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How to advocate for yourself and navigate a strained health-care system

Click to play video: 'Worried about quality health-care in Canada? Here’s how to navigate the system'
Worried about quality health-care in Canada? Here’s how to navigate the system
As the health-care crisis deepens, Canadians' trust in the system is diminishing, according to recent polls. And while there's no way to predict what your experience will be, experts say there are ways to advocate for yourself and loved ones. Naomi Barghiel reports – Jan 25, 2024

Ongoing reports of emergency room overcrowding, long surgery wait times and physician shortages may be causing many Canadians to avoid the health-care system altogether or worry about the care they may receive.

A survey published by Leger this week shows that Canadians are feeling the impact of the country’s health-care crunch, with 70 per cent of respondents saying they worry they won’t be able to get good-quality medical care if they or a family member need it.

Health-care professionals have been warning for years about a dangerous lack of workers, leading to understaffed emergency rooms and a shortage of primary care.

The strain in Canada’s emergency rooms is especially felt this time of year, as doctors struggle to keep up with rising cases of respiratory illnesses.

Dr. Trevor Jain, an ER doctor with the Canadian Association of Emergency Physicians (CAEP), recently called the situation across the country “horrific and inhumane.”

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These compiling issues have diminished Canadians’ confidence in the health-care system, but experts say there are ways to advocate for yourself and your loved ones.

Never stop trying to get your voice heard: CHC

As a breast cancer survivor and parent of a child with a congenital bone anomaly, Anne Lagacé Dowson has years of experience advocating her way through the health-care system.

She says Canada’s medical professionals are extremely skilled in treating patients, but entering the system can be tough without persistence.

“Once you’ve engaged with the health-care system, just keep on it. Don’t give up, call back every week,” said Dowson, who is also the director of communications for the Canadian Health Coalition.

Click to play video: 'As Canada’s health systems strain, more private care would mark ‘deterioration:’ minister'
As Canada’s health systems strain, more private care would mark ‘deterioration:’ minister

Dowson was put on a lengthy wait-list for surgery soon after being diagnosed with breast cancer in 2022, but she says she thinks her regular calls and in-person check-ins with the hospital reception finally got her an official date.

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“You just treat it as a job that you have to do. Every Thursday morning or whatever it is, you call and you say, ‘OK, here I am.’ If you can’t get past those calls, go into the hospital … say, ‘I’ve been calling off and on for a while,’” she told Global News.

Once you’ve made contact with the medical professional you are seeking, whether it’s a nurse, doctor or other specialist, Dowson says to keep a record of every exchange.

“You need to be super rigorous about keeping notes. Get a little notebook or sheet of paper and write down the dates, the times, the phone numbers, the names, the email addresses of the people you come into contact with. You need to stay on track of that stuff so that when or if you need to call back, you know who you talked to,” she said.

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Dowson added that while persistence is key, it’s equally important to be polite. While the system is strained, so are the people within it.

“Be unfailingly polite. You have to remember they are human beings under a lot of pressure. Do not yell at them,” she said, adding that doctors are doing “the best they can.”

A significant part of Canada’s health-care crisis is associated with a national shortage of primary care physicians, largely due to burnout from unsafe and unsupportive working conditions.

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Around 4.6 million Canadians are without a family doctor, according to a 2019 report by Statistics Canada. The shortage has left many Canadians feeling short of options in their times of need.

Dowson says part of the solution to improve care in Canada also has to do with political advocacy.

In February 2023, Prime Minister Justin Trudeau offered premiers across the country a bilateral deal as part of a $196-billion, 10-year national health accord.

B.C., Nova Scotia, P.E.I. and Alberta are the only provinces that have signed on to the deal with Ottawa so far, though Health Minister Mark Holland says others will follow soon.

Still, Dowson says it’s important to hold governments accountable for their promises.

She notes that many in the health-care industry are also concerned that provinces will gradually offer private options to desperate patients as a solution to the major problems within Canada’s public health sector.

“Don’t give up. Part of the political contract we have in Canada is for single-payer, universally accessible health care. That is part of the deal, and if the deal is being broken, then we all need to get on it and fight for it,” she said.

Dr. Kathleen Ross from the Canadian Medical Association echoes Dowson, saying Canadians should not accept the system as it is.

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“I have heard from many Canadians and physicians as well that this crisis that we’re in is the new normal for the health-care system in Canada. And I refuse to accept that. There is a lot more that we can do,” she told Global News.

When should I go to the ER for medical help?

Whether you need urgent medical attention or you’re fed up with waiting six months for a family doctor appointment, emergency rooms have become a default destination for many Canadians in need of professional medical assistance.

However, staffing shortages, overcrowding and limited resources have patients waiting for 10 to up to 32 hours or more in emergency departments. Two Canadian patients have even died this season waiting in an ER at a hospital on Montreal’s south shore.

Click to play video: 'What to do about Canada’s Emergency Room Crisis?'
What to do about Canada’s Emergency Room Crisis?

Quebec Health Minister Christian Dubé suggested in December 2023 that unnecessary emergency department visits significantly contribute to ER overcrowding. His statement has since been criticized by ER doctors and health-care associations, who said patients shouldn’t hesitate to go to the ER if they feel the need to.

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Dowson says Canadians aren’t trying to burden the health-care system with their problems, but often end up at the ER with non-life-threatening problems because there’s nowhere else in the medical system to go.

“I know that people are desperate. Sometimes people end up in the ER for that reason. The ER is increasingly becoming a walk-in clinic for people who are in trouble, especially people with kids who are sick,” she said.

“People don’t go to the hospital for fun. If anything, I think people delay going into the medical system because they don’t want to be a bother.”

What other options do I have?

If you’re in a pinch and can afford it, walk-in clinics and paid virtual care such as Maple or Rocket Doctor may be an option. However, Ross says these avenues cannot provide long-term solutions the way ongoing relationships with family physicians can.

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“That longitudinal relationship of ongoing understanding of what your health is over a period of months to years is really valuable. Episodic care, so virtual care or a one-off walk-in clinic, doesn’t provide the best quality of care for your health,” Ross said.

“But we know that these are measures Canadians are turning to now because they don’t have any other options.”

Dowson says she would “never judge” anyone who needs to use paid virtual care in a pinch, but she “strongly encourages people to find ways in which they can get care already paid for through their taxes.”

If your medical concern doesn’t appear to be life-threatening, Dowson suggests using a number of provincial and local resources.

Click to play video: 'Canadian Medical Association calls for urgent health system rebuild'
Canadian Medical Association calls for urgent health system rebuild

Most provinces offer a phone service that connects patients with a registered nurse. The nurse can assess symptoms and suggest best first steps to care.

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For example, Telehealth in Ontario and Quebec is available 24 hours a day, seven days a week. The number in Ontario is 1-866-797-0000. For Quebec, the number is 811.

B.C. has a similar service called HealthLink, which can also be accessed by calling 811.

Every province also has a health coalition that can provide you with more information about local programs and services.

Dowson says informing Canadian seniors about their access to care is a particular concern, as many may have trouble navigating resources on the internet. She strongly encourages Canadians to use their local public libraries, many of which offer basic computer programs and classes.

“That’s the other thing, a lot of this stuff is now being uploaded online, and you can’t really go anywhere in person to ask for help. And that’s very daunting for older people and people with visual disabilities,” Dowson said.

“It’s a bit of a job navigating the health-care system, so ask for the help you need.”

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