MP a special case
Online posting: May 29, 1996
Published in print: Aug. 15, 1997 (CMAJ 1996;155:368)
Re: MP offers a testimonial: "I've had superb care, and I'm alive
today because of it", by Charlotte Gray, CMAJ
1996; 154: 1241–1243 [in brief / en bref]
In regard to the testimonial by federal Member of Parliament
Beryl Gaffney, I am sure that none of us wants to put a negative
spin on a very satisfactory outcome involving a remarkable women.
However, one must consider whether this case has any general
applications. How many patients have the opportunity to seek
multiple consultations? Is provincial health insurance expected
to cover such care? How many patients have relatives working in
medicine outside of the country who can expedite a further
review? How many have the ear of the prime minister, who also has
a relative in medicine, also, coincidentally, outside of the
country? How many consultants can get an endorsement that their
team is "a world leader in brain tumour research?"
Gaffney's case is an exceedingly special one, involving a
patient who could gain access to the full potential of North
American medicine.
What are the lessons for the rest of us? Gaffney's first
consultation should have led to the discussions and provision of
information that she so desperately needed. However, the reality
is that neurosurgeons face extremely hectic operating-room
schedules, emergencies and limited consultation time.
This is where the family physician can play a role. With the
advent of computerized databases and the Internet, there is
really no excuse for not "plugging in" to current information.
For example, Cancernet is readily available through email (Cancernet@icicb.nci.nih
.gov) or through an Internet browser. In fact, there is an
abundance of information; what is often lacking is the
interpretation of the data in the context of a specific case,
which the family physician can provide.
Can this ideal scenario ever be applied? Finding and
interpreting information is time consuming and poorly
compensated. For many physicians and patients, computer access to
data is still limited. Good liaison and "hook-ups" among
physicians and especially consultants are underdeveloped. As an
exception, the Brain Tumour Foundation appears to be an excellent
resource for physicians and patients.
I respectfully suggest that Gaffney consider the deficiencies
and maldistribution in funding for the kinds of services needed
to bring the level of care up to the standards she obviously
expects. She should also ask herself why so many of her important
medical contacts were outside of the country and why only her
political position prevented her from going to these sources for
definitive care.
Christopher A. Finch, MD, CCFP
Mission, BC
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