30 August 2012

Irony: The medical system makes me sick

Our medical system is so fucked up it makes me sick. There are so many stories, so many examples, and so much to gripe about. But I'm going to go with this one - alternative medicine in the big medical system. Broken.

Some background: In BC, and 4 other provinces (if memory serves), naturopathic doctors are regulated by the province. I don't mean 'holistic medicine practitioners' or any of that nonsense. I mean NDs, who went to school for 6 years and have a degree in naturopathy. Bastyr is one of the better schools - if you can find an ND from there, you're doing well. Anyway, NDs in BC can prescribe medications - not all of them, but most. Not any federally scheduled drugs (like Ritalin or OxyContin, for example). And a few others are apparently randomly excluded. It's bizarre. What NDs cannot do, is order labs through MSP. So, my ND can order thyroid meds for me, but not check my TSH. Well, not entirely true. She can order the labs, but I pay for it, and the testing is done in Alberta. WTF? It's criminal. Seriously. I cannot figure out how the government justifies this.

There is a major shortage of doctors in BC (and most of Canada). I've posted on that before, and I notice that one of the parties in Quebec has recently come up with a plan much like mine to keep doctors in Quebec. I'm naturally taking credit for that. Clearly the powers that be in Quebec politics are among the 4 of you who read this blog. So what those of us who are wealthy enough to do when we can't find an MD is see an ND, and then never go back to looking, because the care is great. Except then we run into the testing problem. Now, I can afford to see the ND once and a while. But I cannot afford the testing. It's too much. So what I do is go to the walk-in, tell them what's going on, and they order the tests. Which is STUPID and a total waste of money. In trying to save money, by not allowing NDs to order tests, they ensure that patients to go MDs who bill for the visit. It costs them money and they're too stupid to see it. The same is true of diagnostic procedures and referrals. I have no idea why an ND isn't allowed to refer me to a specialist. There's no cost. It baffles me.

NDs are regulated in 5 provinces, and need to be in the other 5. But more than regulation, NDs need to be covered under medicare. Several reasons, but here are the most important two:

1) Without coverage under medicare, we have a tier of medicine unavailable to the poor.
NDs are not absolutely essential, but they are damn good care. When I go to mine, I get a minimum of 20 minutes and usually more like 35 or 40. They provide full service care or supplementary care. Since our family doctor is completely overburdened, and appointments take 6 weeks to get, our ND fulfills most of our primary care needs. Sometimes she prescribes regular allopathic medicine (like antibiotics) and sometimes she prescribes herbs. She sells the herbal remedies there, but is quick to tell me that I can get them anywhere, and has given me tips on where to find certain things cheaper.

If I did not have the money to pay for trips to see her, I would be back in the GP game. I had a GP here. He was nice. He also missed a lot of things that the ND picked up immediately. Like my seizures. I have myoclonic seizures - they're short jerks of motion from my head and arms. My brother says it's like little wasps appeared in front of my face, scared me, and I try to bat them away. My husband says it looks like someone stuck me in the back with a cattle prod. Heh. Anyway, I had them for years. The GP sent me to the neurologist who ran a battery of tests and prescribed a drug that has a high risk for dependency and abuse, and means I'd be legally impaired while taking it. No way. So I went to the ND. She got my entire history and then figured out that I had magnesium deficiency, and put me on a high dose of magnesium. And my seizures? Went from ~50/day to ~3/week. And have been like that ever since (we're way way way past placebo effects now), as long as I take my magnesium, and don't get glutened (i.e. eat any gluten by accident). I got glutened this week, and I'm having a few more of them. Maybe 5 or 6 a day. Some of them with dystonia. Ow. If I didn't have my ND, I'd still be seizing several times an hour.

An acquaintance has breast cancer. She sees a whole swak of doctors, including an ND. Of course, she has to pay for that. And yes, it is approved by her MDs. In fact, the ND works in the same clinic as her family doc. The ND handles the side effects of the chemo with vitamin therapy and some herbal remedies. These treatments are doing wonders for her. And she wouldn't have access to them without the privilege of wealth. She's solidly middle class, and she's spending a lot of money on these treatments. And that brings me to point 2.

2) Coverage under medicare protects patients from unscrupulous NDs who gouge patients.
She's paying too much. Yes, she's getting good advice and good treatment, and it's helping her. But she's paying too much for it. For her vitamin B12 shots, she's paying $60 each. My ND charges $16, and I think that's a bit much. I get the liquid prescribed, and then inject myself. Costs me about $2 each time. If medicare covered all or part of naturopathic treatment, the ND would bill the government for a specific amount, regulated by govenment, same as MDs, and profiteers like my acquaintance's doc would be unable to screw patients over. I know, she could go to another one, shop around, hope to find someone who specializes in Cancer, but SHE HAS CANCER. She's tired and sick and vulnerable. And this guy is in the same clinic, so they share info, collaborate on cases, and are all in the loop. So she either pays the big bucks, or doesn't get the treatment. It's not fair. And while life isn't fair, this is something that could be fixed.

We can fix the system. We can save money while reducing the burden on GPs. And do that while making the system more accessible to everyone. And the government won't do it.