Not impressed with our health care system. Posted in PE as well.

Discussion in 'General Parenting' started by welcometowitsend, Nov 21, 2012.

  1. So I finally got hold of the psychiatrist this afternoon. Yes, they got the referral, yes we have an appointment - for APRIL 15, 2013!!! 5 months away.

    Ugh. I am so frustrated with our system. So difficult child can continue to rant and rave and lie and on and on for the next 5 months (wonder what kind of trouble he can manage to get into between now and then) before anyone will see him again. Even his next pediatric appointment isn't until mid-March.

    pediatrician. wanted him back to see psychiatrist based on his rant and rave in his office last week and the fact that he was in the psychiatric ward 6 weeks ago and the lying and behaviour, etc..

    Did I say I was frustrated!? Sheesh.
  2. InsaneCdn

    InsaneCdn Well-Known Member

    Getting INTO the system is horrid. Usually, once you are in there, things move faster. Not fast enough - but faster. We had to move an appointment to be ASAP... what would have been another 6 weeks was shortened to 2 weeks. But we've been with that psychiatrist for years now, and they know the whole picture. At first? we had to wait our turn.
  3. Insane - Oh, I know that I should expect a wait upon an initial referral but he's already seen this psychiatrist (last August) and she told me if I felt we needed to come back to call her again and she'd see him. Now all of a sudden he is considered a 'new' referral because the letter came from the paediatrician instead of the family doctor. That's pretty ridiculous. It's the same kid and the same psychiatrist - semantics really.

    And the paediatrician's follow up appts. are 4 months apart and he's booked solid in between. It is so frustrating. Their take on things is that if it's that urgent you can go to the hospital but the hospital doesn't consider him urgent unless he is an imminent threat to himself or others. So we wait.

    Sorry - just venting my frustrations.
  4. InsaneCdn

    InsaneCdn Well-Known Member

    Hmmm... "new" patient? Really?
    But why would you get a second referral, if he's already on their patient list?

    Here... If you are not seen by a psychiatrist for 12 months, you then need a new referral to get back in - and you go to the bottom of the list. But... within a year? you just call the psychiatrist and book, no need for referral. Ontario might be different, though.

    Our psychiatrist insists on seeing difficult child at least every 9 months... to guarantee continuity of service.
  5. flutterby

    flutterby Fly away!

    We waited a year - and only got in when we did because I raised hell. They lost our referral twice. The wait should have been about 6 months. And after all of that, the CNS who saw my daughter under the supervision of psychiatrists was horrible. This was through Children's Hospital. I then called the university hospital and their waiting list was so long it was closed, but one of their former psychiatrists had just opened a private practice. We got in in a month. Between the time I called and the time we got in, he was already full and could not take any more patients. (He opened his practice Dec 1st. I called on Dec 5th and difficult child's first appointment was Jan. 5th. So within a month he was full.) There is a massive shortage of child psychiatrists in the states...don't know about Canada.
  6. InsaneCdn

    InsaneCdn Well-Known Member

    There's a massive shortage of these... everywhere.
  7. SuZir

    SuZir Well-Known Member

    What are the reasons government/whatever gives you for that? We too have a shortage of psychiatrists, and not only for children but for adults too. Other areas we are short of MDs (mainly primary care, general practise and dentistry especially in small towns) there has been some success hiring foreign doctors and putting them to intensive language programs, but language skills one gets that way are not enough for psychiatry.

    With psychiatry they say they have a really difficult time to get young doctors to choose to specialise to that. They simply can not get residents for the spots they would have. They say that it is because young doctors feel that psychiatry is unrewarding, pill pushing, no therapeutic work or other things they would find meaningful. They don't want to be overworked prescription automates, who see a patient briefly every three months and nothing ever gets better. Sounds like rather grim vision, but I guess there is a point in that.
  8. InsaneCdn

    InsaneCdn Well-Known Member

    We have a massive shortage of doctors... in every single area, every single specialty, including family medicine.
    My take? People can't afford to become doctors... the up-front education costs are just too huge for most students to afford. So, the ones who would make fantastic doctors, don't get there.
  9. confuzzled

    confuzzled Member

    no idea if it works the same up north as it does in the lower 48, but someone from his 6 week stay should have coordinated outpatient followup for you--here its supposed to take place within 2 weeks.

    i'd call and ask for a social worker at the psychiatric hospital and explain you cant get an appointment until april and ask if they can call on his behalf to see if you can get one sooner. (and then i'd carry on like a fool if they said no and ask if i should just get a permanent parking space there since you'll be bringing him back with each and every misstep or medication adjustment needed, since you have no appointment til april :devil:)

    its a shame no one did it for you before he came home.
  10. SuZir

    SuZir Well-Known Member

    But do they still fill the seats on medication schools? As I said, we too have shortage and it can't be a price. Our universities have free tuition (okay, I think they do have something like yearly 150 dollar registering and health care fee) and kids get living stipends that cover most of the living costs (summer jobs or little help from parents may be needed, but my friends who have kids in uni usually help them with 200 hundred dollars or something. Possible for most average families and if not, kids can take loans.) And there are certainly enough kids applying to medication schools and really smart ones too. Entrance exams are brutal and only 5-10% gets in. And still we end up short with doctors especially in certain areas of the country and with certain specialities. And there doesn't seem to be any excess doctors anywhere. Of course we do loose some to other countries at least for some years, but still it is a mystery. of course most of our young doctors are female and we do have very long parental leaves, almost all spend at least a year home with the baby, most longer, up to three years. So if your avearage young doctor has three kids every three years, she could easily be out of service nine years.

    And with the smaller towns they apparently have difficult time finding doctors because significant others are having difficulties finding jobs.
  11. InsaneCdn

    InsaneCdn Well-Known Member

    They have not enough seats... and some drop out due to not being able to afford to continue and those spots get lost. And some years, they don't even fill all the seats in medication school.
  12. Insane - I agree - it shouldn't be a new referral and I said that to the receptionist but she said the wait for a follow up is 4-5 months now anyway. ugh.

    Flutterby - That's what's happened with my son's psychiatrist. His initial appointment we got in after 6 week wait. Now she's backlogged 4-6 months. That happened since August.

    I don't know about psychiatrists but my pediatrician's secretary told me that all the paediatrician's are sub-specializing and none of them (except my paediatrician) want to treat kids with mental health issues, ADHD, that kind of thing. So, my Paediatrician is the only one in our area taking these kids.

    Confuzzled - The pward at our hospital sent him home and referred back to our family doctor - who we went to but all she did was renew his prescription after the 30 day one from the pward at the hospital was up. Then back to the paediatrician to get a 4 month prescription, then he says go back to the psychiatrist. It's supposed to be called a 'circle of care' it feels more like a run around.

    SuZir - Wow, up to 3 years for parental leave! That's amazing. I thought we had it good at 1 year.

    Our doctors have salary caps. They can only make a certain amount of money a year - or bill a certain amount of money a year to the government for services - after that they are basically working for free - so why work? My Dad knew a guy that needed surgery but the surgeon had reached his cap for the year so he said he'd see the guy in January. We have lost a lot of doctors to the USA because of this problem.
  13. TerryJ2

    TerryJ2 Well-Known Member

    I'd call them every two weeks to see if there has been a cancellation or any changes in schedule. I can be a pest. :)
  14. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I like Terry's idea of being a pest! Maybe they'll "find" and open appointment because of it.
  15. susiestar

    susiestar Roll With It

    As with everything else in life, the squeaky wheel gets the grease. I don't care if they have cancellation lists, those spots get filled by parents who call in every week or so to remind them that they will take the soonest available no matter how early or late that appointment is. I have never ever been called for a cancellation even though I ask at every opportunity to be put on the cancellation list. I only have gotten a cancellation spot when I called the doctor each week. It often takes a month or two of calling to get that spot, but it only takes a minute or two to call and ask, Know what I mean????

    I usually put it on my calendar on Mon or Tues mornings, and make sure my phone calendar is set with a ringer to remind me to call at 8:15-8:45, somewhere in there.

    I don't think that all of the cancellation spots I have gotten were true cancellations - I am sure that at least some were because they saw I was not going away until my child was seen.

    I would put ZERO stock into the psychiatric hospital scheduling follow up care. We have had multiple hospitalizations, psychiatric hospital and medical hospital, and we have NEVER had them make an appointment as part of the follow up care. We were always told that our doctor was told that we would be calling to make an appointment and we would get the very first available appointment. That was NEVER with-in 2 weeks. For medical issues it was with-in a month or two, and for psychiatric hospital issues that appointment was often six months out. That is why I would start scheduling the calls and calling every week.

    Be prepared because it there are problems you are going to have to do the psychiatric hospital or ER route for care. It is what it is, and no hating it will change it.

    I odn't know about Canada, but here docs come out of residency with six figure school debt and they end up in things like plastic surgery and other high end specialties because they have such huge payments to make each month. I wish we could put programs like some rural states have into practice everywhere. The town ponies up the money to get a doctor through training and then this is repaid by five or ten years of medical practice in that town. If the doctor refuses to go practice in that town, they end up paying every dollar back, due immediately and NOT on a schedule - the whole amt is due right away. It gets doctors into very rural areas and they have a big commitment to honor. I think we need to do that more, because at least n the states it is common for docs to have half a million in debt the day they are able to open their own practice. That is a big scary amount of money, Know what I mean????

    Keep on pestering - it truly will get the appointment that you need, and usually nothing else will. Also call after hours when you have problems. Usually they will either have a message to call a number to contact the doctor, or they will transfer you to a nurse line and you tell the nurse what is wrong and the nurse can call the doctor. There were nights that I called that number three or four times - I just would wait half an hour or so and then call again until I got some answer.

    You do have to pay attention as you call because some things will have them just send you to a psychiatric hospital. So you learn over time what to say and not to say to give the right amt of squeak.
  16. InsaneCdn

    InsaneCdn Well-Known Member

    Some of those "cancellations" are a different case... our psychiatrist has "gaps" in her schedule that are not released until 1 week ahead. These are so that if she's seeing us, for example, and we have to go from 3-month to 1-month gaps for awhile to deal with medications adjustments, she can just schedule us in... but if those don't get used by the "regulars" then they get released to the "cancellations" list.
  17. Great idea (Terry, Wiped, Susie and Insane) and thank you! They did put me on the 'cancellation' list but I will be calling every Monday morning to check and see if there are any cancellations this week. It certainly can't hurt.

    In hindsight that might be why I got in so quick on the initial appointment. I called them about 5 times in 2 weeks to find out when we could get an appointment - just getting a returned call was an accomplishment. :)

    Insane - I do believe that most doctors leave gaps in their appointment schedule for just those reasons. When we were at the paediatricians he was seeing 2 month old babies and I can guarantee those babies didn't wait four months for an initial appointment. LOL.