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With long MRI wait-lists, how do you decide whether to wait or pay for a private clinic? Here are some considerations
If you’ve been prescribed an MRI scan (Magnetic Resonance Imaging), you’re likely familiar with the wait-lists that have filled BC’s public health care system with patients desperate for a diagnosis.
Canada has one of the lowest rates of MRI scanning machines per capita in the developed world, with six MRI scanners per million people, compared to 40.1 in Japan, 14.4 in Switzerland and 26.6 in the United States. Pittsburgh alone has more MRI machines than all of Canada.
“We seem to think that MRI scanning is some newfangled test, where it’s the basis for medicine in the rest of the globe,” said Dr. Peter Innes, president of medical staff and chief of family medicine for the South Island for the Vancouver Island Health Authority.
MRI scans have become an essential diagnostic imaging tool, revealing problems that aren’t detectable by other more common tests such as x-rays and ultrasounds.
Also, MRI scans have the advantage of avoiding the ionizing radiation that’s used in other radiology tests such as X-rays, computed tomography (CT) scans and positron emission (PET) scans. As difficult as it is to get an MRI appointment, the Canadian Institute for Health Information (CIHI) estimates most Canadians will have at least one MRI or other medical imaging scan at some point in their life.
This puts enormous strain on a system that many argue is in crisis. And with MRI wait-lists that are 12-18 months long, it’s hard to suggest otherwise. The solution, for some, lies in the private clinics that are able to provide an MRI scan within days.
If your health concerns are serious, and you need an MRI scan for your brain, a full body scan or a specific bone scan, waiting over a year in pain and in fear is not an option.
Innes says he’s started to refer patients to the many private MRI scanning labs that have opened around the province. While this means a near-immediate appointment, it also means you have to shoulder the cost, and it’s no small amount; an MRI scan costs around $699 in Vancouver and about $875 in Victoria.
While this cost may be acceptable for some, it’s prohibitively expensive for others. The social safety net that is Canada’s health care system was designed to ensure everyone is able to access necessary exams. But what do you do when you simply can’t wait the typical 12 to 18 months’ delay for your MRI scan? This list of considerations will help you decide which way to go.
What will it cost? If you opt to go private, you must pay for this service yourself. Can you afford it? Will it affect your lifestyle? Will you need to take a loan or borrow money? On average, an MRI scan costs $875. Complex examinations and MRI scans requiring injection of contrast material are more expensive. If you go public, the costs are paid for by the medical services plan.
How long is the wait time for an appointment? With a private clinic, on average you’ll be able to get an appointment in 48 hours. With public health care, on average the wait time is 12 to 18 months.
How will waiting affect my quality of life? An earlier diagnosis means potential treatment can begin earlier, reducing pain and improving overall health. Needing to wait a year or longer could potentially worsen the condition in question. Muscles could atrophy if overall activity is reduced due to pain.
Should I do reference checks? Since private clinics are businesses, you have the ability to ask questions relating to qualifications, technology, success rates, etc. You can ask to speak with doctors, radiologists, etc. In the public system, you won’t know who will be directing your scan or who the radiologist is.
Can I choose the location? You can pick a private clinic based on your criteria, whether it’s aesthetics, level of technology, wait time, or even if it’s in a different province or country. When you’re put on a public wait list, you’ll be waiting for MRIs in your area.
What if another scan is needed? You’ll need to make another appointment and pay again, if you’ve gone private. Or, you’ll be put on a wait list again, if you’ve gone public. If your doctor foresees multiple scans being required (e.g.: to monitor cancer treatment), your appointments may be booked in advance to run parallel with other treatments.
Will I receive better treatment in a private clinic? Doctors are bound by oath to provide the best care possible, regardless of environment and regardless of who’s paying. Many hospitals in the public system also offer MRI scans to private patients, so the level of care and treatment is the same for all.
Do I get a copy of the MRI scans? Yes, images are available to patients in both the public or private system. At private clinics, the images may be part of the overall price or they may be a small additional charge. At hospitals, you will definitely need to pay an additional charge.
What quality of scan should I expect? The quality of the scan is largely dependent on how good the conditions were when the images were taken. It’s crucial for the patient in the MRI scanner to listen to instructions. Even breathing at the wrong moment could compromise the quality of the images.
What kind of a diagnosis can I expect? The radiologist will look at your scans and interpret them. They’ll know why you were sent for a scan and will try to see if there’s evidence for the condition in question. Then the report is sent to your doctor, who will determine the next course of action, whether it’s treatment or further testing.
What happens if the MRI scan is inconclusive? Whether the result is positive or negative, so long as it’s not false, it’s a good scan. If the results are negative, certain conditions can be eliminated and your doctor will proceed with alternate diagnostic tests. If the results are positive, your doctor has a much better idea of the best treatment.
Will the MRI scan definitely tell me what’s wrong? No. An MRI scan is not a magic bullet and is only one out of many different diagnostic tests a doctor might recommend. This scan may not be able to detect what the doctor was hoping to discover.