Zoomer Magazine – Referral RX

 In English, In The Media

ANGELA JOHNSON considers herself a problem-solver. So, four years ago she started developing Medical Confidence, a fee-based patient advocacy service that launched last year to address, chiefly, Canada’s health-care referral process. A 2006 Statistics Canada report revealed that close to 30 per cent of Canadians surveyed felt their wait to see a specialist for a new illness or condition was “unacceptable.” Anyone who has waited months or more for an appointment – only to be referred on to someone else – may also agree the system has its flaws.


Johnson spent most of the start-up time developing a national network of more than 5,000 specialists, the service’s Top Doctors. Clients are connected with these doctors through the Find a Doctor service ($150) by which a Patient Advocate (registered nurse) determines a client’s needs and priorities and, based on that intake, the client is provided with profiles of two or three best matches. Things like proximity and medical condition are considered, in addition to the doctors’ qualifications and experience. Johnson cited a client who was concerned she was not seeing the right pecialist for her case of potentially cancerous ovarian cysts. Johnson and her team were able to find a top specialist in ovarian tumours with a subspecialty in oncology. They were able to secure an initial consultation within two weeks, and surgery occurred a month later. “Your access to specialists is only through your family doctor and who they know and have access to – that’s where it stops,” Johnson says. “And there are some doctors that have a really good network and there are some who don’t.”

Users can take the service further with Find a Doctor Plus ($375) where the Patient Advocate also co-ordinates the referral – ensuring the earliest possible opening – and makes sure the specialist has all of the records, test results and information needed for the initial consultation. And to make sure clients make the most of their visit, there’s coaching. Johnson is a promoter of prep, even writing a book about it: Step-by-Step Guide to Navigating Your Way Through Canada’s Health Care System & Minimizing Your Wait Time (released on Amazon.ca in August). From collecting and keeping thorough records to deciphering doctor jargon, she gives 13 tips with which people can empower themselves. She says, more times than not, stepping on the doc’s toes creates much of her clients’ anxiety. “I think the biggie is ‘I don’t want to offend the doctor.’ And that’s a big part of the coaching: how to pose a question without offending,” she explained. “And I’m always surprised by this … that they’re more concerned about their doctor’s feelings than their health.”

If the issue is not finding a doctor but finding a diagnosis, there’s Medical Detective Service (starting at $650). A multi-disciplinary group of the Top Doctors, custom-picked for each case , uses a differential diagnosis method. They debate and determine which, of all the probable diagnosis that map the symptoms, is most likely. Johnson belives this collaborative approach has been lost in our modern system. “Back in the days when it was a hospital environment, that went on. In today’s environment, it’s extremely rare, ” she laments. For Johnson, developing MedicalConfidence and the detective option in particular was a personal goal, having helped her sister who struggled with misdiagnosis and mistreatment for years. “It got me thinking that if she’s in that situation, how many othes are there? ” she reflected. “And we have really good doctors in Canada” . Maybe we just need a matchmaker.

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