The National Post, today, reports on a start-up technology provider, Realtime Radiology, which interprets the results of x-ray, CT and MRI diagnostic tests - just as do other partnerships of medical radiologists. What makes Realtime Radiology different is that it receives the x-ray. CT and MRI “images” and dispatches them to a team of radiologists electronically. The radiologists may be working anywhere - thousands of kilometres from the patient, on in the same city - but, importantly, someone is always available. For hospitals and doctors in remote areas, the opportunity to access professional radiology consultations where no radiologist would settle and practice is invaluable. For other facilities, access to additional professionals to cover for regular staff during vacations or other absenteeism is extremely valuable. Government-run projects have been offering similar services for years successfully. They have made being ill a lot less traumatic for patients who have been spared long trips to urban hospitals for specialized tests, they have saved the health care system significant expense for patient transport and, no doubt, they have saved lives. Once dubbed “tele-health services”, although the “tele” is a bit of a misnomer now (internet health might be more apt), the services are a vital part of the 21st century health care system.
What makes Realtime Radiology different, and which is the underlying theme of the Post’s report, is that it is a private, profit-making now hopefully, for the investors?) business. This leads, as expected to the usual chorus of chest-beating angst from the usual choristers. That, and the participating radiologists are located in private offices and homes rather than hospital and university health science centres.
No surprise; the Healthcare Coalition of Canada profers that providers like Realtime increase costs and syphon resources from the public health care system. Spokesperson Mike McBane ignores the reality that most of the Canadian health care system is in the private hands of individuals and corporations hoping to profit from their labour and investment. Diagnostic laboratories, imaging services, pharmacies, most long-term care have always been in private hands. Indeed, almost all doctors are private entrepreneurs and few are those who are not in the business to make a very good living. The for-profit argument is a tiring bogeyman which informed observers have long since learned to ignore. Unfortunately, Tom Blackwell, writing for the Post, gives the specious argument an aura of credibility even while he notes that Realtime is paid at the same government health insurance rate as all other radiologists.
Of greater concern is the credence given Dr David Vickar of the Canadian Association of Radiologists (CAR) who characterizes Realtime as a threat to quality care and potentially dangerous for patients. Dr Vickar ignores the years of successful government and university-run projects as he worries about radiologists who are not in close physical proximity to the doctors ordering the tests. Blackwell writes as though Vickar is somehow responsible for ensuring quality of care. He fails to inform readers that, far from being a quality assurance body, the CAR is the radiologists “union”. Its responsibility is to safeguard or increase the share of healthcare spending that ends-up in professional radiologists’ bank accounts. Professional practice standards are the responsibility of the Royal College of Physicians and Surgeons, not the CAR. When Vickar argues against a service which better utilizes part-time radiologists and provides support to under-serviced areas, he really is advocating for more radiologists to be trained and certified, for radiologists to gain a larger share of health care spending and, ultimately, for his association to grow larger and more wealthy. Vickar’s argument is extremely self-serving and should be reported as such.
Secondary to the Peat's report, but encouraging is how Realtime is enabling physicians to work part-time, from home and in other non-conventional ways. It is commonly recognised that Canada needs more medical generalists and specialists than it is training and certifying. Compounding the problem is the fact that many physicians no-longer are willing (or able in the case of some older practitioners) to work the long hours that were once considered the price for being part of a highly paid profession. As noted, Realtime enables skilled professionals to work to their own schedule rather than to withdraw from the health care system entirely and waste their years of training (much of it publicly funded).
Canadians should be thankful that 21st century technology is delivering both cost-efficient and quality health care beyond the previous generation’s wildest dreams.
