Patient-centred care means better coordination of medical appointments

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  • Pina Ciarniello says:

    I wish to address you atrial fibrillation. Your focus is the travel cost and upheaval required to attend AF health care in the lower mainland, in your case St. Paul. Living in the lower mainland does not guarantee better treatment; it can even be inferior. (Your wait time was collapsed compared to some in the lower mainland. )

    You say you had a consultation at St. Paul in January 2018, with the ablation performed in April — a three to four month wait. In my case, my GP played electrophysiologist for a year until I became persistent, and only then did he refer me to a clinic -Vancouver General Hospital, which I feel, was in the early stages of being set up. I could not even get to see an electrophysiologist without an eight month wait time which got collapsed to five months by my complaining to the manager of the cardiology department. Then, from the EP appointment, it would have been three to six months and beyond for the actual ablation by which time I would be in long-standing persistent atrial fibrillation with a totally remodelled heart guaranteeing a poor ablation outcome. I had to go out-of-country at my own cost, and with still a sufficiently remodelled heart which could have been totally avoided.

    My point is that you might want to incorporate wait time with your campaign of travel cost and upheaval ( with also your point on duplicate costs and paperwork).

  • Sara Golling says:

    Excellent analysis. I suspect most people could add to the evidence that we need SO much better communication — utilizing updated use of technology — and SO much more concern for the patients’ time, money, and convenience in our health system.

  • L.kolewaski says:

    Kudos to you. Keep up your battle for change

  • Linda Latcham says:

    Good on you Fanny! If everyone would start being a squeaky wheel and offer well thought out alternatives for there concerns, perhaps the leaders that should be reviewing these convoluted systems will do what they should be doing. Without much accountability in our major systems, we must be thoughtful squeaky wheels. Thanks

  • Janet says:

    Fanny, once you get BC fixed, please come to Ontario! Even routine visits to one’s nearby general practitioner can be a large burden for some people, and surely some could be done by phone or video call.

  • Leslie says:

    An excellent overview of a common problem throughout the health system. Patients can wait months for a specialist consult, travel great distance and incur great costs–only to have a very brief encounter that could have easily been taken care of remotely through video. Good for you for advocating for better options; the system must be designed to improve virtual care and remote consults.

  • Don Taylor says:

    Kudos to you, Fanny. The practices and habits you are working hard to change are, unfortunately, universal across Canada.

  • Mike Fraumeni says:

    Thanks Fanny for relating your experience and thoughts. One can only hope that generic type clinical practice guidelines on conditions and diseases are able to treat each individual with true patient-centred cared unique to each individual rather than what appears to be the case nowadays where such clinical practice guidelines, which governments love to make themselves look better with a “best practice” phoney label and yet being able to deny certain drugs and procedures and diagnostics with the rationale “not enough evidence” despite enough trials to warrant covering the costs for such procedures etc. IMHO evidence-based medicine, in practice, has a long way to go to fully achieve true best practice patient-centred care. The end of generic clinical practice guidelines will be an excellent start in recognizing the unique health situation of every person with their own specific needs and conditions in our health care system.


Fanny Monk


Fanny Monk is a retired X-ray technician and union activist, former competitive horsewoman and farm girl who rides a Can-Am Spyder for fun. Now her priority is working to change health care booking systems.

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