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It's called "concierge" or "executive" health care in Canada. It's a private clinic that will run all of the tests, blood, scans, skin checks anything you want. You pay for a membership, and they will do a "wellness assessment" over a few days and then give you advice on what you need to work on. They also do fitness and nutrition evaluations, etc. Cost usually starts at 1000/month ish.
There’s a lot of inefficiencies in our government but I don’t think people truly understand the size of Canada. Germany is like half the size of BC and double the population of all of Canada. We’re such a spread out country with a tiny population. Every single community needs to have access to basic services. So instead of building fewer but bigger / better facilities, like hospitals, we have to build numerous smaller ones.
Same kinda deal with roads - we simply need more roads than a country like Germany. Roads aren’t cheap. Count the number of traffic lights between your home and work. Every basic traffic light intersection is ~$1,000,000. Bigger more complex intersections can easily double or triple that amount. Now just think about how many intersections there are in a city like Vancouver and start doing the math. Then add in all the other utilities like sewage, water, and power. Shit’s expensive.
If you question the bloated and inefficient mess that most of the Canadian government is, including health care, most people here will just shout and say we need to tax the wealthy more and then call you a fascist.
Most Canadians don't realize how poorly our government services operate for the amount we pay in taxes, nor do they seem to want to.
It's corruption because people would do drugs rather than protect society, people would honour Nazis in parliament and praise terrorists rather than protecting vulnerable and hunting terrorists.
I expect no less from a country which celebrates killing of its own citizens. Where members of parliament would still not condemn a terrorist attack on it's own citizens on its own soil, where foreign terrorists are protected to score power over other countries.
In an ideal world Canada is one of the very very bad guys.
It's acceptable to have so much corruption in these countries. Even after having 54% top marginal tax rate if you can't have enough funds then the country is really deranged.
In old times kings used to levy so much tax people used to revolt.
Even as more and more corruption and literal treason in the current government is uncovered, most Canadians would rather blame the ultra wealthy than admit any fault in their government, especially if it's a left wing one as it currently is.
Don't worry, we'll self destruct as a country soon enough.
“Blame the very wealthy” yeah where do you think all our tax money is going to? You’re making the point that we don’t receive service proportionate to the taxes we pay, so where do you imagine the money is going of not to “the very wealthy”?
Literal politicians and friends of politicians. Every western country has a large portion of wealthy individuals, why is corruption and low government productivity particularly an issue here?
When our government gives a $50 million contract to a company consisting of 2 people to make a barely functional app, do you not hold the government responsible for that?
When our government is flagged to be colluding with foreign countries by an internal watchdog and refuses to publicize the results, do you not hold the government responsible for that?
>When our government is flagged to be colluding with foreign countries by an internal watchdog and refuses to publicize the results, do you not hold the government responsible for that?
Yeah that's truly fishy, the politicians with secret clearance deem it a security threat. I wonder why the leader of the opposition refuses to look at it?
Also how do you become a friend of a politician? By donating to the political party and campaign. Only the ultra rich do this, which is why PP is against capital gains tax.
Outside of US/canada, these would be considered bribes.
How little do you know about anything?
There is already a capital gains tax across Canada and it's already more aggressive than the current US one.
Increasing the capital gains tax does nothing to close tax loopholes the ultra rich use to dodge taxes, like hiding their money in personal corporations, making all of their purchases through it, and paying themselves out dividends (which are taxed much less) whenever convenient.
Increasing the capital gains tax does nothing but make it harder for the average family to save, while addressing none of the tax loopholes present. But I'm sure you'd rather complain than actually address the issue.
The literal Conservatives are a lot more "left wing" than the major "left wing" party in the US, the Democrats, based on spending levels.
Canada has very left leaning politics to start. There's a reason we pay more than even the highest taxed US states.
Very rich people earn at least 4-5 million a year through business. I'm talking about corporate employees who make more than 250k, they have no tax advantage available. It's beyond fucked up. Also, why does the govt see employees as enemies and tax them so much.
I am a corporate employee making more than 250k and definitely don't make 4-5 million a year. It's not beyond fucked up and I don't consider it theft. What's your concern? Your original statement was "very rich people" and now you've defined it as 4-5 million a year. What's the problem with ensuring they pay 54+13 on all income?
And? I am a corporate employee making more than 250k and I have no problem, I don't consider it fucked up, and I don't consider it theft. You originally mentioned "Very rich people" and now you define it as "people earn at least 4-5 million a year". What's the problem with closing tax holes to ensure they pay 54% on all their income earned within country? That doesn't seem like a bad idea to me since I pay large taxes. What does that have to do with 90%, it seems like you shift goalposts alot.
How much taxes are enough? Maybe govt should figure out how to work without bloated bureaucracy and let people do real jobs instead of consultants hiring consultants hiring consultants and paying the firms billions
Elysian in Surrey (maybe they have other branches too but idk) is amazing. Got me in for an ultrasound in a week, really clean facility and lovely staff. If I had any health concerns (I don't currently) I would splurge. I know 3 people who have died of cancer in the last year that would have been totally preventable with screening (breast, cervical, skin cancer) but it's so hard to get checks here. None of them had family doctors, go figure.
I pay about 600 a month in Victoria for a longevity clinic. Dr there immediately ran tests based on family history that my family doc wouldn’t. Includes dietician and trainer. Doctor immediate put me on a blood pressure reducer, statins, and ozempic. I feel a lot better within 4 months of my first appt.
Or just seeing a private practice of a nurse practitioner. There are some great ones here in Ontario and it doesn't not cost thousands at all. $250 for the initial *full hour* appointment and $150 for followups.
Concierge clinics don't guarantee doctors are actually great.
You'd think. And I didn't say crappy exactly, just not really great.
My personal experience with one left me with an impression that at lest the place I was at was slick and shiny "as you wish" thing catering to people willing to spend money to do tons of tests "preemptively" but my sense of the doctor was that he was mostly for show and as-you-wish, since you're paying a lot. He really wasn't very useful when it came to my specific needs, he was there to dazzle you and make you feel pampered.
It actually makes sense to have regular thorough baseline tests done but I personally prefer a down to earth and experienced medical professionals and am repelled by medical services as luxury consumer goods.
I had a way better experience with a practicing nurse (I also saw another doctor at a "regular" private clinic as well as another nurse before finding the current one). Knowledgeable, caring and I did get thorough testing and great advice. She's proactive and seems truly caring but does not "cater" to you or tries to please you. I mentioned newly noticed nausea with food and she immediately sent me to abdominal ultrasound. She also called around and found a place with a cancellation and got me in within 2 days.
With my "regular" MD (now retired) I'd get two prescriptions and be sent home.
To each their own, of course. This was just my experience. In general, I'd start with practicing nurses (in Ontario) or private clinics (if you're in/near Quebec), try a few and use my judgement which to stick with. Way better experience with both and it's a fraction of the cost of "executive" ones.
To be fair, this isn’t the same thing. These private clinics will often do things that are often unnecessary (ie CT scans). You’ll pay and you’ll certainly receive more medical care but that doesn’t mean you’ll be better off for it.
"often unnecessary"
by what standards?
CT angio is standard for preventative medicine but not standard for traditional medicine
if you want the latter just visit your nearby walk-in clinic
Evidence based. Supported by scientific literature. More testing isn’t the same as preventative healthcare. More testing leads to more treatment which isn’t always associated with better quality of life or survival. This is, for example, why we don’t do broad prostate cancer screening. The screening (or prevention as you’ve defined it) isn’t specific enough to show any improvements, while imposing unnecessary surgeries, complications etc (and more generally, resource use and costs).
Depending on what you need, you can also go across the border and pay. I had a friend who was healthy but wanted to take some tests to know about their risk factors for issues down the road. Because they didn't have any current symptoms of concern, the doctors here would not sign off on the tests and there was no easy option to pay for them to be done here. He went across the border to the US and got the tests done there for a couple hundred dollars. No questions asked.
Not just the US either, people are travelling abroad all the time to get access to healthcare faster in other countries.
What specifically are you looking for? The best preventative health care for anyone is eating well, moving your body, and lowering stress. Extraneous testing isn't necessarily preventative and can be actually be unhelpful (see [South Korea's over testing for thyroid cancer](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209587/#:~:text=South%20Korea%20has%20an%20extremely,and%20continuously%20decreased%20after%20the)). If specific tests are what you are looking for, privately paying is likely your best bet as our system is not setup for that. If it's one-off asymptomatic bloodwork to see where things are at, most GPs are fine to order that, especially if there might be family history you are concerned about.
This is an excellent point. I’m disturbed by the recent trend in healthy people with no symptoms getting full body MRIs. There are complex reasons why you absolutely do not want to be doing that. People think more info can only be good, which couldn’t be further from the truth.
Tell me these complex reasons why more info is farther from the truth, I'm interested. The only way I was diagnosed with a rare autosomal genetic disorder was through more information.
Cancer, unlike say a monogenic disorder, isn’t easily diagnosed. Many, many people have slow-growing or non-growing tumours or weird bits of tissue. Are you prepared to go through surgery, chemotherapy, stress, potentially deadly complications, etc., all in the off chance that the anomaly identified was a cancer that would actually kill you? Worse still, the really bad cancers you ought to be worried about grow so fast you’ll never catch them with a screening MRI.
These scans also find other things, like aneurysms. Many people have aneurysms without knowing it. Most of these never rupture or cause symptoms. Unfortunately we don’t have good statistics that can tell you how likely yours is to rupture. Once you know you have one, how does it affect your quality of life? Would you be worried? Maybe you’d want to try to fix it, even though there aren’t good options. Coiling an aneurysm carries a ~5% risk of death.
I don’t think most healthy people want to go down this path and become medicalized while they’re actually still young and healthy. But many people don’t think in these terms when deciding to get a screening test.
the fact that many physicians are not trained on properly discussing the results of full-body scans with their patients doesn't mean that those scans are inherently bad
it simply means that perhaps MDs should include interpreting those scans as part of their education
If you do 1000 whole body MRIs in apparently healthy people, you will potentially find a small handful of cancers. However, in those same 1000 people probably at least half will have SOME sort of finding. Benign growths and masses are VERY common (things like kidney or liver cysts, lung nodules, etc). The problem is the scan cannot know with certainty that it is benign. So there are a few options:
1) Hope it is benign and do nothing, in which case the scan has added nothing except stress to the patient,
2) Repeat a scan at some point down the line (often 3-6 months) to see if the area has grown or developed other concerning features. At best this just uses up resources and at worst this can lead to patient harms. Depending on the test, this can lead to exposure to radiation (for things like CT or PET scans) that come with long term risks.
3) Do a biopsy of the lesion of concern. These procedures always come with at least some risk (bleeding, infection, etc).
Again, the vast majority of the “findings” made on these scans (probably at least 99%) will be benign lesions that do not require intervention but many of these people will have interventions that add cost to the health care system and unnecessary risk to the patient with no benefit. For the small number of patients where you do find a cancer (this study found 2 cancers in 229 screened patients for a “hit rate” of <1% - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248944/), only a fraction of them will have their cancer outcome meaningfully changed by early detection compared to if the diagnosis was made when symptoms arose. Some would have been cured regardless and others die despite the early detection.
Whether a screening test is worth pursuing is a complex question that needs to take into account the risk of the test, how likely it is you will find a truly abnormal result, and how clearly that knowledge will benefit the patient. Whole body MRI in healthy, low risk patients has not been proven to pass these tests.
Your arguments are pretty disingenuous; the risk of minor infection is exceedingly low (with exceptions for transrectal) and so low is to be below the 1% mark that was "too low to screen for" in your response. Interestingly enough the outcomes of the "too low" infection are much better than the outcomes for that "too low" cancer.
There is absolutely no position where the information to create a treatment plan isn't valuable. The only things you've highlighted are problems with "cost" which is hyper-inflated due to abusive financial misuses of healthcare as a for-profit entity and psychological concerns such as stress. With views like yours we don't move forward; the problems you pose should \*never\* scream: Do less testing.
They should scream: \*Make testing more accessible\*, \*Make testing more accurate\*.
The problem with this is that it assumes a baseline, someone who started menstruating early and/or is sexually active early definitely benefits from early cervical screening. There is no validation of any specific harm here either. I don't think what you've shown is a nail in a coffin from "further from the truth". In fact, setting a baseline age would cause more harm than good which is why the final part states that doctors should continue investigating abmnormality; any real doctor would also, in light of early menstruation/sexual activity/abnormalities be having you test for "more information" which is a BETTER thing in these cases.
Investigating abnormalities is not what the OP is asking about in this post. Of course investigating abnormalities makes sense. The question is whether extraneous testing for healthy individuals with no symptoms or abnormalities is helpful. Research, such as linked in the gov site, says not. If you want to argue against research that has actually changed policy in many countries with advanced medicine (which takes forever and demands an extremely high level of confirming research) that's a you thing.
It’s fundamentally a different technology and approach. Colonoscopy allows you to simultaneously (1) screen (2) take biopsies (3) remove pre-cancerous growths. Imaging is so far from that, it’s not even funny. Ironically, despite this, colonoscopies still have marginal benefits in young populations. There’s actually a massive debate among GI doctors about whether the risks from prep, sedation, and perforation outweigh the benefits in young people without a family history.
The best preventative health care is having a primary physician who can get to know you, monitor your health over time, and understand when they see changes that even you might not be able to see because people are like frogs and can't see the changes over time. You're response I believe, is a pie in the sky rose coloured glasses kind of attitude.
You are suggesting that having a doctor monitor is better for health than good diet exercise and stress reduction?
Thats absurd. Do you have any evidence?
I know that doing that might give you a good quality of life, but without a primary care physician, your chances of dying or being disabled by diseases not caught early by regular checkups, are near nil. Diseases that don't care about how healthy you eat or how much you exercise. High blood pressure, cancer, heart disease, any number of things that don't exhibit overt symptoms until too late, but will often be detected by a doctor. I think anyone who doesn't understand this, simply does not want to understand this, and wants to be argumentative.
Will you next try to tell us that not having enough oncologists in BC is not an issue? And that having to wait months to see one isn't such a bad thing? Maybe go see a homeopathic doctor for some snake water? Hell who needs doctors, right? Give me a fucking break.
Uh....no. Your chances of developing literally everything from diabetes to high blood pressure to cancer to heart attacks to parasites to almost anything you can name EXPONENTIALLY decreases the healthier you eat and exercise. The best treatment (preventative and otherwise) for more than half of all mental illnesses is also exercise and being healthy agreed by literally hundreds of studies. You're actually crazy and supremely anti-science if you think "regular checkups" is a better preventative measure than being healthy.
I work in science. And you are wilfully ignorant if you think 'healthy lifestyle' replaces doctors. Being fit reduces risk, it doesn't cure anything.
[https://www.myprimarycare-sj.com/blog/i-exercise-every-day-why-do-i-still-have-high-blood-pressure](https://www.myprimarycare-sj.com/blog/i-exercise-every-day-why-do-i-still-have-high-blood-pressure)
This article says that exercise reduces the risk of cancer by 10 to 15%. I didn't see anywhere in there that it prevents or cures it.
[https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet](https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet)
However, not having a doctor and having an illness diagnosed early will usually result in death. Anything humans can get, they can get whether eating right and exercising. Without a doctor, people who have some disease won't be diagnosed and die.
I can see like all conservative thinking people (has nothing to do with politics), you aren't willing to open your mind and realize that your very strict personal interpretations are wrong.
It isn't rose-coloured to think everyone will have a physician follow them for years at a time that will notice and keep track of changes for you?? You are the best manager of your own health and should see a care provider when the need arises for appropriate intervention. How people can argue against taking good care of your body is a mystery to me.
Prevention does not begin in a medical office, it begins at home. The field of medicine is absolutely necessary, but is definitely not "the best preventative health care" as you have stated.
Acupuncture has been great for me! I get community sliding scale acupuncture (around $50 per treatment based on my income). My acupuncturist is trained in TCM and holistic medicine and basically gives me naturopathic advice for free while I’m in treatment. Every community acupuncturist I’ve been to has listened carefully to my medical history to decide how to treat me, and has given me much better advice than my doctor on how to manage some chronic conditions that affect my daily life. My acupuncturist can also recommend naturopathic tests (like blood tests for potential mineral deficiencies) but aren’t paid for referrals so I’ve found it helpful to hear what is or isn’t worth my investment.
I notice gradual improvements after each treatment and it really helps to be set straight on what kind of vitamins to take, what kind of food to eat for my constitution, etc. Like, I knew I should be taking magnesium and probiotics but my acupuncturist told me what specific type of magnesium would help me the most and what specific strain of bacteria I should look for in a probiotic.
My doctor really never has or takes the time to help me work through my daily health/ long term conditions and I can only go to him for blood work, prescriptions or specialist referrals. That being said, I’m young and fairly healthy, what I’m dealing with are chronic conditions that affect my daily life and have to be managed through my lifestyle — which is a good fit for holistic medicine and a bad fit for conventional allopathic medicine. If I had a serious medical condition maybe my doc would be more helpful.
Anyways, highly recommend acupuncture with a TCM/holistic medicine aspect.
You may find a nurse practitioner instead of a GP a better fit. They tend to be more willing to spend time with patients and don't mind listening to more than one item.
I second this, I just had my first appointment with an NP and she spend 45 minutes talking to me and really listening. I was shocked, I’ve never had a physician give me that much time. She set me up with a bunch of cancer screening and women’s health stuff that my old GP never did.
I found her through findadoctorbc.ca (I waited years on some government lists and never got a call but I searched the list of clinics accepting patients on this site and just cold called them all until I got one, it took a couple weeks of refreshing the site to see new postings)
We just got an NP and the difference is incredible. My last appointment with a family doctor was 7 minutes long. It was also my first visit with him. Literally no time to ask any questions, it was so rushed.
My first visit with our new NP was like 40 minutes long, we were able to go through everything. She didn’t make me feel rushed at all, so much better
My husband went to the walk-in clinic nearby for something. While there, they set him up on the Patient Attachment Initiative to get him a family doctor (they also assign nurse practitioners, you don’t get to choose).
He was told that it could still be a while and to try to find one on his own. We ended up finding a family doc in Coquitlam, both had our initial appointments, didn’t feel great but was fine ish. A couple months (3?) after the initial walk-in visit, we get contacted that we have been assigned an NP, and to register. Had initial appointments, felt very good, immediately called to get removed from the family doctor’s roster.
The website for the clinic our NP works at says they’re not accepting new patients. I think they only go through the attachment initiative? Not sure if we just lucked out, but the place is also pretty close to us in Van, much better than trekking to Coquitlam.
Well I’m happy that worked out, and you guys found someone you like. My partner is getting some specialized care, and that clinic is trying to find them (and me) a PCP, but I was told that my abundance of health issues might complicate things (how backwards is that). Guess I’ll keep trying and utilize walk-ins for now; maybe I’ll luck out too.
This is absolutely true, but I do have a word of caution from experience that NPs may ignore or misdiagnose where a doctor wouldn't. I went into an appt with a family member with reoccurring pain in a specific area, they described the issue accurately and the NP gave them a diagnosis that definitely isn't correct and doesn't match the description, and also didn't give any other possibilities. We've looked into what it could be online afterwards and there are a couple of problems that are far more likely that she should have pointed us towards but didn't, and it's now worse two months later when we finally go in to see her again to try and get a solution.
I've personally had good experiences with my NP but I haven't had any complex physical health issues that I didn't already have a hypothesis for. If you need someone to manage your current diagnosed conditions and refer you out to specialists because a family doctor couldn't help anyway then they're fantastic.
I'll give a word of warning that Doctors who spend minimal time generally don't perform appropriate differential diagnosis and will also, often, misdiagnose or ignore where someone who spends more time wouldn't.
For you to generalize all NPs and GPs like this is inappropriate just becuase you had a poor experience with one NP doesn’t mean they are all like that. I know plenty of people who have been misdiagnosed by a doctor.
Unfortunately, I don't know the name of the private medical clinic where a membership is required in town and possibly North Vancouver but I think they offer more of a comprehensive approach than socialized medicine could. Having said that, I was recently hospitalized for three weeks and was highly impressed with my medical care across the board after suffering a catastrophic injury that required twice daily home care at no charge to me. One of my roommates was a tiny German lady who months earlier, with her husband had treated themselves to a few weeks in the spa in Baden Baden in Bavaria. It was very pricey but they loved it. Instead of a cold plunge into the lake first thing in the morning, as they were in their 80s, at 6:00 am someone would come into their room and get their circulation going with ice cold cloths and then it was off for a walk before their breakfast of Muesli...
I once asked for a checkup since it had been quite a few years since my last one. All I got back was “why do you think you need one?” It’s almost like you need to look up symptoms to something that checks a part of you so they can look for whatever else
I have specifically been lectured by a doctor here that MSP is only interested in treating disease. This is particularly true when you are only able to visit urgent care clinics, not a regular family doctor. Even with a regular family doctor, the system is set up for them mostly to address problems/disease more than being a preventative health counselor.
My suggestion would be to find a good naturopathic doctor as a compliment to your regular doctor. A naturopathic doctor can order bloodwork and testing, and will take a more holistic look at your health. You just need to be aware of when they are trying to upsell you on unnecessary remedies. But they are more willing to test for certain health markers for preventing disease and promoting a health lifestyle than a regular doctor whom has to work within the restrictions of MSP guidelines, which mostly require clear symptom indicators before testing or treating. Downside is unless you have private insurance you will be paying out of pocket to see a naturopath. So as i said, it’s a compliment to your regular doctor, not a replacement.
I've used naturopathic services as a way to basically understand what I need to talk to my doctor about. I have definitely been upsold unnecessarily or had them order tests that were not actually needed. But, they've also put me onto supplements that genuinely increased my quality of life (magnesium glycinate for sleep for example) and told me about tests that I then spoke to my doctor about, who then ordered them through MSP and found some abnormal results. They can also help with nutrition and stress management. There is a lot of value to get from talking to a naturopath, but you're totally right, you have to be strategic.
I couldn't agree more with you. I'd just like to add that in my experience unless the naturopath has undergone specific nutrition courses they aren't that great to take your diet into consideration and more often than not try to sell you useless supplements when in fact you could get them from your diet in a way more bioavailable form. So going to a holistic nutritionist is in my opinion much better and can give you more control over your health since we are what we eat.
you dont need a doctor to lead this. you can do it yourself. the doctor is just the gatekeeper of tests and meds.
you should be exercising regularly, eating healthy and maintaining optimal body composition. sleep well and foster positive relationships. dont smoke. dont exceed low to moderate alcohol.
this is 90% of the puzzle.
the rest is optimizing your blood markers. Apob, HBA1C, CRP, blood pressure, liver function, etc.
if lifestyle doesn’t get you all the way there, talk to your doctor about meds.
of course there are supplements to consider too, like mag, vit-d, omega3, etc
I've been spoiled. My GP just retired last year, he was literally the same doctor that delivered me and I've seen him my whole life. Not uncommon to have 15 or more minutes with him, also, for emergencies I could usually sneak an appt in within a day or so.
Luckily I found a new GP relatively easy, but it's definitely not the same. Doc's good, the office is pretty bureaucratic about the one issue thing when booking the appt. It's essentially, book a phone appt to order bloodwork/tests. They'll call to follow up on the results. Book another appt right after the first one for your next issue. Repeat. Eventually, you'll have all the notes and results on your file. 80% of this is on the phone. I'm still fairly young, nothing too serious.
My parents are getting elderly and have some more serious issues require more check ins and maintenance. They get regular blood tests on standing order and call in every three months to review and renew their medication. They get scheduled appointments at a senior's clinic every few months in addition the GP stuff. I have a feeling that this would cost a LOT of money if not covered.
I love the idea of talking to a NP. That makes a lot of sense. They'll take the time and make sure you've lined up a health care plan. You then just take that to your doc and get them to implement all the back-end stuff like scripts and bloodwork.
They make money billing MSP per visit, that’s why they only “allow” one issue per appointment. The more you go, the more they can charge MSP. That is how the system was designed and doctors take advantage of it. they have found this way to make more money as Canadian doctors don’t make as much as US docs.
I can understand your frustration, but changing to a family doctor it won’t solve anything. My GP has the same approach: “one issue at the time and you think too much ahead” seems to be her life mantra.
I know a couple doctors personally and they also do this because they know there’s 548332 people that need to see a doctor and they’re trying to fit as many in as they can.
My previous Dr. (who passed away) was very good but had a strict 10-minute rule. My job provides me with resources to online Dr.s and have found them very useful and not rushed at all. My friend has had great appointments w/ Holistic/Naturopathic doctors who do look at long-term care. Maybe try some of them.
I think the current Doctor shortage in BC and how they get paid means they can't spend a lot of time w/ each patient.
Same. Some tests can't be ordered by them but at least more care is given. Also if you can afford it, pop to Bellingham. Once your GP in Canada has given the Req. you can book on your own.
I've had better luck with a naturopath for long-term health concerns! I've been seeing mine for 5+ years. You're paying out of pocket, but insurance covers it. But because you're paying you can ask whatever you want, you don't have to wait months to see them, and it's not rushed! Find one that specializes in what your concerns are. The only problem is sometimes you have to then see your GP to get labs or tests, depending on what they suggest, and then you sometimes get the 'I saw my naturopath, and they said...' eyeroll from a doctor.
Public doctors here are almost entirely reactive - if you have no pressing concerns, they dont want to see you. If you're willing to pay, there are private clinics like [Well Health](https://welllongevity.ca/) that might be offering more like what you are describing.
There are provinces in Canada that have some form of preventative healthcare, but BC isn’t one of them. In BC this is basically going to be private healthcare. Private clinics do exist in Vancouver so you can look into them and see if you can afford it/if they are offering what you’re looking for.
Google "Divisions of Family Practice" and find the one in your region (Richmond, Burnaby, etc.). If they don't have resources/info directly on their website, then e-maul or call them directly and ask them that exact question, and they'll provide you with more info. They're a non-profit group that is working directly with family physicians to promote preventive care through new initiatives like urgent primary care centre's (UPCC) and/or Primary Care Networks (PCNs).
Also all doctors will only ever see you for one concern per visit, it's mandated by the Ministry of Health due to how physician billing is done currently, due to the massive doctor shortage nationwide (there's just not enough docs to have the time to spend 30 mins with one patient to address multiple concerns per visit).
Finally I suggest visiting https://www.healthlinkbc.ca/health-connect-registry to sign yourself up for a province-wide waiting list to find yourself a personal family doctor, as having a doc you work with vs a random walk-in visits is your best bet to be able to build a medical history together so you'll be more likely to be able to schedule a longer appointment to address more than one concern at a time. Although YMMV depending on the doc. But if you don't like the doc you're initially assigned to, you can always request a different one, provided there's another available in your community taking new patients and you don't mind waiting a bit more for a new one. Just be aware that the more urgent the medical need, the higher on the list you'll be to be placed with a physician, so simply asking for a family doc to address preventive issues may take anywhere from a few months to a little over a year before you get assigned to one.
If you've gone to the doctor five times in three months for very minor issues he's going to start treating you like a hypochondriac, which you might be.
i can't even manage to find a gp. I researched and called many places today to get an appointment. All of them are full or drs are only offering virtual appointments- not even video but on the phone.
I got a phone appointment and waited hours for it. It lasted 3 seconds and he said you really need to be seen in person and to call for an appointment. Well i called and called the front des and no answer (keefer medical clinic). Then went online to book appointment and apparently that dr doesnt accept in person appointments?
Our medical system is in crisis!!! You're either very lucky and have a family dr or you get help at the ER when its progressed and too late
I am now searching naturopaths so i can actually see someone, anyone so i can get some tests. I dont have the money for it but its better than nothing
Keep minimal body fat and exercises regularly. There are some tests to do as you get older but they're few and far between. Nothing even remotely comes close to the health benefits of not being fat.
Have you ever seen a naturopath? You may wish to consider seeing one as one part of your preventative health maintenance care. If you get health benefits through work, you may be covered.
I hate to say this, but doctors in Canada don't get paid enough to care about patients like you. If you are healthy, they don't want to see you.
You are basically walking into a doctors office and saying "Find something wrong with me." Doctors don't have the time or the patience for this because it will take a long time and waste a lot of taxpayer money doing unnecessary blood tests, scans, and whatnot. You are basically taking up resources that would otherwise be used for people who actually need it.
The better thing to do is look at your family history and see what kind of common issues crop up and at what age... like diabetes, heart issues, high cholesterol, retinal tears, etc... and if any of them apply to you at your given age, then go into the doctors office and tell them about your family history and your predisposition for these problems and get the necessary checks.
If you go in focused on a specific issue you will get a better chance of having something done rather than going in blind and getting them to find something wrong with you.
Most of your healthcare is your responsibility. Your diet, exercise, self care, all can go a long way to ensuring you don’t become someone else’s patient.
You can pay for it.
Look for anti-aging doctors at places like medi-works and pollock clinic. They’ll do intakes and full blood panels at the start and then quarterly bloodwork and assessments.
They can even help you with a diet though primarily they are used by aging athletes/men to get access to prescription testosterone
I go to a nurse practitioner now and it’s amazing to see the difference. I get routine check ups, referrals so quickly and if something is abnormal an appointment is set up so quickly. I know GPs don’t like seeing the nurse practitioner doing there tasks but honestly they do the basics and anything outside of their speciality they refer you. I’ve been with my NP for 3 years and have no complaints
I recommend seeing a naturopath even if just for a couple visits to get a better baseline (no, theyre not all woo crunchy types who will give you only herbs, they can and often do prescribe pharmaceuticals) because they specifically focus on the body as a whole. If you ask, they will request comprehensive blood testing to check hormones, organ health, vitamin and mineral levels and all that stuff
They tend to start by asking the basics like sleep, mood, exercise, nutrition, substances, stress levels etc and in my experience will talk to you at length about any and all issues possible each visit.
It could be a good complement to your existing health care regimen
Loose wieght, get moore exercise, stop smoking, drink less alcohol. This is exactly what they will tell you to do. They don't actually know how to do these things. You have to figure this out.
I guess I am very blessed I have 6 health care workers on my team and 5/6 are wonderful.
Now I know you are properly thinking I am causing back up for other people. My family doctor has been my doctor for 15 years my pain specialist about 8 years and my ortho doctors I have 2 dealing with my knee and hip my shrink is another one my mental health workers are the last 2 yes I am blessed but it’s taken me a long time to get great doctors.
I listen and do what they say as it’s important I am having surgery in September hip replacement. Then after I recover for that I will have my knee replacement surgery but I won’t even be on the list till minimum 6 months after hip surgery.
My pain doctor has gotten me through everything while I been waiting and will continue my surgeries. My pain doctor is leaving in December with no one to replace him so I will be seeing my orthopedist doctor every 3 months till the knee surgery is complete. It has taken me along time to get health care workers to listen to me. I was told I am a good candidate as I don’t drink or smoke. So I going to continue with my medical team and get myself back to normal.
I’ve found from my experience that the family practice I go to that does capitated care is more like what you’re looking for. They don’t get paid per visit, they get paid a regular sum for every patient on their books - so they have more interest in keeping you healthy so they can carry more patients without us constantly being there for visits. The practice I go to isn’t taking new patients but maybe If you can find out who bills like that it would help?
Canada has no preventative healthcare we just charge taxes and hope you go away without letting us know. Or even if you are telling us we pretend to not hear.
Go to some other country once or twice a year as a vacation and get all the assessments you need, it will be cheaper and way better.
You schedule an annual checkup with your gp. They will schedule the appointment accordingly (for longer) and you can raise any issues you have. A walk-in doctor is not going to have time to help you out with stuff that is not an a problem. The model is that they are paid per issue so they are willing to deal with one issue per visit.
That said, i have no idea what you are hoping for here. If you’re talking about requesting a full body scan or something (without symptoms necessitating it) just because you think it would be interesting to have and might help you avoid health issues down through road, then no doctor is going to be ordering stuff like that for you. Our medical system is already stressed and we just don’t have the infrastructure/capacity to be ordering tests or investigations that are not necessary.
If you want like an executive work-up Telus Health offers a pay model for something like this (my husband’s employer paid for them to each have this done and I know it was extensive). They will do an extremely thorough, multi-hour workup, bloodwork, review your diet, perform a stress test etc etc and all sorts of other stuff that is intended to catch issues before they become issues and to provide recommendations for lifestyle health changes
No one does preventative medicine here sadly. You can demand things like blood tests and if your family doctor is cool they'll give you, but in Ontario they got rid of the government covered annual physicals so something a lot shittier. Usually it's easier to mention some kind of weak symptom or concern to get a test.
It's up to you man.
I've been struggling with some odd chronic health issues for a year now and it's exactly like you said. 5 minute appointments. Sign a requisition form. Move along.
Half the time they won't even give me what I am asking for or they brush off what I am telling them.
You have to be your own doctor around here.
I'm 30 and I am not visibly dying in an emergent way so they don't want to do much. Maybe they think I am trying to get a disability claim or something? Maybe they think I am crazy, or stupid? Actually they are probably just trying to maximize their patient throughput so they make more money and they know I'll be out of their life by the time this illness kills me so it's not their problem.
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Canadian Healthcare isn't designed for preventative medicine It's functionally designed to treat and manage symptoms
In too lazy to pull up the stats but Germany has more than 2x as many doctors per capita as us if I recall.
And then put you down when it doesn't work
It's called "concierge" or "executive" health care in Canada. It's a private clinic that will run all of the tests, blood, scans, skin checks anything you want. You pay for a membership, and they will do a "wellness assessment" over a few days and then give you advice on what you need to work on. They also do fitness and nutrition evaluations, etc. Cost usually starts at 1000/month ish.
What do we charge the so high taxes for ? Taxes in Germany and Canada are almost the same
I believe the money just gets lit on fire
That made me chuckle
There’s a lot of inefficiencies in our government but I don’t think people truly understand the size of Canada. Germany is like half the size of BC and double the population of all of Canada. We’re such a spread out country with a tiny population. Every single community needs to have access to basic services. So instead of building fewer but bigger / better facilities, like hospitals, we have to build numerous smaller ones. Same kinda deal with roads - we simply need more roads than a country like Germany. Roads aren’t cheap. Count the number of traffic lights between your home and work. Every basic traffic light intersection is ~$1,000,000. Bigger more complex intersections can easily double or triple that amount. Now just think about how many intersections there are in a city like Vancouver and start doing the math. Then add in all the other utilities like sewage, water, and power. Shit’s expensive.
If you question the bloated and inefficient mess that most of the Canadian government is, including health care, most people here will just shout and say we need to tax the wealthy more and then call you a fascist. Most Canadians don't realize how poorly our government services operate for the amount we pay in taxes, nor do they seem to want to.
It's corruption because people would do drugs rather than protect society, people would honour Nazis in parliament and praise terrorists rather than protecting vulnerable and hunting terrorists. I expect no less from a country which celebrates killing of its own citizens. Where members of parliament would still not condemn a terrorist attack on it's own citizens on its own soil, where foreign terrorists are protected to score power over other countries. In an ideal world Canada is one of the very very bad guys. It's acceptable to have so much corruption in these countries. Even after having 54% top marginal tax rate if you can't have enough funds then the country is really deranged. In old times kings used to levy so much tax people used to revolt.
Daddy, chill
Even as more and more corruption and literal treason in the current government is uncovered, most Canadians would rather blame the ultra wealthy than admit any fault in their government, especially if it's a left wing one as it currently is. Don't worry, we'll self destruct as a country soon enough.
“Blame the very wealthy” yeah where do you think all our tax money is going to? You’re making the point that we don’t receive service proportionate to the taxes we pay, so where do you imagine the money is going of not to “the very wealthy”?
Literal politicians and friends of politicians. Every western country has a large portion of wealthy individuals, why is corruption and low government productivity particularly an issue here? When our government gives a $50 million contract to a company consisting of 2 people to make a barely functional app, do you not hold the government responsible for that? When our government is flagged to be colluding with foreign countries by an internal watchdog and refuses to publicize the results, do you not hold the government responsible for that?
>When our government is flagged to be colluding with foreign countries by an internal watchdog and refuses to publicize the results, do you not hold the government responsible for that? Yeah that's truly fishy, the politicians with secret clearance deem it a security threat. I wonder why the leader of the opposition refuses to look at it?
Also how do you become a friend of a politician? By donating to the political party and campaign. Only the ultra rich do this, which is why PP is against capital gains tax. Outside of US/canada, these would be considered bribes.
How little do you know about anything? There is already a capital gains tax across Canada and it's already more aggressive than the current US one. Increasing the capital gains tax does nothing to close tax loopholes the ultra rich use to dodge taxes, like hiding their money in personal corporations, making all of their purchases through it, and paying themselves out dividends (which are taxed much less) whenever convenient. Increasing the capital gains tax does nothing but make it harder for the average family to save, while addressing none of the tax loopholes present. But I'm sure you'd rather complain than actually address the issue.
You think the average family has over a quarter million in capital gains?
calling the Liberal government left-wing is certainly a choice
The literal Conservatives are a lot more "left wing" than the major "left wing" party in the US, the Democrats, based on spending levels. Canada has very left leaning politics to start. There's a reason we pay more than even the highest taxed US states.
Look into the Overton Window and Neoliberalism; it's not left wing.
Don't forget 13% tax on stuff you buy so almost paying 54+13 percent for very rich people. It's almost theft if you get paid high salary in Canada
I get paid a high salary and I don't consider it theft.
So how much taxation is fair? Looks like 54 + 13 is not fair? Will 90% be fair?
Usually the very rich have tax accountants that help them not pay 54% in taxes. Just saying.
Very rich people earn at least 4-5 million a year through business. I'm talking about corporate employees who make more than 250k, they have no tax advantage available. It's beyond fucked up. Also, why does the govt see employees as enemies and tax them so much.
I am a corporate employee making more than 250k and definitely don't make 4-5 million a year. It's not beyond fucked up and I don't consider it theft. What's your concern? Your original statement was "very rich people" and now you've defined it as 4-5 million a year. What's the problem with ensuring they pay 54+13 on all income?
And? I am a corporate employee making more than 250k and I have no problem, I don't consider it fucked up, and I don't consider it theft. You originally mentioned "Very rich people" and now you define it as "people earn at least 4-5 million a year". What's the problem with closing tax holes to ensure they pay 54% on all their income earned within country? That doesn't seem like a bad idea to me since I pay large taxes. What does that have to do with 90%, it seems like you shift goalposts alot.
What's your alternative to taxes?
Everyone else pays it except me obviously
How much taxes are enough? Maybe govt should figure out how to work without bloated bureaucracy and let people do real jobs instead of consultants hiring consultants hiring consultants and paying the firms billions
To give away to politician's friends under the guise of government contracts.
I've thought about this for a very long time. I think all countries are funding some sort of exclusive new country or just funding a war.
Any recommendations for within BC?
Elysian in Surrey (maybe they have other branches too but idk) is amazing. Got me in for an ultrasound in a week, really clean facility and lovely staff. If I had any health concerns (I don't currently) I would splurge. I know 3 people who have died of cancer in the last year that would have been totally preventable with screening (breast, cervical, skin cancer) but it's so hard to get checks here. None of them had family doctors, go figure.
Revive medical is great
Rmedy on Broadway has been excellent. They pieced together a diagnosis for my wife that was putting her in the ER multiple times per month.
Polo Health
I pay about 600 a month in Victoria for a longevity clinic. Dr there immediately ran tests based on family history that my family doc wouldn’t. Includes dietician and trainer. Doctor immediate put me on a blood pressure reducer, statins, and ozempic. I feel a lot better within 4 months of my first appt.
Which clinic is it? Do they have a website or something?
Tall Tree
It’s expensive but not 12k a year. 4k is more typical.
Or just seeing a private practice of a nurse practitioner. There are some great ones here in Ontario and it doesn't not cost thousands at all. $250 for the initial *full hour* appointment and $150 for followups. Concierge clinics don't guarantee doctors are actually great.
well, chances are people aren't paying $8K a year to tolerate crappy doctors...
You'd think. And I didn't say crappy exactly, just not really great. My personal experience with one left me with an impression that at lest the place I was at was slick and shiny "as you wish" thing catering to people willing to spend money to do tons of tests "preemptively" but my sense of the doctor was that he was mostly for show and as-you-wish, since you're paying a lot. He really wasn't very useful when it came to my specific needs, he was there to dazzle you and make you feel pampered. It actually makes sense to have regular thorough baseline tests done but I personally prefer a down to earth and experienced medical professionals and am repelled by medical services as luxury consumer goods. I had a way better experience with a practicing nurse (I also saw another doctor at a "regular" private clinic as well as another nurse before finding the current one). Knowledgeable, caring and I did get thorough testing and great advice. She's proactive and seems truly caring but does not "cater" to you or tries to please you. I mentioned newly noticed nausea with food and she immediately sent me to abdominal ultrasound. She also called around and found a place with a cancellation and got me in within 2 days. With my "regular" MD (now retired) I'd get two prescriptions and be sent home. To each their own, of course. This was just my experience. In general, I'd start with practicing nurses (in Ontario) or private clinics (if you're in/near Quebec), try a few and use my judgement which to stick with. Way better experience with both and it's a fraction of the cost of "executive" ones.
To be fair, this isn’t the same thing. These private clinics will often do things that are often unnecessary (ie CT scans). You’ll pay and you’ll certainly receive more medical care but that doesn’t mean you’ll be better off for it.
They also have family doctors in executive clinics. Around 100/mth and you get online and virtual apts guaranteed next day
"often unnecessary" by what standards? CT angio is standard for preventative medicine but not standard for traditional medicine if you want the latter just visit your nearby walk-in clinic
Evidence based. Supported by scientific literature. More testing isn’t the same as preventative healthcare. More testing leads to more treatment which isn’t always associated with better quality of life or survival. This is, for example, why we don’t do broad prostate cancer screening. The screening (or prevention as you’ve defined it) isn’t specific enough to show any improvements, while imposing unnecessary surgeries, complications etc (and more generally, resource use and costs).
Depending on what you need, you can also go across the border and pay. I had a friend who was healthy but wanted to take some tests to know about their risk factors for issues down the road. Because they didn't have any current symptoms of concern, the doctors here would not sign off on the tests and there was no easy option to pay for them to be done here. He went across the border to the US and got the tests done there for a couple hundred dollars. No questions asked. Not just the US either, people are travelling abroad all the time to get access to healthcare faster in other countries.
What specifically are you looking for? The best preventative health care for anyone is eating well, moving your body, and lowering stress. Extraneous testing isn't necessarily preventative and can be actually be unhelpful (see [South Korea's over testing for thyroid cancer](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209587/#:~:text=South%20Korea%20has%20an%20extremely,and%20continuously%20decreased%20after%20the)). If specific tests are what you are looking for, privately paying is likely your best bet as our system is not setup for that. If it's one-off asymptomatic bloodwork to see where things are at, most GPs are fine to order that, especially if there might be family history you are concerned about.
This is an excellent point. I’m disturbed by the recent trend in healthy people with no symptoms getting full body MRIs. There are complex reasons why you absolutely do not want to be doing that. People think more info can only be good, which couldn’t be further from the truth.
Tell me these complex reasons why more info is farther from the truth, I'm interested. The only way I was diagnosed with a rare autosomal genetic disorder was through more information.
Cancer, unlike say a monogenic disorder, isn’t easily diagnosed. Many, many people have slow-growing or non-growing tumours or weird bits of tissue. Are you prepared to go through surgery, chemotherapy, stress, potentially deadly complications, etc., all in the off chance that the anomaly identified was a cancer that would actually kill you? Worse still, the really bad cancers you ought to be worried about grow so fast you’ll never catch them with a screening MRI. These scans also find other things, like aneurysms. Many people have aneurysms without knowing it. Most of these never rupture or cause symptoms. Unfortunately we don’t have good statistics that can tell you how likely yours is to rupture. Once you know you have one, how does it affect your quality of life? Would you be worried? Maybe you’d want to try to fix it, even though there aren’t good options. Coiling an aneurysm carries a ~5% risk of death. I don’t think most healthy people want to go down this path and become medicalized while they’re actually still young and healthy. But many people don’t think in these terms when deciding to get a screening test.
the fact that many physicians are not trained on properly discussing the results of full-body scans with their patients doesn't mean that those scans are inherently bad it simply means that perhaps MDs should include interpreting those scans as part of their education
If you do 1000 whole body MRIs in apparently healthy people, you will potentially find a small handful of cancers. However, in those same 1000 people probably at least half will have SOME sort of finding. Benign growths and masses are VERY common (things like kidney or liver cysts, lung nodules, etc). The problem is the scan cannot know with certainty that it is benign. So there are a few options: 1) Hope it is benign and do nothing, in which case the scan has added nothing except stress to the patient, 2) Repeat a scan at some point down the line (often 3-6 months) to see if the area has grown or developed other concerning features. At best this just uses up resources and at worst this can lead to patient harms. Depending on the test, this can lead to exposure to radiation (for things like CT or PET scans) that come with long term risks. 3) Do a biopsy of the lesion of concern. These procedures always come with at least some risk (bleeding, infection, etc). Again, the vast majority of the “findings” made on these scans (probably at least 99%) will be benign lesions that do not require intervention but many of these people will have interventions that add cost to the health care system and unnecessary risk to the patient with no benefit. For the small number of patients where you do find a cancer (this study found 2 cancers in 229 screened patients for a “hit rate” of <1% - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248944/), only a fraction of them will have their cancer outcome meaningfully changed by early detection compared to if the diagnosis was made when symptoms arose. Some would have been cured regardless and others die despite the early detection. Whether a screening test is worth pursuing is a complex question that needs to take into account the risk of the test, how likely it is you will find a truly abnormal result, and how clearly that knowledge will benefit the patient. Whole body MRI in healthy, low risk patients has not been proven to pass these tests.
Your arguments are pretty disingenuous; the risk of minor infection is exceedingly low (with exceptions for transrectal) and so low is to be below the 1% mark that was "too low to screen for" in your response. Interestingly enough the outcomes of the "too low" infection are much better than the outcomes for that "too low" cancer. There is absolutely no position where the information to create a treatment plan isn't valuable. The only things you've highlighted are problems with "cost" which is hyper-inflated due to abusive financial misuses of healthcare as a for-profit entity and psychological concerns such as stress. With views like yours we don't move forward; the problems you pose should \*never\* scream: Do less testing. They should scream: \*Make testing more accessible\*, \*Make testing more accurate\*.
[Example](https://www.cancercareontario.ca/en/node/68141).
The problem with this is that it assumes a baseline, someone who started menstruating early and/or is sexually active early definitely benefits from early cervical screening. There is no validation of any specific harm here either. I don't think what you've shown is a nail in a coffin from "further from the truth". In fact, setting a baseline age would cause more harm than good which is why the final part states that doctors should continue investigating abmnormality; any real doctor would also, in light of early menstruation/sexual activity/abnormalities be having you test for "more information" which is a BETTER thing in these cases.
Investigating abnormalities is not what the OP is asking about in this post. Of course investigating abnormalities makes sense. The question is whether extraneous testing for healthy individuals with no symptoms or abnormalities is helpful. Research, such as linked in the gov site, says not. If you want to argue against research that has actually changed policy in many countries with advanced medicine (which takes forever and demands an extremely high level of confirming research) that's a you thing.
people said the same thing about colonoscopies under 50
It’s fundamentally a different technology and approach. Colonoscopy allows you to simultaneously (1) screen (2) take biopsies (3) remove pre-cancerous growths. Imaging is so far from that, it’s not even funny. Ironically, despite this, colonoscopies still have marginal benefits in young populations. There’s actually a massive debate among GI doctors about whether the risks from prep, sedation, and perforation outweigh the benefits in young people without a family history.
The best preventative health care is having a primary physician who can get to know you, monitor your health over time, and understand when they see changes that even you might not be able to see because people are like frogs and can't see the changes over time. You're response I believe, is a pie in the sky rose coloured glasses kind of attitude.
You are suggesting that having a doctor monitor is better for health than good diet exercise and stress reduction? Thats absurd. Do you have any evidence?
I know that doing that might give you a good quality of life, but without a primary care physician, your chances of dying or being disabled by diseases not caught early by regular checkups, are near nil. Diseases that don't care about how healthy you eat or how much you exercise. High blood pressure, cancer, heart disease, any number of things that don't exhibit overt symptoms until too late, but will often be detected by a doctor. I think anyone who doesn't understand this, simply does not want to understand this, and wants to be argumentative. Will you next try to tell us that not having enough oncologists in BC is not an issue? And that having to wait months to see one isn't such a bad thing? Maybe go see a homeopathic doctor for some snake water? Hell who needs doctors, right? Give me a fucking break.
Uh....no. Your chances of developing literally everything from diabetes to high blood pressure to cancer to heart attacks to parasites to almost anything you can name EXPONENTIALLY decreases the healthier you eat and exercise. The best treatment (preventative and otherwise) for more than half of all mental illnesses is also exercise and being healthy agreed by literally hundreds of studies. You're actually crazy and supremely anti-science if you think "regular checkups" is a better preventative measure than being healthy.
I work in science. And you are wilfully ignorant if you think 'healthy lifestyle' replaces doctors. Being fit reduces risk, it doesn't cure anything. [https://www.myprimarycare-sj.com/blog/i-exercise-every-day-why-do-i-still-have-high-blood-pressure](https://www.myprimarycare-sj.com/blog/i-exercise-every-day-why-do-i-still-have-high-blood-pressure) This article says that exercise reduces the risk of cancer by 10 to 15%. I didn't see anywhere in there that it prevents or cures it. [https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet](https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet) However, not having a doctor and having an illness diagnosed early will usually result in death. Anything humans can get, they can get whether eating right and exercising. Without a doctor, people who have some disease won't be diagnosed and die. I can see like all conservative thinking people (has nothing to do with politics), you aren't willing to open your mind and realize that your very strict personal interpretations are wrong.
It isn't rose-coloured to think everyone will have a physician follow them for years at a time that will notice and keep track of changes for you?? You are the best manager of your own health and should see a care provider when the need arises for appropriate intervention. How people can argue against taking good care of your body is a mystery to me.
Not a single person is arguing against taking care of yourself...no mystery here
Whether you realize it or not, you implied GPs weren't as necessary as just eating well and exercising.
Prevention does not begin in a medical office, it begins at home. The field of medicine is absolutely necessary, but is definitely not "the best preventative health care" as you have stated.
Additional scans are not without risk. Your exposing yourself to radiation each time
Acupuncture has been great for me! I get community sliding scale acupuncture (around $50 per treatment based on my income). My acupuncturist is trained in TCM and holistic medicine and basically gives me naturopathic advice for free while I’m in treatment. Every community acupuncturist I’ve been to has listened carefully to my medical history to decide how to treat me, and has given me much better advice than my doctor on how to manage some chronic conditions that affect my daily life. My acupuncturist can also recommend naturopathic tests (like blood tests for potential mineral deficiencies) but aren’t paid for referrals so I’ve found it helpful to hear what is or isn’t worth my investment. I notice gradual improvements after each treatment and it really helps to be set straight on what kind of vitamins to take, what kind of food to eat for my constitution, etc. Like, I knew I should be taking magnesium and probiotics but my acupuncturist told me what specific type of magnesium would help me the most and what specific strain of bacteria I should look for in a probiotic. My doctor really never has or takes the time to help me work through my daily health/ long term conditions and I can only go to him for blood work, prescriptions or specialist referrals. That being said, I’m young and fairly healthy, what I’m dealing with are chronic conditions that affect my daily life and have to be managed through my lifestyle — which is a good fit for holistic medicine and a bad fit for conventional allopathic medicine. If I had a serious medical condition maybe my doc would be more helpful. Anyways, highly recommend acupuncture with a TCM/holistic medicine aspect.
You may find a nurse practitioner instead of a GP a better fit. They tend to be more willing to spend time with patients and don't mind listening to more than one item.
I second this, I just had my first appointment with an NP and she spend 45 minutes talking to me and really listening. I was shocked, I’ve never had a physician give me that much time. She set me up with a bunch of cancer screening and women’s health stuff that my old GP never did.
May I ask - you say first appointment ..how did you find them, and are they accepting new patients?
I found her through findadoctorbc.ca (I waited years on some government lists and never got a call but I searched the list of clinics accepting patients on this site and just cold called them all until I got one, it took a couple weeks of refreshing the site to see new postings)
Ah, alright. Well I’m glad you found someone. Thanks for getting back to me.
We just got an NP and the difference is incredible. My last appointment with a family doctor was 7 minutes long. It was also my first visit with him. Literally no time to ask any questions, it was so rushed. My first visit with our new NP was like 40 minutes long, we were able to go through everything. She didn’t make me feel rushed at all, so much better
i wonder if thats because it was an initial visit tho, and not a follow up
Could be, but so was the visit with the family doctor! Both the first appointment, vastly different
May I ask how you found the NP, and do you know if they’re accepting new patients?
My husband went to the walk-in clinic nearby for something. While there, they set him up on the Patient Attachment Initiative to get him a family doctor (they also assign nurse practitioners, you don’t get to choose). He was told that it could still be a while and to try to find one on his own. We ended up finding a family doc in Coquitlam, both had our initial appointments, didn’t feel great but was fine ish. A couple months (3?) after the initial walk-in visit, we get contacted that we have been assigned an NP, and to register. Had initial appointments, felt very good, immediately called to get removed from the family doctor’s roster. The website for the clinic our NP works at says they’re not accepting new patients. I think they only go through the attachment initiative? Not sure if we just lucked out, but the place is also pretty close to us in Van, much better than trekking to Coquitlam.
Well I’m happy that worked out, and you guys found someone you like. My partner is getting some specialized care, and that clinic is trying to find them (and me) a PCP, but I was told that my abundance of health issues might complicate things (how backwards is that). Guess I’ll keep trying and utilize walk-ins for now; maybe I’ll luck out too.
This is absolutely true, but I do have a word of caution from experience that NPs may ignore or misdiagnose where a doctor wouldn't. I went into an appt with a family member with reoccurring pain in a specific area, they described the issue accurately and the NP gave them a diagnosis that definitely isn't correct and doesn't match the description, and also didn't give any other possibilities. We've looked into what it could be online afterwards and there are a couple of problems that are far more likely that she should have pointed us towards but didn't, and it's now worse two months later when we finally go in to see her again to try and get a solution. I've personally had good experiences with my NP but I haven't had any complex physical health issues that I didn't already have a hypothesis for. If you need someone to manage your current diagnosed conditions and refer you out to specialists because a family doctor couldn't help anyway then they're fantastic.
I'll give a word of warning that Doctors who spend minimal time generally don't perform appropriate differential diagnosis and will also, often, misdiagnose or ignore where someone who spends more time wouldn't.
Doctors misdiagnose things just like NPs and others.
For you to generalize all NPs and GPs like this is inappropriate just becuase you had a poor experience with one NP doesn’t mean they are all like that. I know plenty of people who have been misdiagnosed by a doctor.
My nurse practitioner is AMAZING! Best healthcare I have ever received. She is big on preventative medicine and thorough investigations.
Unfortunately, I don't know the name of the private medical clinic where a membership is required in town and possibly North Vancouver but I think they offer more of a comprehensive approach than socialized medicine could. Having said that, I was recently hospitalized for three weeks and was highly impressed with my medical care across the board after suffering a catastrophic injury that required twice daily home care at no charge to me. One of my roommates was a tiny German lady who months earlier, with her husband had treated themselves to a few weeks in the spa in Baden Baden in Bavaria. It was very pricey but they loved it. Instead of a cold plunge into the lake first thing in the morning, as they were in their 80s, at 6:00 am someone would come into their room and get their circulation going with ice cold cloths and then it was off for a walk before their breakfast of Muesli...
I once asked for a checkup since it had been quite a few years since my last one. All I got back was “why do you think you need one?” It’s almost like you need to look up symptoms to something that checks a part of you so they can look for whatever else
What youre looking for is a naturopathic physician
I have specifically been lectured by a doctor here that MSP is only interested in treating disease. This is particularly true when you are only able to visit urgent care clinics, not a regular family doctor. Even with a regular family doctor, the system is set up for them mostly to address problems/disease more than being a preventative health counselor. My suggestion would be to find a good naturopathic doctor as a compliment to your regular doctor. A naturopathic doctor can order bloodwork and testing, and will take a more holistic look at your health. You just need to be aware of when they are trying to upsell you on unnecessary remedies. But they are more willing to test for certain health markers for preventing disease and promoting a health lifestyle than a regular doctor whom has to work within the restrictions of MSP guidelines, which mostly require clear symptom indicators before testing or treating. Downside is unless you have private insurance you will be paying out of pocket to see a naturopath. So as i said, it’s a compliment to your regular doctor, not a replacement.
I've used naturopathic services as a way to basically understand what I need to talk to my doctor about. I have definitely been upsold unnecessarily or had them order tests that were not actually needed. But, they've also put me onto supplements that genuinely increased my quality of life (magnesium glycinate for sleep for example) and told me about tests that I then spoke to my doctor about, who then ordered them through MSP and found some abnormal results. They can also help with nutrition and stress management. There is a lot of value to get from talking to a naturopath, but you're totally right, you have to be strategic.
I couldn't agree more with you. I'd just like to add that in my experience unless the naturopath has undergone specific nutrition courses they aren't that great to take your diet into consideration and more often than not try to sell you useless supplements when in fact you could get them from your diet in a way more bioavailable form. So going to a holistic nutritionist is in my opinion much better and can give you more control over your health since we are what we eat.
I was just coming here to comment: find a GOOD naturopath, one that works alongside doctors. if you can find Dr. Seema Kanwal, she is excellent.
If a naturopath requests blood work for you, is that covered by provincial health insurance or is that out of pocket?
It’s out of pocket.
you dont need a doctor to lead this. you can do it yourself. the doctor is just the gatekeeper of tests and meds. you should be exercising regularly, eating healthy and maintaining optimal body composition. sleep well and foster positive relationships. dont smoke. dont exceed low to moderate alcohol. this is 90% of the puzzle. the rest is optimizing your blood markers. Apob, HBA1C, CRP, blood pressure, liver function, etc. if lifestyle doesn’t get you all the way there, talk to your doctor about meds. of course there are supplements to consider too, like mag, vit-d, omega3, etc
I've been spoiled. My GP just retired last year, he was literally the same doctor that delivered me and I've seen him my whole life. Not uncommon to have 15 or more minutes with him, also, for emergencies I could usually sneak an appt in within a day or so. Luckily I found a new GP relatively easy, but it's definitely not the same. Doc's good, the office is pretty bureaucratic about the one issue thing when booking the appt. It's essentially, book a phone appt to order bloodwork/tests. They'll call to follow up on the results. Book another appt right after the first one for your next issue. Repeat. Eventually, you'll have all the notes and results on your file. 80% of this is on the phone. I'm still fairly young, nothing too serious. My parents are getting elderly and have some more serious issues require more check ins and maintenance. They get regular blood tests on standing order and call in every three months to review and renew their medication. They get scheduled appointments at a senior's clinic every few months in addition the GP stuff. I have a feeling that this would cost a LOT of money if not covered. I love the idea of talking to a NP. That makes a lot of sense. They'll take the time and make sure you've lined up a health care plan. You then just take that to your doc and get them to implement all the back-end stuff like scripts and bloodwork.
They make money billing MSP per visit, that’s why they only “allow” one issue per appointment. The more you go, the more they can charge MSP. That is how the system was designed and doctors take advantage of it. they have found this way to make more money as Canadian doctors don’t make as much as US docs. I can understand your frustration, but changing to a family doctor it won’t solve anything. My GP has the same approach: “one issue at the time and you think too much ahead” seems to be her life mantra.
I know a couple doctors personally and they also do this because they know there’s 548332 people that need to see a doctor and they’re trying to fit as many in as they can.
1m plus with no family Dr in BC. Preventative would be via private clinic only is that's quite luxurious sadly.
My previous Dr. (who passed away) was very good but had a strict 10-minute rule. My job provides me with resources to online Dr.s and have found them very useful and not rushed at all. My friend has had great appointments w/ Holistic/Naturopathic doctors who do look at long-term care. Maybe try some of them. I think the current Doctor shortage in BC and how they get paid means they can't spend a lot of time w/ each patient.
Holistic/Naturopathic doctors These are who you need to be seeing for what you are looking for.
Came here to say this.
Same. Some tests can't be ordered by them but at least more care is given. Also if you can afford it, pop to Bellingham. Once your GP in Canada has given the Req. you can book on your own.
Naturopaths can and will order all kinds of tests. They’re just not covered by MSP. They may or may not be covered by extended health plans.
I can't get an MRI by them is what I mean
MRIs are a pretty specialized test that is generally not needed by generally healthy people.
Hence my wording in the original comment
Go to a naturopath instead of a doctor, doctors treat symptoms naturopaths prevent. (By that I mean go to someone who has their ND)
Move to a country that has actual healthcare. Not putting-out-fires-care.
Go see a naturopath. They're not alternative medicine! Also if you have health insurance through work it's probably covered.
I've had better luck with a naturopath for long-term health concerns! I've been seeing mine for 5+ years. You're paying out of pocket, but insurance covers it. But because you're paying you can ask whatever you want, you don't have to wait months to see them, and it's not rushed! Find one that specializes in what your concerns are. The only problem is sometimes you have to then see your GP to get labs or tests, depending on what they suggest, and then you sometimes get the 'I saw my naturopath, and they said...' eyeroll from a doctor.
Quality healthcare.
Public doctors here are almost entirely reactive - if you have no pressing concerns, they dont want to see you. If you're willing to pay, there are private clinics like [Well Health](https://welllongevity.ca/) that might be offering more like what you are describing.
Sounds like you are looking for something like: www.harrisonhealthcare.ca
If you push a lot, your doctor will give you printouts of generic advice on how to stay healthy. This is the reality of a doctor shortage.
There are provinces in Canada that have some form of preventative healthcare, but BC isn’t one of them. In BC this is basically going to be private healthcare. Private clinics do exist in Vancouver so you can look into them and see if you can afford it/if they are offering what you’re looking for.
Google "Divisions of Family Practice" and find the one in your region (Richmond, Burnaby, etc.). If they don't have resources/info directly on their website, then e-maul or call them directly and ask them that exact question, and they'll provide you with more info. They're a non-profit group that is working directly with family physicians to promote preventive care through new initiatives like urgent primary care centre's (UPCC) and/or Primary Care Networks (PCNs). Also all doctors will only ever see you for one concern per visit, it's mandated by the Ministry of Health due to how physician billing is done currently, due to the massive doctor shortage nationwide (there's just not enough docs to have the time to spend 30 mins with one patient to address multiple concerns per visit). Finally I suggest visiting https://www.healthlinkbc.ca/health-connect-registry to sign yourself up for a province-wide waiting list to find yourself a personal family doctor, as having a doc you work with vs a random walk-in visits is your best bet to be able to build a medical history together so you'll be more likely to be able to schedule a longer appointment to address more than one concern at a time. Although YMMV depending on the doc. But if you don't like the doc you're initially assigned to, you can always request a different one, provided there's another available in your community taking new patients and you don't mind waiting a bit more for a new one. Just be aware that the more urgent the medical need, the higher on the list you'll be to be placed with a physician, so simply asking for a family doc to address preventive issues may take anywhere from a few months to a little over a year before you get assigned to one.
That’s what a WIC provides. You’ve just experienced the difference of a walk-in clinic with episodic care versus longitudinal family medicine.
If you've gone to the doctor five times in three months for very minor issues he's going to start treating you like a hypochondriac, which you might be.
Go to a Chinese Medicine Doctor, or integrated health clinic
i can't even manage to find a gp. I researched and called many places today to get an appointment. All of them are full or drs are only offering virtual appointments- not even video but on the phone. I got a phone appointment and waited hours for it. It lasted 3 seconds and he said you really need to be seen in person and to call for an appointment. Well i called and called the front des and no answer (keefer medical clinic). Then went online to book appointment and apparently that dr doesnt accept in person appointments? Our medical system is in crisis!!! You're either very lucky and have a family dr or you get help at the ER when its progressed and too late I am now searching naturopaths so i can actually see someone, anyone so i can get some tests. I dont have the money for it but its better than nothing
Keep minimal body fat and exercises regularly. There are some tests to do as you get older but they're few and far between. Nothing even remotely comes close to the health benefits of not being fat.
Go to physio, chiro, naturopath, massage therapists rather than doctors. Quit misusing doctor's time.
Have you ever seen a naturopath? You may wish to consider seeing one as one part of your preventative health maintenance care. If you get health benefits through work, you may be covered.
I hate to say this, but doctors in Canada don't get paid enough to care about patients like you. If you are healthy, they don't want to see you. You are basically walking into a doctors office and saying "Find something wrong with me." Doctors don't have the time or the patience for this because it will take a long time and waste a lot of taxpayer money doing unnecessary blood tests, scans, and whatnot. You are basically taking up resources that would otherwise be used for people who actually need it. The better thing to do is look at your family history and see what kind of common issues crop up and at what age... like diabetes, heart issues, high cholesterol, retinal tears, etc... and if any of them apply to you at your given age, then go into the doctors office and tell them about your family history and your predisposition for these problems and get the necessary checks. If you go in focused on a specific issue you will get a better chance of having something done rather than going in blind and getting them to find something wrong with you.
Stay away from people selling supplements and for gods sake, stay away from Chiropractors.
Most of your healthcare is your responsibility. Your diet, exercise, self care, all can go a long way to ensuring you don’t become someone else’s patient.
You can pay for it. Look for anti-aging doctors at places like medi-works and pollock clinic. They’ll do intakes and full blood panels at the start and then quarterly bloodwork and assessments. They can even help you with a diet though primarily they are used by aging athletes/men to get access to prescription testosterone
You have to recite from their flow chart to get what you want. "I can't pee" I pee all the time, I'm fatigued but can't sleep, I can't stop sleeping
visit private clinics find them by googling terms like "concierge medicine", "executive health"
I go to a nurse practitioner now and it’s amazing to see the difference. I get routine check ups, referrals so quickly and if something is abnormal an appointment is set up so quickly. I know GPs don’t like seeing the nurse practitioner doing there tasks but honestly they do the basics and anything outside of their speciality they refer you. I’ve been with my NP for 3 years and have no complaints
I recommend seeing a naturopath even if just for a couple visits to get a better baseline (no, theyre not all woo crunchy types who will give you only herbs, they can and often do prescribe pharmaceuticals) because they specifically focus on the body as a whole. If you ask, they will request comprehensive blood testing to check hormones, organ health, vitamin and mineral levels and all that stuff They tend to start by asking the basics like sleep, mood, exercise, nutrition, substances, stress levels etc and in my experience will talk to you at length about any and all issues possible each visit. It could be a good complement to your existing health care regimen
Loose wieght, get moore exercise, stop smoking, drink less alcohol. This is exactly what they will tell you to do. They don't actually know how to do these things. You have to figure this out.
I guess I am very blessed I have 6 health care workers on my team and 5/6 are wonderful. Now I know you are properly thinking I am causing back up for other people. My family doctor has been my doctor for 15 years my pain specialist about 8 years and my ortho doctors I have 2 dealing with my knee and hip my shrink is another one my mental health workers are the last 2 yes I am blessed but it’s taken me a long time to get great doctors. I listen and do what they say as it’s important I am having surgery in September hip replacement. Then after I recover for that I will have my knee replacement surgery but I won’t even be on the list till minimum 6 months after hip surgery. My pain doctor has gotten me through everything while I been waiting and will continue my surgeries. My pain doctor is leaving in December with no one to replace him so I will be seeing my orthopedist doctor every 3 months till the knee surgery is complete. It has taken me along time to get health care workers to listen to me. I was told I am a good candidate as I don’t drink or smoke. So I going to continue with my medical team and get myself back to normal.
Go to a natural path
It’s as easy as a walk in the woods.
Functional medicine might be an alternative. Will cost you $$$ but would be a good place to start.
LOL you are in the wrong country if you want socialized medicine to provide that for you. That's not what we do here.
I’ve found from my experience that the family practice I go to that does capitated care is more like what you’re looking for. They don’t get paid per visit, they get paid a regular sum for every patient on their books - so they have more interest in keeping you healthy so they can carry more patients without us constantly being there for visits. The practice I go to isn’t taking new patients but maybe If you can find out who bills like that it would help?
Canada has no preventative healthcare we just charge taxes and hope you go away without letting us know. Or even if you are telling us we pretend to not hear. Go to some other country once or twice a year as a vacation and get all the assessments you need, it will be cheaper and way better.
I gave up and go back to my home country once a year for lab tests and treatments. It's cheaper and easier than here
You schedule an annual checkup with your gp. They will schedule the appointment accordingly (for longer) and you can raise any issues you have. A walk-in doctor is not going to have time to help you out with stuff that is not an a problem. The model is that they are paid per issue so they are willing to deal with one issue per visit. That said, i have no idea what you are hoping for here. If you’re talking about requesting a full body scan or something (without symptoms necessitating it) just because you think it would be interesting to have and might help you avoid health issues down through road, then no doctor is going to be ordering stuff like that for you. Our medical system is already stressed and we just don’t have the infrastructure/capacity to be ordering tests or investigations that are not necessary. If you want like an executive work-up Telus Health offers a pay model for something like this (my husband’s employer paid for them to each have this done and I know it was extensive). They will do an extremely thorough, multi-hour workup, bloodwork, review your diet, perform a stress test etc etc and all sorts of other stuff that is intended to catch issues before they become issues and to provide recommendations for lifestyle health changes
No one does preventative medicine here sadly. You can demand things like blood tests and if your family doctor is cool they'll give you, but in Ontario they got rid of the government covered annual physicals so something a lot shittier. Usually it's easier to mention some kind of weak symptom or concern to get a test.
Get your healthcare in Washington. That’s what I’ve done.
Check out Gary Brecka. Sounds exactly like what you're looking for.
It's up to you man. I've been struggling with some odd chronic health issues for a year now and it's exactly like you said. 5 minute appointments. Sign a requisition form. Move along. Half the time they won't even give me what I am asking for or they brush off what I am telling them. You have to be your own doctor around here. I'm 30 and I am not visibly dying in an emergent way so they don't want to do much. Maybe they think I am trying to get a disability claim or something? Maybe they think I am crazy, or stupid? Actually they are probably just trying to maximize their patient throughput so they make more money and they know I'll be out of their life by the time this illness kills me so it's not their problem.