Canadian Healthcare M*A*S*H-Up Part 2

In Part 1 of this series, I introduced the concept of how the practice of triage helped achieve successful outcomes on the battlefield and drew comparisons to the way healthcare works in Canada today. Namely, only the sickest or most urgently in need of care, who represent the best chances of survival, are treated first, and everyone else is placed on a wait list for treatment until their condition worsens to the point where they are next in line, miraculously get better – or, get a lot worse.

The differences between conditions on the battlefield, where those decisions are made with massive resources and compressed timeframes and the budget realities of today’s Canadian healthcare system couldn’t be starker. That has led to the ubiquitous news stories and reports from organizations such as the Conservative thinktank, The Fraser Institute, commenting on the unacceptable wait list for doctors’ appointments, diagnostic tests, referrals to specialists and ultimately treatments and surgeries to resolve patient conditions.

The fact that waiting periods can be significant has created the impression that Canadian healthcare is stressed and stretched to the max. And yet, Canadian healthcare represents a wonderful social benefit that has helped this country achieve better health outcomes, lower infant mortality, higher life expectancies and a happier population as compared to many nations, including our closest neighbours along our Southern border.

Our health outcomes and the conditions in which we face them are defined by the universal system of triage that our provincial governments employ, with all its faults and many areas requiring attention. The truth remains—while certainly not perfect—Canadians aren't losing their homes or facing economic ruin because of their need for healthcare, surgeries and treatments.

The critical variable is time.

The question becomes: are we simply consumers of health, or can we become designers of the healthcare we want by taking more personal accountability for the outcomes we desire?

Canadians who become aware of these conditions are waking to the options in private healthcare to help secure diagnoses and treatments domestically and abroad in timeframes that better suit them. And remember—several of these options can be secured using your Healthcare Spending Accounts as a tax-preferred, corporate expense.

If an ounce of prevention is worth a pound of cure, then surely the first step towards evaluating your current condition is a thorough examination of your health benchmark state. In the absence of secure access to an annual physical, it might make sense to secure an annual physical from private sources, again, arranged at a time that suits you.

Question: When was the last time you went for a full annual physical exam with your family doctor? Assuming you are fortunate NOT to be one of the 6 million Canadians without a family doctor, you might be hard-pressed to recall your last exam beyond a quick check of the most basic metrics evaluated through blood tests and urinalysis.

The myriad solutions represent the full range from sound medical science to lesser-known, and perhaps questionable, analyses provided by private practitioners who may or may not provide examinations rooted in medical science. More on that in a minute.

To start, there is a growing network of private clinics, staffed by doctors, nurse practitioners, nurses, radiologists, technicians and clinicians who can offer a detailed report based on a comprehensive physical snapshot of your health. This snapshot is created after patients schedule a full-day diagnostic gauntlet of tests and interviews conducted in a private medical facility designed to create a spa-like atmosphere and ensure patient comfort and confidence. These centres operate across the country. The goal is to identify, in advance, conditions that could be identified early and treated in the earliest stages of development.

The benefits of early intervention provide a sensible alternative to the limitations and possibly negative unintended results of triage medicine.

Typically, the examination and testing day culminate in a series of discussions to provide a benchmark understanding of the patient’s medical condition, their options for treatment and associated costs and timelines. If serious outcomes are identified and flagged, a discussion can quickly orient with the team at the clinic and your own family doctor to discuss next steps.

At this point, the choice is yours whether to opt for treatment within the public system and face the wait times that entail, or opt to step outside your provincial or territorial healthcare system to seek alternatives elsewhere in Canada, in the U.S. or abroad in Europe or elsewhere. Obviously, care inside your province of residence would be covered by the universal facility we all have as a benchmark. Stepping outside the system comes at your expense. We will talk more about these expenses and your available options to mitigate or avoid out-of-pocket expenses in future articles.

Typically, these private medical clinics will charge between $3200-to-$3800 for a full-day session. These clinics additionally offer solutions to those of us who do not have a family doctor or have one who is so busy that it is impossible to secure a timely appointment.

Today’s established doctors may serve between 1200 and 1500 patients. The typical limit imposed in Ontario and perhaps in other provinces is one issue per visit, with a 15-minute maximum time limit per visit. That hardly leaves enough time for personal rapport and might be stressful enough to constrain the quality of the conversation. While the stated long-term goal is to hire additional doctors to lower the patient-to-doctor ratio closer to between 1000 and 1200, that may yet take time.

There is little doubt that today’s doctors want to do the very best for their patients. The demands on their time may not always foster the best environment to make that possible. 

Private clinics can provide dedicated primary medical care via team structures serving the same number of families or fewer and can provide same-day or next-day appointments. Alternatively, an even more acutely enhanced level of service can be provided where doctors serve only 400 patients, while providing the same levels of service and response times and may include house calls.

If you seek the ultimate in personal healthcare, this may be a viable, albeit pricey option. Team care may cost as much as $5000 per person, and fully dedicated individual care might cost as much as $7500 per person. This is truly personalized healthcare. Obviously, terms and conditions will apply.

Access like this comes at a cost. The question is yours to answer if you see the value. It’s up to you. How much is your health, your time and productivity worth?

With over 42 years of experience as a sales professional and business owner, Bob Carter works with small business owners, incorporated individuals and their advisors to provide guidance on their investments, insurance and benefit plans. He has developed a specialty helping Canadians navigate the executive and specialty healthcare and individual private medical insurance market.

bob.carter@carterconsultingcorp.ca