In Canada we have a universal health care system. It's not perfect but it's mainly there when you need it, when anybody needs it. I've had medical emergencies in my life and I received excellent free hospital care as well as surgery. In reality my life would not exist had these services been absent or difficult to access. My one and only son may not have made it into the world either.
BUT.... ah yes it seems there's always a "but" to attach to everything, even good things .... there are glitches. There is misuse, by patients and doctors alike. We are told that we should never go to emergency at the hospital unless our situation is truly an emergency - like a broken bone, appendicitis, something obvious. Emergency is costly they say, more costly to the system than a visit to the doctor (why I wonder), and you can tie up valuable doctor time when you arrive at the emergency room with something like a bad belly ache, a skin rash, a raw throat, etc. On the other hand, there are things that crop up that cannot wait 1 to 3 weeks, or more, until you can get an appointment with your family doctor, or any doctor for that matter.
I recently came up with a skin rash (or insect bite, boil, pimple, or worse case scenario, shingles, skin cancer...you know how your mind works when you have an unknown medical occurrence happening). If you have been a blog reader of mine for awhile you will have read, "An Alien in My Head" published last December, so you will understand why having an unknown 1/4 inch round puffy brown spot with a small white dot in its centre appear on my chin would set off my internal medical alert button (no pain or itch, a little tickle now and then). Once again I felt nothing bite me. I had been working in the garden. It was very hot out and my face had been dripping with sweat. So there I was, sitting at the picnic table with husband and friends, completely unaware of my blotch, and husband says, "You have something on your chin." I attempted to rub it off, nope; I went in and tried to wash it off, nope. Well, we had company so I managed to ignore it for the remainder of the evening.
Next day I'm thinking, I wonder what it is? Maybe I should get it checked out, But I don't want to go to emergency... Yet when I had shingles a few years back I was made aware that some things turn out better when treated right away - what to do, what to do?.. I called my family doctor's assistant, explained what was up and how I felt about it, said do you think I need to get it checked out??? She said it was up to me, a judgement call so to speak, but my doctor happened to have a cancellation that afternoon at 3:00. Okay, I said, I'll come in.
Now I am a country dweller. I live smack-dab-in-the-middle of 4 towns, towns not cities. No matter which way I drive it's pretty well 70 km one way. So a trip to town uses both fuel and time, neither of which I'm fond of spending. I arrived at my appointment and here's how my doctor relieved my concerns.
"Hmmm," he said leaning in for a closer look, "a skin lesion. Is there any particular time when you are not available to come in?"
"No," I said, "pretty well any time is good for me. Why?" The doctor went out of the examination room, came back with a card on which was written an appointment with another doctor, same clinic, in 16 days. This other doctor, he said, was the clinics skin specialist.
"What should I do in the meantime," I said.
"Stay out of the sun," he said. That was not exactly comforting. That was Thursday. So I went home, used aloe vera on the blotch, my own fall back treatment, and continued to worry about what it was. Looking up skin problems on the internet in no way made me more comfortable. I was not pleased. That doctor was paid for a do nothing appointment; I had spent all that time and gas and had no diagnosis or treatment. Maybe I should have gone to emergency!
A friend of mine said there was a walk-in-clinic in another one of those 4 communities equidistant from my home, that I should phone and see if I could get in, so Monday I called, got an appointment that afternoon. This clinic was super efficient. I was in and out in no time flat, saw a doctor and actually discussed what was happening (he felt it was an insect bite), was given a prescription for a steroidal ointment (which, by the way, my seniors' Blue Cross plan did not cover) and was home in record time. Now it's Monday. It's been a week since I began to use the ointment and the blotch seems to be slowly going away. Information sheet in the ointment package said it could take as long as 2 weeks. Doctor at the walk-in-clinic said check back in a week if no improvement. I still have an appointment with that skin specialist so will go if I need to. But, in the meantime, I feel like I'm at least trying to treat the blotch, whatever it may be, and that the walk-in-clinic was a thousand times more efficient and satisfying than the "Hmm" I received on my first appointment.
Non-emergency medical occurrences (which need diagnosis, treatment, prescriptions) happen all the time. We do have access to the Health-Link line, but the nurse that answers your call cannot see you, responds according to your description of your symptoms, which may or may not be accurate, clear or helpful. With one rather exciting exception*, whenever I've called the line I've been told I should go see my doctor!
Surely, if we are not supposed to use emergency rooms as if they were walk-in-clinics then we should have access to walk-in-clinics in these smaller communities. Not every medical occurrence can wait. It may go away, becomes more serious, or kill you. If a separate clinic is too costly to provide in a smaller community, why couldn't one doctor be designated to take walk-ins at the hospital without making us feel guilty for using emergency services? Or maybe a nurse could take these cases. They have a great deal of training as well, and could refer the patient to the doctor on call if he/she felt it was necessary. (I suppose that idea is not feasible due to that ugliest of words in society today - liability.)
The internet is not the answer. We need better medical services for non-life threatening medical issues. It may be better, or worse, in large cities, but it can be frustrating, worrisome and time consuming for rural and small town inhabitants.
*That exciting exception happened when I was doused completely with gasoline due to a broken tank valve. I was told to call poison control. They told me, a memory - not an exact account - to get under a cool shower right away for at least 20 minutes, eyes and all. I was ever so glad to talk to someone at that time, the Help-Link line most certainly has its place and can be very useful and calming in a frightening situation.
