Maria’s Story – Part 4: Bureaucracy

The grueling ten-month journey into Ontario’s healthcare bureaucracy to get a melanoma removed from a woman’s neck.

Bureaucracy run amok

You can review the Timeline of Events here

You can read Part 1: The Bump here

You can read Part 2: Collateral damage from the Coronavirus here

You can read Part 3: Delays, misunderstandings, and a lackadaisical attitude here

December 3 finally arrived, and Maria is bracing herself to hear the results of her biopsy.

The dermatologist tells her she has an invasive form of nodular melanoma and the cancer was already in stage 3. She needs an immediate scan and surgery to remove the melanoma.

For the uninitiated, there are only 4 stages to melanoma and Maria may not have long to live.

“This was the scariest moment of my life,” says Maria. “For months I had been hoping for the best, and now I am literally being told the worst. Suddenly I am making plans for my own funeral. These are not things that a 40-year-old should be doing.”

The first step was to be admitted as a cancer patient at a local hospital to conduct a lymphoscintigraphy scan – a procedure where radioactive dye is injected into cancerous lesion which highlights the lymphatic tissue to determine where the tumour could spread. This would provide doctors with vital and necessary information prior to surgery.

And, unfortunately, at the lowest moment in her life, the bureaucracy of the healthcare system decided to add salt to the skin cancer wound. Below is the typical process to being admitted at a cancer ward:

  • Doctor sends a fax referral to the cancer ward.
  • Cancer ward processes the new patient registration.
  • Patient is admitted and a patient file is opened.

Seems simple, right? Not always.

Turns out bureaucratic oversights are not uncommon and mistakes do happen. Like, for example, a fax not finding itself onto an admin’s desk. Which is why her dermatologist advised Maria to call the hospital regularly to confirm her registration status and make sure she did not slip through the cracks.

Her first follow-up phone call with the hospital was a few days later, on December 7. This is what she was told:

  • No, you are not in the system.
  • No, we cannot confirm or disconfirm that we have received the fax referral.
  • No, we do not know when you will be officially admitted because there is a long line of new patients that need to be registered.

It was a cold and emotionless customer-service-like conversation, not unlike the ones we have with our cable and internet providers. Her life was at the mercy of how quickly hospital admin staff could process a stack of new patient referrals. She could not even confirm whether they received the fax referral or not.

It seemed like some perverse joke was being played on her. Her own personal Catch 22 where she can only find out if she is admitted only after she is processed but cannot find out if she is even in the queue to be admitted.

In Part 5 Maria takes matters into her own hands.

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