PRIVATE HEALTHCARE ETHICS

One biggest challenges the Canadian Healthcare System has is accountability on both the physician and the patient.  What do I mean by that?

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PHYSICIAN - Well, first of all, as a physician working in the public health care system, there is no shortage of patients.  As a result, I don't need to be a great physician to be successful.  No matter how dense the market is with doctors offices on every corner.  In other words, I can be the worst physician in the world working in Canada and still be extremely busy.  A community physician has no competitive market when you consider other privately funded healthcare professionals (Chiropractors, physiotherapist, psychologists, etc).

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PATIENT - A patient has no idea of the cost for a medical service in the public health care system.  They go to their doctor and leave with no financial transaction.  As a result, there is no need to be accountable for how many visits a patient makes to their doctor's office or the emergency department.  In a similar way, a car requires regular attention in order to avoid much larger expenses.  A regular oil change a the minimum is required.  So, we will spend money on a regular oil change for the car but not invest time in a daily 30 min walk that costs nothing.

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So, the healthcare system is in a shambles due to accountability.

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So how does this all related to ethics.

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Well, private healthcare isn't necessarily unethical.  Yes, those with money can be treated earlier but not at the expense of the public healthcare system.  What do I mean by that?

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Mr. Jones suffers an acute back pain that isn't getting better after a week.  He owns a company requiring his availability.  He was told by his doctors secretary that it is going to take 3 weeks to see his family doctor.  He saw his family doctor 3 weeks later with progression in his pain.  His doctor decides to refer him to a physiatrist.  He was told that it would take about 6 months for the assessment.

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Mr. Jones was informed about a physiatrist who was working out side of the AHCIP.  He contacted the physiatrist and he was seen the next day.  It was made clear to him that the recommended treatment can only be performed privately even thought it is covered under the AHCIP.  He proceeded with the treatment privately within 3 weeks of his assessment.

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So how is this ethical?

1. Mr. Jones was removed from the public waitlist - thus allowing another person to be seen earlier.

2. Mr. Jones was treated outside of treatment times of the public patients. (Early AM, Lunch or end of day)