A column that appeared in this space last week, looking at the record high wait times for non-emergency surgery, prompted a heart-wrenching response from one reader.
Jeff Dyck, a 52-year-old wealth-management professional from Calgary, said it hit particularly close to home because three days earlier he had been diagnosed with inoperable Stage 4 cancer in his colon, liver and lymph nodes. His only option left is extension-of-life treatment through chemotherapy.
Dyck’s story is a tragic and deplorable indictment of a Canadian health-care system that can offer world-class treatment — but only if and when you can get access to it.
The married father of two adult daughters waited 20 weeks between being referred by his doctor for specialist treatment and eventually receiving it. It took 10 weeks from a referral to receiving the colonoscopy that discovered his cancer — and even then, only because his GP called specialists all over Calgary and pleaded his case.
He is now waiting a further five weeks for medical oncology.
Dyck’s story puts a human face on all the statistics and international comparisons that suggest that Canada has a problem. Forgive the graphic details but the story demands them.
He said he first suspected a problem last June, which prompted him to visit his family doctor to address blood in his stool and rectal bleeding. He returned to the doctor in August, after the problem did not clear up, and was referred to the Southern Alberta Surgical Center. Dyck said he followed up with the centre’s post-referral but was told his case was not urgent and there would likely be an 8- to 12-week wait before he would hear from someone. “That call never did come,” he said.
Instead, he received a letter suggesting suspected internal hemorrhoids and a recommendation that he add Metamucil, a fibre supplement, to his diet.
In mid-November, the problem worsened and he was admitted to the ER with significant rectal bleeding. He was discharged and told the bleeding was not dangerous at that time.
He was referred to Calgary’s FAST (Facilitated Access to Specialized Treatment) clinic for consideration for an urgent anoscopy. This was encouraging because FAST was designed to improve patient access to specialty care.
I was pushed to the bottom of the list because I wasn’t exhibiting imminent symptoms.
However, a week later he received a call saying the FAST clinic was beyond capacity and unable to see him.
Dyck was, in effect, being penalized for being too healthy.
On November 18, his family doctor received confirmation of a referral to Calgary’s GI Central Triage, which specializes in gastroenterology.
On January 11, he received another referral to the GICT but he never did receive treatment there.
Instead, on the evening of January 23rd, his family doctor called to say he’d found an opening for a last-minute colonoscopy at 7:30 a.m. on the 24th.
“My colonoscopy was a fluke. It only came about because my GP called individual specialists in the city of Calgary, hospital by hospital. None of them had capacity until the last one looked at my file and agreed to get me in at the last minute. It was not through GI Central. It was a well-connected GP with a solid list of phone numbers,” he said.
The results of the colonoscopy showed a large ulcerated mass. Dyck was admitted to the Foothills Medical Centre on the same day for a CT scan and biopsies that showed cancer in his colon, liver and lymph nodes. He was given an appointment for medical oncology on March 5th — and the chance to reflect on whether his condition might have been treatable if he’d received timely care.
Dyck said he started exploring private colonoscopy options once it became clear that he was getting nowhere in the public system.
“Shame on me for being otherwise healthy and in reasonably good shape,” he said. “I was pushed to the bottom of the list because I wasn’t exhibiting imminent symptoms.”
He said the two private clinics he contacted were ready to go within several weeks, from first contact through to consultation and an eventual colonoscopy.
His options were Surgical Solutions Network in Toronto and Cambie Clinics in Vancouver, where he was due to have a consultation with an anesthesiologist on the day he finally received his colonoscopy. He said the cost was in the region of $4,500 plus travel.
Dyck could be excused for feeling he has been cheated but he is adamant that this is a story about the system, not the health-care professionals.
“I have yet to meet a surgeon, specialist, doctor or nurse that hasn’t been amazing and compassionate,” he said. “Once you are in the system, things move.”
An OECD study in 2022 suggested that 56 per cent of Canadians are happy with the health-care system. That is low by the standards of most peer countries, but it is a wonder that it is that high.
By international standards, Canada’s 2.5 doctors per 1,000 people is fewer than most rich countries. The numbers suggest things aren’t that bad and that the number of physicians has outpaced the growth in population since the late 1980s. Yet, as a paper in the Canadian Medical Association Journal in 2023 pointed out, the bald statistics do not reflect the fact that the average hours worked by doctors has declined by 21 per cent between 1987 and 2019, or that the rise in the number of doctors has largely been offset by the increased demand due to an aging and growing population.
Everyone who interacts with the system knows its failings. Many have made suggestions to make it better: lower the barriers (and cost) that block international medical graduates from gaining medical residency training in Canada; allow more companies to provide specialist services that are in short supply; prioritize digitization so that the system is not still reliant on fax machines.
Some of these things are happening, albeit slowly.
But that is scant consolation for Dyck, who is now waiting to access extension-of-life treatment.
“The cancer isn’t waiting,” he said. “Both my daughters are getting married this year, so I need to be there to walk them down the aisle. But our health-care system is working against that objective.”
National Post
Get more deep-dive National Post political coverage and analysis in your inbox with the Political Hack newsletter, where Ottawa bureau chief Stuart Thomson and political analyst Tasha Kheiriddin get at what’s really going on behind the scenes on Parliament Hill every Wednesday and Friday, exclusively for subscribers. Sign up here.