Health Care Wait Times: Advocacy goes a long way

presentation of diagnostic tomographI am a big supporter of our single-payer medicare system in Canada, warts and all. I am also very reluctant to comment on wait times for health care services in this country because when I wrote about my own experiences eight years ago in Employee Benefit News Canada, the American Association of Retired People posted a clip from the article on their website as an example of what U.S. government-run health care would look like!

But the Canadian Institute of Health Information recently posted the results of the Commonwealth Fund’s 2014 International Health Policy Survey focused on people age 55 and older from 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

And it is no surprise that timely access to primary health care and specialist care remains a persistent challenge in Canada. Canadians wait longer to see their family doctors and specialists and have fewer options for after-hours care outside of emergency departments (EDs) than older people in comparator countries.

For some older Canadians, cost can also be a barrier to accessing some health services that are not universally-covered under provincial public insurance plans. This includes access to prescription drugs (particularly for those under age 65), dental care and home care support services.

While I certainly can’t speak for anyone else, I found these results surprising because my recent experience accessing health care services for spinal stenosis and sciatic pain has been so much better than when I had an even more acute health crisis over five years ago.

But that may be because I now know how to get what I need.

In November 2009 I was totally unable to function because of the meds I was taking which barely took the edge off my back and leg pain. I used both a wheelchair and a walker for about three months, as I could barely stand. I needed an MRI to even get a referral to a surgeon or a hospital pain clinic but I couldn’t get an appointment for an MRI until May 2010.

I decided to go to Hull Quebec and pay for an MRI when I was visiting my daughter in Ottawa during Christmas week. A small amount was reimbursed by OHIP. I subsequently learned that there was an earlier cancellation, but by then I had what I needed. The MRI showed a cyst on my spine.

The wait time for epidural cortisone shots administered by an anesthetist at St. Michael’s Hospital was nine months, but a family friend who worked in the clinic reviewed my scan and I got a call to come in for the first of three shots the same week.

The shots worked, probably in part because the needle ruptured the cyst. I didn’t have any major problems for another four years but when it started to hurt again, I began  physio immediately (paid for by my retiree medical care) and my family doctor referred me to the Toronto Rehabilitation Institute (TRI). By the time my appointment came through at TRI, the physio was working and further care was not required.

But when the pain came back with a vengeance this fall I didn’t waste any time. I got an appointment at TRI within two weeks because I was an existing patient and a midnight appointment for an MRI at Toronto Western two weeks later. Then my doctor at TRI referred me to Toronto Western for cortisone shots but for no apparent reason they never called me with an appointment.

I knew my sister and others had received cortisone shots in private run/publically paid clinics so I went back to my family doctor and asked for another referral. She sent me to the Toronto Poly Clinic close to my home where I got an appointment within a week and the in-house anesthetist immediately give me the first of three shots in my back. I am feeling much better.

 I am not denying that wait times are an unfortunate reality for many Canadians. But if you do your research and don’t take “no” for an answer, you’ll have a better chance of accessing the services you need within a reasonable period of time, particularly in an emergency. Ontario has a Wait Times website where you can find out which hospitals in your area have the shortest waits in the ER, for diagnostic testing or for surgeries but it is not always up-to-date.

Canada may not have a perfect health care system, but universal access is a value I believe is worth preserving. However, like in any other situation, “the squeaky wheel” gets the grease. If you or your family member is unable to advocate on your own behalf, an independent health advocate may be able to help you navigate the system. You can find one in your area using the online AdvoConnection Directory. Health care advocates listed can be retained on an individual fee-for-services basis

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