Editor’s Note: On September 6th 2012, Betty Dean, CARP’s North Bay Chapter Chair, attended a Town Hall Meeting on Healthcare. What follows is he most interesting and instructive field report. To visit the find out more or get involved with CARP North Bay’s please visit their chapter website.
About 100 citizens and about 20 local doctors attended last night’s meeting moderated by local MPP Vic Fedeli. Both MPP and Doctors emphasized the importance of refraining from political statements (but the personal is political…) It was held at the Empire retirement residence and two rural mayors were in attendance. Most attendees were age 50+.
Doctors gave some very clear examples of how the planned cutbacks in health ($300M now and eventually $1.1B) will affect patient care in the north.
#1 For example, a family Dr refers a patient for a test and the specialist on reviewing the test results, determines further testing is required. The patient must be referred back to the family Dr who can then refer patient back to specialist or elsewhere for additional tests. The logic in this mystifies me but what really impacts us locally is that we are reliant upon referrals to Sudbury for cancer treatment and cardiologists. That means as I personally experienced when my father was alive, leaving my work at Cambrian College, Sudbury and driving two hours to Powassan to pick up my father (then in his late 80s), taking him to specialist in Sudbury and then driving him home and driving back to Sudbury for work. Total driving time for me – 8 hours – same day. Under the new restrictions, if the Sudbury specialist had determined another test was required in Sudbury, we would have to return to family doctor in Powassan and wait for the referral process and then subject my frail father to yet another road trip.
When my mother was in dire need of kidney stone surgery in 2000 and lithotripsy failed in London, she was referred to Sudbury. During a pre-op visit, she was interviewed/assessed by an anesthesiologist who, given my mother’s multiple and chronic health issues, referred her to another specialist that day in Sudbury so that they could arrange special equipment for the operating room should the surgery prove problematic. I doubt my mother would survive under current restrictions because the referral process would take too long and the road trip too onerous.
#2 North Bay has one dermatologist (the north that geographically represents over 80% of province land mass has only three dermatologists). Northeast cancer rates are I believe highest in province. Using the example of skin cancer, attendees last night learned that the fee payment is $58 if the lesion is cancerous, $44 if it is found to be pre-cancerous and $29 if non-cancerous. Not being medically trained, again the logic mystifies me, given my assumption that the amount of time spent with the patient would be relatively the same regardless of whether the lesion was cancerous or not and not readily known in advance.
#3 Medical students just graduating and trained in group practice are no longer permitted to do so – process is frozen. The group practice process locally translated into 12 new family doctors in North Bay (we still have 8-10,000 unattached patients in this area). The fear is that, now, after training new doctors they will leave for USA and the north will remain under-serviced.
Not withstanding the doctors’ vested interests, I had the distinct impression, they felt blindsided by the ministry of health and aggrieved that they had not been consulted about patient impact. Having survived the cuts of the mid-1990s and the migration of doctors to USA at that time (one of those who left but came back spoke about the experience last night), several 35 year practitioners expressed the need for more collaboration/cooperation and the opportunity to advocate for better patient care.
One doctor spoke passionately about the uniqueness of North Bay Regional Health Centre where 90% of family doctors still provide hospital care (he was late to meeting because he was making a home visit). Another, spoke eloquently about “lost trust”. The doctors acknowledged that not all parties to this debate individually have all the answers but together we can improve the system and urged those attending to initiate a letter campaign to elected officials.