Time to throw a tantrum

Dear sir:
I am having a tantrum and I believe that most local citizens also should be having tantrums.
An election has been called, we are being asked to vote. I acknowledge the very large political issues out there and don’t think that we can do much about them. What we can affect is a small but important local issue—travel grants.
All three parties, when in power, have promised financial help towards travel expenses when specialist services are not available locally. Such services usually are provided through tertiary care centres such as Health Sciences or St. Boniface in Winnipeg, or by the physicians who work in them.
Waiting lists in Thunder Bay are inordinately long and earlier this year, we were instructed not to send anything but urgent trauma cases to their hospitals. Cardiac surgery is not performed in Thunder Bay, nor is balloon angioplasty and stent insertion.
It usually is possible to have an orthopaedic patient seen and operated upon in Winnipeg by the time they can have an initial appointment in Thunder Bay.
As a community, we always have been dependent upon the tertiary care facilities in Winnipeg. This is our nearest university medical centre and they serve us well.
In Manitoba, the laws of the province require the College of Physicians and Surgeons to review the qualifications of physicians and decide—on the basis of experience and specialist training—whether they will be placed on the register as specialists or generalists.
Usually, specialists trained in Canada will have taken the Fellowship of the College of Physicians and Surgeons of Canada as their entry level to their specialty.
To allow the recruitment of exceptionally well-trained specialists (often to serve as heads of departments) and to improve the international standing of the university, the Manitoba college has a separate specialist register which exempts such specific physicians from taking the Fellowship of the Canadian Colleges.
To make his life simple, some bureaucratic genius in Toronto decided all specialists must have the Canadian Fellowship. This ruling excludes about 15 percent of all the specialists in the world.
Even when properly qualified and registered as specialists under Manitoba law, and paid specialist fees by the Province of Ontario, some Manitoba specialists are deemed to be generalists by the Ontario ministry.
As such, patients from Ontario will not receive a travel grant when visiting these specialists. This leads to some truly wonderful situations.
I referred a critically-ill patient from our I.C.U. to the cardiologist on call at St. Boniface in Winnipeg late one evening. This cardiologist took the patient to the Cath. Lab, catheterized his heart, dilated three stenoses, and inserted three stents. This undoubtedly saved the patient from a major cardiac event.
The patient was returned to us, none the worse for wear, the following day.
The cardiologist concerned, a truly excellent physician, asked to see the patient in follow-up a month later. He was bewildered when payment to the patient, for the travel grant he signed, was refused—on the grounds the cardiologist was not a specialist.
He expressed puzzlement that the ministry paid for an air ambulance to transport the patient to and from his care, and paid his fees for the very specialized work he performed, and then informed the patient that he was not really a specialist.
I told him the Ministry of Health in Ontario is populated by characters from “Alice in Wonderland,” led by a minister who vanishes like the Cheshire Cat if asked to make any decision favourable to patients in Northwestern Ontario.
He understood a little better when I explained that three of my patients, referred for aneurysm surgery to Thunder Bay, had been paid for travel to Jaffray-Melick, where no one has ever done an aneurysm repair.
Every doctor in the area can quote many similar absurdities.
The Ministry of Health’s position appears to be that to be eligible to sign travel grants for Ontario patients, some Manitoba specialists should spend a lot of money and considerable time acquiring a qualification which their university and their provincial college do not require them to possess.
The specialists are not paid a sizable amount for signing travel grants and it is of no moment to them if the patient gets such a grant. This requirement that they sit the Canadian College exams, when already exempted from them, makes about as much sense as a ministry decree that all specialists wear nipple rings.
As a general rule, bureaucrats run ministries. Politicians come and go. Occasionally, a strong minister will override some especially stupid piece of bureaucratic nonsense. Usually, this only happens at election time when a fed-up electorate threatens to vote for a different party unless someone pays them some attention.
If a political party comes asking for your vote in this election, ask why residents of Northwestern Ontario do not receive travel grants for visiting any legally and properly qualified specialists on the specialist registrar in Manitoba under the laws of Manitoba. Ask your candidate what they propose to do about it.
Make sure you get an answer. If you don’t like the answer, ask why you should vote for them.
You may not be able to influence larger policy issues, but you may perhaps affect local ones if you are prepared to fight for them.
Sincerely,
B.T. Johnstone
Fort Frances, Ont.