I am Canadian, so I feel I should hesitate before I complain about our health care system. It is public health care, which means everyone has access to it and if you chop off your hand with a chainsaw, you will get treatment whether or not you have enough money to pay for the surgery. I have heard and read about the health care systems in other parts of the world and they scare me and I am desperately glad that our system is as good as it is. This does not stop me from wishing it was better.
Maybe you chopped off your hand with a chainsaw because you were drunk. Maybe it was an honest-to-goodness accident. Or maybe you chopped your hand off with a chainsaw because you were having dizzy spells and headaches due to an undiagnosed condition - undiagnosed because you were on a 6 month waiting list for tests, or because your doctor half-listened to your description of symptoms and wrote you a prescription for an extra strength pain killer.
You still get the same treatment. You still get your hand re-attached, your blood re-filled, your hospital bed, your jellied dessert. But my frustration with our system is this: there is so little focus on
prevention. We are in a constant state of crisis, of triage, of stop the bleeding. And there are amazing specialists doing fantastic work in this country. But the family doctor, the general practitioner, is almost impossible to find.
This is on my mind because I have in my hands a referral - worth its weight in gold - for a new family doctor. I left my old childhood doctor 15 years ago. Since then I have mainly gone to walk-in clinics, with the exception of my two pregnancies, where I saw maternity doctors. Why? Because there are, on an average day, three family doctors taking new patients within a 30 km radius of my house and you can bet that they have something wrong with them. I have seen several over the years.
One was awesome - but 72 years old and retired after three visits, leaving no replacement and no referrals.
One prescribed birth control pills and Botox for just about every ailment.
Two never called me back.
One screened us, asked if we were "healthy," took a week to decide that yes, he would take us on, as we had no chronic conditions or addictions and then let me know that actually he didn't do immunizations (the only reason I'd bothered to look for a doctor; silly me, I didn't know about Public Health) so I could just take my 8 week old baby back home with me.
Our current family doctor took us on after my second son was born. She didn't want to, but I had a referral from my maternity doctor.
She is not a very good doctor. She is dismissive, disorganized and often uninformed. She gave my 6 month old a sticker to distract him while she administered his vaccination. (I then had to pry it out of his throat while she jabbed the needle in.) She sent my husband on a wild goose chase for a blood test when what he needed was a cheek swab that she could have done in her office. By the time he got back to her office, she had left for the day, so he went to a walk-in clinic. When I asked her about having an IUD inserted, she told me that an IUD wasn't what I wanted and that anyway, they are not very effective.
Lady. I didn't ask your opinion. I know how effective IUDs are and I know that a family doctor can put one in. Not that I would want you to because you would probably put it in my liver by mistake.
For all of the above reasons, and many more, I am reluctant to go see my doctor. If that means I sit around stewing about something for days and then end up at the walk-in clinic because my snot is orange (true story - sinus infection!) so be it. I would rather wait and see than deal with someone who may or may not know what she is talking about.
I have become used to this approach over the years, since family doctors are so hard to find. I have been lucky enough to not need a doctor until now. But my kids are in the picture now and I want there to be someone in our lives, be it doctor or nurse practitioner or naturopath, who can look at them and say, yes, that's a weird rash or hmm, let's get that strange bump checked out or even, hey, you grew three inches since last year, way to go.
I don't look to a doctor to reassure me that my kids are normal. I don't want one to go to every month just to see what's up. But when I do need a doctor, I want that doctor to be someone who wants to be there, who cares about people, who is not stupider than me, who is at least as up to date on birth control as I am.
Here is my vision of health care. It is doctor-focused here, but I would happily see a nurse practitioner if there were any.
First, medical school should be accessible and affordable. People who want to be doctors should be able to be doctors. That way, we end up with doctors who want to be doctors, not doctors who want to be rich / famous / just like X relative who was a doctor.
Second, residency should not break anyone's relationship or spirit. Doctors need families. They need support. They need to be treated as human beings if they are to treat other human beings.
Third, general practice should pay well. Doctors should be able to maintain a practice and a private life and make a living.
If people go in to medicine in order to help people, if family doctors can make enough money to live comfortably and not have to sacrifice everything, money and soul, to be physicians, then I truly believe there would be enough general practitioners to go around. Everyone would have a doctor she trusts. Everyone would have an annual check up. Everyone would know what "normal" was for her, so that when something was abnormal, she would recognize it. Her doctor could say, "Hey, you haven't had headaches like this before. Better not operate any chainsaws for a while, at least until we can run some tests."
That frees up a bed in Emergency. And it also frees up my current doctor to go back to school and figure out what she really wants to do with her life. Cattle hand, perhaps? Or electrician? I think I'll give her a list of suggestions at my last visit.