Yours Truly discovered Tuesday, quite by accident, that her favourite (and only) family doctor is closing up shop to take on a new career in surgery. This is fabulous news for him, and poopifying news for Yours Truly. Our family doctor believes in wholistic healing; in treating each patient as a *person* rather than as a collection of symptoms. He always takes time to talk about your medical history, any issues you may be having, and he is well-read and well-studied in new journal articles. He’s also leery of any drug company that sends out promotional samples, which, as you know, is right up this cenobyte’s alley.
So imagine cenobyte’s surprise and dismay when she went to the medical office to book her children’s annual physical examinations and found a note on the door saying “Dear patients of Dr. Awesome: Dr. Awesome has been flown to the moon by sparkling monkeys with steam-powered transporational devices strapped to their backs. He will be entering into lunar, then martian practice as of the beginning of September. Please inform us into which vacuum tube you would like your medical records shunted, over the period of the next two months, and we will comply with your request. Best wishes, etc., etc.” cenobyte may be paraphrasing here, but that’s the gist of the letter.
Yours Truly then spent some time in requisite, and deep palaver over the telephone with Dr. Awesome’s staff, regarding patient records. Yours Truly is Very Nervous about her patient records, because of a Bad Experience with an Arseknuckle doctor who refused to release cenobyte’s prenatal records during her pregnancy with The Captain. This resulted in the staff at the hospital whence The Captain was delivered being douche bags. Well, the lack of prenatal records and the addition of cenobyte’s best friend TUO offering to go find a pimp drug dealer to ease cenobyte’s labour pains.
With the help of cenobyte’s personal posse of Very Clever Peeps, cenobyte has learned that doctors cannot, according to the Saskatchewan College of Physicians and Surgeons, hand over patient records. They *can*, however, make copies, and most doctors will charge a fee for this service. Small price to pay, when one’s doctor picks up shop and moves to the moon, to ensure you have at least some control over your own medical information (and that of your chit’l’uns). The Very Kind And Patient Lady at Dr. Awesome’s office spent a good deal of time holding cenobyte’s hand through this traumatic experience. Thank you, Kind Lady.
But. Now we delve into a deeper, darker subject.
I’d like to point out at this juncture that I am not criticising socialised medicine for any of the problems I’m having. First, it is untrue that those of us fortunate to be covered under universal medicare cannot choose our own doctors. We are free to do so. In fact, our regional health authority has a convenient list of doctors who are currently accepting new patients. Doctors in Saskatchewan (and, in fact, doctors in most of Canada) operate private practices. They either purchase or rent office/clinic space, and they pay expenses just like anyone else operating a business. The difference betw….one of the differences between universal medicare and so-called “private” health care lies in who does the paying for services.
In Canada, our provincial health authorities partner with the federal health authorities to pay doctors for their services. Each citizen of Canada who pays tax pays for our medical care. This is as it should be. I’m not going to debate that point. But there are problems.
The problems lie in several areas:
- If you happen to live outside of a major urban centre, it is difficult, for some stupid reason, to find doctors to work in your community.
- Some communities have fallen prey to backwards-thinking legislators who are keen on decentralising services away from rural communities to urban areas. (They do this in the field of education as well, with just as asinine reasons.) Many rural communities in the province have lost their hospitals, their clinics, and even their regional health nurses. So if you’re having a massive coronary in Val Marie, you’d better hope that the hospital in Swift Current, two hours away, has a bed for you.
- There seems to be a lack of interest on the part of medical doctors to enter into general family practice. This means that you don’t have a primary health care contact, and if you happen to be having a massive coronary in Val Marie, you probably won’t have a continuation of services for your emergency care physician to draw upon.
- Regional health authorities seem to be making heads-in-their-bums decisions about which areas they would most like to fund. They seem to be choosing “executive in an office” versus “caring, qualified doctor” or “caring, qualified nurse”.
- Nurses*, who are often the first point of contact in the health care field, are being sent from here to hell’s half acre and back because health authorities don’t want to schedule them or pay them for full-time work. So they end up hiring three times as many part-time or casual staff who then end up racking up overtime (which has to be paid out) and sending nurses where they need to be. Which is an interesting, if backwards, idea, particularly when it comes to continual care.
It is *vitally important* to have a family physician. This is a relationship you will foster for years, if you are fortunate enough to a) find a physician who is accepting new patients; b) find a physician who is accepting new patients with whom you feel comfortable enough to share your deepest darkest secrets about your vaginal yeast infection/impacted bowel; c) find a physician who meets all of the above requirements who is able to provide ongoing care for you and who has the time to actually listen to you.
So Yours Truly is frustrated as all hell, because now that Dr. Awesome is doing lunar surgery on itinerant aliens, our family has to find a new family doctor. Who isn’t in Strasbourg-home-of-the-Strasbourg-Maroons. Nothing wrong with Strasbourg; we just don’t much fancy driving for an hour to do so. As an aside, I was Taken Aback when the Kindly Lady began talking about the doctor’s nationality. I pointedly told her I don’t care about that, but she continued, so I guess she’s had a lot of questions about it, which makes me think there’s a Very Good Reason that some doctors don’t want to practice in rural centres, but I digress.
Our regional health authority has a sadly paltry list of family physicians who are accepting new patients. None of them has a list of qualifications or an history you can look through. They’re just names and telephone numbers. This bothers me. I am, essentially, hiring someone to gaze professionally into my vagina once a year, someone who will scrutinize my breast tissue and who will peer into my facial orifices with a keen eye for Out Of The Ordinary stuff. I will be naked with this person, in his or her professional capacity, at least once a year, and so will my incredible and sexy husband, and my two remarkable and brilliant children. I will be sitting with this person at least once a year and discussing things like my mother’s (and her family’s) alcohol abuse issues, my father’s family’s heart problems and mental health battles, my own struggles with psychiatric care and medications, my decisions regarding where, when, and how often to breed, and the state of my **LIFE**. My *life*. The *lives* of my family.
There’s nothing saying I can’t interview as many doctors as I want, and spend the next two weeks shuffling from one physician to the next, like a high school kid with a Billy Ray Cyrus mullet trying to find a date to the prom. Sure, I can do that. I’m *willing* to do that. Many people aren’t, and so I guess maybe I don’t have a right to be upset at the fact that the whole system seems to be designed to alienate patients and make them feel like second-rate sideshow rejects. Not that there’s anything wrong with sideshow rejects, be they first-rate, second-rate, or strictly unrated for the purposes of the Motion Pictures Association of America.
But….here’s the problem with that: I *do* have a right to be upset about this. I *do* have the right to feel like my opinion in all of this should matter. It wouldn’t be any different at all in a completely privatised system, except that I’d have to pay much more by way of insurance than I do by way of taxes for the privilege of having to forage for a new family physician (incidentally, ‘foraging for a new family physician’ would be a good title for a book of poetry). I would still be made to feel like an outsider, someone not *quite* clever enough to figure out how to get things done. Unless I had the kind of ‘disposable’ income required to hire someone to take shit *for* me. (I’d hire grad students for that, if I had my druthers.)
Do we not have the right to quality of life? Perhaps it’s not a right ensconced in the Canadian Charter of Rights and Freedoms (Stark Raving Dad? Is it?) Maybe this isn’t even a ‘rights’ issue. Maybe I’m just all pee ohed because I spent an hour on hold, listening to the World’s Crappiest Music on constant repeat (seriously; that crap doesn’t even have a beat, much less a discernible melody; it’s like all the souls of all the people who’ve ever died are being forced to hum their favourite nursery rhyme through “musical tubes” made of old plumbing pipes and the hardened arteries of despots). Maybe I’m just pee ohed because the people I’ve been talking to today (with the exception of the Kindly Lady) have taken that “well you can’t just DO that” tone of voice with me that makes me want to hit them in the face with shovels.
It’s like it’s this huge power trip and as soon as they hang up the phones, they snigger a little in the stacks of patient files and compare stories about how stupid such-and-such a patient was that she thought she could just call up any old family physician and expect that physician to have the time of day for her. For cripe’s sake, I don’t want to be treated with kid gloves (as in, small goats, not small children. Because gloves made from the flesh of small children are just a Disturbing Image and although it’s close to Hallowe’enie Beanie, not the image I really wanted to invoke here. Evoke? Bring up. But now that I have, I’m sorry I made you picture that. A little. I’m a little sorry I made you picture that. You should write a story about gloves made from the flesh of small children. It’d be like that story I read in one of the Darklands series called “foet”, about purses and such made from the flesh of foetuses. But different. And better. Because you will have written it! Go forth and write!), but I also don’t want to feel like I’m being addressed as the intolerant jackass who assumes she’ll get Better Treatment Than Everyone Else simply because she Has Connections.
And now that I’ve COMPLETELY gone off the rails, and you’ve spent more time than you *ever imagined you would* reading a post that includes references to my pink bits, nasty gloves, and Billy Ray Cyrus, let me just say this:
Why does this have to be so difficult? Even the doctors listed on the regional health authority’s “accepting new patients” list aren’t accepting new patients. If you happen to work for one of the doctors I’m calling, let me just say (again, cenobyte will apologise for this later; she’s really not this much of a douche – it’s the season getting to her, and everything’s pissing her off, so please don’t take this too personally. She’s mad at the whole situation, not at you personally) bite me.
*I probably mean Registered Nurses here, as there is a Very Important Distinction between Registered Nurses, Licensed Practical Nurses, and Nurse Sharks.