What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Tuesday, December 19, 2006

Suffering, a Canadian Value

“In a society where instant gratification is barely fast enough, Canadian’s fierce defense of their right to queue for medical treatment is anomalous. Yet, for some, publicly funded health care defines who we are”.
The above statements were the lead statements in today’s editorial of the Calgary herald. The part that caught my eye was not the part of how bizarre it was for a society to tolerate waiting for weeks and months, in a system that pertains to life or death, but, then won’t tolerate minutes and hours to purchase junk food. The part that amazes me is the fact that some Canadians would define themselves by identifying with our Canadian Health Care System.
Let’s take a few practical examples:
1) A 20 year old patient sees a doctor because she is having some double vision for the past two weeks. She sees her family doctor and relates that three months ago she had a weird sensation in her left leg that lasted six weeks and seems to be stumbling more. She relates that she had an aunt who had similar symptoms ten years ago, has been diagnosed with Multiple Sclerosis, and is now in a nursing home at the age of thirty five. Her doctor examines her and says that MS is a possibility but she would have to see a neurologist, an ophthalmologist, and have a CAT scan to confirm the diagnosis. The patient now is faced with, weeks at the best, and several months at the worst, to have the following questions answered: a) Do I have multiple sclerosis? b) Will I end up like my aunt? c) Can it be treated better than my aunts was? d) What can I do to help?
2) You have just been diagnosed with heart disease that requires by-pass surgery. You have been put on an urgent waiting list. You have been told that survival is far better if you have the surgery, and that the waiting time for this surgery could be up to one month. You realize that your life is at risk while you wait for the surgery; you have trouble sleeping, eating, concentrating, etc.
3) You have had a cough for about a month, see your doctor, and a chest X-ray is done. Your doctor tells you that you have a suspicious area on your lung and need a CT scan of your chest and a bronchoscopy. You think “cancer”. You wait three weeks for the CAT scan and it confirms a “serious problem”. You wait another two weeks to see a chest specialist and another ten days for the broncoschopy. Your thinking “Its taking too long. I’m going to die”. The bronchoscopy and biopsy are done and it takes ten days to get the results. You are told that you have adenocarcinoma of the lung. You are referred to the cancer clinic and see a “team” of specialists. You are told that you need a head and body scan to insure that the lesion is operable. A bone scan is booked to insure that you are a surgical candidate. All the while you wonder “will I live or will I die? If I am going to die, how long have I got to live? Will I die in pain? You have a million other questions.
So tell me again why we Canadians identify ourselves by our public health system? People on waiting lists experience the same basic fears as hostages captured by terrorist; will I live or die, if I am going to die, how long have I got to live and will I die in pain. Many are in pain while they wait for decisions. In short they are under an incredible degree of suffering, and their loved ones suffer with them. Ordinarily, we would call a situation like this cruel and inhumane. Our government calls it difficult, complex, but still keeps the gates to freedom locked. The aged, the poor and the chronically ill have no alternatives but to stay imprisoned in this, our public health care system. The wealthy can pay and escape. They see the specialist, have the CAT scans, bone scans, the surgeon, the radiation oncologist, and the medical oncologist in a matter of days and a course is plotted. They know what lies ahead and what they must do, and they can get it done.
To a large extent, much of the suffering is in “not knowing” and thus, not being able to intervene. Waiting lists are lists of suffering people. What kind of society would take pride in this abuse of the most vulnerable? What kind of society identifies itself by this kind of torture? Depraved dictatorships?
No, it would seem to be our Canadian society; led by the advocates of our universal, monopolistic, and immoral, healthcare system. Each day I would leave work, feeling I had let my patients down. Each day patients were put on lists that were too long; lists where, I knew, in spite of my best efforts, they would suffer much longer than needed. Human rights advocates, where are you when thousands of Canadians need you? We need to be rescued from this “Canadian value”.

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