Here’s a problem that goes against the common mis-perception about practicing medicine in Canada. While we often hear false allegations from mostly Republicans in the United States that there is inadequate access to medical care in Canada, I have found out recently that many of my patients are over-doctoring. Yes, they are seeing more than one ophthalmologist for their glaucoma, having the same tests repeated, and burdening our healthcare system because of this. Not only is this wasteful of our resources but it also creates confusion to patients and their doctors regarding their care.
It is understandable that many patients are concerned about their medical care. Does our system of universal coverage result in patients abusing the healthcare system by making unnecessary visits to doctors for insignificant things and to seek out second and third opinions? Is it just a small subset of our population that is doing this or is this rampant and an inherent fault in our system? Bear in mind, although we have universal coverage through a single payor (the provincial government and transfer funds from the federal government,) this is not a FREE system. Our tax dollars as well as medicare premiums pay for our healthcare. There are even people who do not have medicare as they do not pay their premiums however this percentage is much smaller than in the United States.
I fear that when patients over-doctor, they run the risk of having each one offer slightly different advice, oftentimes not aware of what recommendations have already been made. Sometimes it is only when the patient is not on the same meds as prescribed when I last saw them or are on several medications with the same active ingredients (there are several glaucoma drops that are combination agents that all contain timolol - a beta blocker) that the patient reveals that they have seen one or two other doctors since last seeing me. Not only does this muddle the treatment, it can lead to dangerous consequences. The glaucoma medications, although they are eyedrops, they do get absorbed into the rest of the body. Double of triple the proper dose of a topical beta-blocker can slow down the heart or drop the blood pressure enough to lead to a cardiac arrest or catastrophic fall from a drop in blood pressure in this patient population.
When medical resources are already scarce, it is a shame that some patients over-doctor yet others never seek the care that they need. There must be a better way. Any thoughts?