American doctor says we can do better

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Dear editor,
I am an American physician who has practiced internal medicine/geriatrics for over 30 years who chose to spend my summers in Newfoundland, not just because of its natural beauty, but also because of the warmth of its people.

letter to the editor

I consider Newfoundland my second home. I read about your health care concerns in The Telegram and hear about medical issues from my neighbours. For such a great country, I've realized that I would never want to get ill here.

It's not that we Americans have such a wonderful system. We don't.

Millions of people have no access to any health care at all in the U.S.

But really, Newfoundland, some of your "standards" are laughable.

In The Telegram's lead story Aug. 1, you state that the national benchmark for emergency surgeries for hip fractures is 48 hours, and that you reach that 83 per cent of the time.

I'm sorry but the benchmark itself and your success rate both stink. I practice in a retirement area of 40,000 summer population and 150,000 winter population, (note still smaller than St. John's even in winter) and no patient who comes to an emergency room ever waits more than 24 hours for hip surgery, with many being done the same day if they arrive early enough in the day.

Newfoundland, you leave one sixth of your (usually elderly) patients in great pain and at high risk for life threatening blood clots. I don't consider that acceptable.

Elective surgeries don't fare much better.

A benchmark of six months for hip- or knee-replacement surgery is embarrassing. By the time a person is ready for this procedure, they have tried anti-inflammatories, cortisone injections and even artificial cartilage injections into the joint without success. Their quality of life is usually horrible by this point, living on pain pills and with severe debilitation. To make someone wait up to six months for relief is a crime, especially since again you are usually dealing with the elderly, whose time is already at a premium.

I have also heard horror stories from my neighbours, some of whom are practicing nurses in St. John's.

Some are laughable, some just sad.

I hear about the six-month wait for a colonoscopy for a person suspected of colon cancer recurrence. This usually takes 2-3 days to get done in my practice.

I hear about the elderly lady presently in the hospital for nine days following a small heart attack, still waiting for a heart catheterization.

Now she has a fever, probably a hospital-acquired infection from the long stay.

And with prolonged bed rest, she'll probably require rehab when she finally gets out, as elderly people lose three per cent of their leg strength for each day they lay in bed.

My patients usually get their caths the next day, and then are home the following day.

I hear about months of being in pain to get an elective gall bladder removal.

I hear about non-air conditioned hospitals having to give extra water and fans to patients to keep them cool and hydrated.

I hear about people leaving the province to get a PET (cancer) scan and months waiting for an MRI.

Our little town has two PET scanners, four MRI scanners, and four CT scanners. I can usually get an elective scan done in 48 hours.

And I read about it taking up to six years to build a new hospital, when it should take half that long.

Yes, the median age in my hometown is 49 years, old while Newfoundland's is 45.

However, with the median age in Canada being 40, Newfoundland has the oldest population of all the Canadian provinces, therefore it will need to spend more per person than the Canadian average.

Newfoundland, you are no longer a poor province.

I read about billions being poured into Muskrat Falls, whatever that is.

You obviously have money to spend. I think that your priorities need to be adjusted. A lot.

As for me, if I ever get sick while summering here, I'm asking my family to have me airlifted back to the States to get costly, but at least timely medical treatment in an air conditioned hospital.

- Paul March is a former Chief-of-Staff at Florida Hospital, runs a health and maternity clinic in Mali, Africa, and sepnds his summers in Tors Cove.

Geographic location: Newfoundland, St. John's, Canada Muskrat Falls

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Recent comments

  • Terry Pike
    August 20, 2014 - 20:55

    This wealthy American physician unfortunately focuses on anecdotal evidence instead of research and concrete statistics. The emphasis of his letter is on wait times as opposed to outcomes. He seems to draw conclusions of outcomes based on stories of wait times he's heard instead of looking at the literature. Privileged Americans want a Drive Thru type health care system regardless of the cost and disparity involved. If you look at the larger picture Canada (Newfoundland) consistently ranks higher than the US when comparing healthcare systems. I agree it is grossly underfunded but I believe it's a better system when you take the entire population into consideration as opposed to the privileged few.

    • gord
      August 25, 2014 - 22:17

      You may have a different opinion if you spend time as a patient..There is much room for improvement. You'll see as you get older.

  • Duffy
    August 20, 2014 - 20:18

    Thank you for your well thought out comments but as a retired American (45 years in USA) I may offer a few undisclosed facts that you possibly missed. At my retirement I lost health coverage at my place of employment and my wife and I then paid $12,400 a year for coverage (about the average) and there was a deductible of 20% until we returned to Newfoundland. Those that can not afford health insurance in the USA just "waste away" like in a Third World Country" unless on Welfare (Social Assistance) and get Medicade Coverage via the government. So good doctor, in many if not all cases, those that get excellent treatment have excellent health coverage and doctors get paid accordingly with the market bearing the price - I would guess like supply and demand at Wall Mart. IF you "got the money" you get the product. We wait here but we all get treated - system problems you bet - but the poor are covered as are the rich. Sorry to say I did not see that in the USA.................and I worked in the system. PS: We enjoy Newfoundland and all its beauty as you do and thank them for the system they have in place.

  • Joan Hiscock
    August 20, 2014 - 11:58

    Reading this article I find that there is a great element of truth in it which is frightening in and of itself. I am reverse to the good doctor as I summer here in Newfoundland, the land of my birth and winter in his state of Florida. I have had the unfortunate experience to use the health care system in Florida. While the hospital I visited was clean and orderly I waited 3 hours to be seen by a LPN for my problem. A doctor was seen only at the end when he walked into the room and asked if I felt OK. I was billed over $1600 for a 15 minute stay in an emergency bed. My insurance covered that fortunately. Three months later the good hospital and it's doctors tried to get another $375 out of me for doctor services. When I refused to pay as I knew already about this practice of double billing they threatened to take me to a collection agency and to court. I told them good luck with that and told them to not call me again. I never heard from them again after I turned the information over to my insurance company. Thankfully they said that what they were trying to do was get the difference that the insurance company had refused to pay upon mutual agreement with the hospital and the insurance company. This is a regular practice in the US when dealing with their so called health care system and non US patients. Thank God for the Canadian Snowbird Association who keep us informed about these underhanded practices. Yes maybe the wait times are longer here but at least we are not hit with bills for hundreds of thousands of dollars to have a life saving procedure done when we need it. I will take our Canadian system over the American any day. At least here everyone is eligible for the same medical care and it is not based on whether we can afford to pay or not. Perhaps the good doctor may be able to fly back to Florida or where ever he chooses for treatment but that ability is not available to all Americans so where do they go and how do they pay? Give me our medicare system and thanks to Tommy Douglas for not giving up the fight for all Canadians.

  • Anna Kelly
    August 19, 2014 - 10:42

    As I read this letter from our summer visitor it pains me to have to agree with him...we have some amazing Doctors General Practitioners ,they have a better understanding about what their patients need but are all to often told the test they requested as urgent cannot be done for Months....having said that I know that if I researched some Hospitals in the States I could come up with some horror stories there as for all our shortcomings ...give me Newfoundland Healthcare over money being the choice to live or die anyday