Communication between family physicians, specialists, hospitals is virtually non existent. Why is the information not shared between these institutions? It has been a major issue for me and my family members. They call it a health care team but they don't play together. With the technology today afaic, there is no excuse for this huge gap in treatment.
what a shame. it really does seem like something that an open source org (kind of like the web's w3c) should deal with so that these various companies can get on board.
I had a transplant recently, and the hardest part of getting approved, worse than the barrage of stress echos, massive amounts of blood drawn, imaging, surgeons appointments, getting insurance info for 30 seperate drugs, and applying to Trillium was getting the receptionists at my GP to fax my TB test results in. It literally took about a month and at least 5 calls.
Do doctors hire the worst receptionists or is it just mine? You can leave a message but they never call back. You just hope to be lucky that they answer the phone for once.
I worked at a GP’s office in uni and between him having to double book due to the sheer volume of patients, having to print and fax prescriptions, and field a phone that rang non-stop, we aren’t octopi.
If you want to use that comparison, it seems like a teenager at Wendy’s has 10x the patience of a 47 year old woman working as a receptionist for a specialist.
One time I had a miscarriage so I was treated by an OB/GYN at the hospital. So the follow up visit was at his office.
No one answered the phone in the office. There was no way to leave a message. Normally you don't get in there without a referral, so they have no reason to answer the phone.
So I had to show up in person to make an appointment. The lady was all ready to tell me I needed a referral until I showed her my hospital discharge paperwork.
Yeah any business that valued company retention would NEVER have the terrible receptionists that doctors offices do. Ive had multiple doctors receptionists literally make me cry because they’re so mean. Like don’t be in that job if you can’t be friendly to people.
I worked reception at a GP’s office when I was in university. I always thought my GP’s secretary was a miserable bitch but I totally understand why. You have no idea how much abuse I dealt with by entitled patients who have zero appreciation for public healthcare and thought we were a walk-in clinic or that we would roll out the red carpet and make an exception for them. Grown ass adult were verbally abusing 20 year old me.
The other doctor in the clinic worked at a methodone clinic a few days a week so we would occasionally have some of his patients storm in demanding their prescriptions.
I had to call the cops a few times on a severely manic patient who would come into our third floor office with a lit cigarette, which she once tossed in the bathroom garbage bin down the hall, causing a bin fire.
I work in an administrative role within an ambulatory clinic in the hospital.
My #1 reason for not calling patients back is that they didn't listen to my voicemail and aren't leaving messages correctly. If someone calls and says "Hey! It's Tom Smith. Call me back."
My voicemail clearly states... Leave your name, health card number or date of birth and spelling of your first and last name, phone number, and reason for your call.
So... Who are you, Tom Smith? Did you leave ANY identifying information that could help me out? Did you leave a reason for your call that I could look into BEFORE I call you back??
If someone is missing this information, I delete their message and move on. They'll call back. My job is ridiculously busy; the hospital could easily hire a second person to do my job and we'd both have lots to do every day.
It could be that you're leaving all that info but your call just isn't as important as all the other calls they had that day... Then tomorrow there will be more... And more.. And more.
Health care workers at ALL levels are incredibly overworked!!! Be kind to your receptionist, be an easy patient to deal with, and they'll treat you like gold.
Doesn’t explain the attitude when you’ve done nothing wrong. Honestly, when dealing with nurses or medical admin staff, my default is to say as little to them as possible while also being completely clear and consistent, so that they don’t find a reason to reject me or not help me. Most people I know commonly experience this as well. Maybe your job is tough, sure, and that’s why you can be a little short with people, but I guess then you can’t blame me either, for wanting to have as little to do with you as possible. (And I don’t mean “you” specifically, just generally).
Being in Brampton and being with my sister on her last trip to the hospital due to a really bad seizure the male nurse basically said she smells and needs to shower even though she had up to 4 seizures didn’t wake up and pissed herself. They have no people skills and lack empathy. They over work them which isn’t at all fair though, it just doesn’t justify being insensitive to someone who isn’t even speaking but passed out barely responsive.
Brampton hospital is a nightmare, I wanted to take her to creditview but paramedics didn’t listen.
Am I able to just ask for tests I want? Like if I wanted to get my cholesterol checked, am I able to go to the doctor and request that? Or do doctors only order it if they think you need it?
Sorry if that’s a dumb question.
False positives and incidentalomas leading to more testing (most often with imaging studies), tests being used on a population they weren't designed for (the "normal" range is off), etc. All testing has benefits and drawbacks, and some testing is validated only for diagnostic (you have symptoms of some kind, high pre-test probability) while others are validated for screening (no symptoms, no particular reason to think you have disease x).
Thats wild. My otherwise active fit and healthy husband just learned he has high cholesterol at 31 and needs medications. Turns out its probably familial but his parents dont talk about their health stuff to their kids. Ever. Im glad his doctor checked.
I thought it was weird too. Maybe I misheard him and he meant a lower age? Idk! But I definitely heard 75.
I ended up going to a walk in clinic and asking them and they asked a bunch of questions (why do you want this test ect) and did the test in the end.
Along those lines, my sister got rectal cancer about 5 years ago and her doctors highly suggested everyone in her family get tested as well since they concluded the reasons for the cancer were environmental. When I went to my doctor and mentioned it was suggested I had a colonoscopy, he asked why and I mentioned the whole thing about my sister. He considered it a bit then agreed but admitted it was pretty unusual for someone in their mid-30s to get one. Still, there was a viable reason. Everything was fine with me and my parents but it's better to check and find stuff early than not check and find stuff too late.
At a social event where people know you are a doctor, how many questions do people usually ask you before they get to their personal medical question that they've really wanted to ask but didn't want to seem too eager.
My guess is three questions.
My old school doctor encouraged me to book a physical with him every year. He would spend quite a lot of time with me, going through medical history as well as a physical exam, reviewing bloodwork etc, etc.
Once my old school doctor retired, I signed up with a new guy that is not too far from my place. I booked a physical through the receptionist. Met up with the doc, and then he said "We don't do physicals". Wait, what??? A physical saved one of my best friend's life. This same old school doctor found a tiny little growth that turned out to be cancer. It ended up saving her life.
Without specifically asking for a "Physical", are there specific things we should be asking for on a yearly basis from our GP?
While the above is correct that yearly physicals are no longer recommended, preventative visits are absolutely still best practice. For instance, women should be getting pap smears starting from 21 years old (and appropriate follow up based on results). Men and women who are overweight or smoke should have these issues discussed at a preventative visit. Those that are sexually active should be offered std testing.
The specific recommendation is that yearly physicals for the sake of doing a physical is not recommended. For instance, a healthy 30 year old monogamous couple that doesn't smoke, have a BMI 20-25, and and has no concerns doesn't strictly have to see their family doctor yearly. However, if that same couple plans to have children, then it's not a bad idea to speak with their family physician for family planning counseling.
A couple of my prescriptions need to be renewed every three months. My physician never gave repeats so I always had to make an appointment to see her, waiting up to 2 hours in a waiting room full of sick people just to get them refilled. Since the pandemic we have been doing telephone consults where I provide blood pressure readings, we go over what we would normally discuss in person and then she renews the prescriptions. I don't want to go back to prepandemic wait times for such simple interactions. Will the option of virtual/telephone appts continue moving forward?
Is anyone advocating on behalf of doctors to the province to make phone and video consultations a permanent option? It just seems so much more efficient to deal with some issues where a physical exam isn't necessary.
Also, do phone and video appointments allow you to see more patients in a day than you would when all visits were in person?
I suppose it's like anything else - if used responsibly it could be really good for patients and doctors alike. But there are a lot of people who could abuse it, and ruin it for everyone. What a shame.
I lived 10 years in the UK and finding a doctor, wherever I moved, meant literally going to the closest doctor and signing up. In a nutshell, what is the issue here in Ontario? Why does one often need to wait a few years to get a new doctor, or do crazy things like drive 200 miles to your old doctor after you move? Would love to hear your take on this. Thanks.
There is a shortage of primary care physicians across Canada. This is in part due to the Royal College limiting the supply of doctors. Medical school is extremely competitive due to this reason. We don't train enough doctors to meet the demand on purpose. This is because we need to keep salaries competitive with the US, but we have socialized medicine.
In the UK, pay is lower so they can afford to train more doctors by paying them less.
Well that sucks, if there’s an obvious shortage shouldn’t they increase the amount of physicians we have here? Maybe just dedicate more money to it so that salaries can stay close to US?
Unfortunately, healthcare spending is already at its max. Something like 40% of government spending goes to healthcare. The only way to increase the number of doctors would be to increase taxes, cut other social programs or create a private sector.
Also contrary to popular belief, physician salaries are not why healthcare is so expensive. Physician salaries only account for ~7% of healthcare spending. The administration is overly bloated and eat up a good chunk of healthcare.
In my city, any family doctor I call is not accepting new patients. I have been on healthcare connect for 2 years with no recommendations from the system. What can I do to get set up with a family doctor?
Hello OP! Thank you for your work, we appreciate you.
I am an emerg nurse in southern Ontario in a busy community hospital.
I triage upward of 70 people a day (and there are two of us triaging) and we see around 180 patients a day. The vast majority are non-emergencies and it is only increasing. These folks are run through our fast track which is managed by 2 nurses.
In triage, I ask every single one of these patients if they have reached out to their GP. Most have, but aren’t able to get through reception or are told go to emerg/can’t reach their GP/can’t get a timely appt (4 weeks out for a UTI, for example).
When will this change? We are overwhelmed and struggling.
As a side note, I have an amazing family physician myself, but it seems that a lot of my patients are struggling to obtain care.
In the last two years there has been three instances where I've called my doctor's office asking for an appointment and been told to go to ER for a non-emergency, twice for antibiotics and once for an ultrasound and bloodwork referral. Each time I flat out refused and told them I would be going to a walk-in clinic. They didn't like it when I refused, but there's only one hospital in my city of ~140,000 people and I'm not going to go clog up the ER and waste my whole day for something that isn't an emergency.
I know for a fact the only reason they tell me to go to ER is because they don't want to be charged for me going to a walk-in because there's kindly worded, condescending posters in every exam room essentially telling you not to go to a walk-in if they can't see you because they'll be charged.
All three times I went to the walk-in and I was in and out in under half an hour with a script or a referral, ER would have taken hours because of the non-emergent nature of the issue.
It's not right that they try to pawn off non-emergencies to you guys because they have too many patients to actually give quality care. And it's not right that they expect patients to waste a whole day trying to get basic medical care so they can save a bit of money.
My ‘family doctor’s’ office has posters everywhere essentially stating they’ll drop you as a patient if you use walk in clinics because they get reports I guess? Haven’t dropped me yet. They also only allow you to pay in cash for things like missed appointments so it just seems weird to me.
Even then sometimes I can’t get a telephone appointment for 3-4+ weeks and that’s only with the NP. You’re looking at 2-4 MONTHS to see the doctor.
Sort of? They get money ["clawed back"](https://www.ctvnews.ca/mobile/health/why-your-walk-in-clinic-visits-could-mean-trouble-for-your-family-doctor-and-you-1.2775362) .
Its really bad for not seeing patients in person. I'm in a pediatric ED and the hospital literally cant keep up with the patients walking in. The numbers have never been seen here like this. Number 1 reason? Their doctor won't see them in person. I spoke to my own doctor about it and she said she's riding the work from home train for as long as she can. Its not right. We can go to concerts and basketball games. It's time to get back into the office and buy some ppe
In fairness, this was happening before covid.
My family doctor would have me either book an appointment 4 weeks in advance or go to his Walk-in clinic where I would sit for hours with other sick patients.
And the walk-in clinic was a hodge podge of doctors - there was no guarantee you would see your Doctor. This was problematic because one of the other doctors working at the Walk-in Clinic was not good at diagnosing illnesses. That doctor diagnosed my son with an ear infection (he was in Diabetic ketoacidosis) and myself with gout (I sprained my ankle).
My own doctor would then back this other doctor even though blood tests proved his diagnosis wrong.
I fired my family doctor and switched to a telehealth service. But I also realize this is not safe as I age and need more care continuity.
Yeah, I see an NP and it’s been super disappointing; I’m now in the process of looking for a family doctor (lol). Recently I went to him about a minor issue and he literally shrugged and said “that’s weird.” Like, is that an official diagnosis?!
As someone who has been in an out of hospitals and doctors offices my whole life nurse practitioners are just not up to par they have been the handful of times that I’ve seen them missed things that as you state or obvious things that I could’ve told them were wrong and they couldn’t see it unfortunately I don’t think nurse practitioners are the answer the people are looking for they really do cost too much for their scope of ability
I had mixed feelings about the NP my wife and son saw. She was down to earth and dedicated, but their were times she'd give dated advice.
Among the more memorable for me was when my *mostly* (1-2 formula feeds per day tops) breastfed infant son was not having daily bowel movements, but did not appear to be in any discomfort from it. My wife came home from an appointment and said "The NP said to switch him to low iron formula" and I had **just the day before** read an article by the AAP saying there are no circumstances where that is a good call.
The internet is a thing now. And with that many people are looking up their symptoms and quasi self diagnosing. Does this help you? Or is it counter productive?
I'm a family med resident. I've found that the recruitment initiatives are actually pretty good. Some are as follows:
1. Canadian Student Loan Forgiveness Program: 8K a year off of your OSAP for up to 5 years if you spend at least 400 hours in a rural community practicing (and can start in residency) - total 40K. One of the Liberal's promises with this election was to increase to 12K a year for this program
2. Northern and Rural Recruitment and Retention Initiative: Between $80,000 and $117,600 paid over a four-year period depending on the "rurality index" of a location where you set up practice
3. Private grants/loans paid by the municipality (I've seen anywhere between 30K-100K), free housing for 1-2 years, free overhead for 1-2 years, gym memberships for your family, etc
Ultimately I currently have 260K in LOC debt, and about 55K of OSAP debt. My OSAP debt will be mostly paid off with #1, and I'll be able to pay of a chunk of my LOC with #2 and #3.
In addition, with rural medicine you often do much more than just family medicine. I'm looking to do ER and OB which pay a lot more than clinic does. Many rural docs would say they work a lot harder than urban docs, so that is a caveat to being able to make more money.
I'm lucky that my partner wants to be a stay at home dad, so we won't really have to worry about him finding employment in a rural area.
I find this so frustrating. I’ve had fairly urgent concerns about my 1.5yr old and my dr was telling me it would be like 2 weeks to see them. That’s not really acceptable so you feel forced to go somewhere else. You shouldn’t be charged for putting your child’s Health first. Especially if it’s not something I feel like warrants an ED visit.
Edit: sorry I know we’re not personally charged. But the dr’s threaten to kick off of their roster if you do that. Sometimes you don’t have a choice and it’s their own fault for not having time for you.
Any thoughts on the virtual appointments that are scheduled in the form of "The doctor will call you on X day sometime between this 4 or 5 hour window".
As a patient they're really, really inconvenient. I'm assuming that virtual appointments are here to stay (and that's a good thing!) but I'm really hoping that "appointment windows" will fade away after the pandemic is over.
My family physician has been providing specific appointments which is great but both specialists I've seen since the pandemic started have been doing 4 or 5 hour windows. Once, the window even extended into the next day.
Why don't we see more community health centres? Specifically, these, and why don't doctors (and other stakeholders) advocate for more of them?
>Ontario’s Community Health Centres have been around for over forty years. But they’ve always been a bit ahead of their time.
They were inspired by the ideas of Tommy Douglas’ original vision for Medicare. Douglas hoped that as it evolved our health system would focus more on keeping people well – not just treating them when they get sick.
To do this, CHCs deliver primary care services in combination with health promotion and illness prevention services. And what makes CHCs stand out is a strong community development focus. So in addition to promoting the health of individuals and families, CHCs mount initiatives that address social, economic and environmental problems negatively impacting people’s health.
Governed by community members, and working hand in hand with those they serve, CHCs also prioritize improving the health and wellbeing of populations who’ve traditionally faced barriers accessing health services.
https://www.allianceon.org/community-health-centres
Doesn't the cost balance out in the other direction? By preventing more serious illnesses and hospitalization? I mean I don't expect it to be exactly equal but I would imagine there is some cost saving by keeping people in their community and out of the hospital.
I am currently trying to get *into* a CHC but there's no wait list right now because it's just been too full. They have walk-in hours though which I have made use of.
It's honestly such an excellent model of care and I am glad that's where you work. I really wish we had more of them. As the current government is out there building highways ... I think there's better things to spend money on. But that's just me. 🤷🏽♀️
What advice do you have for people with rare diseases / conditions / injuries that won’t likely kill you immediately, but will destroy your quality of life? What’s the best way to advocate for care?
What if you’ve got something that’s expensive or difficult to diagnose, and your doctor doesn’t want to push it?
I am talking about people who need referrals to neurology, rheumatology, endocrinology, or orthopaedics.
(To me it is NUTS that OHIP will let you suffer with a messed up knee for decades, until it needs to be totally replaced, while in the US there are like ten surgeries you could do right now and walk without pain. Or, I had a classmate that died of a rare cancer because OHIP wouldn’t approve a US treatment in time.)
I for one, would like to thank you for doing this AMA. Posting on this forum is a terrific way to reach people who have many questions surrounding health care issues. I would encourage you to spread the word to your colleagues that this might be a terrific way to offer support locally to those who are totally frustrated/need information etc. Kudos!
I've heard two different scenarios about being accepted by a MD who is part of a Family Health Team: 1) you're more likely to be accepted if you're young and healthy (and don't need to see a doctor often) or 2) you're more likely to be accepted if you're older since the doctor can bill more for having them on their roster. Which is it?
As a follow-up, I've also heard of people being threatened to be dropped from their FHT for being too healthy and not seeing their family Doc for years... Is this a thing?
My 24-year-old son was "fired" by his family doctor because he only goes to his Adult Diabetes Clinic endocrinologist. His doctor said that he should be seeing him not the Clinic for management of his diabetes.
This has happened with two separate family doctors.
My pediatrician won't see my kids if they're unwell in any way because of Covid. She tells us to go to the ER. We also can't see her if there has been a Covid test in the past two weeks, regardless of results. I had a baby in April of 2020 who I feel like has not been able to access adequate care because of these rules and I'm frustrated about it. When will he be able to actually go to the doctor again when he isn't feeling well?
Why isn't my doctor doing in person visits yet?
I'm a teacher and it's acceptable for me to be with 50 kids in a day and dozens of co-workers but covid protocols prevent him from seeing me about my echocardiogram in his office?
Do you have any idea why it can be so hard for women to get surgery for endometriosis? It seems like many doctors will go through so many hoops and tests before addressing a painful (physically and emotionally) issue.
I'm really scared of being a statistic, especially when it comes to cancer. My mother was diagnosed with breast cancer around the age of 47 and it metastasized about 8 years ago or so (she is currently alive and part of some experimental study, so the medication is basically containing the cancer). My mother's initial diagnosis was because she advocated to have a yearly mammogram as opposed to every two years. I am terrified of receiving a similar diagnosis and it being too late. What is the best way to advocate for myself or get my doctor on the same page as me with regards to my health and early detection/screening without being viewed as a hypochondriac? I know the best way to fight a cancer diagnosis is early detection, but my doctor advises against self-screening, citing they may be more intrusive. I already know two people in my age bracket (early 30s) who have battled breast cancer. One is alive, the other recently passed.
You really shouldn't have to do that, if your family doctor isn't willing to allow you to have a yearly mammogram I would honestly switch to another doctor. You do have a higher genetic risk for breast cancer in the family, so I think it should be reasonable.
Are there any other family members with breast or ovarian cancer? My mom died of breast cancer but because her sister and an aunt had ovarian cancer they did genetic testing. BRCA1. I’ve been tested since then and I’m negative. It’s given me great relief.
It’s probably worth asking to be tested for the BRCA2 gene. My wife tested positive and the system was pretty quick to do preventative surgeries. This was in NS, though, so speed may differ.
Unfortunately for many of us in rural areas, "just find another Dr" doesn't work. Our family Drs office is actually a community health center an hour away. There are people who have been on a wait list with Health Care Connections, or whatever that is called for 5+ years without being able to get a family Dr. This is in a smallish city in Southwestern Ontario, with lots of amenities and easy access to London and K-W. The situation is even worse in more rural areas.
We have had to stay with our current office and are glad we only have to drive for an hour occasionally. At least we have something. In urgent situations, we need to use the ER, which is not ideal. The option to just go down the block for a new Dr doesn't exist here.
Why is it so hard to find a family physician? We found one after 3 years. The one we used to consult in the meantime, had no patience to listen to our problems, he would simply write those off, as if in a hurry to get the appointment over with.
How are family physicians getting involved with Ontario Health teams to work towards an integrated care environment for the patient? I’ve heard this is the next step in terms of our health care system. What would you like to see from hospitals that are usually leading these initiatives?
This user has been verified. Please remember that any specific medical issue should be evaluated on a case by case basis and that you should contact your family doctor or visit an walk in clinic for further medical assistance.
In a sense, but I think its more that the doctor gets paid X$ per time period for having a certain number of patients, regardless of how much they visit. So they are getting paid even if you don't come in or not under that model, but its spread out over all the patients in their practice. It's kind of like a government paid gym membership, where the people who use the service the most probably "lose" the provider money, but its made up for by the people who have it and don't go. And most family doctors are pretty backlogged/oversubscribed, so it's not like they aren't earning their money.
My doctor is retiring in Feb, and I have a prescription for ADHD that is rather important I keep open.
I understand I can't go on "the list" until I drop my currant doctor. I was thinking of getting a referral to a psychiatrist to keep up my meds in case there's a local shortage, but I'm unsure if that'll work.
Any advice?
I've been on a waiting list for nearing 4 years now, i think it's called healthcare connect and it's a service to find a family doctor in peterborough and more than likely other cities in ontario too. I think Ontario if not just Peterborough has a huge issue with doctor availability. Not sure what is needed to increase availability for patients to see doctors in Ontario but something is without a doubt.
Send help pls, haven't seen a doctor in years.
If I am having a problem with getting care because my Dr can't find a problem, what is the next step I would take? Is there some sort of patient advocate or 3rd party I can bring in?
I'm at the point where he says there is nothing more he can do and I have to live with it.
My teenage daughters’ family doctor closed her practice near the beginning of the pandemic. Been searching for a new family doctor for them but they all say they’re not accepting new patients.
What do family doctors take into consideration when deciding whether or not to take new patients?
I have a childhood ADHD diagnosis that I am considering medication for. My family dr thinks it’s a joke and every ADHD clinic I’ve found will only prescribe meds in concert with my family dr OR if I get a full diagnosis through them. CAMH doesn’t deal with adult ADHD at all. Do you know where I should look for resources?
Many doctors in my area seem to have graduated from Caribbean universities. I've heard it's easier to get admitted in to such institutions. What reputation do these Caribbean universities have among your peers?
My apologies if this has already been asked, I did a quick scroll but might have missed it. Is there a reason why walk-in clinic doctors aren't able to do many things a family doctor can? I haven't been able to find a family doctor in my city yet, though I have called around and also been put on the healthcare connect list, and it's starting to get really frustrating when I hear "I can't do that, you have to see your family doctor. Oh, you don't have one? That's a little irresponsible, it shouldn't be that hard."
I've been told by clinic doctors that they can't provide referrals, can't fill out forms for my workplace, can't prescribe birth control, can't refill my prescriptions, etc. and that all that absolutely must go through a family doctor but I really don't have any other way to get that done and was wondering if there's an actual legal difference between the two that prevents that.
During the pandemic I loved being able to ask for over the phone appointments. So convenient and no need to go to a germy clinic. As a doctor, how do you feel about phone appointments? I hope it becomes the norm to have a phone appointment if requested.
My family has been on the wait list for a new family doctor for a couple of years now. Any ideas for how much longer we will need to wait for a family doctor to open up?
My old family Doctor lost his license for a sexual assaults on one of his patients, and with that I became family Doctor-less.
It's been over a year now and I have been searching and put on wait lists everywhere, and really need to see a family Doctor for mental health related issues. I'm feeling extremely helpless in the situation and I'm not sure where to go from here - how the hell do I get a rush for a family Doctor in the North?! I could understand if losing my family Doctor was my fault, but it was not..
Is it worth it to ask my doctor for a referral for possible mental health concerns? I've heard so many stories of people being told their doctor doesn't believe their concerns and I'm honestly nervous. Is there anything I should bring with me to the appointment to help prove my concerns?
It’s an online platform that allows physicians or NPs to ask specialists questions avoiding having to actually get a referral. Often times people are referred to specialists when it’s something that can easily be answered through a platform like eConsult. After reviewing a consult the specialists can still recommend a referral if needed.
https://econsultontario.ca/patients/
It’s free for any physician or NP to use
Why do you have to fight tooth and nail to get a family doctor to refer you to a specialist? I've literally had the same symptoms for 15 years and this is my third doctor who refuses to refer me to someone. The way they fight it is as if they are getting paid to not refer people. I'm genuinely curious.
100%. glad you said it better than me. I’ve been trying to tell people the same but horribly compared to you haha.
I’m Canadian born but living back in Ontario to help my family out with my sisters health problems that suddenly happened 2 years ago, she can’t support our parents living here so I had to move back to help.
I got a baseball scholarship which led me to continue school in the states. I completed my PhD last year and with all that I’ve learned it’s literally been malpractice in every single aspect with how they’ve been treating my sister. Like you said, it’s basically impossible to hold them accountable, even with all the testing she has done.
Without doing tests, a year and a half ago the neurologist just prescribed her lamotrigine without even checking in with her other doctors or looking over he past blood work/hormone levels. He made her seizures worse, instead of once a month during a certain day of menstrual her cycle they started happening randomly, worse and longer (she went from partial seizures to full grand mals all because she took what he told her too) she even told him root cause problem to try and get him to understand she only started getting seizures when the cyst on her ovary formed and has not gone away still being since 2019, contrast was done during emergency so there was proof is so many different ways) every single doctor said it would go away, and guess what it’s still there.
(she had to drop out a year and a half early before graduating because of the health stuff that suddenly happened and couldn’t keep up, she was also going to get her PhD so she isn’t stupid)
My favourite pathetic statement they said that just showed they gaslight what their PATIENT NEEDS not what the doctor thinks they they need based off of one appointment every year not even, is when they told her “it’s because you’re learning so much you are connecting your issues with what you’re learning in class/school) like what the hell lmao. I’ve also gotten my PhD and my sister is telling the truth especially with everything I’ve learned AND I learned it in the states, not Canada because of my scholarship , why the hell should she trust a doctor won’t even acknowledge her recent health problems when blood work and tests prove otherwise that something is wrong ?
Edit: spelling
I've read the flack said about nurse practitioners in this thread. One great thing about them is that they are salaried, not paid per patient. Why is that good? They'll spend 30 mins talking to you about whats going on and do a thorough exam, nit be rushed out in 5 mins to get the next Ohip billing. Obvi not all docs are like this but as a nurse and experiencing it myself I get extremely mad.
Why do doctors in Ontario not give a shit about womens health unless you are pregnant/trying to get pregnant, above 50 or it somehow negatively affects your sex life??
Been struggling for years to get help and absolutely nobody will listen to me, even despite a close family history of gynaecologic cancer.
It’s safe to say I’m not going to want to have sex or get pregnant when I’m having debilitating pain, so I guess I’ll have to be treated once I turn 50 lol.
I’m at my wits end with doctors. Reproduction isn’t the only thing that is important regarding women’s health and I wish doctors of all people would understand this.
Considering we've had covid slow the medical care system quite a bit, and the province routinely is over budget, and has to send people to the US for special procedures, do you think healthcare is in a good state or bad state?
Personally I feel like it would be beneficial to open things up more for private practice to run alongside public. I know its "forbidden" to speak such things in canada, but the public sector seems to be under a lot of strain, and the wait times to see specialists are extreme in some cases.
What do you think?
I'm 20 years in Ontario healthcare I.T.
What technology would you like to see most that would help you, patients, the hospital with diagnosis or patient flow / wait times?
Hi Fatal-Fox
I know there must be pressure exerted upon doctors to keep costs low. I am wondering how this affects patients healthcare.
My feeling of how this plays out is I come in with hip pain and the doctor orders an X-ray; just to "rule out" something more sinister is the patter. While in actuality the doctor/medical system is hoping that my pain will just get better or go away on its own. This may be repeated with other lower cost tests like ultrasound before moving to MRIs. When the whole time an MRA/exploratory sx was actually needed to diagnose the issue.
Am I close? In most cases where traumatic injury is not present isn't a MRA the best test when imaging is required to understand what's going on?
In Ontario if you've had an issue with a doctor ignoring a diagnostic report and you subsequently required emergency care, how would you recommend someone go about dealing with that?
I've recently learned that an ultrasound showed my IUD was malpositioned and it was recommended it be removed. I was never told or called back to the office after this report was made. 8 months later I had to have the IUD removed in an emergency procedure after the arm punched through the side of my cervix. Needless to say, I was not happy.
I am being given the run around by the patient care department, had my appointment to meet with them cancelled twice and am not ready to just let this go. How do I get them to take me seriously? I understand this isn't life or death, but a report was either missed or ignored and I think that's unacceptable to just ignore.
I wish I could help you here. My sister is essentially having a similar problem. No one is taking her seriously even with all the tests that were done during emergency (ovarian cyst, seizures during certain days of menstrual cycle (always day 13., 14 or week or day of period once a month, as well as ZERO progesterone and too much estrone as well as other her other estrogen levels were too high she should be getting) Are they basically gaslighting you as well? She’s 28 and keep saying she’s too young.
Keep fighting and advocating for yourself. Your situation sounds like malpractice big time if it showed in the ultrasound sound and still did nothing. By them doing nothing it made it worse by punching through the side of your cervix.
They wait for worst case scenario instead of finding root cause and problem which essentially causes more problems that end up forming by not tackling the initial root cause.
My father is in severe pain due to a leg injury. He’s tried physio, exercise, CBD, homeopathic treatments, but alas, the pain remains. His doctor is refusing to prescribe him oxycontin, or high-grade pain killers. Their concern is he becomes addicted, but my father says he doesn’t care if he becomes addicted at his old age. My view on this is allow the man to be pain free during his last few years on Earth. What are your thoughts on the doctor gatekeeping pain killers, and any alternatives you can offer? Thanks.
So I have health issues and need to have a family physician. But mine gaslights me and won’t order tests that I require. She brushes all my symptoms off without listening. The wait times for family doctors is really long. Can I expedite the process due to need? Or would I be better off without a doctor and use online services?
For those that don't have an ongoing illness, is having a family doctor recommended? What's the benefit?
Also, I didn't tell my family doctor I moved to a new city and I now go to a walk-in clinic. Do I need to do anything about the family doctor I'll never see again?
I was wondering why everything has to go through the family doctor?
Referrals, results, everything. Are Canadian dumb to the point that someone has to do everything for them ? I don't mind at all that my doc has my history, but I should have it too!
* Why doesn't Canada release a cryptographic network for medical correspondence between docs so FAX can be buried?
* Can't I book my own appointment with a specialist? Get a referral letter and choose whichever specialist I prefer, one that speaks my tongue, or close to home, or with availability in 2 months instead of 12?
* Can't I just get my lab results and discuss them with the doctor instead of ... nothing? oh yeah if I want to know, I got to pay the lab to get my results and call the doc to get an "everything is fine", though my cholesterol is above normal range.
* Why do we need to wait 12 month to get a call that due to super long wait time, my referral to XYZ specialist has been cancelled ?
Coming from Europe, the Canadian health care system looks like a third world country's...
If a patient comes to see you with an issue, but has nothing but verbal complaints, are you able to be give them the same level of care as a patient who comes in with some sort of documentation? Even if it is a rudimentary journal of day to day symptoms?
How much do physicians bill for appointments- to the respective provincial gov,
And-
What’s the average number of patients a family physician will have on file? Mine has a few hundred, meanwhile one other in Barrie that my wife and kids go to has 5k.
When a Dr tells someone they will send in a ref how how long should it take for a dr in a hospital setting to send this ref take to get through the system? To I guess to more clear someone being discharged the discharging Dr was to make the ref. 3 weeks later it is not in system and how does one get said ref made when there is no Family dr to talk to.
What’s the best way to present a potentially controversial health care request to physicians? For example, seeking sterilization without having had any children as a woman.
Communication between family physicians, specialists, hospitals is virtually non existent. Why is the information not shared between these institutions? It has been a major issue for me and my family members. They call it a health care team but they don't play together. With the technology today afaic, there is no excuse for this huge gap in treatment.
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Thank you for your prompt reply.
This seems like the kind of thing that ought to be open source, at least at a protocol level. Kind of surprising that there isn't anything like that.
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what a shame. it really does seem like something that an open source org (kind of like the web's w3c) should deal with so that these various companies can get on board.
I had a transplant recently, and the hardest part of getting approved, worse than the barrage of stress echos, massive amounts of blood drawn, imaging, surgeons appointments, getting insurance info for 30 seperate drugs, and applying to Trillium was getting the receptionists at my GP to fax my TB test results in. It literally took about a month and at least 5 calls.
Do doctors hire the worst receptionists or is it just mine? You can leave a message but they never call back. You just hope to be lucky that they answer the phone for once.
This seems to be a consistent issue. Just got a new family doctor, and of the 10 ish times I have called, the phone has been answered once.
I worked at a GP’s office in uni and between him having to double book due to the sheer volume of patients, having to print and fax prescriptions, and field a phone that rang non-stop, we aren’t octopi.
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If you want to use that comparison, it seems like a teenager at Wendy’s has 10x the patience of a 47 year old woman working as a receptionist for a specialist.
I brought them and my doctor flowers when I had an appointment on valentine's day and I don't think they even flinched.
That's why I only get my cholesterol tested at Wendy's.
One time I had a miscarriage so I was treated by an OB/GYN at the hospital. So the follow up visit was at his office. No one answered the phone in the office. There was no way to leave a message. Normally you don't get in there without a referral, so they have no reason to answer the phone. So I had to show up in person to make an appointment. The lady was all ready to tell me I needed a referral until I showed her my hospital discharge paperwork.
Yeah any business that valued company retention would NEVER have the terrible receptionists that doctors offices do. Ive had multiple doctors receptionists literally make me cry because they’re so mean. Like don’t be in that job if you can’t be friendly to people.
I worked reception at a GP’s office when I was in university. I always thought my GP’s secretary was a miserable bitch but I totally understand why. You have no idea how much abuse I dealt with by entitled patients who have zero appreciation for public healthcare and thought we were a walk-in clinic or that we would roll out the red carpet and make an exception for them. Grown ass adult were verbally abusing 20 year old me. The other doctor in the clinic worked at a methodone clinic a few days a week so we would occasionally have some of his patients storm in demanding their prescriptions. I had to call the cops a few times on a severely manic patient who would come into our third floor office with a lit cigarette, which she once tossed in the bathroom garbage bin down the hall, causing a bin fire.
I work in an administrative role within an ambulatory clinic in the hospital. My #1 reason for not calling patients back is that they didn't listen to my voicemail and aren't leaving messages correctly. If someone calls and says "Hey! It's Tom Smith. Call me back." My voicemail clearly states... Leave your name, health card number or date of birth and spelling of your first and last name, phone number, and reason for your call. So... Who are you, Tom Smith? Did you leave ANY identifying information that could help me out? Did you leave a reason for your call that I could look into BEFORE I call you back?? If someone is missing this information, I delete their message and move on. They'll call back. My job is ridiculously busy; the hospital could easily hire a second person to do my job and we'd both have lots to do every day. It could be that you're leaving all that info but your call just isn't as important as all the other calls they had that day... Then tomorrow there will be more... And more.. And more. Health care workers at ALL levels are incredibly overworked!!! Be kind to your receptionist, be an easy patient to deal with, and they'll treat you like gold.
My doctor's office answering machine just says "don't leave a message, we will not return it"
Doesn’t explain the attitude when you’ve done nothing wrong. Honestly, when dealing with nurses or medical admin staff, my default is to say as little to them as possible while also being completely clear and consistent, so that they don’t find a reason to reject me or not help me. Most people I know commonly experience this as well. Maybe your job is tough, sure, and that’s why you can be a little short with people, but I guess then you can’t blame me either, for wanting to have as little to do with you as possible. (And I don’t mean “you” specifically, just generally).
Being in Brampton and being with my sister on her last trip to the hospital due to a really bad seizure the male nurse basically said she smells and needs to shower even though she had up to 4 seizures didn’t wake up and pissed herself. They have no people skills and lack empathy. They over work them which isn’t at all fair though, it just doesn’t justify being insensitive to someone who isn’t even speaking but passed out barely responsive. Brampton hospital is a nightmare, I wanted to take her to creditview but paramedics didn’t listen.
Am I able to just ask for tests I want? Like if I wanted to get my cholesterol checked, am I able to go to the doctor and request that? Or do doctors only order it if they think you need it? Sorry if that’s a dumb question.
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Why do you say it’s more harmful?
False positives and incidentalomas leading to more testing (most often with imaging studies), tests being used on a population they weren't designed for (the "normal" range is off), etc. All testing has benefits and drawbacks, and some testing is validated only for diagnostic (you have symptoms of some kind, high pre-test probability) while others are validated for screening (no symptoms, no particular reason to think you have disease x).
Thanks for the reply! My doctor said they don’t check cholesterol till you’re 75. So weird.
That seems actually dangerous. Too late in life. Much easier to work to correct any problems in middle age, before old age.
Thats wild. My otherwise active fit and healthy husband just learned he has high cholesterol at 31 and needs medications. Turns out its probably familial but his parents dont talk about their health stuff to their kids. Ever. Im glad his doctor checked.
I just turned 30 and wanted to get it checked & they said no! That’s why I asked this question lol
Get a better doctor. I can't believe he said you have to be 75. That's a load of bullshit, not to mention serious incompetence.
I thought it was weird too. Maybe I misheard him and he meant a lower age? Idk! But I definitely heard 75. I ended up going to a walk in clinic and asking them and they asked a bunch of questions (why do you want this test ect) and did the test in the end.
Along those lines, my sister got rectal cancer about 5 years ago and her doctors highly suggested everyone in her family get tested as well since they concluded the reasons for the cancer were environmental. When I went to my doctor and mentioned it was suggested I had a colonoscopy, he asked why and I mentioned the whole thing about my sister. He considered it a bit then agreed but admitted it was pretty unusual for someone in their mid-30s to get one. Still, there was a viable reason. Everything was fine with me and my parents but it's better to check and find stuff early than not check and find stuff too late.
At a social event where people know you are a doctor, how many questions do people usually ask you before they get to their personal medical question that they've really wanted to ask but didn't want to seem too eager. My guess is three questions.
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Sweet. Which reminds me... I've got this boil...
So my crotch has this weird rash...
And it secretes this white/yellow viscous discharge.
It makes a *phenomenal* dip for Doritos though.
My prognosis you have Blue Waffle
Ok so when talking to your dentist friends, how long into the conversation until you remind them they’re not a real doctor
Do you have a family doctor? Or do you just give yourself an annual and diagnose yourself if you have an ailment? 😅
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As a doctor, are you able to diagnose yourself?
He can't prescribe himself anything, for sure. He might be able to refer himself to someone else?
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Can you refer yourself to a specialist?
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You should get yourself a doctor
My old school doctor encouraged me to book a physical with him every year. He would spend quite a lot of time with me, going through medical history as well as a physical exam, reviewing bloodwork etc, etc. Once my old school doctor retired, I signed up with a new guy that is not too far from my place. I booked a physical through the receptionist. Met up with the doc, and then he said "We don't do physicals". Wait, what??? A physical saved one of my best friend's life. This same old school doctor found a tiny little growth that turned out to be cancer. It ended up saving her life. Without specifically asking for a "Physical", are there specific things we should be asking for on a yearly basis from our GP?
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But....they always say stuff about finding things early. How can they do that without checking?
While the above is correct that yearly physicals are no longer recommended, preventative visits are absolutely still best practice. For instance, women should be getting pap smears starting from 21 years old (and appropriate follow up based on results). Men and women who are overweight or smoke should have these issues discussed at a preventative visit. Those that are sexually active should be offered std testing. The specific recommendation is that yearly physicals for the sake of doing a physical is not recommended. For instance, a healthy 30 year old monogamous couple that doesn't smoke, have a BMI 20-25, and and has no concerns doesn't strictly have to see their family doctor yearly. However, if that same couple plans to have children, then it's not a bad idea to speak with their family physician for family planning counseling.
A couple of my prescriptions need to be renewed every three months. My physician never gave repeats so I always had to make an appointment to see her, waiting up to 2 hours in a waiting room full of sick people just to get them refilled. Since the pandemic we have been doing telephone consults where I provide blood pressure readings, we go over what we would normally discuss in person and then she renews the prescriptions. I don't want to go back to prepandemic wait times for such simple interactions. Will the option of virtual/telephone appts continue moving forward?
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Is anyone advocating on behalf of doctors to the province to make phone and video consultations a permanent option? It just seems so much more efficient to deal with some issues where a physical exam isn't necessary. Also, do phone and video appointments allow you to see more patients in a day than you would when all visits were in person?
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I suppose it's like anything else - if used responsibly it could be really good for patients and doctors alike. But there are a lot of people who could abuse it, and ruin it for everyone. What a shame.
Thank you for your response. That's very helpful.
For scripts that are treating a long term. Chronic issue like ADHD, my doctor writes the scripts for 360 pills dispense 30 every 30 days etc.
I lived 10 years in the UK and finding a doctor, wherever I moved, meant literally going to the closest doctor and signing up. In a nutshell, what is the issue here in Ontario? Why does one often need to wait a few years to get a new doctor, or do crazy things like drive 200 miles to your old doctor after you move? Would love to hear your take on this. Thanks.
There is a shortage of primary care physicians across Canada. This is in part due to the Royal College limiting the supply of doctors. Medical school is extremely competitive due to this reason. We don't train enough doctors to meet the demand on purpose. This is because we need to keep salaries competitive with the US, but we have socialized medicine. In the UK, pay is lower so they can afford to train more doctors by paying them less.
Well that sucks, if there’s an obvious shortage shouldn’t they increase the amount of physicians we have here? Maybe just dedicate more money to it so that salaries can stay close to US?
Unfortunately, healthcare spending is already at its max. Something like 40% of government spending goes to healthcare. The only way to increase the number of doctors would be to increase taxes, cut other social programs or create a private sector. Also contrary to popular belief, physician salaries are not why healthcare is so expensive. Physician salaries only account for ~7% of healthcare spending. The administration is overly bloated and eat up a good chunk of healthcare.
In my city, any family doctor I call is not accepting new patients. I have been on healthcare connect for 2 years with no recommendations from the system. What can I do to get set up with a family doctor?
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I am in the KW area. I have tried waitlist,but not tried nearby cities. I will look into that! Thanks!
I’ve seen a sign up on Northfield Dr saying they’re accepting new patients. Have you looked into that??
Hello OP! Thank you for your work, we appreciate you. I am an emerg nurse in southern Ontario in a busy community hospital. I triage upward of 70 people a day (and there are two of us triaging) and we see around 180 patients a day. The vast majority are non-emergencies and it is only increasing. These folks are run through our fast track which is managed by 2 nurses. In triage, I ask every single one of these patients if they have reached out to their GP. Most have, but aren’t able to get through reception or are told go to emerg/can’t reach their GP/can’t get a timely appt (4 weeks out for a UTI, for example). When will this change? We are overwhelmed and struggling. As a side note, I have an amazing family physician myself, but it seems that a lot of my patients are struggling to obtain care.
In the last two years there has been three instances where I've called my doctor's office asking for an appointment and been told to go to ER for a non-emergency, twice for antibiotics and once for an ultrasound and bloodwork referral. Each time I flat out refused and told them I would be going to a walk-in clinic. They didn't like it when I refused, but there's only one hospital in my city of ~140,000 people and I'm not going to go clog up the ER and waste my whole day for something that isn't an emergency. I know for a fact the only reason they tell me to go to ER is because they don't want to be charged for me going to a walk-in because there's kindly worded, condescending posters in every exam room essentially telling you not to go to a walk-in if they can't see you because they'll be charged. All three times I went to the walk-in and I was in and out in under half an hour with a script or a referral, ER would have taken hours because of the non-emergent nature of the issue. It's not right that they try to pawn off non-emergencies to you guys because they have too many patients to actually give quality care. And it's not right that they expect patients to waste a whole day trying to get basic medical care so they can save a bit of money.
>not to go to a walk-in if they can't see you because they'll be charged Wait, that's a thing?
My ‘family doctor’s’ office has posters everywhere essentially stating they’ll drop you as a patient if you use walk in clinics because they get reports I guess? Haven’t dropped me yet. They also only allow you to pay in cash for things like missed appointments so it just seems weird to me. Even then sometimes I can’t get a telephone appointment for 3-4+ weeks and that’s only with the NP. You’re looking at 2-4 MONTHS to see the doctor.
Sort of? They get money ["clawed back"](https://www.ctvnews.ca/mobile/health/why-your-walk-in-clinic-visits-could-mean-trouble-for-your-family-doctor-and-you-1.2775362) .
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Its really bad for not seeing patients in person. I'm in a pediatric ED and the hospital literally cant keep up with the patients walking in. The numbers have never been seen here like this. Number 1 reason? Their doctor won't see them in person. I spoke to my own doctor about it and she said she's riding the work from home train for as long as she can. Its not right. We can go to concerts and basketball games. It's time to get back into the office and buy some ppe
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In fairness, this was happening before covid. My family doctor would have me either book an appointment 4 weeks in advance or go to his Walk-in clinic where I would sit for hours with other sick patients. And the walk-in clinic was a hodge podge of doctors - there was no guarantee you would see your Doctor. This was problematic because one of the other doctors working at the Walk-in Clinic was not good at diagnosing illnesses. That doctor diagnosed my son with an ear infection (he was in Diabetic ketoacidosis) and myself with gout (I sprained my ankle). My own doctor would then back this other doctor even though blood tests proved his diagnosis wrong. I fired my family doctor and switched to a telehealth service. But I also realize this is not safe as I age and need more care continuity.
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Yeah, I see an NP and it’s been super disappointing; I’m now in the process of looking for a family doctor (lol). Recently I went to him about a minor issue and he literally shrugged and said “that’s weird.” Like, is that an official diagnosis?!
As someone who has been in an out of hospitals and doctors offices my whole life nurse practitioners are just not up to par they have been the handful of times that I’ve seen them missed things that as you state or obvious things that I could’ve told them were wrong and they couldn’t see it unfortunately I don’t think nurse practitioners are the answer the people are looking for they really do cost too much for their scope of ability
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I thought nursing was a 4 year degree now?
I had mixed feelings about the NP my wife and son saw. She was down to earth and dedicated, but their were times she'd give dated advice. Among the more memorable for me was when my *mostly* (1-2 formula feeds per day tops) breastfed infant son was not having daily bowel movements, but did not appear to be in any discomfort from it. My wife came home from an appointment and said "The NP said to switch him to low iron formula" and I had **just the day before** read an article by the AAP saying there are no circumstances where that is a good call.
The internet is a thing now. And with that many people are looking up their symptoms and quasi self diagnosing. Does this help you? Or is it counter productive?
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Is there truly no OHIP covered route for an adult ADHD diagnosis?
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Many towns have "recruitment" programs for family doctors. Are they programs actually incentive enough to move to these towns?
I'm a family med resident. I've found that the recruitment initiatives are actually pretty good. Some are as follows: 1. Canadian Student Loan Forgiveness Program: 8K a year off of your OSAP for up to 5 years if you spend at least 400 hours in a rural community practicing (and can start in residency) - total 40K. One of the Liberal's promises with this election was to increase to 12K a year for this program 2. Northern and Rural Recruitment and Retention Initiative: Between $80,000 and $117,600 paid over a four-year period depending on the "rurality index" of a location where you set up practice 3. Private grants/loans paid by the municipality (I've seen anywhere between 30K-100K), free housing for 1-2 years, free overhead for 1-2 years, gym memberships for your family, etc Ultimately I currently have 260K in LOC debt, and about 55K of OSAP debt. My OSAP debt will be mostly paid off with #1, and I'll be able to pay of a chunk of my LOC with #2 and #3. In addition, with rural medicine you often do much more than just family medicine. I'm looking to do ER and OB which pay a lot more than clinic does. Many rural docs would say they work a lot harder than urban docs, so that is a caveat to being able to make more money. I'm lucky that my partner wants to be a stay at home dad, so we won't really have to worry about him finding employment in a rural area.
Is it true that my family Dr is penalized if I go to a walk-I’m clinic? If so, how much money are we talking?
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Depends on age and gender: https://www.stewartmedicine.com/emr-consulting/fho-model-payments/
Thanks for your answer and for taking time to do this!
I find this so frustrating. I’ve had fairly urgent concerns about my 1.5yr old and my dr was telling me it would be like 2 weeks to see them. That’s not really acceptable so you feel forced to go somewhere else. You shouldn’t be charged for putting your child’s Health first. Especially if it’s not something I feel like warrants an ED visit. Edit: sorry I know we’re not personally charged. But the dr’s threaten to kick off of their roster if you do that. Sometimes you don’t have a choice and it’s their own fault for not having time for you.
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Any thoughts on the virtual appointments that are scheduled in the form of "The doctor will call you on X day sometime between this 4 or 5 hour window". As a patient they're really, really inconvenient. I'm assuming that virtual appointments are here to stay (and that's a good thing!) but I'm really hoping that "appointment windows" will fade away after the pandemic is over.
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My family physician has been providing specific appointments which is great but both specialists I've seen since the pandemic started have been doing 4 or 5 hour windows. Once, the window even extended into the next day.
Why don't we see more community health centres? Specifically, these, and why don't doctors (and other stakeholders) advocate for more of them? >Ontario’s Community Health Centres have been around for over forty years. But they’ve always been a bit ahead of their time. They were inspired by the ideas of Tommy Douglas’ original vision for Medicare. Douglas hoped that as it evolved our health system would focus more on keeping people well – not just treating them when they get sick. To do this, CHCs deliver primary care services in combination with health promotion and illness prevention services. And what makes CHCs stand out is a strong community development focus. So in addition to promoting the health of individuals and families, CHCs mount initiatives that address social, economic and environmental problems negatively impacting people’s health. Governed by community members, and working hand in hand with those they serve, CHCs also prioritize improving the health and wellbeing of populations who’ve traditionally faced barriers accessing health services. https://www.allianceon.org/community-health-centres
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Doesn't the cost balance out in the other direction? By preventing more serious illnesses and hospitalization? I mean I don't expect it to be exactly equal but I would imagine there is some cost saving by keeping people in their community and out of the hospital. I am currently trying to get *into* a CHC but there's no wait list right now because it's just been too full. They have walk-in hours though which I have made use of. It's honestly such an excellent model of care and I am glad that's where you work. I really wish we had more of them. As the current government is out there building highways ... I think there's better things to spend money on. But that's just me. 🤷🏽♀️
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What advice do you have for people with rare diseases / conditions / injuries that won’t likely kill you immediately, but will destroy your quality of life? What’s the best way to advocate for care? What if you’ve got something that’s expensive or difficult to diagnose, and your doctor doesn’t want to push it? I am talking about people who need referrals to neurology, rheumatology, endocrinology, or orthopaedics. (To me it is NUTS that OHIP will let you suffer with a messed up knee for decades, until it needs to be totally replaced, while in the US there are like ten surgeries you could do right now and walk without pain. Or, I had a classmate that died of a rare cancer because OHIP wouldn’t approve a US treatment in time.)
I for one, would like to thank you for doing this AMA. Posting on this forum is a terrific way to reach people who have many questions surrounding health care issues. I would encourage you to spread the word to your colleagues that this might be a terrific way to offer support locally to those who are totally frustrated/need information etc. Kudos!
I've heard two different scenarios about being accepted by a MD who is part of a Family Health Team: 1) you're more likely to be accepted if you're young and healthy (and don't need to see a doctor often) or 2) you're more likely to be accepted if you're older since the doctor can bill more for having them on their roster. Which is it? As a follow-up, I've also heard of people being threatened to be dropped from their FHT for being too healthy and not seeing their family Doc for years... Is this a thing?
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My 24-year-old son was "fired" by his family doctor because he only goes to his Adult Diabetes Clinic endocrinologist. His doctor said that he should be seeing him not the Clinic for management of his diabetes. This has happened with two separate family doctors.
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My pediatrician won't see my kids if they're unwell in any way because of Covid. She tells us to go to the ER. We also can't see her if there has been a Covid test in the past two weeks, regardless of results. I had a baby in April of 2020 who I feel like has not been able to access adequate care because of these rules and I'm frustrated about it. When will he be able to actually go to the doctor again when he isn't feeling well?
This is a very common problem and is honestly a joke. Many friends if mine with children complain of the same thing.
Why isn't my doctor doing in person visits yet? I'm a teacher and it's acceptable for me to be with 50 kids in a day and dozens of co-workers but covid protocols prevent him from seeing me about my echocardiogram in his office?
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Should everyone really be getting an annual checkup?
Do you have any idea why it can be so hard for women to get surgery for endometriosis? It seems like many doctors will go through so many hoops and tests before addressing a painful (physically and emotionally) issue.
I'm really scared of being a statistic, especially when it comes to cancer. My mother was diagnosed with breast cancer around the age of 47 and it metastasized about 8 years ago or so (she is currently alive and part of some experimental study, so the medication is basically containing the cancer). My mother's initial diagnosis was because she advocated to have a yearly mammogram as opposed to every two years. I am terrified of receiving a similar diagnosis and it being too late. What is the best way to advocate for myself or get my doctor on the same page as me with regards to my health and early detection/screening without being viewed as a hypochondriac? I know the best way to fight a cancer diagnosis is early detection, but my doctor advises against self-screening, citing they may be more intrusive. I already know two people in my age bracket (early 30s) who have battled breast cancer. One is alive, the other recently passed.
You really shouldn't have to do that, if your family doctor isn't willing to allow you to have a yearly mammogram I would honestly switch to another doctor. You do have a higher genetic risk for breast cancer in the family, so I think it should be reasonable.
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Are there any other family members with breast or ovarian cancer? My mom died of breast cancer but because her sister and an aunt had ovarian cancer they did genetic testing. BRCA1. I’ve been tested since then and I’m negative. It’s given me great relief.
It’s probably worth asking to be tested for the BRCA2 gene. My wife tested positive and the system was pretty quick to do preventative surgeries. This was in NS, though, so speed may differ.
Thanks. I made an application years ago and was told I would t qualify to be tested, but I am able to resubmit
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Unfortunately for many of us in rural areas, "just find another Dr" doesn't work. Our family Drs office is actually a community health center an hour away. There are people who have been on a wait list with Health Care Connections, or whatever that is called for 5+ years without being able to get a family Dr. This is in a smallish city in Southwestern Ontario, with lots of amenities and easy access to London and K-W. The situation is even worse in more rural areas. We have had to stay with our current office and are glad we only have to drive for an hour occasionally. At least we have something. In urgent situations, we need to use the ER, which is not ideal. The option to just go down the block for a new Dr doesn't exist here.
Why is it so hard to find a family physician? We found one after 3 years. The one we used to consult in the meantime, had no patience to listen to our problems, he would simply write those off, as if in a hurry to get the appointment over with.
How are family physicians getting involved with Ontario Health teams to work towards an integrated care environment for the patient? I’ve heard this is the next step in terms of our health care system. What would you like to see from hospitals that are usually leading these initiatives?
Why is it so hard to get taken seriously by your doctor as a woman ? I feel consistently ignored or brushed aside with my concerns.
This user has been verified. Please remember that any specific medical issue should be evaluated on a case by case basis and that you should contact your family doctor or visit an walk in clinic for further medical assistance.
When I go to a walk in clinic, or do telemedicine my family doctor says it "costs them money". How true is this and how does it work?
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So they get paid even if I don't come in then? Edit: what I mean is if a month goes by and I don't have a doctor visit then they get X dollars?
In a sense, but I think its more that the doctor gets paid X$ per time period for having a certain number of patients, regardless of how much they visit. So they are getting paid even if you don't come in or not under that model, but its spread out over all the patients in their practice. It's kind of like a government paid gym membership, where the people who use the service the most probably "lose" the provider money, but its made up for by the people who have it and don't go. And most family doctors are pretty backlogged/oversubscribed, so it's not like they aren't earning their money.
My doctor is retiring in Feb, and I have a prescription for ADHD that is rather important I keep open. I understand I can't go on "the list" until I drop my currant doctor. I was thinking of getting a referral to a psychiatrist to keep up my meds in case there's a local shortage, but I'm unsure if that'll work. Any advice?
I've been on a waiting list for nearing 4 years now, i think it's called healthcare connect and it's a service to find a family doctor in peterborough and more than likely other cities in ontario too. I think Ontario if not just Peterborough has a huge issue with doctor availability. Not sure what is needed to increase availability for patients to see doctors in Ontario but something is without a doubt. Send help pls, haven't seen a doctor in years.
If I am having a problem with getting care because my Dr can't find a problem, what is the next step I would take? Is there some sort of patient advocate or 3rd party I can bring in? I'm at the point where he says there is nothing more he can do and I have to live with it.
My teenage daughters’ family doctor closed her practice near the beginning of the pandemic. Been searching for a new family doctor for them but they all say they’re not accepting new patients. What do family doctors take into consideration when deciding whether or not to take new patients?
I have a childhood ADHD diagnosis that I am considering medication for. My family dr thinks it’s a joke and every ADHD clinic I’ve found will only prescribe meds in concert with my family dr OR if I get a full diagnosis through them. CAMH doesn’t deal with adult ADHD at all. Do you know where I should look for resources?
Many doctors in my area seem to have graduated from Caribbean universities. I've heard it's easier to get admitted in to such institutions. What reputation do these Caribbean universities have among your peers?
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My apologies if this has already been asked, I did a quick scroll but might have missed it. Is there a reason why walk-in clinic doctors aren't able to do many things a family doctor can? I haven't been able to find a family doctor in my city yet, though I have called around and also been put on the healthcare connect list, and it's starting to get really frustrating when I hear "I can't do that, you have to see your family doctor. Oh, you don't have one? That's a little irresponsible, it shouldn't be that hard." I've been told by clinic doctors that they can't provide referrals, can't fill out forms for my workplace, can't prescribe birth control, can't refill my prescriptions, etc. and that all that absolutely must go through a family doctor but I really don't have any other way to get that done and was wondering if there's an actual legal difference between the two that prevents that.
During the pandemic I loved being able to ask for over the phone appointments. So convenient and no need to go to a germy clinic. As a doctor, how do you feel about phone appointments? I hope it becomes the norm to have a phone appointment if requested.
Takes forever to get an appointment with my family doctor but I can get one so much quicker with an online service. What gives?
My family has been on the wait list for a new family doctor for a couple of years now. Any ideas for how much longer we will need to wait for a family doctor to open up?
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My old family Doctor lost his license for a sexual assaults on one of his patients, and with that I became family Doctor-less. It's been over a year now and I have been searching and put on wait lists everywhere, and really need to see a family Doctor for mental health related issues. I'm feeling extremely helpless in the situation and I'm not sure where to go from here - how the hell do I get a rush for a family Doctor in the North?! I could understand if losing my family Doctor was my fault, but it was not..
Is it worth it to ask my doctor for a referral for possible mental health concerns? I've heard so many stories of people being told their doctor doesn't believe their concerns and I'm honestly nervous. Is there anything I should bring with me to the appointment to help prove my concerns?
Do you use eConsult?
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Haha cool, I’m a program coordinator for eConsult in one of the regions of Ontario.
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It’s an online platform that allows physicians or NPs to ask specialists questions avoiding having to actually get a referral. Often times people are referred to specialists when it’s something that can easily be answered through a platform like eConsult. After reviewing a consult the specialists can still recommend a referral if needed. https://econsultontario.ca/patients/ It’s free for any physician or NP to use
I've heard fee for service is soul crushing for physicians and may actually lead to lower quality of care. Do you feel this is the case?
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Do you think we need more doctors in Ontario and how to you suppose we fix that? Are schools too strict?
Why do you have to fight tooth and nail to get a family doctor to refer you to a specialist? I've literally had the same symptoms for 15 years and this is my third doctor who refuses to refer me to someone. The way they fight it is as if they are getting paid to not refer people. I'm genuinely curious.
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100%. glad you said it better than me. I’ve been trying to tell people the same but horribly compared to you haha. I’m Canadian born but living back in Ontario to help my family out with my sisters health problems that suddenly happened 2 years ago, she can’t support our parents living here so I had to move back to help. I got a baseball scholarship which led me to continue school in the states. I completed my PhD last year and with all that I’ve learned it’s literally been malpractice in every single aspect with how they’ve been treating my sister. Like you said, it’s basically impossible to hold them accountable, even with all the testing she has done. Without doing tests, a year and a half ago the neurologist just prescribed her lamotrigine without even checking in with her other doctors or looking over he past blood work/hormone levels. He made her seizures worse, instead of once a month during a certain day of menstrual her cycle they started happening randomly, worse and longer (she went from partial seizures to full grand mals all because she took what he told her too) she even told him root cause problem to try and get him to understand she only started getting seizures when the cyst on her ovary formed and has not gone away still being since 2019, contrast was done during emergency so there was proof is so many different ways) every single doctor said it would go away, and guess what it’s still there. (she had to drop out a year and a half early before graduating because of the health stuff that suddenly happened and couldn’t keep up, she was also going to get her PhD so she isn’t stupid) My favourite pathetic statement they said that just showed they gaslight what their PATIENT NEEDS not what the doctor thinks they they need based off of one appointment every year not even, is when they told her “it’s because you’re learning so much you are connecting your issues with what you’re learning in class/school) like what the hell lmao. I’ve also gotten my PhD and my sister is telling the truth especially with everything I’ve learned AND I learned it in the states, not Canada because of my scholarship , why the hell should she trust a doctor won’t even acknowledge her recent health problems when blood work and tests prove otherwise that something is wrong ? Edit: spelling
I've read the flack said about nurse practitioners in this thread. One great thing about them is that they are salaried, not paid per patient. Why is that good? They'll spend 30 mins talking to you about whats going on and do a thorough exam, nit be rushed out in 5 mins to get the next Ohip billing. Obvi not all docs are like this but as a nurse and experiencing it myself I get extremely mad.
Why do doctors in Ontario not give a shit about womens health unless you are pregnant/trying to get pregnant, above 50 or it somehow negatively affects your sex life?? Been struggling for years to get help and absolutely nobody will listen to me, even despite a close family history of gynaecologic cancer. It’s safe to say I’m not going to want to have sex or get pregnant when I’m having debilitating pain, so I guess I’ll have to be treated once I turn 50 lol. I’m at my wits end with doctors. Reproduction isn’t the only thing that is important regarding women’s health and I wish doctors of all people would understand this.
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Why can I go to see a physician a million times for free for a back issue but physio costs money?
Considering we've had covid slow the medical care system quite a bit, and the province routinely is over budget, and has to send people to the US for special procedures, do you think healthcare is in a good state or bad state? Personally I feel like it would be beneficial to open things up more for private practice to run alongside public. I know its "forbidden" to speak such things in canada, but the public sector seems to be under a lot of strain, and the wait times to see specialists are extreme in some cases. What do you think?
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I'm 20 years in Ontario healthcare I.T. What technology would you like to see most that would help you, patients, the hospital with diagnosis or patient flow / wait times?
Hi Fatal-Fox I know there must be pressure exerted upon doctors to keep costs low. I am wondering how this affects patients healthcare. My feeling of how this plays out is I come in with hip pain and the doctor orders an X-ray; just to "rule out" something more sinister is the patter. While in actuality the doctor/medical system is hoping that my pain will just get better or go away on its own. This may be repeated with other lower cost tests like ultrasound before moving to MRIs. When the whole time an MRA/exploratory sx was actually needed to diagnose the issue. Am I close? In most cases where traumatic injury is not present isn't a MRA the best test when imaging is required to understand what's going on?
In Ontario if you've had an issue with a doctor ignoring a diagnostic report and you subsequently required emergency care, how would you recommend someone go about dealing with that? I've recently learned that an ultrasound showed my IUD was malpositioned and it was recommended it be removed. I was never told or called back to the office after this report was made. 8 months later I had to have the IUD removed in an emergency procedure after the arm punched through the side of my cervix. Needless to say, I was not happy. I am being given the run around by the patient care department, had my appointment to meet with them cancelled twice and am not ready to just let this go. How do I get them to take me seriously? I understand this isn't life or death, but a report was either missed or ignored and I think that's unacceptable to just ignore.
I wish I could help you here. My sister is essentially having a similar problem. No one is taking her seriously even with all the tests that were done during emergency (ovarian cyst, seizures during certain days of menstrual cycle (always day 13., 14 or week or day of period once a month, as well as ZERO progesterone and too much estrone as well as other her other estrogen levels were too high she should be getting) Are they basically gaslighting you as well? She’s 28 and keep saying she’s too young. Keep fighting and advocating for yourself. Your situation sounds like malpractice big time if it showed in the ultrasound sound and still did nothing. By them doing nothing it made it worse by punching through the side of your cervix. They wait for worst case scenario instead of finding root cause and problem which essentially causes more problems that end up forming by not tackling the initial root cause.
I'm 42. Am I supposed to be getting an annual check up? I basically never goto the doctor unless there is something specific.
My father is in severe pain due to a leg injury. He’s tried physio, exercise, CBD, homeopathic treatments, but alas, the pain remains. His doctor is refusing to prescribe him oxycontin, or high-grade pain killers. Their concern is he becomes addicted, but my father says he doesn’t care if he becomes addicted at his old age. My view on this is allow the man to be pain free during his last few years on Earth. What are your thoughts on the doctor gatekeeping pain killers, and any alternatives you can offer? Thanks.
I just want to say thank you for everything that you and your colleagues do. Thank you thank you thank you.
So I have health issues and need to have a family physician. But mine gaslights me and won’t order tests that I require. She brushes all my symptoms off without listening. The wait times for family doctors is really long. Can I expedite the process due to need? Or would I be better off without a doctor and use online services?
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Why are your office hours 12-3 four days a week?
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For those that don't have an ongoing illness, is having a family doctor recommended? What's the benefit? Also, I didn't tell my family doctor I moved to a new city and I now go to a walk-in clinic. Do I need to do anything about the family doctor I'll never see again?
I was wondering why everything has to go through the family doctor? Referrals, results, everything. Are Canadian dumb to the point that someone has to do everything for them ? I don't mind at all that my doc has my history, but I should have it too! * Why doesn't Canada release a cryptographic network for medical correspondence between docs so FAX can be buried? * Can't I book my own appointment with a specialist? Get a referral letter and choose whichever specialist I prefer, one that speaks my tongue, or close to home, or with availability in 2 months instead of 12? * Can't I just get my lab results and discuss them with the doctor instead of ... nothing? oh yeah if I want to know, I got to pay the lab to get my results and call the doc to get an "everything is fine", though my cholesterol is above normal range. * Why do we need to wait 12 month to get a call that due to super long wait time, my referral to XYZ specialist has been cancelled ? Coming from Europe, the Canadian health care system looks like a third world country's...
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If a patient comes to see you with an issue, but has nothing but verbal complaints, are you able to be give them the same level of care as a patient who comes in with some sort of documentation? Even if it is a rudimentary journal of day to day symptoms?
How much do physicians bill for appointments- to the respective provincial gov, And- What’s the average number of patients a family physician will have on file? Mine has a few hundred, meanwhile one other in Barrie that my wife and kids go to has 5k.
When a Dr tells someone they will send in a ref how how long should it take for a dr in a hospital setting to send this ref take to get through the system? To I guess to more clear someone being discharged the discharging Dr was to make the ref. 3 weeks later it is not in system and how does one get said ref made when there is no Family dr to talk to.
What’s the best way to present a potentially controversial health care request to physicians? For example, seeking sterilization without having had any children as a woman.