Difference In Level of Care (Barriers to Integration of Healthcare (Time,…
Difference In Level of Care
Enablers of Integrated Healthcare
Toronto-based doctor willing to work with the patient to ensure that she is able to participate in all forms of physical activity.
The patient communicated openly with her family doctor about her 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
Family doctor advocated for the patients needs
Barriers to Integration of Healthcare
Traveling to seek care
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.
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 in varying circumstances may not be able to travel to a big city to seek care.
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.
Long wait time to have an MRI and then another 6 months to have the arthroscopy.
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.
Interdependencies Between Main Actors
Toronto-based Doctor and Patient
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.
Toronto-based doctor worked with the patient and her physiotherapist to ensure that she got back to the sport she loved playing.
Toronto-based doctor confirmed she had torn her ACL and recommended surgical treatment.
Family Doctor and Local Orthopaedic Surgeon
Local Orthopaedic surgeon performed an arthroscopy, but will not move forward with the ACL repair.
Family doctor referred patient for a consult and MRI.
Family Doctor and Patient
The patient was very interested in having the surgery done so that she could enjoy participating in physical activity without requiring a knee brace.
The patient picked this specialist based off of a family friends recommendation.
Family doctor advocated for the patient referral to a specialist in Toronto.
Confirmed the patient had a fully torn ACL and performed the surgery 6 weeks later.
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.
Referred the patient to the local orthopaedic surgeon. After the arthroscopy, they referred the patient to the Toronto-based doctor for a second opinion.
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).