Well, I finally joined the precarious ranks of the “Two-million” in Canada, set to double in number by 2026 – the medical orphans – i.e., those without a family physician.
I have been here twice before. The first time was when I immigrated to this country in the late ’80s. At that time, I just walked around the block to a family doctor, and he signed me up, and my young family too – no problem. I fell in awe of the Canadian Medical System. Then he died twenty years later, and I was orphaned again at the height of the Global Financial Crisis in 2008. This time it was harder, because I had also moved to a small town by then where doctors were scarce. However, with some “influence” (I hate to use that lever, but sometimes it is necessary), I emerged from orphanhood within a few months by meeting a very nice doctor who would talk not only of medicine but of literature, politics, and the general state of our messed-up world – the stuff that writers gobble up ravenously, more readily than antibiotics. I was a model patient too, preferring not to see doctors until things got really hairy with my constitution, so those conversations were unfortunately infrequent. Post-pandemic, they became even rarer as we limited our contact to phone consultations only. Given that doctors are only paid a measly $37.95 per consult (my massage therapist charges me over a hundred dollars per session, and let’s not even talk about my dentist!) or $256.34 per year flat fee per patient (for unlimited consultations) by OHIP, I hoped he had me on the latter plan because I felt he was worth the full $256.34 for the solitary hour I spent with him once a year.
Then he decided to retire, cold turkey. Although caught flat-footed, I couldn’t fault him because we were the same age, and I retired three years ago. But he wasn’t selling or transitioning his practice to a successor, because, apparently, family medical practices are worth nothing these days. Nothing? You mean a client list of 1000 patients suddenly thrown out onto the street to fend for themselves is worth nothing? Dammit, even I sold my travel agency prior to retirement for a (reduced) price during the height of the pandemic when it was producing zero revenue, and would do so for another two years, because it was going to be “worth something” again after the virus stopped scaring people from travelling.
So now I am back in the ranks of the orphans, and this time it’s going to be a real slog. In calling around and putting myself on various waiting lists, I’ve been told that the wait time for a family doctor is between five months and two years. I could be dead by then, why bother? In the meantime there are walk-in clinics and hospital emergency rooms where the wait times are variable to eternal, based on the weather, the flu season, and the general paranoia of Ontarians. Or I could phone Telehealth, who will invariably send me back to walk-in-clinics or hospital emergency rooms, if I have waited until my constitution had gotten really hairy. Alternatively, I could consult Dr. Google, try to figure out what was wrong with me from the multiple pages of information provided, and opt for a DIY solution.
As a user, I’m still a fan of our free medical system, but I now realize the insidiousness of the “single payer” model. If this all-powerful single payer wants to destroy the system, cut off parts of it, or force it down an alternative path (one that may benefit the payer and its cronies), all it has to do is pull some levers. $37.95 per consult? – therein lies the problem! By freezing this fee, OHIP has pushed the family practice part of the medical system into forced retirement. No one but the desperate will enter this branch of medicine, and those in it are shrugging and retiring, or just quitting – after all, there’s more money in privatized massage (also in travel agencies)! Although, I wouldn’t advise them to write their memoirs – there’s no money in books.
Or, is this part of the grand plan to move family medicine to AI? That might be feasible, but not with this generation of bots who like to hallucinate. Just imagine going to Dr. Robot for a headache and being told that you have a cancerous toe? But at the rate AI is developing, I’m likely to meet a reasonably smart robot doctor long before I get cleared off those never ending waiting lists to hook up with another live one.
And this time, if I am so lucky as to get on the patient list of a live doctor again, I want to make sure he/she/it is at least 25 years younger than me. I don’t want this live one ending up a dead one or a retired one again. Hang on to your family doctors, people, they are finite and as rare as Bitcoin. We might even want to start a trading exchange in family doctors – their practices may be worth nothing, but they certainly are.
