Thursday, November 02, 2023

Hinterland and Healthcare

We are finally getting somewhere with my arm/shoulder issue, which I will simply call arm from here on, for not only is it shorter to type, but it is also a little more accurate, at least in terms of where the pain is located. There is still some uncertainty about the specific cause.

Now, I want to wax pedantic and talk more about our health care situation, especially within our local geographic context. I do this because there were recently some comments that revealed an understandably incomplete appreciation of our local situation. 

Please bear with me.

Canadian healthcare funds doctors and hospitals. I have had two surgeries and three cystoscopies this year and not had to worry for one moment about the cost. It has been the same with Sue's ambulance ride and surgery. However, for the most part, pharmaceuticals or ancillary services such as dentistry are not covered, and some people carry extra private insurance through via their employment. 

Physio is mostly not government funded here in Ontario. In our town, however, the hospital does have a physiotherapy department, and being in hospital it does not charge a fee. If you can get a referral there, it's a good deal, and they give you great care. I did get a referral, but I had expected that the wait time would be three months for the demand is great, but I was lucky enough to be seen within two weeks. (I possibly got a quick referral because I am a senior without any extra private coverage.)

I still haven't had my X-Ray and Ultrasound, but now we know that the delay has been due to an atypical malfunction. Apparently, they called the very day after my referral and left a voice message. Well, I was unaware of either the phone call or the message. It was either a technological issue or human error and either on my end or their end. Who knows? But it happened, and me being me, I can guess that it was, somehow, my fault.? However, I now have an appointment for next week.

After yesterday's physio session and the concomitant poking and prodding, my arm was sorer than usual last night. However, I managed to sleep just as well or, as the case may be, just as poorly as ever. 

Now. permit me to explain our geography and how it can relate to healthcare availability.

First, I need to help you to understand what our hospital is and where it is.

It's called a hospital, but it is largely an ER along with radiology and physio as I have already described. It is not the scale of institution that most people think of when they think of hospitals.

Onward I now proceed to unfold the scintillating geography part of the lesson. 

Below is a GMaps screen capture of us (red circle) and the region to the west, extending about 150km/100mi (blue arrow). The green represents forest. As you can see, we are on the edge of a very rural, sparsely populated hinterland; even most of the dots closest to us represent only very small hamlets. There is no white, to speak of, showing evenly settled farmland. It's just not that kind of region.

Carleton Place now has an estimated 12 500 inhabitants due to recent growth and is the most populated community within the map area. The two north-south red arrows show the line of about five other significant towns on the fringes of Ottawa. A few of these were somewhat larger than Carleton Place until our very recent growth. The blue arrow extending westward for about 150k/100m leads to the blue circle which is the next western major town. However, Bancroft is not really that major, for it has only about 4000 permanent residents although it services a recreational area, and its summer population is much larger. 

The point is that we are on the edge of a rather unpopulated region. So no, there is not a clinic that one can conveniently drop into for an X-Ray (unless one wishes to drive into the city, which is off the map to the east. Sometimes, we need to wait for a medical service for just a little bit. If I need a CT Scan or need to see my urologist, I must travel a half hour south to Smiths Falls. A few years ago when I required hernia surgery, I was sent to another hospital and surgeon in Perth, also a half hour away. If we require even higher-end services, such as Sue's recent, emergency appendectomy, we are sent eastward into the big hospitals in Ottawa. (In fact we are going there tomorrow to see specialists in the infectious disease centre. Doubtless, I will report on that in due course.)

Given the regional population density our health care system works pretty well. Urgent needs, such as Sue's appendectomy, get dealt with pretty promptly. Meanwhile, an arm X-Ray for just chronic soreness might take a few days or even a week, assuming no communication hiccups as there were in my case. Of course, there are flaws, but, from what I read, every health care system in every country has its share of problems. My distinct impression, as much as we might complain from time to time, very few Canadians want to swap it for a different system. 

So that was me reverting to my former pedagogical self. I hope it made sense, for it was tough to organize and explain clearly and succinctly in a short blog post.


gigi-hawaii said...

Sounds like an ideal situation. Good to have the Canadian system.

Marie Smith said...

Hope the physio works, AC. I remember the soreness when I first started it. I am still doing the exercises and have seen an orthopedist within four months of referral which is really good for here. He will follow-up with me in January via telephone.

I have insurance through my teachers’ pension which covers so much for physio every year. A wait at the hospital here for the free physio is many months. I have a friend who can’t afford physio herself and doesn’t have insurance. She has been waiting 6 months.

You are fortunate there with such a quick response.

Ed said...

I can't imagine having to wait that long. When ever I've had an x-ray or any other sort of diagnostic ordered, I always get it on the same day at the same place, before going home. When I tore my rotator cuff, I had an x-ray before going home and could have had an MRI but I declined. The following day I went to my first physical therapy appointment to get my rubber bands and instructions. But as you will point out, it wasn't free. Even though my insurance covered everything, I still had to pay the premiums for that insurance policy.

Jenny the Pirate said...

I just hope that you continue to get the care you need to resolve both your arm and other problems! xoxo

Marcia said...

Thanks for the geography lesson. Didn't realize you were in such a rural area. We too are not in a big population center but have the advantage of being very close to Dartmouth College and the medical school there which provides up with quite a few options for medical care. We both have medical insurance from retirement that supplements Medicare.
Infectious diseases? Can't wait to read what that's all about.

Margaret said...

I didn't realize that you were in such a rural area either since you show beautiful buildings and lovely coffee shops in your photos. Your explanation is very informative; I would love to have the Canadian health care system. Ours is so expensive yet we still have to wait and search for care.

Margaret said...

I should also mention that I'm close to Seattle which has top of the line medical care. (but definitely not free)

Boud said...

I wrote and lost a long appreciative comment and lost it. Oh well. I live in a town of 20K with smallish towns around. But it's an attractive area for doctors, hospitals and same day surgery centers, everything minutes from my house. Medicare covers everything illness and surgery related I've ever needed. My late husband was covered for home care physio, doctors and nursing care.
We always want more, but I'm happy . I have gap insurance to cover very small bills bucked to them after Medicare has paid its larger share.
I like never having to wait!

Liz Hinds said...

It sounds like a pretty good system you have there in Canada.

Red said...

We have major wait problems and we are n a populated area. The Micro Manager has been waiting for six months for an ultra sound

Anvilcloud said...

@Red. OMG, what is going on out there?

DrumMajor said...

Ok, thanks for that map through the forest. So, you have no urgent care in your town? And the hospital is the town 100 miles to the west? Free is grand! Linda in Kansas

roentare said...

Your system is certainly better than what we have in Australia.

Anvilcloud said...

@Drum. No. We have an ER. That is almost the main aspect of our hospital. I mentioned Bancroft just to show how far we would have to go west, through the back country to even get to a 4000 person settlement. It was part of describing how sparsely populated the hinterland is. When you don't have a large population, you don't have same infrastructure as a populated area like a city. So, I can get an X-Ray at the hospital but not in random drop-in clinics that some were suggesting in an earlier post.

Jeanie said...

I find this very interesting. Over here we hear different htings about the Canadian system, focusing mostly on the very long waits to get a doc or finding a family doc or to get a badly needed but not body-critical surgery (knee, hip replacements, etc.) I'm glad your ER isn't too far away -- I think that's something about which to worry if one can't there in a timely way!

Thanks for the explanation!

MARY G said...

That's a fine explanation for American friends. We are, as you probably could assess, half an hour from Perth and therefore an hour plus to Ottawa or Kingston, and can expect to be sent to either.
Our wait times for low priority services can be long, but so they can be in the city.
American readers should note, because it bears repeating, that most of our hospital visits cost $4.00. For the parking.

Jenn Jilks said...

So glad to hear you are getting physio.
That is a really good explanation of our healthcare. I wouldn't trade it for the world.
All the best.

Kay said...

Wow! You are so lucky! This is much better than our system, that's for sure. Granted I'm covered under Art's military service and get a lot of our services for a decent coverage fee along with Medicare, but you're getting better service and much faster too.

Tom said...

Interesting to see how your system works. Hope your arm feels better . . . well, I hope your physiotherapy works, which will probably make it feel worse at first, but better in the end. Good luck!

Granny Sue said...

Interesting. I am also in a rural are but fortunately can get to 2 fairly large hospitals within an hour, and big places like Mayo Clinic or Columbus in 2+ hours. I think wait times are endemic to almost all medical systems, whatever county.

Debby said...

As someone navigating a significant health situation in the United States, let me tell you, we would be delighted to have your health care system.

It took us months to pay off the bills from the Tim's stroke at the beginning of the year. We will spend the beginning of next year paying off the bills from his cancer.

Still, I count us lucky. Many people on this planet don't have access to medical care at all.

Vicki Lane said...

Thanks for the explanation. Sounds like a very decent system.

William Kendall said...

I'm a few blocks from the nearest hospital- though that is a chronic care hospital.