"Should the route to a specialist always be through a family doc?",among other topics

[da_birdie]

http://www.canadavalueshealth.ca/

 

A website created by the Health Council of Canada to "raise questions, seek answers and generate debate about how to best sustain our publicly-funded health care system"

 

In the Discussions section, there are a few topics raised:

 

1. Is an ounce of prevention worth a pound of cure?

 

2. Do we need to lessen our dependence on drugs to treat symptoms and place more emphasis on alternative medicine to assist healing?

 

3. Should the route to a specialist always be through a family doctor?

 

4. A stick or a carrot: Will hospital “pay-for-performance” incentives improve patient care?

 

etc.

 

 

Have fun reading / posting your comments

[Guest copacetic]

nice post, we need more of this. as future doctors and health care workers we need to appraise ourselves of issues and debates like these. too many premeds know little of the issues that face healthcare and their profession.

[future_doc]

A family member needed cataract surgery and went directly to her surgeon. He tried to send her to a general practitioner (across the hall in the same building) whom she knew simply plays the system to collect fees. The intent was for the general practitioner to earn a fee for a 5 minute visit and to 'refer' the patient to the surgeon, thereby entitling the surgeon to earn a higher consultation fee on the first visit. My family member refused to see the general practitioner and the surgeon did not insist.

[shaka84]

Judging from your previous posts, the GP must have been a male as he apparently was only in medicine for the money. Gasp! Everyone knows that real doctors have no possessions, donate their salary to charity and live in mud huts.

 

Who decided that your family member needed cataract sugery? The family member him/herself? If so, that is crazy. Can you imagine if everyone was allowed to direct themselves to specialists because they self diagnosed themselves.

 

I enjoyed reading how your family member knew that the GP played the system just to collect fees and that the surgeon just wanted to charge more for the consult. It sounds like self-righteousness runs in the family. This is our system. The GP's are the gatekeepers.

 

I don't understand why you want to go into medicine when it's obviously full of greedy, money hungry doctors. You must get dizzy sometimes when you look down on the rest of mere mortals from way above us.

 

rant over.

 

shaka

[NLengr]

Ouch!

 

I agree though. Family physicians play a key role in the system. They can treat all kinds of common issues. They can provide valuable follow up to care from a specialist. There are lots of problems a person may have that they think requires a specialist all the time, but in reality, can be handled by the family doc alone, or by the family doc after a specialist consult.

 

Lets take uncomplicated UTI's as an example. Family physicians are perfectly capable of handling them. Yet if there was a system that allowed direct access to urologists by patients I can guarantee that people would be lining up to see them for simple, uncomplicated UTI's. That's a huge waste of time and money on the part of the system.

 

Even many cases of recurrent UTI could be handled by a family doc after a simple consult. Patient presents with recurrent post coital UTI's. Urology consults, puts her on prophylactic nitrofurantoin. Follow up with family doc unless issues arise. There is no reason to go back to urology for follow up if that solves the problem.

 

Mole checks and monitoring is another case where people would go straight to the Dermatologist, when in reality, a large amount could easily be handled at the FP level, with consults as needed.

 

Also most medical problems have a huge range of differential diagnoses. A person without medical training would have no idea if they were going to the right person. Lets say a patient presents with abdominal pain. Who are they going to go see? GI, Gen Surg, Urology, Obs-Gyn, Heme, MSK, Psych? All of those specialties could have at least one condition they treat on the differential. All that would happen is you'd end up with patients being shuttled around from specialist to specialist with no continuity of care, and costing the system much more than it would have cost to have the person go to their GP initially.