I have an appointment for a physical booked in four weeks but my prescription runs out in two weeks. When I called the doctor's office for an appointment for a refill, I was told she has no appointments for five weeks and I would be charged $20 for the fax renewal. I asked why I have to pay since I was willing to see her and the receptionist said it's the patient's responsibility to have prescriptions renewed with ample time between refills.
Fine – that makes sense – but five weeks with no opportunity to see my doctor seems unreasonable. It seems unfair to penalize the patient when the doctor clearly has too heavy a patient load to see people in a timely manner. Do I have unrealistic expectations? Is this the norm?
As I read your question, I could practically see your family doctor, hunched over her desk, double booked for that day, trying to plough through a mass of paperwork, prescription renewals and preoperative forms, feeling she has little control over her work life. It looks as if she has a long lead time for booking non-urgent cases – such as prescription renewals – and likely has no idea of the exchange between you and the office worker. However, you should not pay the price for poor access.
Timely access to family physicians is a relatively common problem, with Canada having some of the worst waits in the developed world: Only 51 per cent of sick patients could see their doctors the same day, according to a 2011 Commonwealth International Health Policy Survey done in 11 countries. That compares to the United Kingdom, where 79 per cent of patients could see their doctor in that same time period.
While some may argue the problem is a shortage of family physicians, another major factor could be a scheduling flaw, according to Danielle Martin, a family physician at Women's College Hospital in Toronto.
"Very often, it's a flaw in the way we schedule," said Dr. Martin, board chair of Canadian Doctors for Medicare. "The wait time feeds itself, where doctors are constantly seeing people who needed to be seen four weeks ago."
That's why more doctors are moving toward an advanced access form of scheduling, which involves leaving about two-thirds of the day open, allowing more same-day and next-day appointments.
Overall, I don't think a long wait time for a non-urgent issue – a prescription renewal – is a problem in itself. What troubles me is that there is no mechanism for you to avoid the fee, which may leave you feeling powerless – instead of an active partner – in your care.
In answer to your question, I don't think you have unrealistic expectations. But I do suggest you pay the bill, then take it with you the next time you see your physician. Explain to her how you tried to make an appointment for a refill but the wait was five weeks. There's a good chance she will agree with you and waive the fee. If not, your point was made.
The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to firstname.lastname@example.org.