
Both worked and paid their taxes, essentially paid into the system for years. One was 45, liver disease girl, and heart attack guy passed away at 53.

It happens all the time but unless the family raises a stink it's not reported.
The fried with liver issues had PREVIOUSLY waited 8 months for a simple ultrasound, THEN another 10 months for the specialist appointment. We're pretty lucky she has some decent dna and didn't die.

Your friend was obviously too passive and accepting of how her doctor was handling things. Eight months to get an ultrasound...in Toronto?

My wife had some acute stomach-area pain earlier this year. We went to the emergency department at the University Hospital in our city, and as part of the examination they gave her an ultrasound right on the spot. We did a follow up with her physician a week later, and he booked a follow up CT Scan and an MRI. The CT Scan was scheduled for one month later, and the MRI was done within 6 weeks (they sent us to an out-of-town Hospital because their wait times were shorter there...was a 40 minute drive).

Her stomach issue ended up being ulcer-related, and they spotted another issue related to her liver while they were checking the other stuff out. She now goes for follow up ultrasounds every six months, just to monitor the situation (and to make sure it doesn't progress). No muss, no fuss.

I would be the first to agree that wait times are an issue in Ontario. But 8 months to get a first ultrasound? That sounds like a doctor/patient issue to me. The doctor (or his staff) didn't take any time to make suitable arrangements, and the patient didn't jump up and down when told how long they had to wait.

originally posted by: Bigburgh
a reply to: infolurker

Yikes..
Hope no one gets cancer, heart didease.... lupus.. some autoimmune disease.

Well I was on the liver transplant list for a whopping 13 days before surgery. In Ontario.

Of course there was prelim work. 6 months without a drink. Tests out the wazoo. They don't just hand livers out. But once qualified it was ZOOM. Aside from this I've seen a specialist in about 2 weeks. Just remember our media isn't above political manipulation either. Just like ATS isn't above it. This thread is an example.

ETA: Last weekend I had a fever and was instructed to go to the closest Emerg. Infection is a major concern due to the anti-rejection drugs. IDK how many blood tests were done. Too many to count. Also an abdominal ultrasound and chest Xray.

a reply to: infolurker

Much of what you said is true....But, that is how it is in a for profit system. On top of that, doctors are trained to administrate drugs from Pharma companies, not to fix things properly by altering diet of the patient. They get very little nutrition as related to disease training in their schooling. Most doctors spend more time on studying applications for meds and just identifying diseases than training on how our metabolic pathways work and how to adjust them as related to disease symptoms. They treat the symptoms, most times that is not curing the disease.

Doctors in this country are trained to provide future sustainability and profit of Pharma companies and the medical field. A doctor who goes off and studies how to stop disease from progressing is rare in our mainstream medical system. The whole teaching system is wrong. I saw what the future doctors were like when I was in pre-med back in the seventies. I quit college because I wanted no part of it, I had all my medical school paid for by some influential people, one on the board of the AMA. I wanted to study medicine to help people, but they were teaching us that it is alright to take the money of patients and get rich because those people did not eat properly. Most disease progression can be controlled by diet.

I call BS on this. A doctor making appts 4.5 years out? It is just a different way of saying they had no availability.

A different healthcare system also would not mean more Drs. or any less wait times.

There is much to this story that is being left out.

a reply to: infolurker
Quel dommage!! You guys were right all along...better sign me up for Trumpcare immédiatement if not sooner!! I'll feel so much more secure!

Canada is a cesspool of global cabal members and it is way more crooked than the USA and other big countries...the medical system is rife with kickback frauds forcing people into Laneway treatment streams many which are unneeded or less than optimal and WCB insurance frauds by arbitrary and oppositional denial of benefits force 300+ people to suicide every year.

originally posted by: one4all
Canada is a cesspool of global cabal members and it is way more crooked than the USA and other big countries...the medical system is rife with kickback frauds forcing people into Laneway treatment streams many which are unneeded or less than optimal and WCB insurance frauds by arbitrary and oppositional denial of benefits force 300+ people to suicide every year.

My cancer was cured for $32 out of pocket. I think I'll go with the imperfect system.

a reply to: JohnnyCanuck

Glad to hear you won the battle.Its always nice to see a representative of the minority experience sucess.

Even the Devil has a belly-button so this in no way alters my opinion of the Canadian state-of-affairs.

originally posted by: one4all
a reply to: JohnnyCanuck

Glad to hear you won the battle.Its always nice to see a representative of the minority experience sucess.

Even the Devil has a belly-button so this in no way alters my opinion of the Canadian state-of-affairs.

I am by no means in the minority, and I have yet met a Canadian who wants to trade their system for the American experience.

originally posted by: JohnnyCanuck

originally posted by: one4all
a reply to: JohnnyCanuck

Glad to hear you won the battle.Its always nice to see a representative of the minority experience sucess.

Even the Devil has a belly-button so this in no way alters my opinion of the Canadian state-of-affairs.

I am by no means in the minority, and I have yet met a Canadian who wants to trade their system for the American experience.

I was referring to your being a Canadian Cancer Survivor by proxy making you a member of a minority.The majority of people the messed up Canadian System tries to help are not cured.

A close friend hd son with rare form of leukeia.....he needed treatments with a new medicine which cost 50K and would give him an 80% chance of survival but these treatments were only available in the USA....Health Canada supported only surgical intervention with bone marrow transplants costing 800K dollars with a survial rate of only TWENTY PERCENT.

The proper treatments were purchased completely outside the Canadian System after a Court battle against the crooked Canadian processes where the Canadian System tried FORCING the 800k low survival surgery on the kid.....

Today the kid is a fine healthy young man who knows how very close he came to being murdered by proxy by his own government and Countries milking of the Systems.....he also knows the Devil has a belly-button.

I am glad both of you met and bested such tremendous challenges from such widely spaced spots on the spectrum.

originally posted by: one4all
A close friend hd son with rare form of leukeia.....he needed treatments with a new medicine which cost 50K and would give him an 80% chance of survival but these treatments were only available in the USA....Health Canada supported only surgical intervention with bone marrow transplants costing 800K dollars with a survial rate of only TWENTY PERCENT.

Hard to be accurate without knowing the exact disease but this part is easy. It's new, thus probably not approved in Canada yet.

As to your 20% that's BS. Acute lymphoblastic leukemia in the worst case scenario is almost 60%:

bloodcell.transplant.hrsa.gov...

You see, the devil's belly button is in the details.

originally posted by: intrepid

originally posted by: one4all
A close friend hd son with rare form of leukeia.....he needed treatments with a new medicine which cost 50K and would give him an 80% chance of survival but these treatments were only available in the USA....Health Canada supported only surgical intervention with bone marrow transplants costing 800K dollars with a survial rate of only TWENTY PERCENT.

Hard to be accurate without knowing the exact disease but this part is easy. It's new, thus probably not approved in Canada yet.

As to your 20% that's BS. Acute lymphoblastic leukemia in the worst case scenario is almost 60%:

bloodcell.transplant.hrsa.gov...

You see, the devil's belly button is in the details.

Spare me your rhetoric....obviously anyone who knows how crooked the processes are knows Canada intentionally delayed approval to feed the fraudulent abyss of a system they have in place......" BS"....lol....you are a fool......current condition of patient combined with potential positive impacts from treatment define odds and recover rates...it is an individual dynamic......you are an ignoramus to even offer some 1/2 arsed argument over such a small part of a conversation.

So your link and rhetoric are not relevant.

And yes ,the Devils belly-button is in the details.

originally posted by: JohnnyCanuck

originally posted by: one4all
a reply to: JohnnyCanuck

Glad to hear you won the battle.Its always nice to see a representative of the minority experience sucess.

Even the Devil has a belly-button so this in no way alters my opinion of the Canadian state-of-affairs.

I am by no means in the minority, and I have yet met a Canadian who wants to trade their system for the American experience.

Don't you remember this?

Canadian Politician Comes to U.S. for Heart Surgery

The top politician in Canada's easternmost province has set off fireworks by deciding to go to the U.S. for heart surgery. It is rare that a simple matter of patient choice causes an international flap.

But that's what happened when 60-year-old Danny Williams of St. John's, Newfoundland, decided to go to the U.S. for heart surgery.

a reply to: one4all

Well I countered your opinion with facts. You can dismiss those facts with rhetoric and insults. Doesn't mean that you are correct. Just means your argument has no legs. Or belly button. Hell, no substance whatsoever.

originally posted by: LogicalGraphitti

originally posted by: JohnnyCanuck

originally posted by: one4all
a reply to: JohnnyCanuck

Glad to hear you won the battle.Its always nice to see a representative of the minority experience sucess.

Even the Devil has a belly-button so this in no way alters my opinion of the Canadian state-of-affairs.

I am by no means in the minority, and I have yet met a Canadian who wants to trade their system for the American experience.

Don't you remember this?

Canadian Politician Comes to U.S. for Heart Surgery

The top politician in Canada's easternmost province has set off fireworks by deciding to go to the U.S. for heart surgery. It is rare that a simple matter of patient choice causes an international flap.

But that's what happened when 60-year-old Danny Williams of St. John's, Newfoundland, decided to go to the U.S. for heart surgery.

Yes. This 7 yo story is often used in the States to defend their system. Continue the article though:

The New York Post, for instance, in an article headlined "Oh (no), Canada" used the news to take a whack at healthcare reform in the U.S. And the American Thinker blog -- among many others -- argued that Williams' choice is evidence of the inferiority of Canada's "technologically second-rate and rationed system."

In Canada, cardiac specialists defended the premier's decision as a matter of choice and at the same time noted that -- with few exceptions -- most cardiac procedures are both available and done well in Canada.

On the other hand, Newfoundland -- with a population of about 500,000, less than Wyoming -- is less well equipped. Doctors in the province do coronary artery bypass grafts (CABG) and other common procedures, but often send patients elsewhere in the country for transplants or rare operations.

a reply to: intrepid

You're right, the article went on but in the end, that person chose to get the procedure on the USA. He could easily have gone elsewhere in Canada.