Health Care in Newfoundland: Public and Paid, Doctors and Nurses, Waiting and Waiting

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SHOW NOTES 

The overall situation of health services in Newfoundland: facts and personal experience

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Sources 

||||| Statistics Canada, The Daily, “Government Spending by Function, 2023,” 2024, https://www150.statcan.gc.ca/n1/daily-quotidien/241127/dq241127a-eng.htm ||||| ___

||||| Statistics Canada, Primary Health Care Providers, 2019, 2020, https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article/00004-eng.htm ||||| ___

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Transcript

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I’m currently in the same situation as many people in Newfoundland and in fact many Canadians in general: I don’t have a family doctor. Or a family nurse practitioner. According to Statistics Canada, about 15% of Canadians and about 13% of Newfoundlanders do not have a “regular health care provider.” That’s a lot of people, about 4.6 million people in the country as a whole.

So what that means is that Newfoundlanders have a couple of options:

·        live their lives without having a doctor at all (don’t see a doctor, until something serious happens and you have to go to the hospital)

·        go to a government-funded walk-in clinic (the services are free but the lineups are long)

·        go to a private clinic (where they have to pay)

When I moved back to Newfoundland about two years ago, I arranged to have my name in the system as someone who would like to have a doctor, but of course I had to live my life in the meantime, when things went wrong or when I required medications. Waiting to have a doctor assigned to you is kind of a running joke in the province. I remember that more than one person told me that I would “never” get one. As a quick but disappointing aside though, I got a call from someone at NL Health Services asking if I was still looking for a doctor. I was thrilled, and said that I was, and enthusiastically told her, yes, I did want my name added to the waiting list. Naively, I thought the call meant that Health Services were on the case and that I would soon have a doctor. Alas, that was several months ago now and I haven’t heard a word since. I’m still waiting for Dr. Godot.

I opted for the paid clinics while I am waiting. These are essentially private companies where you can get faster service, but you have to pay for it. The cost at the one I chose was reasonable but still not what I would call cheap: $75 for an in-person consultation with not a doctor but a nurse practitioner (NP) and about half that for a telephone call. I noticed that things changed over time though: frankly service got worse. The people are still friendly, and I can still get tests done and results back pretty quickly, but the nurse practitioner spends much less time with me. When I first started, I remember that they assigned me to a specific NP and my in-person consultations with her lasted about a full hour! I’ve noticed that their language and procedures have changed recently. It used to be that that one NP was “mine,” so to speak, but she kept electronic records so that in case she was away from the office when I needed an appointment, another NP could fill in for that visit. It’s very different now. They describe themselves as a “team of nurse practitioners”—I don’t have a particular one assigned to me—and the in-office visits, or at least the last one anyway, last about fifteen minutes and are necessarily more cursory. My guess is either that their service has become more popular and so there are more patients to care for, or some of the NP’s have left and so, like the provincial health service itself, this paid clinic is having to try to do more with less.

This has made me turn back to the free government service, especially after a friend told me about the 811 number you can call. There’s an app, and literally within minutes of submitting your request, a real live nurse practitioner calls you and then recommends or carries out one service or another. Mostly I just want to be able to get my prescriptions renewed efficiently, and get a requisition for blood work at least once a year so that I can get a checkup of some kind. I’ve used the service two or three times now, and the NPs on the phone have been excellent. That’s the good news. The bad news is of course what they have to do in some cases is refer you to the same big healthcare system that doesn’t have enough doctors in the first place. And to add aggravation to my own request during one of the calls with the NP, the doctor I was given an appointment with was terrible. He treated me as if I was just an annoyance in his day, complained about how busy he is, and told me out loud that though I was on the waiting list for a family doctor or NP, I would never get one. Jesus, buddy, take a vacation or retire or something.

I also just in the past couple of weeks had the experience of the walk-in clinic. I drove down there around noon and was happy to see that the parking lot wasn’t crammed. I parked and walked confidently up to the door, looking forward to a short wait on an uncomfortable chair. But I didn’t even get it that good. Those who knew the clinic routine better than I did had already arrived there in the morning, and so a large signed posted on the door said NO MORE APPOINTMENTS FOR THE REST OF THE DAY.

There is a final option that people have, other than not going to a doctor at all. I haven’t done this, and don’t plan to, but apparently some people seeking even non-urgent care just go to the emergency section of the hospital. And wait and wait and wait.

And that’s the landscape in Newfoundland, and it’s similar in the other provinces and territories as well. I ask myself, How is this sustainable?, but it’s been like this for many years and so apparently it is sustainable in some way. The other side of the equation of course is the doctors and nurses and nurse practitioners who are working in the system. Or perhaps more accurately, being overworked in the system.

Healthcare is a massive expense for federal, provincial, territorial, and municipal governments in Canada. A recent report from StatsCan says that “as a function of government spending, health was the largest expense for these governments, at over one-third (34.2%) of … spending.” Newfoundland spends the most per capita on health care ($7,823) and Ontario spends the least ($5,357).

It feels like it has to break some time. I’m just keeping my head down for now, hoping I do get a call about a family doctor or nurse practitioner, and taking care of prescriptions and an annual checkup.

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