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The System Can Be Tamed
(Practical Advice for Canadian Patients)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed in the March 14-15, 2009 issue of
The Mississauga News under the Feature:
Health, Wellness & Beauty, Medicine Matters
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Few people visit my office with tales of how wonderful socialized medicine is. Tough decisions, physician shortages and an expanding myriad of rules and exceptions even serve to confuse us doctors of how best to function in this system. What follows, is some suggestions to help you navigate this complex system.

Emergency Advice
Emergency departments are chronically overcrowded, because emergency patients may need to wait for beds to become available on overcrowded hospital wards. Emergency departments prioritize based on a patient's need. Some people wait minutes, most wait hours. Sometimes it is difficult to determine if your problem warrants a trip to the emergency. It may be worth a quick visit to your doctor, walk-in clinic, or call to the health advisory number to decide if you should go to emergency. The advantage of a "pre-visit" is that a clinic physician determines that you need further assessment. The clinic physician may perform some preliminary testing and write a letter to the emergency physician. This may help get you through the triage process quicker. Acute life threatening situations should proceed directly to the emergency department.

Laboratory Visits
My patients often complain about long waits for blood work and testing at the local lab. Ever since the large players in the business joined forces, we now have only three basic laboratories. Consequently, the blood that is drawn is not tested on the premises but is delivered to a central testing facility. All the required information is on your laboratory sheet. That means if one lab is busy, you can go to another one. There are many blood-collecting centers throughout the city, whose wait time may be considerably less than elsewhere.

If you find yourself in the position of having to pay for your medication, my advice is to shop around. The cost of your prescription can vary greatly, depending on the pharmacy and the product. A low "dispensing fee" does not always mean that the product fee is a bargain.

If you find yourself waiting seemingly forever to see a specialist, you may want to consider alternatives. It is very difficult for physicians to track wait times for specialists. Although you cannot make an OHIP appointment directly with a specialist, you can assist yourself and your doctor by calling around and finding out who is seeing patients sooner.

When your children receive shots from anyone other than their doctor, take the time to ask the name, lot number and expiration date of the product. Give the information to your child's doctor at the next opportune time. It is the only semi-complete medical record around.

Walk-in clinics
Currently, there are no requirements for a walk-in to keep"ongoing" health records. The result is an incomplete history with your regular doctor (if you have one). In British Columbia, a new incentive is being brought forward in which three visits to a walk-in clinic assigns you to that clinic that takes over your care. This is something to watch for over the next year.

Read the Fine Print
When you ask your doctor to provide non-insured services, such as work evaluations, fitness evaluations and sickness evaluations, read the fine print and sign the authorization before handing it to the receptionist. It often states that you are giving up your right to privacy and confidentiality. The fee that you or your employer pays for the service further reinforces this. When you say: "Give them everything!" don't be surprised that confidential data has left your chart. It might be that blood test we did 10 years ago.

Related resources:

Triage from Wikipedia, the free encyclopedia. The term comes from the French verb trier, meaning to separate, sort, sift or select. Article deals with concept of triage as it occurs in medical emergencies.
Five things not to do in the ER from CNN.
Large Variations In How Long Admitted Patients Wait In Emergency Rooms For Hospital Beds, Canada from Medical News Today.
Canadian Health Care from Snopes.com. Info on Canadian Health Care system from a Canadian taxpayer for Americans.
InDepth: Health Care - Calgary difference: A booming population and strained hospitals from CBC News Online.
MedsCheck from Ontario Ministry of Health and Long Term Care. MedsCheck is a program that allows you to schedule a free annual medication review with a pharmacist for up to 30 minutes.
MedsCheck: An Opportunity Missed by C. Shawn Tracy, BSc and Ross E.G. Upshur, MD MSc, from Canadian Medical Association Journal.

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