Friday, August 1st, 2014

The Path to Patient-Centred Care

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The Saskatchewan Ministry of Health website has a diagram showing the ten steps patients take on their path through diagnostic imaging in the public health care system. I decided to take a different path.

During an appointment with my family doctor I told her that I was willing and able to leave the province to access a diagnostic tool called a Magnetic Resonance Imaging (MRI) scan. I found a private clinic in Vancouver, British Columbia, where I could pay directly for the scan. My doctor wrote a referral and the clinic scheduled my appointment within a couple of days. I received an electronic copy of the scan before I left the clinic and the results of the scan were emailed to my doctor and me two days after my appointment.

Here’s why I didn’t choose the public health care route:

Only a specialist can order an MRI scan in Saskatchewan. Your family doctor has to refer you to a specialist. You could spend a few months waiting on a list for a specialist appointment. The specialist then sends the order for the MRI scan to a central booking office. The MRI radiologist reviews your medical history and assigns you an urgency classification level based on government guidelines for prioritization. Consideration is also given to the availability of hospital resources as well as other surgical and emergency cases.

Cheaper imaging tools must be used before allowing the more expensive MRI scan, as the guidelines for patient prioritization state “In general, other appropriate, more accessible and less expensive imaging examinations will be required prior to considering the MRI request. The MRI radiologist should review these studies prior to assigning a priority.”

Wait times for MRI scans in Saskatchewan are posted on the Ministry of Health website. As of December 31, 2011, there were 4,317 patients waiting on the list. Wait times are now reported as certain percentages indicating the number of scans completed within a certain number of days. These numbers are only updated quarterly. Also, keep in mind that health authorities can use various data collection and reporting methods. This wait time information is essentially useless for patients trying to figure out when they will have access to MRI.

There are no guarantees for wait times but not to worry, the government is balancing the needs of the population within the limits of a public health care system. As the guidelines state “The wait times suggested for MRI studies in the prioritization guidelines are the recommended maximum wait times for patients with the conditions listed, based on what we feel is an appropriate balance between limited access and patient need. The actual wait times for patients may be different depending on demand and availability of scanning time.”

Who really knows how long you’ll wait for an MRI scan in the public health care system? What impact will wait times have on your health and quality of life? When they do call your number, can you choose a day and time that’s convenient for you? Can you choose which hospital to go to? Can you choose the state-of-the-art MRI scanner or will you be assigned to an old scanner? Do you get to make any decisions about your health care while travelling the public health care path?

My health belongs to me. I’m willing to do my own research, weigh the risks and benefits, make health care decisions and spend my own money on my own health care. I’ve found the path to patient-centred care and I’m going to keep following it.

 

 

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