Difference In Level of Care (Barriers to Integration of Healthcare (Wait…
Difference In Level of Care
Patient (my sister)
Healthy, 23 year old. Played soccer since the age of 4, had a knee-on-knee collision in soccer the previous year (before the ACL surgery).
Referred the patient to the local orthopaedic surgeon. After the arthroscopy, they referred the patient to the Toronto-based doctor for a second opinion.
Performed an arthroscopy in February, told the patient that they wouldn't perform an ACL surgery and that her ACL may only be "a little" torn.
Confirmed the patient had a fully torn ACL and performed the surgery 6 weeks later.
Interdependencies Between Main Actors
Family Doctor and Patient
Family doctor advocated for the patient referral to a specialist in Toronto.
The patient picked this specialist based off of a family friends recommendation.
The patient was very interested in having the surgery done so that she could enjoy participating in physical activity without requiring a knee brace.
Family Doctor and Local Orthopaedic Surgeon
Family doctor referred patient for a consult and MRI.
Local Orthopaedic surgeon performed an arthroscopy, but will not move forward with the ACL repair.
Toronto-based Doctor and Patient
Toronto-based doctor confirmed she had torn her ACL and recommended surgical treatment.
Toronto-based doctor worked with the patient and her physiotherapist to ensure that she got back to the sport she loved playing.
The patient was willing to drive to Toronto several times for appointments and surgeries in order to improve her health. She was also motivated to move forward with the surgery because she missed playing soccer.
Barriers to Integration of Healthcare
The patient experienced a longer wait time when working with the local orthopaedic surgeon. The total process from first initial injury to surgery date was approximately 2 years.
Long wait time to have an MRI and then another 6 months to have the arthroscopy.
Sending patient to local surgeon
The patient did not have a positive experience working with this doctor. The doctor was unwilling to perform the surgery on her and told her to find another hobby.
Individuals in varying circumstances may not be able to travel to a big city to seek care.
ACL surgery took pace at the beginning of the summer and she is a teacher so she didn't have to worry about taking time off work.
Individuals may not have the ability to take the time off work to go to specialist appointments in another city or to perform the surgery.
Traveling to seek care
Enablers of Integrated Healthcare
Family doctor advocated for the patients needs
She was able to build up her strength prior to the ACL surgery since she was already doing physiotherapy. Believes this helped with have a speedy recovery
The patient communicated openly with her family doctor about her needs
Toronto-based doctor willing to work with the patient to ensure that she is able to participate in all forms of physical activity.