Canada Waits

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As America tries to penalize doctors for the length of time it takes for a patient to get an appointment, Canada is also making some noise about “wait times”.  This from an article from a Canadian site:

  • Canadians lost about $1.1 billion last year while waiting for medically necessary health care, a new study from the Fraser Institute has found.
  • The study looked at the average amount of time that each of the 928,000 or so Canadians lost last year while they waited for surgery or other care.
  • It noted that the median waiting time between a patient seeing a specialist to actually having treatment was around 9.6 weeks in 2013. They focused on 12 medical specialties, including orthopaedic surgery, radiation oncology and cardiovascular surgery.
  • The public policy think-tank says the estimate in its report — entitled “The Private Cost of Public Queues for Medically Necessary Care” — is likely conservative, noting it only looked at costs borne by the patient waiting for treatment, not the costs of family members providing supportive care.
  • But he says the negative impact of waiting on a patient’s ability to participate fully in life is often ignored in the health-care debate.

My take home points:

  1. Our insane drive to decrease wait times is a farce because it is driven by the insurance companies who wave money in the face of the hospitals (employers) but it rarely trickles down to the doctors
  2. The Canadian’s complaint about wait times is a farce because it is driven by the government who also give no real incentive for the doctors to improve
  3. The only way this country hits all these indicators is for doctors to practice the old-fashioned way; that being to eschew insurance and prove enough value for customers so they pull money out of their own pocket.  This improves wait times.  In fact, with Direct Primary Care, there are no wait times. 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Canada Waits

  1. July 15, 2014 at 10:54 pm

    “Wait time” is an absurdity, like “best speed to drive” or “amount of time needed to cook dinner.” The statistics are meaningless.
    Acute admission for chest pain is a failure if the patient waits 4 hours until receiving EKG or being seen. On the other hand, a wait time of 6 weeks for rheumatological issues is not only acceptable, but actually diagnostically beneficial. The differential diagnosis for acute polyarthralgia without systemic findings is myriad, and often never diagnosed. A primary care provider usually ought not refer for 6-8 weeks anyhow; otherwise the rheumatologist consult may be a wasted effort.
    I like driving at 65 miles an hour, but not in a school zone. The average amount of time to cook dinner varies between 15 seconds and 2 hours; the average of that is about 1 hour (and 7.5 seconds.) 37.24% of statistics are made up on the spot.

  2. Ray
    July 15, 2014 at 7:32 pm

    I always laugh at the wait vs time argument. We doctors are penalized and hassled for increased wait times for hospital follow up visits, new patient physicals, or acute visits. At the same time we are hassled for not spending enough time with each and every patient. The so called “patient satisfaction index”. “Did the doctor answer ALL your questions on your list? Were you seen on time? ). This is really Physics. You have space and time but they are limited. You cannot see an unlimited number of patients and give them an unlimited amount of time and stay on time. Oh yeah, and provide “QUALITY” in your spare time. Maybe Einstein can figure this out…it’s just Physics.

    • Michael Gorback
      July 15, 2014 at 8:47 pm

      Excellent observation Ray. And as Einstein also showed, Time=Money.

  3. Michael Gorback
    July 15, 2014 at 3:15 pm

    You can see the actual wait times online. Each province posts wait times for procedures and specific surgeons. Check out the time to get M&T’s, a hip MRI, heart surgery.

    For example, see http://waittimes.alberta.ca/ The median wait time for M&T’s is about 6 weeks. The wait time to treat 90% with M&T’s runs 3-4 MONTHS.

    Speed, quality, price. Pick any two.

  4. Pat
    July 15, 2014 at 11:24 am

    Back in 2002 a friend of mind opened up a Direct Primary Care practice that was immediately successful, opened a branch clinic the following year, and in less than two years was seeing over 10% of his (large and growing) county. He took no insurance of any kind ever – especially not Medicare/Medicaid- and told me that he never had a patient wait longer than 20 minutes.

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