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Tips on How to Navigate
the Ontario Health Care System

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

Article written by Dr. Kujtan, August 25, 2014.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Few people seem to show up at 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 departments are chronically overcrowded, because to move people out of emergency beds requires waiting for overcrowded hospital wards to become empty. Emergency departments determine who gets seen first based on need, and not time of arrival. Some people wait minutes, most wait hours. Sometimes it is difficult to decide 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 emergency is where you should be. The advantage of a "pre-visit" is that if the clinic physician feels that you need to be further assessed, they may perform some prelimenary testing and write a letter to the emergency physician, which may help get you through the triage process.

One of the biggest complaints my patients have is the long waits for blood work and testing at the local lab. It too can be measured in hours. Ever since the government put caps on laboratory services, the large players in the business joined forces, so that we now have only three basic laboratories. The blood that is drawn is not tested on the premises but is picked-up and delivered to a central testing facility, and the result is delivered back to the ordering physician. All the required information is on your laboratory sheet. That means if one lab is busy, you can go to another one. And believe it or not, there are blood collecting centers around the city, which wait time is regularly measured in minutes.

If you feel that you must complain about deficiencies in the system, do it in a way that is effective. Yelling at the clerk or nurse will generally not fix things and only add to everyone's stress. Systemic changes may come by sharing your views with your local political representative or taking your hospital complaints to the appropriate administrator. Change is possible.

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 in the position of waiting to see a specialist, whose appointment seems months away, you may want to consider alternatives. I have a growing group of patients who have found themselves in the position of moving to a new community, but finding it necessary to travel back to see me for medical problems. 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 they are being injected with. Give the information to your child's doctor at the next opportune time. It is the only semi-complete medical record around. You will be glad you did when it comes time to apply for university, a job or travel.

Walk-in clinics. Many people who use them do have a regular doctor. Currently, there are no requirements for a walk-in to keep "ongoing" health records. There is that sub-set of patients whose medical records are mostly empty due to lack of visits, but claim to be afflicted with numerous conditions and insist that the system should function to their own level of convenience. In my view, people who choose to receive the bulk of their health care in walk-in clinics are soon retired and replaced by patients who understand the benefits of ongoing care, prevention and team work. Our waiting lists have hundreds of these poor souls on them. In British Columbia, a new incentive is being brought forward in which three visits to a walk-in clinic assigns you to that clinic who takes over your care.

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 must pay 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. You may want to specifically limit what you want released to third parties.

Related resources:

Understanding Health Care in Ontario from Ontario Ministry of Health and Long Term Care. Site provides info on how to access the system, and to learn about the many health care options in Ontario.

OHIP and Physiotherapy for Seniors: What You Need to Know from Focus Physiotherapy.

9 ways to jump the health care queue by Camilla Cornell, Canadian Living. When dealing with your health, you don't want to have to wait. Here are 9 simple ways you can speed up your health care service.

Loud and Clear - Seniors and Caregivers on Navigating Ontario's Healthcare System. Seniors and caregivers speak out about navigating Ontario's healthcare system. This report (PDF, 62 pages, 5.3 MB) is about their stories, experiences and ideas. April 2012. Toronto: The Change Foundation.

Ontario Health Insurance Plan (OHIP) Questions and Answers. Public information. A resident of Ontario must have a health card to show that he or she is entitled to health care services paid for by OHIP. The Ministry of Health and Long-Term Care pays for a wide range of services, however, it does not pay for services that are not medically necessary, such as cosmetic surgery. Most of your Ontario health benefits are covered across Canada. The province or territory you are visiting will usually bill the Ontario Ministry of Health and Long-Term Care directly for hospital and physician services.

Apply for OHIP and get a health card. The Ontario Health Insurance Plan (OHIP) pays for many health services you may need.

Health Care Options: Find the location of the health care service you need [in Ontario, Canada]. Browse locations: Walk-In Clinics, Family Health Care Providers, Urgent Care Centres, Community Health Centres, Family Health Teams, Nurse Practitioner-Led Clinics, Emergency Rooms, Breast Screening Centres, Public Health Units, Diabetes Education Programs, Sexual Health Clinics, Home Help and Homemaking, Pharmacies, Community Care Access Centres, Long-Term Care Homes, Exercise and Falls Prevention Programs, Physiotherapy Clinics, Ontario Breast Screening Programs, Immunization Clinics, Seniors Centres, Community Support Services, Aboriginal Health Centres and Programs, Care for the Caregiver, Transportation for Seniors and People with Disabilities, Deafness and Impaired Hearing, Blindness and Impaired Vision, Acquired Brain Injury Services, Alzheimer Disease and Related Dementias, and many more ...

Transforming Ontario's Health Care System: Vision. The Ontario Government has set out an agenda to realize an unprecedented paradigm shift in the delivery of health care, particularly around quality of services delivered, integration of services across the continuum of care, cost of services, and the long-term sustainability of the health care system as a whole.

Faster Access to Stronger Family Health Care. Accessing family health care in Ontario is part of staying healthy. Learn how to find the care and services you need, when you need them. The more you know the better choices you can make.

Healthy Change: Right Care, Right Time, Right Place. You have many health care needs and these needs change as you age. It's important to find the help you need in the community to connect to the right care at the right time in the right place.

About Ontario's Health Care System Learn more about Ontario's health care system and how it works. The Canada Health Act is Canada's federal legislation for publicly funded health care insurance. Its primary aim is to "protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers."

Canada Health Act from Wikipedia.

Primary Care Transformation. "On December 17, 2015, the Ministry of Health and Long Term Care released the Patients First: A proposal to strengthen patient-centred health care in Ontario discussion paper. The paper proposes significant changes to our health care system."

Navigating the Mental Health Care System in Ontario from Ontario Shores, Centre for Mental Health Sciences.

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