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'I made noise, and things moved'

From Saturday's Globe and Mail

The Globe's four-week cancer series concludes with a look at patients who blaze their own trails through a maze of treatment. ...Read the full article

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  1. James Harrison from Toronto, Canada writes: The only thing that I could think about when reading this article is the fact that our hospital system has gotten to a point where only the squeeky wheel gets the oil, or the treatment it needs. It's great to give advice about standing up and asking for what your deserve, but the reality is: should we have to bully our doctors and specialists into the treatment that we need? At the moment it sounds like there is only enough (on-time) treatment to go around for those that do bullly. I personally have a lot of cancer in my family and expect to die from it also. It scares me to read about the state of our health care system at the moment. I am saving my money, because it seems quite obviuos to me that future treatment will go to the loudest person or the one with who can pay for it.
    I am really impressedwith the series of articles that the Globe and Mail is running recently about cancer. They seem to be very real life oriented, and not scared to talk about the realities of cancer and our health care system. Unfortunately this series is also not painting a pretty picture for those who will have cancer in the near future. Canada's system is already overwhelmed and will only get worse in the years to come. The aging baby boomers as a demographic bulk of the population will put even more of a strain on our already overstrained system.
    Canadians can be too reserved and quiet. On the issue of cancer treatment, we had all better learn to be a little louder, because it seems that only the really squeeky wheel is the one that is listened to, and the one who gets treatment. All at the expense of those who didn't speak up and did what their doctor told them. Here it sounds like the good guy loses and the bully wins.
  2. Andrea Timmons from Kingston, Ontario, Canada writes: Thank you Erin Anderssen for your article publishing good advice for cancer patients, & consequently all patients who often seem to be at the mercy of busy, blunt speaking Oncology Specialists.
    The best way to improve any system is to get involved, make your opinion know, & demand the respect we all deserve from medical practioners.
    Hospitals could help cure the problems faced by patients who feel alienated by the Specialists who treat them by requesting patients to fill out questionnaires(with room for comments) re how they felt about a Specialist's level of care & communication style. Then, feedback from these reports could be shared with the Specialists who were evaluated by their patients.
    Sometimes all that is needed to solve a problem, is to simply point out that a problem exists & to suggest various solutions the individual might apply to correct it.
    I don't agree with hiring mediators to communicate for Specialists. Specialists can learn to communicate effectively no matter how busy they are. They should be trained to always ask a patient if she/he would like to speak with a Counsellor, etc to discuss the psysho-sociological effects of being told bad news.
    Thanks again for a very informative article. I hope many patients will learn to be more assertive after reading it.
  3. Surfer Dude from Seattle, Washington, United States writes: Well informed persistent patients are more like Selfish Patients to me.
    As a physician it amazes me that people lack so much sympathy towards physicians and often think they are emotionally distant or rude and to the point. This article points out how physicians are set up to fail from the start. Physicians become a convenient scape goat for the lack of funding by the government and the unrealistic expectations of patients.
    Do the math for the physician in the article. He sees 40 patients a day. In an 8 hour day that means seeing one patient every 10 minutes. Seeing one very sick patient with multiple system problems every 10 minutes is unsustainable. If every patient brings in 40 questions then that just shortens the visit of the next patient.
    So this persistent patient with 40 questions is more a selfish patient and takes the time away from the equally as sick patient without an advocate.
    I am sure this poor physician like me maybe has 5 minutes for lunch if any, no breaks during the day and at the end of the day spends hours after work unpaid doing charts and filling out paperwork for prior authorizations. The physician probably gets home from work around 8PM and regularly misses dinner with his/her family, comes in on days off and weekends to catch up.
    People should be a little more appreciative for the people who try and help them.
  4. Thomas Price from Whitefish, Canada writes: A big part of the problem is specialization. I recently went through this with my father-in-law. In our area there is no health care person (doctor, nurse or anything else) who assumes the patient as 'their' patient. Each professional in the system addressed his/her area of expertise and tossed the ball over the fence to someone else while at the same time ignoring anything else than their area of expertise with the explanation that 'youll have to see someone else about that'. Once I realized the shortcoming of the system, I assumed him as my patient and began the arduous task of making sure all appointments were real, that test results got to the specialist before he met the patient, that timely response to results of tests was accomplished, etc. I could write a book on this but the bottom line is, THERE IS A STRONG NEED FOR A FAMILY DOCTOR that is not being filled or even addressed. Often the results of the cancer treatment causes other symptoms that the specialist does not address. Also, the specialists need to respond to and report to the family doctor and not act likes gods unto themselves. They are the tradesmen of the medical world and need to be responding to someone who is managing the entire project.
  5. Michael Bonazza from Toronto, Canada writes: These articles do a good job of demonstrating the devastating shortfalls of Canadian health care. To an extent I agree with post #3, although, since taxpayers pay 11 percent of Canadian income on healthcare, I feel they are entitled to quality care, but you're right that blaming the physician because they are forced to work within a terrible public system is wrong. Canadians who recieve poor quality care, or are stuck on waiting lists should be blaming liberal Canadians who have supported public health care and have ignored the fact that the people who actually need it are the ones that suffer. Average Canadians who see the doctor twice a year will continue to support public health so they can go on feeling good about themselves, it's only when THEY are the ones on the waiting list that they start to realize what a problem it is, that or they just don't care about sick people.
  6. Marlene Cairns from Charlottetown, PEI, Canada writes: Thank you to everyone at the Globe and Mail for bringing so much light to this disease which can often lean towards darkness. Erin you are bang on with what to do if you are diagnosed. I went went step further and just had local freezing (I don't recommend it to everyone) so that I could interact with everyone in the OR while they were operating to save my life. Living with cancer, my wish is to keep living so that when the maze is finally figured out I will live to a ripe old age.
  7. dfdf ddfdf from Canada writes: I can relate to this article. I was diagnosed with Non-Hodgkins lymphoma this past year and found my Oncologist at Mt.Sinai hospital in Toronto laxidasical and seemingly in no rush to get any tests done. To make matters worse, his secretary would yell at me when I called seeking my biopsy results. Things got so bad that my treatment was delayed because a diognostic test which was supposed to be set because of a lack of communication between the doctor and his own secretary! They each blamed each other at why the test wasn't scheduled. Luckily I found another doctor at Princess Margaret Hospital and was able to go there for treatment. When I met with the first doctor at Mt.Sinai to tell him I was going elsewhere (which is my right as a patient), his response was to angrily close his file and say 'Well I guess I won't waste my time anymore.' Don't flatter youself doc. He even failed to tell me that my chemotherapy was to begin in 3 days! I found out from a nurse that day. I felt lucky to get away from this bad doctor. Anyone who has someone going to this hospital and wishes to have the doctor's name in fear their loved one might fall under his care please email me and I will tell you his name.
  8. Steve Wilkinson from Canada writes: Hearing about the Fraudulent 250,000 OHIP users this week really hits home after reading this story. Tax Paying Canadian citizens are being denied proper care due to an corrupt immigration policy that allows any scum of the earth to abuse our system. Families of people from all over the World abuse our OHIP system. Rental scans or Finger printed identification should have been implemented years ago. The System is way overburdened and Canadians are not getting proper service.
  9. I, Publius from Canada writes: Cancer’s threat of imminent death increases the poignancy of these stories and induces a sense of urgency about fixing the medical system. I would like to point out that waiting lists, treatment of disease rather than patient, and their concomitant physical, psychological, and emotional pain are not only borne by cancer patients. While I hope this series of articles improves the treatment of cancer patients, I also hope that policy makers do not throw resources at this “squeaky wheel” and make worse the problems facing folks facing less frightening but still debilitating ailments.

    Just as a patient who demands more of his physician’s time removes a resource from other patients, so might a particular disease.

    Note: I come from a family with a cancer history and have personally had a tumor removed. No ad hominen attacks, please.
  10. Dave G from Ottawa, Canada writes: Being an immigrant from England (now a Canadian citizen, not that people view us that way or that it counts for much anyway) I have become appalled at the standard of medical care on offer in Ontario and the way in which the Provincial government and physicians appear to have complete disregard for those towards whom they have obligations. While Hydro One has been busy criminally squandering a $127 million of our public money on leather jackets and helicopter rides instead of hospitals my physician in Ottawa West didn't even have the courtesy to tell me I would have to wait until September 2007 to see a specialist. Nor does she think it worthwhile annually checking out a joint injury to ensure there has been no soft or hard tissue degradation when every other physician I have ever met tells me to do just that. I will ignore her 'professional advice' and go to another physician whom I really can trust, who has my best interests at heart and who deserves my tax dollars that they earn in pay. Governments at both levels seem busy squandering our vital taxes and allowing self-governing 'professional' bodies to keep the public short of physicians and nurses yet we have thousands of unemployed foreign-trained physicians in Ontario and, while shortages persist, more foreign-trained physicians arrive each day to be junked on the great heap of accreditation hurdles. Has Canada ever heard of responsible government, management and accountability? Or is the practice here only to benefit and reward grossly overpaid buffoons, inept relatives and outright criminals who will never see the inside of a jail despite their bilking millions? This shambles of a system is the direct result of managers/owners knowing that there are never any serious consequences for the most disreputable and incompetent conduct. Want to reach 21st century standards? Then punish the guilty.
  11. Sessa C from Waterloo, Canada writes: To the surfer dude from Seattle - You are asking people who are fighting for their lives to consider your personal life choices above their own will to live. Yes, doctors are extremely busy and the good ones don't let this get in the way of their approach to patient care. The good ones know they may not have enough time to answer their patients' many questions and choose to prepare printed copies of material with reference to reputable web sites for their patients to take home and read. The good ones take the time to call a patient who has reached out to them and told them about their son with bad table manners and use 30 seconds of that 10 minute time slot to ask their patients how they're doing. The good ones understand that they are in a partnership with people whose lives have changed forever and who are now fighting for their lives. Patients don't have a choice but to become well prepared and persistent because their doctors are busy and don't have the time to help their patients consider all of the options. You seem to want gratitude from your patients for a choice that you had to make in your life - to become a doctor. The people who are writing these articles and dealing with cancer had NO CHOICE about getting this disease, they're afraid, they're sick and they have questions. I am grateful for those doctors that chose to took the time with my mum when she was dying to explain her choices, get to know her kids, her husband, her parents, her work, a little bit about those things that made her life meaningful. I am frustrated to hear that there are still doctors out there who don't appreciate the impact they can have on a patient's struggle with cancer, and who haven't taken the time to figure out manageable methods to make a true difference in this global fight. Quit your job and spend time with your wife and kids eating long lunches if that's what's more important to you - after all, you still have the ability to make those choices in your life.
  12. Yvonne Wackernagel from Woodville, Canada writes: I have a letter from Smitherman telling me that the doctor makes the decision with respect to waiting times. This was in reply to a question as to why my Canadian Decorated Soldier had to wait 7 months to see a Consultant and then maybe 2 years for treatment. Well, with the necessary papers from two Orthopaedic Surgeons telling me that I had to start treatment immediately for two severe breaks to my upper arm or I could lose the use of my hand, I threatened to sue them if I did not get the treatment in a timely manner. It worked, because they knew I meant it. The position now is that the patient is a by-product. Hospitals are large Employers with approximately 85% of their revenue going to salaries and benefits and only about 6% going to health. Doctors getting $350 an hour in Emergency consider themselves underpaid and many times do not give of their best when it comes to courtesy. I prefer a foreign trained doctor, and I really think we should ignore the Americans and invite the Cubans into Canada as Cuba has one of the best cancer care wards IN THE WORLD and and an overeflow of doctors. When 80 year old widows are having breast removal and sent home immediately after surgery to be alone, and when she starts hemorrhaging and calls an ambulance at midnight, the hospital stops the bleeding and sends her back home at 3 a.m. to be alone, this country is in serious trouble. This Government should put an embargo on these expensive drugs which at $40,000 a treatment only helps a few hundred cancer patients. Then the manufacturers would wake up to the fact that the Government might pay $3000 each for 2 million tratments which would be just as cost effective to the manufacturer. Surely this is not rocket science, just plain math! The Government, LIKE THE AMERICANS, are just pandering to the big drug manufacturers, OR the bureaucrats (politicians) are unintelligent, to put it mildly.
  13. Larry Robinson from white Rock, writes: The best thing about this article is that an end-user was able to analytically write about her situation. And the resulting comments have brought the same tone absent of the usual hysteria and political points.
    Our Health Care system has deteriorated for patients and health care providers. A doctor limited to 6-7 minutes per appointment and no more than two questions cannot do a multi-layered diagnosis or treatment plan. Nurses fighting for sufficient beds, laundry, and even food for patients when private canteens are closed cannot provide 'nursing'. Patients are screened as suspects because of the multiple abuses of the system and premium on treatment and space. The bottom line is we have sick people and we have people who would like to do their job. In between is a lot of philosophical driven policy and administration, and an intolerant electorate.
    This article cuts through it all and the resulting comments are on point.
  14. J.C. Davies from Canada writes: If Lance Armstrong were Canadian he would be long dead.
  15. Ashley - from Toronto, Canada writes: Surfer Dude:
    I think we're all aware that doctors are over-worked and have extremely stressful careers. I know that your response must come from a personal place, because I'm sure it's hard for you to hear criticism of your profession when you're working long hours and making sacrifices. However, I don't agree with the tone of your statement. I think most of us do appreciate the wonderful doctors who have helped us. I don't expect them to spend 2 hours with me, but I do expect them to answer the questions I have. If you don't want to be pestered by questions by 'Selfish Patients', you may want to consider a career that doesn't involve people. Many of us also have stressful lives and careers (I have two), and don't make anywhere near the money a doctor does....so forgive us if we aren't appreciating your plight enough. We may be busy making our own sacrifices.

    In January of 2005 I started to experience blurriness in one eye. I went to my own doctor, then to an ophthalmologist and finally to a large hospital for tests. AFter a long day of various exams, the final test was a 'physical', which I took to be a routine examination. When he was finished, the doctor announced himself as an oncologist and informed me that I had cancer in my eye. He immediately launched into a detailed explanation of how they would remove my eye. There was no bedside manner whatsoever, and I was bombarded with very scary information and statistics I wasn't ready for. My formal diagnosis was to be the next day, and his information turned out to be incorrect. Removing my eye is not a strong possibility in any way, and he turned it into a much scarier situation than it needed to be. Surfer Dude may explain that this doctor was under stress or too busy......but he was also the cause of a year of nightmares and panic attacks. Thankfully, my regular doctor there is wonderful and supportive. But, I absolutely made it known to all that the first doctor's approach was entirely unappreciated.
  16. Bruce Batchelor from Langley, Canada writes: Poster #12 really has it right. The solution to most of the vexing examples cited, including those in the article, lies in a binding and universal declaration of patient rights, inclusing wait times, privacy, access to files, second opinions, and so on. The health navigator is good idea, but it is not practical economically for every patient; we would need thousands of them! Some of the persons cited in the article did not in fact have a medical problem, though they honestly felt that they might have one if they were not involved in the kind of communication they desired. The article made it look too easy to make your practitioner responsive. In our experience, and dealing with truly serious medical issues, getting edgy with doctors puts you at the bottom of the list, or gets you discharged home, or gets you an offer of faster service at a paid facility, in which no doubt the specialist has a financial interest. Keep in mind that when doctors monopolistically erased midwifery 100 years ago, they knew less about infant delivery than the midwives they erased and their outcomes were no better. Similar issues exit today, if not in that field.
  17. Chris Leighton from Windsor, Canada writes: As an oncologist who works part-time I have the fortune of spending a bit extra time to provide patient counselling. However, my full-time colleagues are very effective at communicating with their patients. I think we must be cognizant that a few bad experiences should not cause one to generalize that all oncologists do not take the time to carefully explain disease and treatment options. Patients are often overwhelmed when first seeing a cancer specialist. This anxiety state often causes one to forget what was told to them. Their memory is often: 'The doctor didn't explain that to me'. It is important as cancer specialists that we continue to re-inforce what was discussed in the initial consultatation. It is important for patients to bring family and friends to your initial appointments -- that way what may be missed by the patient, will be heard by the family member.

    Christopher Leighton MD, FRCPC
    Radiation Oncologist
  18. MJ Patchouli from Regina, Canada writes: Great article and fascinating discussion. As I read the article, I wondered if physicians would also be reading it, so I am gratified to hear that point of view represented here. Surfer Dude has raised points that are not generally considered, but with a tone that is frighteningly uncompassionate and cold. Surfer Dude, I wish you would post again with some ideas for resolving your lack of available time for your patients, and their rights to understand what's happening to them. Do you need the services of some kind of specialist nurse who can work with you and then communicate to your patients -- cuz if I have cancer, I'm going to have a lot of questions for you, and you're the guy I'm turning to and believing in. Don't blow that faith. Thomas Price said there is a greater role for general practitioners and I agree with that -- although it's bare bones picking here in Regina to find a good family doctor that will take new patients. I have often thought the family doctor has become nothing more than a middle man, the keeper of the gate to the specialists. The gp just sends me to different places for tests, then onto a specialist, doesn't want to answer any questions.
  19. Dianna Schreuer from Dartmouth, Canada writes: I read with interest the comments that have been posted. I come at cancer from both sides of the bed, as a breast cancer survivor and one who works in health care. I am a Patient Navigator with the Nova Scotia Breast Screening Program and impact on an abnormality rather than a diagnosis of breast cancer. The time between not knowing and knowing that you have cancer is exttremely stressful so that is where our program starts. The cancer patient navigators do a tremendous job of helping cancer patients with the day to day getting through treatment and follow up. Your highlight of Joanne Cumminger was well done. I have known of her postitive impact on her community for years. She is very well respected and rightfully so. Bad news travels faster than good so I was not surprised at individuals writing about their bad experiences. However, the surgeons and oncologists that I interact with really take their time with patients and genuinely care about them. I have seen them interacting with their patients in a positive manner. Their concerns are also very evident in when they discuss cases at the Clinical Site Team. Sure there are individuals who ought never to have gone into the medical field, but such is not the case at Capital Health in Halifax. We are fortunate to have the best and brightest and most empathetic individuals that I have ever had the priviledge to know.
  20. Andrea Timmons from Kingston, Ontario, Canada writes: Surfer Dude's, Washington Doc's Post emphazises the fact Physicians are their own worst enemies. If Surfer Dude & other Docs are too busy to communicate with their Patients, they should, at the very least, schedule in, educational sessions, using multi media presentations, to inform their Patients, about their disease & treatment, diagnoses, FAQ, etc., and a feedback session, to afford Patients the opportunity to ask questions & have them answered.
    Blaming the Patients or the Health Care System will never solve the incurable problem of cancerous communication by Dr. Surfer Dude & his Physician Peers, because by its very negativity, it poisons the medical environment & blocks the focus on solving the problem.
  21. Jenna Bush from Calgary, Canada writes: Blame the multinational drug companies that lobby for medicianl plants and other alternative methods to be outlawed so they can continue to push their expensive poison. Get back to having medically trained people administer hosptals, not a bunch of MBA idiots. Oh, and try taking carpet out of hospitals, shoes and carpets are one of the worst for spreading infectious diseases. Of course if we payed no taxes and people were able to pick their treatment you would soon see doctors drop the snot nosed attitude. I don't know why as Canadians we find it fine for private business to bring us cellphones, make our cars, our TV's, our books, our houses, but have fits when private health care is brought up. Throwing more money in the system will do nothing to improve it, neither will making it bigger, that is the reason it is so stupid and unflexible already.
  22. Paul P from Lisboa, Portugal writes: I am a Canadian Citizen and had to leave, what I regard is the best country in the World, because I could not receive the appropriate health care in Canada. After time and time again being told that I had to wait to see a specialist, I returned to my country of birth. Here I see a specialist whenever I need to at a cost of about $100 a visit. I now have private health insurance which costs me 500 euros a year ($750) which covers 80% of my health costs no matter which doctor I decide to see. The Canadian system is at a breaking point and only those who still believe that Canada has the best medical system in the world are those who have never had to deal with it. An please, no comments about how it's free for everyone because nothing is free, it comes out of your taxes.
  23. Rick in Calgary from Canada writes: So let me get this straight, Surfer Dude: people who are experiencing a painful, torturous, often drawn-out death sentence are 'selfish' because they're thinking of their imminent death instead of the fact that you work long hours.

    God help anyone who ever has to see you for anything more than a head cold.
  24. Nicky Bois from Toronto, Canada writes: Surfer Dude posts that 'Well informed persistent patients are more like Selfish Patients to me.'. Dr. Dude, is it wrong to be well informed? Apparently, you would rather people be ignorant of a situation that could cost them their life. After all, that makes things easier for you. And how dare they be persisent in demanding life-saving treatment, especially the ones that know what they are talking about. That is so wrong of your patients, because you didn't have dinner with your family the evening before. Did you hear that, Dr. Dude's patients? Do not inform yourself of your condition, and do not be persistent in pursuing treatment. Dr. Dude, if I ever develop a condition that requires your services, I am sure within just a few moments of meeting you I will have a good idea of your inability to treat people as human beings. And I will find a more compassionate doctor elsewhere, since I am a little persistent that way. And maybe you can get home 15 minutes earlier that evening.
  25. Jimmy K from Toronto, Canada writes: Surfer Dude, I think the problem is you started treating cancer and stopped treating patients.
  26. S N from Canada writes: I have seen through a young adult friend's journey and recurrence the critical importance of self-advocacy and family support as one struggles through treatment and recovery from cancer. I did find this article, and others in ther series quite valuable for a number of reasons. I am disappointed, however, that absent from this collection of stories/articles are the voices and experiences of people of colour. While there will certainly be overlap and intersection of experiences, there are likely to be significant differences in how their journey plays out as well, at least from what I've seen. Cancer happens to women (people) of colour too, and their unique stories and journeys deserve to be told. Many of these people are part of the Globe's audience as well! I know that they are out there and willing to talk about what they've gone through, and ought to be able to see themselves reflected in these pages. They have collected wisdom to share as well. There is much that health care providers, family and community can learn about ways to increase individuals' agency and to better appreciate the subtle and frank barriers that impede the diagnosis and treatment process for this oft-neglected 'group' of people. I hope that this form of diversity will be explored in future columns.
  27. c mctavish from Barrie, Canada writes: Surfer Dude. You chose to be a physician. Suck it up. Most people don't have the option of making 250k or more a year. People that make that much money pretty much give up the right to get sympathy from the public. '5 minutes for lunch if any, no breaks during the day and at the end of the day spends hours after work unpaid doing charts and filling out paperwork for prior authorizations. The physician probably gets home from work around 8PM and regularly misses dinner with his/her family, comes in on days off and weekends to catch up.' Cry me a river. I think nine out of ten people would sacrifice that time to make over 250k. You don't like your job? Quit! Most people hate their jobs, and don't make near 100k so quit whining. Obviously, you have time to surf, with your name 'surfer dude'. Maybe if you spent that time instead with your family instead with your time off you wouldn't complain so much.
  28. S W from Canada writes: IF the cancer stats are accurate, I'd like to read more about what kind of treatment a doctor's family gets. None of these stories seem to have a doctor or cancer doctor in their story. Given these high stats, why is that???? Or do those ones, alla Marla Shapiro just sprint off to the US??? AND... to me you can't really blame the patient too much for agressive or 'selfish' behaviour. Cancer has gone coporate and has created its much needed consumers. And sadly these consumers are yelling at the check out clerk, with varying degrees of success. AND... Now they are really just true consumers. Waiting for the next 'new' ' improved' thing to buy into. Sad. Read the writing of Dr. John McDougall to get a whiff of the BIG business end of this issue. Sick it is. 'Made a noise'??? Nope, you just moved into the check out line.
  29. Steve K from Alberta, Canada writes: #21 - the economics of health care 'obeys' much different principles than the standard 'widget production' economics you may (or may not) have learned in first/second yr university economics. Simplistic notions of 'private enterprise good, public bad' are just that... simplistic. One of the most (if not the most) privatized health care systems in the world is but a few hrs south of you, in the USA. In the USA, average health outcomes are worse & yet costs are much higher. Despite this, you are welcome to hop a plane & take a short ride from Calgary to the USA for your treatment. The fact you don't tells us something. 'Throwing more money in the system will do nothing to improve it' - that is a now-standard criticism by the uninformed/right wing. Ultimately, the $$ for healthcare comes from the same source - the people. We can either fund it in an egalitarian fashion, thru progressive-rate taxes, or let those with the most $$ get the best & fastest treatment. It appears that the conservatives/right-wingers favour this second choice. Give the Conservative Party 2 majorities, & we will back to the health care system of the 1950's.
  30. Eric Weir from Richmond, B.C., Canada writes: On January 7th 2005, my wife was diagnosed with pancreatic cancer, and she passed away 10 months later on November 3rd, 2005. We had been referred to the B.C. Cancer Agency by our family doctor, and were aware that prospects were not good. In September of 2004, my wife had suffered a sub-cranial aneurysm. During our initial interview at the Cancer Agency, the attending Oncoligist when noting the aneurysm stated 'you were lucky, this (the pancreatic cancer) will kill you' Despite the fact we knew the prognosis would not be favourable we were stunned and shocked by the comment. Subsequent treatment, care and attention from the Oncoligsts (not the same one) and nurses assigned to us was caring and compassionate. But, I will never get over the initial reaction, and can only hope that particular individual has learned some skills in dealing with people who desperately in need of hope.
  31. Charles Wirrell from Vancouver, B.C., Canada writes: The comments in the article apply to ALL waiting lists and surgery. Two weeks ago on a Tuesday I called my cardiac surgeon to enquire when my upcoming valve repair (originally scheduled for September/October) might be expected to occur. I was told no sooner than the end of December if then. Unsatisfied with the delay I called B.C. Health and the surgical coordinator at the hospital to see if they even had me on the list yet. I was told end of January possibly. I explained the issues of being in construction and unable to work (I'm 45 years old) and having no definite date for surgery and how that greatly impacts ones life. I also explained that sitting at home, waiting for a phone call is no way to live. She suggested we go off for a visit to relatives as we would not be in till January anyways. We also wrote to the health ministry. Thursday the phone rang and I was asked if I could take a cancellation on the following Wednesday. I said, 'Put my name down, I WILL be there no matter what the road conditions are (we live 8-10 hours from the hospital)! Late Thursday another call says cancelled! I said, 'When will it happen?' I was informed Dec. 4 when it did actually happen! Now I am in recovery, the 'beginning of the end' as my 14 year old says about this ordeal!
    It does prove the squeaky wheel makes it happen. I should have done this 2-3 months ago.
  32. Helen Pettingill from Ontario, Canada writes: People shouldn't have to stand up & bully their way to the treatment they deserve. It's just not right. For some people, the level of confidence that requires or the friendly support just isn't there. Does that mean they deserve to be pushed back to the end of the line? I think not. When people are diagnosed with cancer, they are probably more vulnerable & insecure than they would be at any other time of their lives. We all deserve the same level of treatment whether we're rich or poor.
    Now is the time for the feds & the provincials to stop blowing money on Afghanistan & Hydro One & CAS executives (as an example) & start putting it into all hard working, tax paying Canadians who have cancer. When will they really listen? Cancer can come to any of us at the drop of a hat. It plays no favourites so the treatment system shouldn't either.
  33. Sue James from Toronto, Canada writes: I agree that you need to be forceful in dealing with the medical system. Had I not been, I would be dead now. That's my reality. But, part of that is due to doctor shortages. I needed a type of surgery that is highly specialized. Most of the practitioners of this type of surgery have left Canada as they are able to pursue their profession with more financial success, lighter workloads, and better equipment. I was blessed to find a decent caring surgeon (who I was referred to after bullying another specialist who refused to move with any type of urgency; she didn't have the expertise to judge my condition, but, decided to do so, which meant that an uninformed doctor was making the decision on how fast I needed surgery!). However, due to the shortage of such practitioners, I might have been referred to anyone, with no choice to leave and go to another surgeon. If we had more doctors to choose from, then,yes, patient satisfaction ratings might change some doctors. But, when you're in a high demand field, why should you improve your system, manner, etc, if you know that it doesn't matter to you financially or in terms of patient referral???? We need to have more doctors in Canada, and discourage highly trained professionals from leaving. Also, if you are in tight time frames, the time to search out another doctor might not be there. Re Ombudsmen: my experience with Mt. Sinai was horrific. I got to see my patient file (on the sly). She was documenting my complaints from a view of protecting the hospital from legal liability, and recommending courses that would help the hospital, not me. A similar experience with Sick Kids, however, was very different, in that our complaints were treated with respect, and processes were actually put in place to ensure that a similar situation to what arose with our daughter would not occur in the future. So, don't assume all Ombudsmen are created equal!
  34. One Canadian from Canada writes: You finally have a government in place that is not afraid to tackle this issue. The last government would simply generate a fear factor to prevent any change then throw a wad of money at the problem with no idea on where to spend it.

    The Liberals like to operate in a state of confusion when there is money around....it make it much easier to steal and their propaganda machines (CBC, G&M) can easily cover for them.

    The conservatives recognize the Health Care system is in trouble. Let your MP know how you feel, and your thoughts on how it might be fixed. The conservatives will make it happen but they need support from the other parties. If they can't get it done, give them a majority government in the next election.

    As it stands the liberals are holding up the crime bill as we have gang with guns running wild in our cities.

    What can you do as an individual to fix the health care system.....bottom line...... GET YOUR MP TO SUPPORT THE CURRENT GOVERNMENT
  35. Edward Thomas from Glorious Capital City of Almaty, Canada writes: Why do doctors miss the obvious connection between their salaries and their lifestyles? Every time physician burnout comes up in negotiations between the OMA and the Ontario government, doctors always claim they need higher salaries to deal with their inability to do their jobs properly. A grade-school dropout can see that what doctors need is more doctors. Instead, the OMA and other physicians' bodies always lobby for higher salaries and artificial restrictions on entry into the profession in order to maintain the very same skilled labour shortages that make their working lives so miserable.
    So will these intelligent professionals ever opt to take a pay cut to make room for more doctors ... the signs aren't promising. During the last round the OMA and the Ontario government agreed to delay funding for a seniors care program in order to make room for even higher salaries.
    Doctors don't have to make salary concessions because labour shortages give them a hammer in negotiations. But the same doctors are too blinkered to realize those same labour shortages are ruining their personal lives and killing their professional reputations. Freeing up more money to train and license doctors (which would also reduce the wage pressure on doctors' salaries, alas) would allow physicians to do their jobs properly, with less stress, less time invested and yes ... less income.
    Does a doctor need $250k to do her job? If she did the same job for $175k with a 60-hour week instead of 80-to-90 hours would that be more attractive to her? It's time for the public to put the question to its physicians and negotiate a plan that will actually improve the quality of doctors' work if not fatten their wallets.
  36. S Foley from Ottawa, Canada writes: #12, #16, #29 are living in a dream world if they think creating some sort of charter or throwing more money into the system will make miracles happen.

    Doctors and nurses work very hard but they work within a flawed system of a monopoly on care. Adding another layer of bureaucracy or more money will have little effect. As an analogy, we could all declare ourselves the universal human right of a free house and free food. Sounds great, doesn't it? The problem is the delivery.
    More money or guarantees will do little in a flawed system.

    What is needed in the system is competition. This delivers several things, al of which are lacking in our medical system:
    -competition allows the freedom for health providers to experiment and deliver improvements on their own without their new ideas being obstructed within the existing system (a simple example is how union rules forbid doctors from changing light bulbs).
    -competition allows providers to see where their own system is flawed and where it is not (nobody is perfect, people need to see someone else doing it better to make improvements)
    -competition forces providers to be accountable for their work lest their clients seek treatment with competitors (and no more doctors shooing you out the door after a 1 minute consultation)
    -competition cleanses the system of those health providers who simply refuse to deliver quality (we've all seen some of the bad practices)

    There is little competition in the current system.

    So instead of a system in which we earn our health care with paying through our own pocket, we now have a system in which individuals with connections or persuasive/demanding personalities receive the timely care at the expense of everyone else.

    We need freedom: we need a private health care system.
  37. l r from toronto, Canada writes: Speaking from my experience with breast cancer, I am grateful for all the expertise and support my doctors have given me - Dr. Sehdev (quoted in this article), Dr. Heisler and Dr. Tang. It's been 5 years now - thanks to them!
  38. Misty Blue from Kelowna, Canada writes: I once read about an ancient medical system...I think in China. A family would retain a doctor, commit to this doctor, and pay this doctor a monthly amount of money suggested by the size of the family. As long as a patient stayed healthy, then the fee kept being paid. As soon as someone became ill, the payments stopped until the person was cured, or died I guess. I love the idea of this system of preventative care because it makes so much sense. When people fall ill, they can't work and can't pay in a lot of cases, so this sort of system would prepay for care while sick. It is a huge incentive right up front for the doctors to keep you healthy, because if they do, they get paid. Of course, it's simplistic, but I believe it would work, with modifications to a public health system, for the benefit of everyone.
  39. A Cynic from Terrace, Canada writes: Surfer Dude, please read the comments made by Dr. Christopher Leighton. Dr. Leighton's comments, although protective of doctors, still provides good advice to patients and he shows a caring attitude. Something you, Surfer Dude, lack. Why not give up your overpaid job and go surfing, leaving your position to someone far more capable and caring than you are.
  40. jorly fuster from t.o., Canada writes: Are you guys going to write about non-wealthy cancer sufferers too?
  41. leslie g from Canada writes: I realize that I am coming late to this conversation, but none the less I have to throw in my 2 cents. I have a very rare and unfortunately incurable form of cancer. The first oncologist I saw came into the room, and without so much as by your leave or an introduction, performed a pelvic. He left the room and returned 5 minutes later and announced "you have leiomyosarcoma, and if its in your lungs, you're in trouble." He then went off on vacation. I waited for two weeks for a call from The Cancer Clinic as he had promised my care would continue regardless. Then I went down and demanded an appointment with someone. I found out then that said Dr had not only failed read my chart. He had made absolutley no arrangements for my care at all. I saw another Dr who, after scanning my chart for only about 10 minutes, told me that I don't have LMS ( a very rare and agressive form of sarcoma) , I have something even more rare, but with a somewhat better prognosis, even though incurable. If I did have LMS, those few weeks would have been crucial to my life to prolonging what was left of my life. What happened to me was unconscionable, and No one should ever have to go through it.

    With all due respect, SurferDude, if indeed you are a physician as you claim; leave your practice and go into research. There you can practice your profession without all those pesky necessary evils called patients. You will likely even make it home for dinner.
  42. Timothy Nessus from Somewhere, Canada writes: I have long sustained the Canadian health care system (and particularly Ontario's) stinks!. I had been diagnosed with Renal Carcinoma. A radiologist caught it (yup! that's right, 2 Oncologists overlooked it). When I was referred to a "specialist" (aka surgeon), he recommended (i.e. "decided") I would be better off with only one kidney. When I inquired about a "partial" he told me that no way. And YES! I was also yelled-at and mistreated by his secretary. Not happy with the outcome, I sought a second, third and fourth opinion (in US and in a Latin American county -yup!- a Banana Republic) and ALL of the specialists agreed that a PARTIAL was a way to go! I finally found a surgeon in Princess Margaret that was profesional, kind, considered, busy AND would do a partial. WOW!!! What a find!!!! The operation was great, except that the Morphine self-administered pump failed and I came really, really close to a fatal overdose... I guess the people in the IC unit were not to be bothered with checking the pumps.... Today I am the happy owner of one and half kidneys and a couple of titanium staples in them. The ISSUE in Ontario is that there is NO accoutability in the medical profession. A "bottom" of the class MD is the same as the "top" of the class MD. THIS is not only ludicrous, but DANGEROUS to a patient. MORE if you are DEAD SCARED and witht a DEADLY DISEASE!!! So... do I like doctors in Canada??? NO WAY!!! They may be under stress, but from were I sit I also see a lot of laziness, arrogance, stupidity and disinterest!
  43. yyc kelly from Calgary, Canada writes: Actually, it seems Surfer Dude from Seattle, Washington, United States must think he's posting to a US forum, and it's not the first time he attacks Canadians. I find it ironic that a "physician" would make such comments regardless what country, but the simple fact is he is a "physician" from the US where they do treat patients as if they are on a assembly line. Money Money Money, the more they can get through. My doc does schedule appointments every 15 or so minutes but if someone says can we talk about this I have questions, he will take as long as the person needs to talk. I think I speak for alot in saying doc's in Canada do care for their patients well being and not about the $$$. They become doc's because the care for people not the money and or the heartache of watching so many suffer. Hell for that and for less schooling become a drug dealer.....100k in the first year or 100k after 10 years ...hmmmm. rocket scientist i say. SD, it's ok, we have doc's in your field here, not recruiting. LOL
  44. Pearl Neidlinger from London, Canada writes: Hello everyone great to find this site. I went to a clinic with a breast lump and the felt it and said "oh that's nothing to worry about" . 15 weeks later I saw another Dr same clinic who also said it's nothing I was feeling unwell they had taken blood and it was way off but they just said I must be fighting some infection. Then I went in for a nasty earache and after discussing the earache I asked her to look at my lump and she first told me a patient was only allowed two complaints and since I had also questioned my previous blood analysis (that was my second complaint). Then I asked her to please look at my lump again ths time it had grown alot, I explained to her that I had asked about it a year ago and the Dr said "who told you this was nothing to worry about" and I said "you did" well then she became afraid and ordered a mammogram. I had the mammogram then they called back and said I needed an ultrasound so I had one and it came back as begnign, well I was getting sicker and sicker and more and more tired and went back again so she sent me to an internist also part of the medical group she the Internists told me I was anxious and gave me antideppresants, so I thought okay maybe I am so I took them waited four weeks an noticed no difference but continued to feel in the mud more and more. So I had an appointment with my back Dr. and as an afterthought asked her to feel my lump the size of a walnut at this point. She immediately booked me for an ultrasound and biopsy and an appt with onco. Well turned out I had Stage 111 invasive cancer of the the breast (above the breast actually). So I was stunned that two years later a Dr. who didn't have to help me at all saved my life, or at least started to. My surgury is June 19/07 I want to sue the clinic but don't have the funds but more than that I want to know how many other women and men are ill feeling bad but have been told they are fine. Scary thought it keeps up at night. What to do?
  45. Pearl Neidlinger from London, Canada writes: Surfer dude, I understand your busy but why take on more patients than you can properly handle on a daily basis. I don't get it take to less a day leave some extra time for the patients that really need it. And if you end up with extra time call in some cancellations or patients on a waiting list. I was misdiagnosed because of a busy Dr. and carried invasive cancer around for an extra year and half, now if this Dr. wasn't so busy would I be worrying about dying right now, no way. I do understand Dr.s are busy but our lives depent on you Doctors so make time and just listen to your patients. How long does it take to right up a requistion for an ultrasound, mammogram, bloodowork. Less that 30 seconds and you could save a life.

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