I must be clear: the following is not a debate of the merits and imperfections of the Canada Health Act. My goal is to answer the specific question “Why does Dr. Helper practice Interventional Spine Pain Medicine, primarily, in the private sector?”
My clearest response is to ask and answer a few more simple questions:
1. What does it take to offer a high quality Interventional Spine practice?
a. Quick access to a qualified spine physician
b. A detailed assessment by that spine physician to accurately provide a diagnosis
c. Quick access to MRI or CT scan
d. Adequate operating/procedure room time
e. Access to a fluoroscope (live x-ray machine for performing procedures)
f. A qualified x-ray technologist
g. A dedicated nurse who understands the procedures being performed
h. A short wait list
2. What is the current wait to access some of the necessary services in B.C.?
a. Non-emergent (e.g. of emergent: spinal cord injury, infection, tumour) MRI of the lumbar spine: 7 months
b. Basic Spine Injection: 1 to 4 months
c. More advanced minimally invasive procedures: 3 to 12 months
3. Why do some surgeons/physicians work in both the public and private sector? (E.g. 3 days public, 2 days private)
a. Most surgeons are provided with inadequate O.R. time to keep up with the number of patients waiting to be treated. The only way for them to treat more patients is to find O.R. time somewhere else…private hospitals.
b. Some surgeons who perform procedures X, Y and Z will provideX and Y in the public hospital and Z only in the private setting. This allows them to keep the wait list down on X and Y, while still being able to offer/perform Z.
4. Why doesn’t Dr. Helper work in both the public and private sector?
a. The short answer is, see question #1, #2, and #3.
b. Access to resources is difficult in British Columbia (not that it is great anywhere in Canada!).
c. If a medical clinic were to provide optimal care for spine pain patients they would need to invest in an MRI scanner, a CT scanner, x-ray machine (or 2), an x-ray technician (or 2), a nurse (or 2), a secretary (or 2), an office building, and an O.R. suite (or 2). How will these resources be funded? You do the math.
