Australia or canada for doctors
Mar 6th 2014 | 3:12 pm
#46
BE Enthusiast
Joined: Apr 2008
Posts: 413
From: Okanagan Canada
Re: Australia or canada for doctors
Sorry- further thoughts
Wait times- some are better here , some worse. But in the UK- as of when I left almost 5 years ago- it was becoming more "standardised"- with less ability to be able to exercise judgement. They have the 2 week waits for possible cancer but everything else seemed to wait longer- but not all urgent is cancer. 2 week wait for cancer was excellent for some things- breast lumps for e.g.- investigated, biopsied, seen by a specialist in 1 day- sorted. Here it could take several weeks, with several hospital visits. But when I have referred once diagnosed- I have been offered same day/week appointments for my patients.
But now in BC, the new colorectal screening is good, and patients who have a positive stool test should have a colonoscopy by a specialist within 8 weeks- in the UK - patients were getting a sigmoidoscopy by a trained nurse- within 2 weeks yes -but totally inadequate investigation.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
We have local TIA clinic who see patients in less than a week, cardiothoracic surgeons who will see next day. Pediatricians who try to see urgents in less than a week-one even phoned me to apologise that it was 1 week.
Routine rheumatology/neurology expect a Christmas or two to go by but urgents- within 2-4 weeks
Internal medicine- urgent- within 1 week, routine- max 2-3 months
Orthopaedic appointments- urgent- 1-2 weeks- routine 2-4 months but wait to surgery very long unless urgent.
One of my biggest frustrations compared to the UK is the cost to patients for prescriptions- particularly those who have low income but just not quite low enough to get much paid for, but not rich enough to afford it!
And PHYSIO! How shortsighted that you have to pay! Well unless post op or fracture and then limited. Physios would pay for themselves by less time off work, less time in hospital after operations (how about some pre-op physio!) etc etc
Wait times- some are better here , some worse. But in the UK- as of when I left almost 5 years ago- it was becoming more "standardised"- with less ability to be able to exercise judgement. They have the 2 week waits for possible cancer but everything else seemed to wait longer- but not all urgent is cancer. 2 week wait for cancer was excellent for some things- breast lumps for e.g.- investigated, biopsied, seen by a specialist in 1 day- sorted. Here it could take several weeks, with several hospital visits. But when I have referred once diagnosed- I have been offered same day/week appointments for my patients.
But now in BC, the new colorectal screening is good, and patients who have a positive stool test should have a colonoscopy by a specialist within 8 weeks- in the UK - patients were getting a sigmoidoscopy by a trained nurse- within 2 weeks yes -but totally inadequate investigation.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
We have local TIA clinic who see patients in less than a week, cardiothoracic surgeons who will see next day. Pediatricians who try to see urgents in less than a week-one even phoned me to apologise that it was 1 week.
Routine rheumatology/neurology expect a Christmas or two to go by but urgents- within 2-4 weeks
Internal medicine- urgent- within 1 week, routine- max 2-3 months
Orthopaedic appointments- urgent- 1-2 weeks- routine 2-4 months but wait to surgery very long unless urgent.
One of my biggest frustrations compared to the UK is the cost to patients for prescriptions- particularly those who have low income but just not quite low enough to get much paid for, but not rich enough to afford it!
And PHYSIO! How shortsighted that you have to pay! Well unless post op or fracture and then limited. Physios would pay for themselves by less time off work, less time in hospital after operations (how about some pre-op physio!) etc etc
Mar 6th 2014 | 3:15 pm
#47
Pea Brain
Joined: Jun 2005
Posts: 6,005
From: TBD
Re: Australia or canada for doctors
Agreed Kelowna can be weird- I know they regularly refer to Vernon, Salmon Arm, Kamloops for a variety of things- for a shorter wait time- but ban Vernon patients from having some procedures there.
I have referred to orthopaedics there, Dr Plausinis- the very guy that abandoned you -very nice, very good surgeon. He has accepted and seen my patients.
If you are being refused I think that will be individual surgeons who have made that decision- or your own doctor. I have also referred to orthopaedic surgeons in Vancouver and Calgary- for sheer convenience of patients- i.e. they have family whom they wish to convalesce with after surgery.
I have referred to orthopaedics there, Dr Plausinis- the very guy that abandoned you -very nice, very good surgeon. He has accepted and seen my patients.
If you are being refused I think that will be individual surgeons who have made that decision- or your own doctor. I have also referred to orthopaedic surgeons in Vancouver and Calgary- for sheer convenience of patients- i.e. they have family whom they wish to convalesce with after surgery.
He lay in hospital for an unnecessary extra week until the politics were sorted out, by getting his consultant to accidentally leave his patient record behind, photocopying them, then leaving hospital and walking into emerg in Kelowna a day later as an out patient and demanding care. Ridiculous.
Mar 6th 2014 | 4:55 pm
#48
BE Enthusiast
Joined: Apr 2008
Posts: 413
From: Okanagan Canada
Re: Australia or canada for doctors
There are so many inconsistencies, it's frustrating. A friend's father, who lives alone in Abbotsford, had a quadruple by-pass surgery this year, and needed ongoing help while convalescing. Family who can facilitate that live in the Okanagan, but Fraser Valley Health couldn't get Kelowna to accept a formal transfer of care. It was absurd to think he could travel regularly between the 2 places for check ups (he's diabetic too, and had added complications).
He lay in hospital for an unnecessary extra week until the politics were sorted out, by getting his consultant to accidentally leave his patient record behind, photocopying them, then leaving hospital and walking into emerg in Kelowna a day later as an out patient and demanding care. Ridiculous.
He lay in hospital for an unnecessary extra week until the politics were sorted out, by getting his consultant to accidentally leave his patient record behind, photocopying them, then leaving hospital and walking into emerg in Kelowna a day later as an out patient and demanding care. Ridiculous.
Mar 6th 2014 | 5:27 pm
#49
Pea Brain
Joined: Jun 2005
Posts: 6,005
From: TBD
Re: Australia or canada for doctors
Totally agree the above is not acceptable in an ideal world.The only excuse would be if Kelowna hospital was totally full which happens on occasions.If they have sick people waiting for a bed in ER , it would be hard to say someone who had a bed but was in Vancouver would be a priority. When there is availability generally they will transfer- and Kelowna themselves transfer out very promptly.
Mar 6th 2014 | 9:54 pm
#50
Account Closed
Joined: Jan 2006
Posts: 0
Re: Australia or canada for doctors
Jsmth321 , you are right re the drugs and WIC- sort of! Most reputable WICs will not prescribe strong narcotics- sort that need the special prescriptions and benzos for risk of addiction. There are a few around who will- the appropriate patients tend to know who!!!
But- all walk in clinics and hospital know your past prescriptions , although they are supposed to ask your permission to access it- its from a web site called pharmanet- pharmacists also have access obviously.
GPs can sign up also but most rely on their own EMRs
And EMRs are why dbd33's idea of carrying his own records won't come about anytime soon. There are still too many different companies with totally incompatible systems and still a lot of IMO stupid docs who are on paper still. I know this is changing though- Telus have become the largest EMR provider in Canada -just- and it will be hard for the competition to compete.
Also- yes I know almost all my patients- although I may pretend not to notice one in Superstore etc. I may not remember ones who come in once every 2-3 years. No- I don't remember off hand the last pap, rectal, physical, lab work ,X-ray they may have had -but if it was within the last month or two I probably will do.
Do I look at every chart before I see the patient- no- no time- but I will look at the patients who are complicated/ill. I would love to look at all but I would have to cut down numbers - not that I see a lot! I am good at having a look whilst completely initial niceties though. If someone was prescribed a medicine they have an allergy/sensitivity to, their doctor is either on paper, has a rubbish EMR or doesn't update the one they have. Mine will not let me prescribe with out an "override " by me.
But- all walk in clinics and hospital know your past prescriptions , although they are supposed to ask your permission to access it- its from a web site called pharmanet- pharmacists also have access obviously.
GPs can sign up also but most rely on their own EMRs
And EMRs are why dbd33's idea of carrying his own records won't come about anytime soon. There are still too many different companies with totally incompatible systems and still a lot of IMO stupid docs who are on paper still. I know this is changing though- Telus have become the largest EMR provider in Canada -just- and it will be hard for the competition to compete.
Also- yes I know almost all my patients- although I may pretend not to notice one in Superstore etc. I may not remember ones who come in once every 2-3 years. No- I don't remember off hand the last pap, rectal, physical, lab work ,X-ray they may have had -but if it was within the last month or two I probably will do.
Do I look at every chart before I see the patient- no- no time- but I will look at the patients who are complicated/ill. I would love to look at all but I would have to cut down numbers - not that I see a lot! I am good at having a look whilst completely initial niceties though. If someone was prescribed a medicine they have an allergy/sensitivity to, their doctor is either on paper, has a rubbish EMR or doesn't update the one they have. Mine will not let me prescribe with out an "override " by me.
If I could easily access a psychiatrist life would be so much easier...
Mar 6th 2014 | 10:06 pm
#51
Account Closed
Joined: Jan 2006
Posts: 0
Re: Australia or canada for doctors
But now in BC, the new colorectal screening is good, and patients who have a positive stool test should have a colonoscopy by a specialist within 8 weeks- in the UK - patients were getting a sigmoidoscopy by a trained nurse- within 2 weeks yes -but totally inadequate investigation.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
My mom had the same procedure done in California and her wait was almost double mine, and she got to pay for a good chunk of it.
I was impressed with how fast my GF got in for surgery as well last fall for the gall bladder, we had initially expected a good wait based on the wait time website averages, but she was in within days of the referral for surgery. Only down side is she had to have it in Vancouver which was a bit difficult, but its to be expected in a small town to have to travel for things. (I do feel sorry for her mom's BF, he has cancer and has to go to Vancouver near daily for treatment, and its really wearing him out, wish we had more cancer treatment locally for regions.)
Mar 6th 2014 | 11:44 pm
#52
Muskoka, Ontario
Joined: Aug 2013
Posts: 3,045
Re: Australia or canada for doctors
Sorry- further thoughts
Wait times- some are better here , some worse. But in the UK- as of when I left almost 5 years ago- it was becoming more "standardised"- with less ability to be able to exercise judgement. They have the 2 week waits for possible cancer but everything else seemed to wait longer- but not all urgent is cancer. 2 week wait for cancer was excellent for some things- breast lumps for e.g.- investigated, biopsied, seen by a specialist in 1 day- sorted. Here it could take several weeks, with several hospital visits. But when I have referred once diagnosed- I have been offered same day/week appointments for my patients.
But now in BC, the new colorectal screening is good, and patients who have a positive stool test should have a colonoscopy by a specialist within 8 weeks- in the UK - patients were getting a sigmoidoscopy by a trained nurse- within 2 weeks yes -but totally inadequate investigation.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
We have local TIA clinic who see patients in less than a week, cardiothoracic surgeons who will see next day. Pediatricians who try to see urgents in less than a week-one even phoned me to apologise that it was 1 week.
Routine rheumatology/neurology expect a Christmas or two to go by but urgents- within 2-4 weeks
Internal medicine- urgent- within 1 week, routine- max 2-3 months
Orthopaedic appointments- urgent- 1-2 weeks- routine 2-4 months but wait to surgery very long unless urgent.
One of my biggest frustrations compared to the UK is the cost to patients for prescriptions- particularly those who have low income but just not quite low enough to get much paid for, but not rich enough to afford it!
And PHYSIO! How shortsighted that you have to pay! Well unless post op or fracture and then limited. Physios would pay for themselves by less time off work, less time in hospital after operations (how about some pre-op physio!) etc etc
Wait times- some are better here , some worse. But in the UK- as of when I left almost 5 years ago- it was becoming more "standardised"- with less ability to be able to exercise judgement. They have the 2 week waits for possible cancer but everything else seemed to wait longer- but not all urgent is cancer. 2 week wait for cancer was excellent for some things- breast lumps for e.g.- investigated, biopsied, seen by a specialist in 1 day- sorted. Here it could take several weeks, with several hospital visits. But when I have referred once diagnosed- I have been offered same day/week appointments for my patients.
But now in BC, the new colorectal screening is good, and patients who have a positive stool test should have a colonoscopy by a specialist within 8 weeks- in the UK - patients were getting a sigmoidoscopy by a trained nurse- within 2 weeks yes -but totally inadequate investigation.
I can pick up a phone and get really quick investigations, consults if I'm really worried,it was getting harder in the UK.
We have local TIA clinic who see patients in less than a week, cardiothoracic surgeons who will see next day. Pediatricians who try to see urgents in less than a week-one even phoned me to apologise that it was 1 week.
Routine rheumatology/neurology expect a Christmas or two to go by but urgents- within 2-4 weeks
Internal medicine- urgent- within 1 week, routine- max 2-3 months
Orthopaedic appointments- urgent- 1-2 weeks- routine 2-4 months but wait to surgery very long unless urgent.
One of my biggest frustrations compared to the UK is the cost to patients for prescriptions- particularly those who have low income but just not quite low enough to get much paid for, but not rich enough to afford it!
And PHYSIO! How shortsighted that you have to pay! Well unless post op or fracture and then limited. Physios would pay for themselves by less time off work, less time in hospital after operations (how about some pre-op physio!) etc etc
Bowel screening "participants" are offered a colonoscopy by a consultant who has gone through rigorous testing of their skills within 10 days. USC "patients" are often two or three weeks although obviously meant to be hitting the 10 day target.
Nurse Practitioners do not participate in bowel screening or USC because of the therapeutic nature of bowel screening. But they do full colonoscopy on designated patients, have been doing so for many years. My differential of participants and pts is huge as the care given to the different sets of groups is huge and completely unfair IMO, and all due to money. The welsh assembly pay for bowel screening, USC out of the pot.
There is still scope for individual assessment of a pt bipassing the system, at least in my department there was.
Last edited by Tirytory; Mar 6th 2014 at 11:55 pm.
