sunVancouver Sun
Published: Saturday, October 11, 2008

I have watched with interest your readers’ responses to the Oct. 2 editorial, “Private clinics and insurers are part of the Canadian health care system.” I wonder whether the public realizes that the patients seeking treatment or diagnosis in private facilities frequently end up back in the public system.

As a doctor in a community hospital, I have…

treated patients with complications such as seizures or a heart attack after cosmetic surgery; blood clots in the leg veins after joint surgery, and anaphylaxis (a life-threatening allergic reaction) following anesthetic given at a private facility. One patient required six weeks of intravenous antibiotics for a joint infection acquired in a private facility.

You may have your surgery at a private clinic, but if you have serious complications you get directed to the ER.

There are also patients, usually business executives, whose privately paid “executive physicals” involve coronary CT scanning or whole-body CT scanning.

This sometimes picks up asymptomatic abnormalities that require further investigations such as stress testing or a coronary angiogram, or a biopsy for a lesion that often turns out to be benign — all arranged by specialists through the public system.

The New England Journal of Medicine recently published an editorial advising against such testing.

Some doctors and investors are making a lot of money from the fact that relatively easy, high-volume procedures are being done in private clinics while hospitals and the Medical Services Plan are stuck footing the bill for the complications.

This is one of the reasons why public hospitals in the United States often end up in financial difficulties while the private, for-profit hospitals across the road are laughing.

It’s in everyone’s interest to have a well-funded and robust public health care system.

Dr. Anna Kang


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