The medical lottery: treatment rates vary wildly from one city to another
By Julia Belluz - Tuesday, November 13, 2012 - 0 Comments
A look at the highest and lowest rates of surgery in the country
Ghislain & Marie David de Lossy/cultura/Corbis
Ewan Affleck, medical director of Yellowknife’s health and social services, describes it as “a huge issue that is largely unaddressed” in Canadian health care, in many ways “a hidden secret.” He’s seen it in the places he’s worked as a family doctor, from urban clinics in Montreal to hospitals and nursing stations in the Inuit villages of northern Quebec, and now in the primary-care centres of the sprawling Northwest Territories.
The secret is “unwarranted variation”: the stark and sometimes alarming regional differences in the health care patients receive, determined by things like the capacity of the local system on a given day or the preference of the doctor instead of actual need or even medical evidence. Canadians participate in a lottery every time they have a brush with the health care system; it can mean the difference between getting screened for prostate cancer or not, or whether or not you have your uterus removed. Though medicine is now supposed to be evidence-based, the simple fact of where you get care, and from whom, can influence your treatment as much as the latest science.
This arbitrariness disturbed Affleck, who has the lean frame and single-minded focus of the ultra-marathon runner that he is. “This is a national issue,” he says. “Who drives the Canadian health system? The day-to-day drivers are mostly doctors and other health professionals.” Continue…
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How to act after your heart attack
By Julia McKinnell - Tuesday, March 16, 2010 at 10:05 AM - 24 Comments
For night terrors on business trips, call the hotel front desk and don’t flaunt your meds
Chris Rogers/Corbis
Newfoundland Premier Danny Williams would be wise to say as little as possible about his heart surgery and recovery, according to advice in a new book on how to cope with the emotional after-effects of heart surgery through an “eight-step Cardiac Comeback Plan.”
“One day I was strong. The next day I was weak. One day my colleagues looked up to me. The next day they seemed to see me as weak and ‘damaged,’ ” writes Dr. Marc Wallack in Back to Life After a Heart Crisis. Wallack is a New York surgical oncologist who had a quadruple bypass. “Only tell people about your heart disease on a need-to-know basis,” he advises. “You do not need people talking about you while you are trying to recover. You do not need people using the details of your illness for their own personal gain.”
Before going into the hospital, pack the following, he suggests: slip-on shoes, bathrobe, baseball cap and sunglasses. “After being indoors that long, the glare of the sun can be uncomfortable, and you don’t need anything else to make you uncomfortable during that long, hard walk from the hospital door to your waiting car. You might also want to bring a puffy jacket, such as a ski jacket.” The jacket isn’t for warmth, “but to protect your tender incision area and prevent other people from getting too close to you.”
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Here's hoping Danny Williams got Canadian-style heart surgery
By John Geddes - Monday, February 22, 2010 at 8:28 PM - 80 Comments
Newfoundland Premier Danny Williams has finally done an interview discussing his decision to go to the U.S. for heart surgery. You’ll recall that critics of public health insurance on both sides of the border pounced on this high-profile case of medical tourism as evidence that the Canadian system is hopelessly second-rate.
But wait a minute. I see that Williams says his problem was with his mitral valve. Now, I’m no expert, but I seem to remember reading something recently about that particular part of the old ticker.
