Long waits for publicly funded physiotherapists 'disgraceful,' says senior

When Karen Lent was released from a Halifax hospital in February with what was believed to be an arthritic flare-up in her left knee, she was promised physiotherapy to help get her back on her feet again.

Two weeks ago, she got a call saying she was ready to be seen.

"They expected me to wait from February until July," said Lent, 75, who called the wait "disgraceful."

Luckily for her, she used her husband's health insurance coverage to see a physiotherapist right away rather than wait to see a publicly funded one.

When Lent was admitted to hospital in February, she couldn't stand.

Lent credits her physiotherapist, Stephen Richey, for helping her regain her strength.

"I would not have been able to get out of that chair," she said. "Without his help, I would have been sitting in bed dying without a proper diagnosis with what was wrong with me."

Three weeks ago, a specialist diagnosed her with Parkinson's disease.

Wait times

According to the Nova Scotia Health Authority, most people who are referred to a publicly funded physiotherapist fall into one of three categories: urgent, priority or general. The target for urgent cases is for a patient to be seen within a week from date of referral. Priority patients are expected to be seen within one to four weeks, while it's four to eight weeks for general patients.

Lent was classified as a general case.

Richey, who heads the association that represents physiotherapists in Nova Scotia, said many patients are waiting too long for the care he and his colleagues can provide and are experiencing wait times longer than the standards.

And it's unlikely the situation will improve.

'Tsunami' of coming health demands

Richey pointed to orthopedic surgeon Michael Dunbar's recent warning about a "tsunami" of coming health demands.

Dunbar used his appearance before the Nova Scotia Legislature's health committee to call for more spending on preventive measures to keep people healthier, particularly children.

"Your long-term health is predictive on what you invested early," Dunbar told reporters after his testimony.

"The early investment is our children, is to change how we look at them to make sure they are a fit population," he said.

Richey agreed, but also suggested the province could take measures now to help lessen current demands, such as hiring more physiotherapists to come to the aid of people with non-urgent problems.

A focus on prevention

"If we can prevent these problems down the road, often the cost of prevention is far less than actually dealing with the issue at hand," he said.

Richey suggested the province could target adults in their 50s, 60s or 70s — people "just starting that slight decline in their activity levels [who are] noticing a little bit of pain and discomfort."

"Those are the instances where we can intervene, provide an exercise program, provide guidance, recommend proper mobility aids, whether it's a cane or walker, and we can address those issues before they deteriorate," he said.

Richey also suggested working with private insurers to end the practice of requiring people to get a doctor's referral in order for those seeing private physiotherapists to be reimbursed. He said Nova Scotia's shortage of family doctors makes that tougher to do.

'Small-scale changes' needed, says Richey

"Those are kind of small-scale changes," said Richey. "They don't necessarily require a lot of drastic policy changes."

Health Minister Randy Delorey said it was the first time he'd heard of the idea of ending doctor's referrals for physiotherapists.

"There will always be opportunity to do more in our health-care system, and what the responsibility of the Health Department, the health ministry, the government of the day is always to look at, evaluate the opportunities and ensure we're investing in those areas that we believe will provide the most value to Nova Scotians," he said.

Lent agreed changes were needed and healthy lifestyles alone are not the answer.

"You know it's all well and good to say, 'Go eat right,' which I have all my life. 'And do exercise,' which I have all my life. But we all still get sick," she said.

Despite the time it has taken to get her Parkinson's diagnosis, Lent considered herself fortunate to finally be on the right medication and lucky to have had private insurance coverage to help her start her physiotherapy sooner.

"Now I'm able to move around," she said. "I'm getting to the point where I can walk without a walker."

"I mean, we can afford physiotherapy, but what about all the people who can't?"