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Any country that
has a national health service is to be commended. My initial
impressions are based on the only other country where I experienced
such a service and that was in Scotland.
From an historical perspective
Scotland was known to be the very best place in the world to learn
medicine and many people from all over the world travelled there to
study and learn.
Now I should make it clear that this
initial perspective is very much from a laymans point of view and as
a recipient of the service as I have absolutely no medical
knowledge. In
Scotland I was diagnosed as a diabetic. This was as a result
of going for a private medical to secure insurance for a bank loan
for my business. As a result of that medical I was advised to
see my family doctor but they wouldn't say why as that was not their
role.
And so with that
recommendation it made sense for me to follow that up with a visit
to my family doctor and that when the diagnosis was made.
As a result of the diagnosis I went
onto a special program which meant that I had to visit the diabetic
clinic at the local hospital every six months. On each visit I
was given an eye test which included getting my eyes photographed.
I was given a circulation test and a practical test where they
touched my toes with a light touch to see if I could feel that.
My blood pressure was taken and I had blood work done.
As a diabetic I was also sent to an
optician where they did another series of tests on my eyes that the
clinic couldn't undertake.
I should say at this point that all
this is free under the Scottish National Health Service. This
included my prescriptions.
After the first six
months I was put onto an extra diabetic pill but warned that in some
cases this could cause me to have the runs. At that point I
was considerd to be stable and so didn't need any other treatment
but stayed on that drug regime and the six monthly visits.
My family doctor while being kept
informed didn't require to see me for follow up.
Now into Canada where I intended to
live and become a Canadian citizen. I was advised by Canadian
Immigration that after being here for 3 months that I should apply
for an OHIP health card to be eligible for the Canadian Health Care
system. That I did. However, as I was still a UK
citizen, I still got my medicines from the UK sent over to me.
It was when I moved
to Chatham and got Permanent Landed Status that I decided it was
time to get a family doctor here. I then found out that due to
the shortage of doctors it could be up to 5 years before being taken
on. As it happens I did manage to find a doctor within a month
of arriving and so the rest of this story is about my experience
with the Canadian Health Care system.
The first thing I noted was my doctor
didn't seem to be able to organise her time very well as I usually
had to wait around 4 hours to see her. That to me was irritating as
I wasn't used to such a long wait. I got various blood tests
done and thereafter she looked after things.
I noted at once
that I had to pay quite a lot of money for my diabetic drugs.
That was certainly a lot different from Scotland. As a
diabetic I wasn't at first able to join any health plans that would
offer me any savings although I was eventually pointed to a plan
that might take me on and since then have used their services which
does cut my costs by around half.
The next thing I noted was that it had
been two years since I had had an eye test. So I asked my
doctor about that and she immediately referred me to an optician. I
note that as she referred me the eye test was free. However I
would note that in Scotland the eye test was automatic but
apparently in Canada it isn't so you have to request it.
As my last blood sugar test indicated
that I needed to change my medicine I was referred to a diabetic
specialist. However as my doctor fell ill and subsequently gave up
practice I found I needed to push to actually get the referral as
the doctor hadn't put that through paperwork wise. So again the need
to be proactive.
I then visited the new doctor (note
that she is not my family doctor) to be told that I needed to go
onto insulin. That's life so that was what happened. However
after seeing her for a year I mentioned that in Scotland they
checked my circulation and so gave me that test to see if I could
feel the light touch on my toes. Note again I had to ask about
that for it to happen.
I would note that with this doctor she
saw me right on time on every visit so at most I'd only wait 5
minutes. I
was then advised by the diabetic health care at the local hospital
that blood testing meters can be up to 20% out. When I then
saw my specialist I asked her about that and she agreed with the
statement. I had noted several adverts on TV for meters so
asked if there was one she would recommend. She said they were all
the same. So I asked if there was any comparison reports but
she said no. I then asked, as she was a specialist, would she
not do some testing to better advise her patients. She then said
there was no money in it.
Now I have to say that last statement
bothered me. And for that matter it still bothers me today.
You'd think that if you were a specialist in diabetes that you'd
want to be the best you can be and so I didn't see why money should
come into it.
I was also given a new drug to take
and this time it did give me the runs and I had to learn how to take
this at a more meaningful time to avoid the worst of this effect.
However she didn't point out this possible side effect although they
had done so in Scotland.
Now... I eventually got myself another
family doctor and this time it took me two years to find one.
Note also at this time I took the
initiative to phone the optician to ask if I could get an annual eye
test and he agreed and put it under the referrel system so I didn't
need to pay for it. I felt this was something he didn't need to do
so was much appreciative of his service. In fact of all the doctors
I've seen he is by far the best in coming over as a friendly and
caring person.
So to date I have only just been taken
on by this new doctor and my first appointment with her is two
months on from that initial interview.
On that initial interview she told me
that I should not use the local walk in clinic as if I did she would
lose $40.00. Again I was taken aback that she should say this.
From my own knowledge of the medical situation in Scotland I would
never have thought of going to a walk in clinic if I had a family
doctor but when she mentioned she would lose $40.00 if I did go
there seemed to me uncalled for.
It was then that I
decided to do my own wee bit of research on doctors in Canada.
In my opinion the
health care system in Scotland was much better than in Canada and
I'd certainly never received any comments about money from any
doctor I saw over there.
In my investigations I discovered that
the average family doctor in Canada receives a salary of around
$230,000 a year. That seemed to me to be an extremely good
salary which is why the comment of losing $40 seemed rather strange.
In my doctors case she also participates in emergency at the local
hospital so I would assume she earns more money from that work.
I then started to ask around and each
person I talked to said that most doctors were in it for the money.
Guess I'm a bit naive as I always thought being a doctor was a
calling rather than a money issue. However being in it for the money
doesn't mean the doctor can't also be good at what they do.
The system in Canada however seems to
be that the more patients a doctor has the more they will make. That
in my opinion means there is no real incentive for a doctor to try
and get to know their patients. Now I say this for a reason.
I have spoken to several people that
don't earn much money at all and I hear the stories of them being
diagnosed with something or other and being given a prescription.
Problem is that these people simply can't afford the prescription so
they end up buying what they can afford.
That to me makes no
sense at all. On one hand they should really tell the doctor they
can't afford it and thus give the doctor an opportunity to try and
find cheaper alternatives. I spoke to one woman in this
position and I urged her to tell her doctor.
On the other hand if the doctor was
doing a good job then surely they would detect that the problem is
not getting better given the drugs the person is supposed to have
taken. So this system doesn't seem to give the doctor time to
learn about their patient and is contributing to poorer health care.
I also note that the service in Canada
is designed to give good basic care. However that doesn't include
things like dentistry, eye operations, etc. These usually need to be
paid privately and this can run to thousands of dollars. All
this means is that you need to get medical health coverage as soon
as possible.
Overall the
National Health care system is really very good and much better that
say the model in the USA. However there are obviously issues
and so the patient in Canada must be pro-active in seeking good
advice and be prepared to ask questions. In other words you really
can't totally trust your doctor to give you the very best care and
advice.
On another matter I
watched a segment on the Canadian news as I was writing this. It was
about research done on food insecurity in Canada. I noted down a few
facts from the interview...
- 2 million Canadians are food
insecure meaning they are not getting enough to eat.
- 1 in 4 Canadians are obese
- 60% of Canadians are over weight. |
