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The Reality of the Modern Canadian Healthcare System

We have already discussed the modern healthcare system, touching on the issues of Canadian medicine: Why Does Modern Medicine Not Always Help People? Now let’s delve into how the Canadian healthcare system works in more detail. Like in other countries, the modern system of medical practice in Canada is based on standardized treatment protocols and optimal utilization of the doctor’s time. It has the right to exist, but as soon as a patient has more than one problem, this system fails. And that’s not the only problem with modern medicine.

How the Canadian healthcare system works

Let’s examine step by step how this system works. Many people now think that the system is broken and serves no purpose. So, let’s discuss how the functioning of such a system was envisioned. In my opinion, the main problem now is that Canada is striving to maintain equal access to healthcare for all residents, but there is a catastrophic lack of funds for it.

Doctors from Canada can leave and work in the United States, so the authorities do not limit the size of payments relative to the time spent. However, they restrict the time that will be compensated for each patient visit. Yes, that’s why our doctors are constantly stressed; they have to see up to 50 people per day just to earn something.

Let’s consider a real situation

For example, a patient experiences severe headaches – a situation that needs to be initially checked at the hospital because it could indicate a life-threatening problem. In the hospital, they will examine for such issues, and if none are found, they will say that everything is fine, and the problem is not identified. If there’s a long queue at the hospital, there aren’t enough doctors because the hospitals are overloaded, stress levels are even higher, and relative time compensation is lacking.

And, unfortunately, here you don’t have any paid alternative. You have to endure the queue or call an ambulance if you believe your problem is critical and you cannot wait in line for hours. The advantage of calling an ambulance is that the initial assessment of the urgency of medical care for your specific case will be conducted by emergency medical personnel. The downside is that the ambulance service is currently facing the same problems as the entire Canadian healthcare system – there is also a lack of funds and a shortage of personnel. They simply may not come to you or take a very long time to arrive.

Go to the doctor after visiting the hospital

If the hospital tells you that no problem has been found, it means there is no life-threatening issue. That’s the primary concern of the hospital. The patient should then return to their family doctor and explain what happened. This is if you have a family doctor. If not, in British Columbia (BC), you can seek a naturopathic doctor (ND). In BC, an ND can act as a family doctor; they are actually Naturopathic Physicians (NPs). So, in this case, you have a paid alternative. Unfortunately, the hospital often fails to inform you of this and simply says, “Nothing is found.” And the person is left with a feeling that their problem has been ignored. No, the hospital has simply completed its part of the work and transferred the responsibility for your care to other specialists.

Keep copies of all tests!

It is always better to obtain and keep copies of your test results everywhere. The Canadian healthcare system is designed in such a way that your tests are not visible to other specialists unless you give consent directly at the laboratory. There, you can specify a list of specialists to whom the test results should be sent. By default, it is the same doctor who referred you for the tests, but you can add other doctors to the list. This is how your right to confidentiality of medical information is implemented.

Gathering all the necessary signatures to access your personal information is an extremely complex and time-consuming process, and no one compensates specialists for that time. Therefore, it is always easier for them to prescribe new testing. But new tests often do not reflect the situation that led you to the hospital. So always take copies of your tests and carry them from one specialist to another until the cause of your problems is found.

What should the family doctor do?

In an ideal world, the family doctor should consider all other less critical possibilities and prescribe all necessary investigations. They should refer you to the appropriate specialist or specialists. In reality, family doctors are also constrained, so they only refer to specialists in the most extreme cases.

Now think about how many questions and checks the doctor must perform to understand the root cause of your problem. How many tests should they conduct just to eliminate some possibilities? How much time will it take? If the problem is complex, it may require a considerable amount of time. However, the doctor only has a few minutes per patient. Don’t be offended by the doctors; they are placed in conditions where they often cannot understand the underlying problem and treat what should ideally be treated. So, if nothing dangerous is found in the hospital, the doctor will simply prescribe a remedy for your headache. And the pain will disappear temporarily while you take the pill.

But pain is a signal from your body; it is trying to tell you that something is wrong. Yet, metaphorically speaking, you are plugging your ears. Yes, you followed the doctor’s orders, but doctors in Canada don’t work for you; they work for the government. Their task is not to increase the burden on the healthcare system while also keeping an eye out to prevent anything critical from happening to you. As you understand, there is no room here for thoughts about your quality of life or the fact that your headache may be caused by some underlying reasons that should be investigated. There is simply no time left for that. Nothing critical? Great, here’s a headache pill for you.

I don’t oppose painkillers; they help us temporarily maintain functionality until the cause of the pain is identified. However, using them just to alleviate pain without taking any further action can lead to the next stage of the problem. Your body warned you, but you didn’t listen. Next time, you may encounter more serious health issues.

Why does the doctor ask you to discuss only one complaint and schedule another visit for the second complaint?

Doctors are paid based on the number of visits, not the duration of the visit. So, if you come to the doctor with a different problem next time, it’s often challenging for them to connect it with the previous complaint because they don’t have time for it either. If you have multiple problems, you may need to visit the doctor 5-10 times, and each time they will be paid for just a few minutes. Yes, they will earn ten times more if you come ten times instead of once, but they won’t have a complete picture of your problem regardless. They have several dozen other patients to attend to every day. It’s not feasible for the doctor to record everything, review it all, sit down, and think about how it’s all interconnected under this payment system. That’s why treatments are often prescribed symptomatically, and usually, medication is prescribed along with it. I want to add that when I’m asked to have short visits to have everything covered by benefits, I refuse to do so precisely for this reason – it’s impossible to work comprehensively with complex cases. Naturopathic doctors are not covered by the Medical Services Plan (MSP) unless they choose to be, and I don’t know any ND (Naturopathic Doctor) who wants that. They have the ability to handle complex cases, if they want to, but not all NDs engage in that.

Pharmaceutical drugs:

As we know, every pharmaceutical drug has side effects. After some time, you may come with a new problem that is a side effect of the prescribed medication. That’s why doctors often have a conservative approach to prescribing medications. But even with this approach, patients often end up taking multiple medications for years because no one reviews the previous prescriptions. Some cases even lead to patients ending up with drug addictions and needing to find addiction rehab clinic locations that can offer proper treatment.

Why don’t Canadian MD doctors recommend alternative therapies?

Actually, it’s not entirely true. There are problems for which non-pharmacological therapies are officially recommended, but they can be counted on one hand. For example, in the case of otitis in children, it’s often recommended not to give antibiotics right away but wait a few days. Light therapy is officially recommended for seasonal depression. In the case of excess weight, lifestyle changes are recommended first before considering pharmacological methods.

But that’s not all. Often doctors cannot recommend safer and natural therapies because they have clear protocols based on research. Conducting research is expensive, and usually, it’s done by pharmaceutical companies, which often test their own medications. You can already guess the results of such research with this conflict of interest.

What do benefits cover?

I often hear people say, “I don’t have benefits, so I can’t afford to see alternative medicine specialists.” You can never have too many benefits, and they usually cover enough to have an annual check-up. Regular check-ups are important, even if you don’t have benefits. If you think that benefits don’t cost anything to those who have them, you’re mistaken. Money is deducted from your salary to cover them. If you don’t work for anyone, you simply have to take care of your health on your own. Just like you take care of your pets, who never have benefits, and the existing insurance policies are expensive and only cover critical situations. At one point, we calculated how much we were spending on our dog’s insurance and decided to set aside the same amount of money each month into a separate account. To save money effectively, it’s crucial to learn the principles of investing for retirement, a key strategy that can pave the way for financial security in the later stages of life. After two years, we canceled the insurance policy when we realized that we were constantly getting rejected by them. Over $100 every month for 14-2=12 years of our dog’s life accumulated a significant sum. On average, we spent between $250 and $500 per year on her health. I think this is a good idea in principle. Additionally, you can choose an account where the interest will be deposited, and the amount will only increase from there.

Why is the cost of functional treatment higher in Canada?

It all comes down to the fact that this type of treatment requires time. Doctors who utilize a functional approach earn a living by helping people and sharing the tools and knowledge they have acquired through education and personal experience. Like other healthcare professionals, they are not allowed to assist people if they lack professional credentials such as education, practice licenses, insurance, certificates, and so on. It is precisely these credentials that enable doctors to help people on an ongoing basis.

  • Time-Intensive Treatment: Functional treatment requires a significant amount of time and attention from doctors. These doctors earn a living by helping people and sharing the tools and knowledge they have acquired through education and personal experience. Like other medical professionals, they are not allowed to assist individuals without the necessary professional qualifications, such as education, practice licenses, insurance, certifications, and more. These qualifications enable doctors to provide ongoing assistance to people.
  • Education and Ongoing Expenses: Providing functional treatment necessitates education, which comes with associated costs. These expenses continue indefinitely as doctors must continue their learning and professional development.
  • Sustainable Income: To earn a livelihood, doctors require an adequate income. Since most doctors dealing with complex chronic problems typically see an average of four to five patients per day, the hourly rate must be appropriate for them to sustain their livelihood. However, this does not mean they only work four to five hours per day. The remaining time is dedicated to record-keeping, reviewing notes, planning, research, further study, administration, and other tasks. Seeing four to five clients per day constitutes full-time work for most of these doctors. Without adequate compensation, there would be a shortage of specialists working with complex, multifaceted illnesses.
  • Additional Support Staff: Some specialists may see more patients, but this requires having a team of assistants. However, this does not reduce the cost of the service; on the contrary, it often increases the cost of their services. Assistant staff need to be paid a salary regardless of the level of patient load.
  • Benefit Coverage: It’s worth noting that, unlike in the United States, such specialists in Canada can receive payment (or partial payment) through benefits. In the United States, they are forced to opt out of working with insurance companies because all doctors (MD and ND) must adhere to the same protocols for insurance companies to cover their work. This makes it impossible to treat non-standard problems.

Conclusion

  • If MD doctors inform you that nothing is found, you have two options: consult with a naturopathic doctor in your province or consult with an MD doctor in another province or country. In one province, all doctors use the same treatment guidelines, which represent the modern standardized approach to medicine.
  • Do not expect that public healthcare will change and cover such a treatment approach. Our system is already struggling to meet the basic needs of the population. Also, do not expect insurance coverage to emerge for this treatment approach, not even in the United States. It is impossible to use benefits for alternative therapies there.
  • Naturopathic doctors in BC have almost the same opportunities as family doctors, and they are not limited to specific treatment protocols. They can use benefits for functional treatment, which is impossible in the United States. In the US, specialists practicing a functional approach to treatment only accept cash payments, and the cost of their services is significantly higher than in Canada (around US$450 per hour).

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