Stories From a Failing Health Care System

By now we’ve all seen multiple new stories of the failing health system in Ontario. It would not be inaccurate to suggest that our health care is now in a permanent state of crisis. But most of these stories deal in numbers that seem almost abstract. For example 2.5 million without a family doctor. 30 weeks to see a specialist from the time of a referral from your family doctor. Hospitals at 134% capacity.

They all are awful stories -but what does this mean on a human level? Do these numbers actually tell of the suffering of patients on a human level? Today, let’s look at what some of my patients (all anonymized) are going through.

Patient A

Patient A had a persistent cough for a number of months despite my attempts to treat them with the usual therapies (puffers, prednisone, antibiotics and a Hail Mary pass of trying to see if acid suppressants would help). I recently attended a Continuing Medical Education seminar on Interstitial Lung Disease (ILD). ILD is a bit of miserable new condition that is very difficult to diagnose and even more difficult to treat.

I ordered a chest xray which was done on July 29 – and concern was raised that this might be the diagnosis. A high resolution CT scan (gold standard for diagnosing ILD) was ordered by myself to follow up on this – and this could not be done until Sep 10. This unfortunately confirmed ILD was the correct diagnosis.

One of the things that was evident from the conference I took is that time to see a specialist for ILD was paramount. There is no cure for this illness. But timely treatment can salvage lung tissue and improve quality of life. A referral was immediately made to a Respirologist.

Six days later, I got a note from the first Respirologist, who refused the consult. Basically he was too busy and asked me to find someone else. A second Respirologist was sent a referral on September 16. On October 25, I got a reply, also refusing the consult. A third referral was sent and the patient was finally seen on Jan 5. But for five months, their lung tissue continued to deteriorate and worsen.

Patient B

Patient B is 8 years old. Has had a number of viral illnesses, mostly upper respiratory in nature. But all of them have been associated with wheezing. She has responded nicely to puffers, and I wanted her to get assessed for asthma and get some asthma teaching for her parents – help them understand what things to avoid and so on.

I referred them to the excellent paediatrics group in Barrie (our local referral centre). Unfortunately, I got the following message from their staff (and I understand why, but it’s heartbreaking):

“Due to large influx of referrals Barrie Pediatrics is booking into late fall 2025 – early winter 2026.”

This is of course, not their fault. But for children with health issues, many of whom will deteriorate without specialist care, this is devastating.

Patient C

I saw them in my office on February 8, 2023 with what clearly seemed to be sciatica. Because there were no red flags – I tried anti-inflammatories and physiotherapy first. After a month or so this did not improve, so I ordered an MRI. This was not done until AUGUST of 2023 and it confirmed that may patient had a left L5/S1 disc herniation in his spine, which was causing his sciatica.

Now six months with no relief of pain with conservative measures, the standard would be to refer him to a neurosurgeon for assessment. Which was done. Unfortunately, we got no word back from the neurosurgeon. In fact in September and October of 2023 – the patient called my office to check to ensure that the referral had been sent.

By June of 2024 (!) he was in so much pain that I wound up referring him to a pain clinic for control of his back issue. In November of 2024 (!) he finally saw the surgeon who agreed with my diagnosis, and that my patient was a good candidate for surgery. But by now the MRI was felt to be too old – and – another one was ordered (still not done yet). And of course. my patient continues to be in chronic daily pain.

I could tell many more stories. I could probably write two dozen blogs just listing the difficulties I have had accessing psychiatric care for my patients. But by now I hope you get the point. Behind each number you may read about in the news (12 hour wait time in Emergency! 9 months to get diagnostic testing! 118% average overcapacity in hospitals!) – there are a large number of real human beings. People who are in constant pain and whose health is deteriorating faster and more than it should.

Hopefully you can spare a thought for the individual patients and what they are going through as our health system continues to collapse.

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Author: justanoldcountrydoctor

Dr. M. S. Gandhi, MD, CCFP. Practicing rural family medicine since 1992. I still have active privileges at the Collingwood Hospital. One Time President of the Ontario Medical Association. Follow me on Twitter: @drmsgandhi

One thought on “Stories From a Failing Health Care System”

  1. I wish more doctors would speak up like yourself. I don’t understand the aloof attitude of many who won’t take the time to educate the general public. It’s just wrong and sad . Kelly Banerjee, medical office manager Sent from my iPhone

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