Home April 2018 Access to Specialists

Access to Specialists

With long wait times, what can patients do?

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Dr. Ian Lo – Orthopedic specialist, private practice and Gateway Health Solutions.

According to Alberta Health, wait time is defined as “the time between when a patient and [specialist] decide that a procedure or diagnostic test is required and the date the procedure or test is performed.”

Wait lists have been a problem for decades and remain one of the most significant issues facing our health-care system. For example, Alberta Health’s Wait Times website indicates that the majority of patients can wait up to three months for a CT scan and up to 12 months for an MRI. If a patient requires a more complicated surgery, such as a knee replacement, they can wait up to 10 to 12 months (or more) from the date of decision to treat to the date of treatment.

So what can patients do and where can they go to see a specialist faster? In the past, according to orthopedic surgeon Dr. Brian Day, Albertans have generally gone abroad. “The author of a recent article in an Italian law journal described Canada’s health system as one designed for the very rich, who can afford to go abroad when they are in need of care.”

Day, a pioneer in arthroscopic surgery and sports medicine in Canada, established the B.C.-based Specialist Referral Clinic (SRC) in 2002 to address the lack of access to specialists right here in Canada. SRC accepts direct requests, “as long as we have the appropriate specialists,” says Day. The clinic claims to be one of Canada’s premier private health facilities where “Everyone’s a VIP at SRC.”

SRC now has over 50 specialists and two locations: one in Vancouver and one in nearby New Westminster. SRC also operates two satellite locations: one in Burnaby at Fortius and one in Whistler Village.

The process to see a specialist at SRC is relatively easy: make a phone call or send a fax or email and “receive rapid access to world-class specialists.” No referral is required and the cost is reasonable, around $500, says Day.

SRC offers independent medical assessments, second opinions and IMEs (independent medical evaluations). Day says appointments can be booked in weeks not years. “SRC takes great care to ensure you are seeing the right specialist for the right problem.”

When necessary, the clinic can also arrange surgery at the Cambie Surgery Centre (CSC) which was opened in 1996 by a group of nationally- and internationally-renowned doctors and independent investors, guided by Day’s vision. Equipped with state-of-the-art technology, CSC allows surgeons to utilize minimally-invasive surgical techniques that ultimately result in a faster recovery.

For sports and recreational activity-related injuries, Innovative Sports Medicine in Calgary offers, in addition to many other services, the Rapid Access Sport Injury Clinic which, according to its website, is structured to assess patients with acute (new), recreational activity or sport-related injuries within 24 to 72 hours following an injury. Like CSC, patients do not require a referral from another physician and the program includes an evaluation and diagnosis by an experienced sport medicine physician. And there are no direct costs to patients – visits are covered by Alberta Health Care.

Surgical Centres Inc. operates seven clinics of which two are located in Calgary: Riverview Surgical Centre, specializing in plastic and reconstructive surgery, dental surgery, infertility surgery and podiatry; and Rockyview Surgical Centre, specializing in ophthalmology including FEMTO cataract surgery and Mohs micrographic surgery. The goal is to “give timely access to world-class surgeons who are using advanced technology.”

Dr. Ian Lo, a Calgary-based orthopedic surgeon, has dedicated his practice solely to the treatment of shoulder conditions and has pioneered several arthroscopic shoulder procedures – improving the quality of life of thousands of patients across Canada.

In addition to running his own private practice, Lo is affiliated with Gateway Health Solutions. Lo explains that with the exception of British Columbia, Canada’s health laws usually do not allow for private, medically necessary surgeries. “The option available to most patients wanting to avoid long wait times for orthopedic surgery is to travel to destinations outside the province, where private surgery is readily available. However, these patients often have difficulty coordinating local care before and after their procedure.”

Gateway facilitates local and out-of-province orthopedic surgeries for Canadians and provides two options to patients seeking out-of-province surgery: 1) When travel is required to access private surgery, Gateway usually provides local surgeons to travel with you to perform your surgery at the destination. 2) Surgeons at the destination facility are available to perform your surgery.

“Though Gateway is not the provider of medical services,” states their website, “they engage their network of medical expertise and facilities to coordinate diagnosis surgery and rehabilitation needs of Canadians who opt for private surgery.”

Lo says Gateway provides a seamless continuity of care for patients interested in the value of timely treatment and private surgery in their province. They are committed to completing the circle of care for any Canadian opting for private surgery taking care of patient needs before, during and after the surgery. They are able guide patients through every step of the process, from initial assessment through to rehabilitation.

Marianne*, a Calgarian who suffers from arthritis in her lower back and a ruptured disc, wanted to see an orthopedic specialist in the city, but was told the wait time would be around 20 months. “I was concerned that there was something I should be doing and didn’t want the problem to get worse.” Anxious to get answers and treatment sooner than later, Marianne decided to seek treatment outside of the province at the Spine Institute in Phoenix.

Marianne says the process was quick and effortless. “I called on a Friday and got an appointment for the following Tuesday – so less than three business days later. To facilitate the appointment, I brought a CD copy of my MRI from Calgary to Phoenix.”

The out-of-pocket expense for Marianne was $250 to see an orthopedic specialist, who happened to also be a pain specialist, and $350 to see a spinal surgeon. Of course, there was also the travel cost to the U.S. She says, “It was absolutely worth it. I got the information I needed in a very timely manner, faster than I would have if I had waited to see a specialist in Calgary.”

Marianne was pleased with her out-of-country treatment and says the specialist spent 90 minutes with her conducting a very thorough exam and assessment, reviewing her MRI, providing a detailed explanation of the issues with her back, discussing options, and what the potential benefits and risks were with surgery. “It was very thorough and I was really happy I made the decision to travel to the Spine Institute. I know people who have had their surgery done there and they were very impressed.”

According to Marianne, patients make the decision to access private health-care specialists because they want a fast resolution to their medical problem. Interestingly, the specialist who treated Marianne says that in the case of back issues, many of them just resolve themselves to an acceptable level within a year. In addition, the risks of surgery are high and the results are not always great. He also believes there are benefits to the Canadian system that forces people to wait.

*patient’s last name withheld for confidentiality

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