The Dad Thread

[Hawrylyshyn]

I would personally be more comfortable with the pay of family doctors if they actually cared about their patients and did their jobs properly. I can't remember the last time myself or anyone close to me had a good experience with their doctor.

I had severe vertigo and was told "to look up videos on YouTube on how to solve it" -- cool glad you're getting ~200k for that advice. I've all been on a regular anti-seizure medication for years and the office frequently sends my medication tithe wrong pharmacy, or never responds to the pharmacy when the request a refill. I frequently have to pay out of pocket to get the pharmacist to write an extension for these because of the incompetence of the doctor to complete a routine refill.

My partner got in a bad car crash (car was written off) and had some neck pain. The doctor 1) didn't even look for any concussion symptoms then told her to "go home and drink a warm glass of milk"

My partner's grandma (84) fell and hit her head. Again, the doctor did zero concussion protocol checks, didn't actually do any sort of physical on. We literally had to refuse to leave the office until they actually did their job.

It's been made very clear they just want to rush through as many patients as possible as fast as possible.

At this point bring on private healthcare. I would rather pay out of pocket for health insurance if it means I actually get quality care compared to the shit show that is health care today.

[theman23]

In Ontario they actually get paid $20 for that advice, which is less than what you pay for your haircut at Great Clips. Physician remuneration has been growing below inflation for close to a decade in our biggest province, and was actually negative for the last few years of the Wynne government.

BC was also a wasteland but the NDP bumped up GP salaries big time last year, and I think they saw a 20% increase in GPs within a year. Not sure if the quality of care will improve right away since most mid career GPs are not going to change their practice style now, but newer GPs will undoubtedly be more thorough now that they get compensated for time and not just how many patients they churn through. In Australia, where they pay better, the quality of care seems better too but you’re usually paying out of pocket $50 to $100 bucks to see a GP. It’s not an unreasonable amount to pay, even for just the convenience of it all.

You get what you pay for.

[MonctonRad]

Originally Posted by Hawrylyshyn

I would personally be more comfortable with the pay of family doctors if they actually cared about their patients and did their jobs properly. I can't remember the last time myself or anyone close to me had a good experience with their doctor.

I had severe vertigo and was told "to look up videos on YouTube on how to solve it" -- cool glad you're getting ~200k for that advice. I've all been on a regular anti-seizure medication for years and the office frequently sends my medication tithe wrong pharmacy, or never responds to the pharmacy when the request a refill. I frequently have to pay out of pocket to get the pharmacist to write an extension for these because of the incompetence of the doctor to complete a routine refill.

My partner got in a bad car crash (car was written off) and had some neck pain. The doctor 1) didn't even look for any concussion symptoms then told her to "go home and drink a warm glass of milk"

My partner's grandma (84) fell and hit her head. Again, the doctor did zero concussion protocol checks, didn't actually do any sort of physical on. We literally had to refuse to leave the office until they actually did their job.

It's been made very clear they just want to rush through as many patients as possible as fast as possible.

At this point bring on private healthcare. I would rather pay out of pocket for health insurance if it means I actually get quality care compared to the shit show that is health care today.

I'm very sorry to hear about your negative experiences with the Canadian health care "system."

The job of being an FP is frustrating and difficult. The main job of an FP is to be an entry point into the system. This requires being able to distinguish between trivial complaints and serious illness. This can be harder than you think because most patients are lousy historians. Add in the fact that 95% of the time when a patient presents to the FP with a new complaint, there is nothing serious going on, then it is not surprising that FPs tend to blow people off (at least the first time). If people are truly ill, they will come back, and this is usually when investigations start.

Do people get burned by such an approach? Absolutely!!! Meningitis for example can present as a trivial sore throat, fever and URTI symptoms. Neck rigidity is the clue, but, I betcha 99% of the time someone shows up at the FP office, this isn't checked and the patient may be sent home with advice to use Tylenol, get some rest and drink plenty of fluids. 24 hours later, this patient could be dead. What they really needed was a CBC, blood cultures, an LP and perhaps a contrast enhanced CT scan.

Was the FP negligent? Perhaps, but, at the same time, you can't overcall things. If you do, then you overload the system. You can't order an LP for everyone with a headache or sore throat. You need to use judgement. If the patient is usually a non complainer, seems unusually ill, is perhaps confused and, they live in a communal environment such as a university dormitory, then these are red flags. and should be an indication that the patient's symptoms should be taken more seriously. This is where the art of medicine comes in.

As for your relatives with the absent concussion protocols, if they were seen by the FP several days after the fall, then a concussion protocol might be meaningless. Running a concussion protocol immediately after the event is more telling. If the patient is elderly and suffered a significant fall (even from standing height), it makes sense to do a CT scan to exclude an expanding subdural hematoma (which could be a surgical emergency). A patient such as this should really be seen in an urgent care centre or an ER, not an FP office. It is often easier to get an emergent CT ordered from the ER than a doctors office. Remember, the FP is primarily charged with first point access for non emergent conditions, looking after chronic conditions and medication management to prevent polypharmacy. They don't do so well with emergency care.

Not all MDs are equal. We all have different specialties or niches. FPs are quite valuable in the system for chronic care and making sure the patient record is maintained coherently in a single place. A good FP is someone who knows his patient well, can recognize the early sign of health deterioration, can handle the small things that he is comfortable with and knows how to refer appropriately when he gets out of his depth. If you have an FP like this, then you are quite lucky.