Why are Canadians Not Permitted to Choose Specialists?

I would like to know why Canadians are not allowed to choose specialists. The Alberta College of Physicians and Surgeons' web site says they are but they aren't. Even if patients are willing to wait forever, after being told that the doctor at the top of the list is the one they will have to see, they will still find out that the doctor who was at the top of the list six months before is still at the top of the list.

Does this mean that specialists are designated to work for certain groups of people or does it mean that one specialist is so bad that he's always the only one accepting patients? Perhaps it means that each clinic only wants to send people to the specialist in that clinic.

I think everyone knows of at least one person who was permitted to choose their own specialist, if they claimed they were related or were friends or whatever (and indeed were) but why shouldn't that option be available to everyone?

How does this work in your province?

Rtp9 wrote: I would like to

Rtp9 wrote:

I would like to know why Canadians are not allowed to choose specialists. The Alberta College of Physicians and Surgeons' web site says they are but they aren't.

Rtp9, your generalization, "Canadians are not allowed to choose specialists", is simply not true. I'll allow that in certain circumstances, a shortage of doctors practising in a certain specialty may have led to allocating patients among practitioners or that some practitioners may be designating which patient groups they'd accept, but that's about it. By the latter, I'm referring to cardiologists who may wish to concentrate on cardiology patient who suffer from diabetes or who do not suffer from that. However, in the end, it is your decision on whether or not to see a certain specialist.

Doctors have various rationales on which they base their referrals. New physicians may refer to medical school classmates. Physicians in a large medical building may simply refer to others down the hall. Either way, most will refer to those within their "practice group", usually meaning those who have admitting privileges at the same hospital.

I was recently given a diagnosis for which the usual remedy is surgery. My doctor told me to expect a call from a surgeon, that surgeon being the only one performing the procedure at the local hospital. I've had four surgeries there, three of them going very badly. I told my doctor that I wasn't aiming for 4/5 and to seek a specialist at a hospital across town specializing in cardiac care. My doctor asked me if I had a name in mind, and I told him I'd take anyone at the hospital across town. I have faith, as the facility is known as a centre for excellence in cardiac care, accepting patients from neighbouring provinces and the US.

While I'll end up with "the best", I'm also rolling the dice by putting myself on a waiting list.

This is what "universal access to medical care", the definition of our system, means.

In my case, I just wanted to

In my case, I just wanted to know if I could see a skin specialist other than the one in the same building. The case wasn't particularly unusual, and there were many skin specialists in the city. I tried waiting a few more months, but that one was the only one whose name was always on the top, and I had to take the one at the top of the list. For some reason he never moved down, which led me to believe that either there was no such list or he was so bad that no one else wanted him.

It was not possible to get a referral to any other. By the way, are you logged on to this site under more than one name?

This is how it went for me in

This is how it went for me in British Columbia. When I needed to see a Dermatologist, I got the required referral from my GP. I trusted that my GP would send me to someone competent and he did. When that Dermatologist retired, I did not want to continue with the doctor that took over the practice (too focused on cosmetic procedures rather than skin problems) so I went back to my GP and asked if he would refer me to a Dermatologist of my choice (one I chose based on RateMD comparisons). He had no problem with that.

The reality of all referrals to specialists here in BC is that there are long wait times for an appointment unless your situation is urgent or life-threatening.

Wow_HolyCow wrote: The

Wow_HolyCow wrote:

The reality of all referrals to specialists here in BC is that there are long wait times for an appointment unless your situation is urgent or life-threatening.

I think that's a bit of a generalization. It can depend on the practice (hospital) group, specialty, and even the time of year.

Last October, I received a referral to a endocrinologist with a wait time of a few weeks. Two weeks ago, I got one to an internist/cardiologist for a week following the next day's tests. On the other hand, I've been waiting weeks for a callback from a surgeon.

Does it surprise you that urgent cases would be first in line?

Rtrp9 wrote: In my case, I

Rtrp9 wrote:

In my case, I just wanted to know if I could see a skin specialist other than the one in the same building. The case wasn't particularly unusual, and there were many skin specialists in the city. I tried waiting a few more months, but that one was the only one whose name was always on the top, and I had to take the one at the top of the list. For some reason he never moved down, which led me to believe that either there was no such list or he was so bad that no one else wanted him.

It was not possible to get a referral to any other.

Rtp9, you always have a say in who you see for your medical care. No one can force a certain doctor on you, but if you choose not to see the one recommended, you just have to bear in mind that your preference may have a long waiting list. If there are no other specialists available, then I guess your choice is the one recommended, or no one.

Rtrp9 wrote:

By the way, are you logged on to this site under more than one name?

If you're asking me, the answer is no.

I live in Guelph Ontario. I

I live in Guelph Ontario. I had a GP who referred me to a urologist whom I disliked. I requested to see another urologist. He refused, saying that Guelph has only one urologist and told me that I was not permitted to see a urologist outside of Guelph. There were in fact three urologists in Guelph!! I have now found had experience with two additional GPs. They have been both willing to allow me to pick the doc I choose in any geographic area. I always have the name and ph no of the doc I have chosen when I ask for the referral. Your GP will balk if you do not like his choice of referral, but do not have a specific doc in mind. Get a new GP and specificy who you want to see. (Sometimes I have had the specialist decline to accept me.)

Actually, not everyone is

Actually, not everyone is allowed to choose specialists. It depends on doctors. I had to wait to see an endocrinologist for six years because while my tumour grew, and and finally begged and begged the hospital to put me in touch with one. That resulted in a lot of politics and anger between the hospital, doctor, and me, and still I got nowhere except that it resulted in the near loss of a doctor that was better than most in most other ways. There has been tension ever since.

Same thing with the spinal clinic. Waited 7 years, begged for four to see ANYONE here, and finally got booked with one who did the entire neurology testing and report on behalf of the specialist. That doctor had no rank on the College of Physicians and surgeon's website because according to the College, was supposed to be acting only as a clinical assistant under supervision at all times.

The person who was supposed to be supervising didn't sign on behalf of the clinical assistant who signed as a doctor. Instead, the clinical assistant who signed as a doctor wrote it on behalf of the person who was supposed to be supervising. The person who was supposed to be supervising billed for the appointment, though very low.

The report had a number of serious problems in it and neither doctor signed it. Signatures were only typewritten.

It was my feeling that if they didn't just both simply forget, but possibly both might have felt uncomfortable with things they had been assigned to do.

Rtrp9 wrote: Actually, not

Rtrp9 wrote:

Actually, not everyone is allowed to choose specialists. It depends on doctors.

The patient always has a choice. Of course, it depends on the willingness of a specialist to agree. No one can be forced to see a patient if they don't wish to. Equally, no physician can be forced to make a referral they aren't comfortable with.

As far as your provincial health care coverage is concerned, you have all the choice in the world, provided you can find a specialist that you wish (given that a referral is appropriate) and who is willing to see you.

fellow sufferer wrote: I live

fellow sufferer wrote:

I live in Guelph Ontario. I had a GP who referred me to a urologist whom I disliked. I requested to see another urologist. He refused, saying that Guelph has only one urologist and told me that I was not permitted to see a urologist outside of Guelph. There were in fact three urologists in Guelph!! I have now found had experience with two additional GPs. They have been both willing to allow me to pick the doc I choose in any geographic area. I always have the name and ph no of the doc I have chosen when I ask for the referral. Your GP will balk if you do not like his choice of referral, but do not have a specific doc in mind. Get a new GP and specificy who you want to see. (Sometimes I have had the specialist decline to accept me.)

Thanks there, fellow sufferer! I see you too learned the tricks. That is exactly the route I took with success after waiting several years. Took a biopsy, some surgery and two treatments but I finally got rid of one condition that was so bad it was driving me crazy!

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.