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bienvenue a canada
singapore sunset
amw
A few weeks ago i became eligible for the state health plan. Aside from my immigration medical and getting a hormones refill at a walk-in clinic i haven't been to a doctor in over a year. I'm supposed to be getting blood tests every 6 months for liver function and hormone levels. I'm less than a week off running out of my bipolar medication. Plus i've had this weird blood sugar thing for a few months now, and i've lost 10 pounds in the last month. Unsurprisingly, i've been very eager to see a doctor to discuss all this stuff.

My frustration started with the initial call. Apparently you can't just "see a doctor" here - you have to audition. Your first appointment with a family doctor (aka primary care physician/general practitioner) is a meet-and-greet only. On finding this out i skipped waiting for a female doctor or one with any particular speciality and just went for whoever had the first available appointment. I booked in for Monday last week.

The doctor kicked off our meeting with a big spiel about how he wouldn't prescribe narcotics and how he was extremely uncomfortable dealing with psychiatric medication. I told him he didn't need to deal with my psychiatric medication and that i actually wanted a psychiatric referral for that, but he persisted with his whining. He talked about how he'd never had a transsexual patient before so he didn't know what "standard" hormone levels were supposed to be and bla bla bla. I'm like wtf. The entire goddamn job description of a family doctor, their fucking raison d'être, is to fix problems that are simple and otherwise refer to a specialist. What's the big fucking deal? If he wants to be a lazy fuck and not consult textbooks then he has every option to refer me to an endocrinologist or a psychiatrist and i won't complain. Seriously!

I would have just said fuck it and gone to a different doctor, but i don't have the time to sit around trying ten different physicians till i find someone "compatible". All i want is someone to do their fucking job! So i made a second appointment for blood tests and a "real" consultation. Today i walked in and he continued to whine about how i've put him in an awkward position. I said look, just refer me to a psychiatrist and be done with it. His reply was that most psychiatrists in Canada tend to make a one-time diagnosis and a recommendation for treatment, which is subsequently maintained by the family doctor. What the fuck? I admit i've been negligent over the past 7 years by simply having my general practitioner continue prescribing my medication without any input from a specialist, but surely when you move to a different fucking country where the medication you've been on for almost 10 years isn't fucking available it's not unreasonable to ask for some specialist input? Yeah apparently it is.

In any case, i finally got my referral to the psychiatrist, who has a 4-6 week waiting period before even calling to schedule a consultation. And i got a prescription for a new drug slightly different to the one i took in Australia and slightly different to the one i took in the US in a slightly different dosage that may or may not fuck with my stability and my doctor is cranky about the whole situation because he doesn't like prescribing psychiatric medication in the first place. Not to mention he was a huge fucking mountain of useless for the other medical issues i wanted to talk about. Getting simple ongoing treatment should not be this fucking hard.

I thought when i heard J's horror stories of her terminally incompetent family doctor here in Canada she just got unlucky. I guess so did i. It's tempting to draw the conclusion that because all doctors get paid the same rate here there's no incentive to actually give decent service. It frustrates the hell out of me that i got better service when i paid cash at a walk-in than i am getting on the state health plan. I have to keep telling myself it's better to have free shitty healthcare than not being able to afford any healthcare at all. And Jesus, i gotta trust that if my blood tests come back showing anything unusual they're at least going to call me in for a follow-up appointment. They're still doctors, right? Fuck.
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Sounds a lot like in the Sicko movie by Michael Moore.

I haven't seen the movie, but i assume it's about the US healthcare system - it's ironic that the Canadian healthcare system which is pointed to as a possible path to follow for America is actually full of its own issues. I really liked how it was in Australia - the government covers all healthcare up to a certain rate, but doctors have the option to charge above that rate if they choose. I think it was a good balance of allowing free market competition while still ensuring an affordable level of care for all citizens.

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