Socialized medicine up north

[bedrock]

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Canadian Health Care Leaves Patients Frozen In Line

This year, Canadian patients faced a median wait of 27.7 weeks for medically necessary treatment from a specialist after being referred by a general practitioner.

www.forbes.com

 

[plasma.]

I don't disagree. I started my practice after fellowship this year. Offered to help the University clinic with their waitlist. Saw numerous referrals initially sent to them in 2019. More than a handful of whom had already passed away. Problem with a "free healthcare" system is that if you open the floodgates, the Government can't keep up with expenditures. You have to use waitlists / lines as a way of keeping healthcare costs in check.

 

[thiswonthurtabit]

That's about the wait time to see a neurologist in my area of the US...maybe a little bit shorter tbh.

 

[bedrock]

That's about the wait time to see a neurologist in my area of the US...maybe a little bit shorter tbh.

I have noticed that neurology evaluations take forever to be seen the last 5 years.

Are neurology residencies not filling, maybe retiring early, or doing something besides direct patient care ?

 

[MitchLevi]

Neurology and Rheum.

 

[BobBarker]

I think their visits are just extremely long and it is a complex field that midlevels aren’t too capable of helping.

 

[Agast]

I feel like neurology and rheumatology get a lot of inappropriate referrals and it sucks up their time

My patients insist on seeing a neurologist for sciatica “to see why I’m hurting” completely ignoring what I tell them or a spine surgeon tells them. 2 months later and they get their answer, which is to come back to see me.

 

[MitchLevi]

I outright deny referrals to neurology for ppl who aren't better despite all my attempts. As I tell them, "I'm not attaching my name to that referral."

 

[bedrock]

I outright deny referrals to neurology for ppl who aren't better despite all my attempts. As I tell them, "I'm not attaching my name to that referral."

I feel like neurology and rheumatology get a lot of inappropriate referrals and it sucks up their time

Agree with you both. I think that a very high percentage of outpatient neurology and rheumatology referrals are because the patient is crazy. The patient has non-anatomic symptoms, with normal exam and imaging, and the referring doc just wants them out of their practice.

I respect Mitch approach, but I admit I’ve referred several patients to university neurology because they are nuts, and a referral was quicker for me than arguing with them for 10 minutes.

Very different from a pain patient who just can’t accept they have a failed TKA, failed back, or generic DDD, when I tell them kindly but firmly that this is their life now.
I offer to send them for complementary treatments such as acupuncture, pain psych, etc? but I also make it clear to that there is no treatment which has been overlooked, that will magically make them feel 18 again.

 

[hyperalgesia]

I don't mind referring after trying to educate them. The worst is when they specifically request a known quack.

 

[Dr. Ice]

I have no issue punting to either of those specialities as they try to dump on pain docs all the time

 

[Baron S]

"You could always talk to your Primary Care about a second opinion from another specialist"

 

[Ducttape]

you guys really should spend some time with neurologists before you make such blanket statements. they see things in a vastly different way



i have seen enough cases of transverse myelitis, ALS, CIDP, lupus to last a lifetime.

this last year, 465 applicants, 8 did not match.

 

[callmeanesthesia]

Neurology and Rheum.

We don’t even have rheum in our area anymore. Have to try to get them into the academic center 2 1/2 hours away. At least half the time they reject the referral due to “capacity”

 

[hyperalgesia]

I've seen Rheum do very well as a cash practice in a rural area when they're the only game in town.

 

[Dr. Ice]

Rheum is handcuffed by blood work, the results of which are (based on our bell curve) inexplicable for chronic pain states and so they are forced to offer biologics without a dx or tell people that they have fibro and that “they still matter.”

Sux to be them, glad I didn’t pick it, but I’m sure many of them say that about us