Medical Meltdown

I had a medical meltdown the other day... not about the corona virus, but about the medical system here in general. This is not an issue in Nova Scotia alone however. We are supposed to have universal health care in Canada. For years we did. Our system is often still excellent when it is responding to a crisis in a person’s health – that is in a reactive way. It is not at all good in a proactive way, at least from my experience.

We do not have a doctor here. It does not seem likely that we ever will have one. We would gladly take a nurse practitioner. It is not to be. We have been on a waiting list for several years now. We have not advanced on that list it appears. If we have, the advancement is not meaningful or significant. Part of the problem is availability of doctors outside the dense urban areas. It was the same in Ontario.

When we left Ontario, we gave up a very good family doctor and connexions with many specialists.  However, for years after our doctor there had retired, we were likewise doctorless and on a waiting list that did not seem to be effective. We found a doctor only through a friend’s referral.

It seems to me the answer is fairly simply, more nurse practitioners, greater use of foreign trained doctors and a requirement that people who receive medical training in Canada, which is to a degree subsidized here, have to spend some time in rural medicine, even if it means assigning them, as clergy are often assigned to rural areas.

Here in Nova Scotia we have a community medical clinic nearby. Once it was a hospital, and quite a good one I understand. It no longer is. It still has an Emergency department, when it is staffed and open. Covid has not helped the situation.

My tribulations in relation to the clinic have a long history. I don’t think I have ever been there without stress resulting from the visit. The procedure is never the same twice. One used to be able to get an appointment to see an on duty medical professional. That stopped some time ago, even before Covid. Once I waited three hours to get a referral, and then just as I though my turn was approaching, a sign went up that only emergencies would be seen for the next three hours. I walked out.

Recently, my partner and I both had confirmed appointments for bloodwork at the clinic ten minutes apart. He had booked the appointments online.   Apparently he had spoken on the phone with some doctor, perhaps a nurse, in the process. This person told him not to worry about a requisition; they would look after it. This is a new procedure, possibly arising from the pandemic limits on personal contact.

We arrived at the clinic and my partner went in first, as his appointment was scheduled for ten minutes before mine. We were told on the emailed confirmation form not to enter the clinic until five minutes before our scheduled time.

As my appointed time approached I went in. I was greeted at the door by security and an inquisitor. She said to me, “What are you here for? “Bloodwork”, I said as I passed her my appointment confirmation form. She did not seem to want it. “Where's your requisition?” she asked. I again offered her the paper that said my appointment for 9:20 that morning was confirmed. She asked, “What doctor ordered the bloodwork?” I said “None. I did!  I don't have a doctor. I have an appointment in four minutes. It was booked online.” She said, “Go to the next wicket”.

The next wicket is where one takes a number before sitting down in the waiting room. As I grabbed for the ticket, a woman behind the next screen called out, “Don’t take that! You need a requisition - You'll have to go down to the collaborative practice to get one.” She’d obviously had listened in on the previous conversation.

I went down to the collaborative practice and waited for another several minutes until someone paid attention to my presence! She finally looked up: “Can I help you?” I said, “I need a requisition”. She asked, “For what?” I said “For bloodwork”. “Who's your doctor?” she retorted. I replied, “I don't have one”. She asked, “Do you have an appointment”. “For what?” I said. “To see a doctor about a requisition”, she answered. I said, “No, I have an appointment for bloodwork ten minutes ago. When we booked it online, it did not say I required a requisition.” “Just a minute”, she said with some frustration.

Then a doctor came out and intervened.... He told me to go into his office. The interrogation started again. My blood pressure was rising enough to send a rocket to Venus. “What's it for?” “Why do you need it?” “Who ordered it?” - blah blah blah. If I had a doctor, they would know that I’ve had cancer and am supposed to have my bloodwork taken every year as follow-up.

However, I was fed up. My appointment time had passed anyway and so I stood up. I had been there before for a simple referral and waited more than three hours. I did not want to repeat that. The doctor then said, “Would you like me to start the process for the requisition?”  

I sighed, and said: “No, I am tired of this bloody system” and I walked out.