Woman struggles to find a doctor

Irene Lavoie learned how to knit when she was a young girl. Her grandmother taught her when she was still in school, she said.

Irene Lavoie learned how to knit when she was a young girl.

Her grandmother taught her when she was still in school, she said.

But in the last few weeks, Lavoie has had to call a friend to ask how to do a straight stocking stitch.

“It’s stupid,” she said, mentioning how long she’s been working on the same pair of thick, red-wool socks. “And it’s scary when you can’t even figure a meal out, or your bills at the end of the month or a simple knitting thing, like just straight knitting – nothing complicated.”

After reading a book written by a doctor, Lavoie believes the memory loss is another symptom of her self-diagnosed lupus.

That book and the self-diagnosis is important because Lavoie can’t retain a family doctor in Whitehorse.

“In a period of 12 years, I have had about 16 doctors,” she said. “That includes five years with no doctor at all. And I have never had a doctor that’s actually had a lupus patient.”

Lavoie also has a badly deteriorated spine and struggles with stress and depression, she said.

She shakes and has trouble getting around. She also falls frequently and can’t get herself back up again. She doesn’t know why.

And she is in constant pain, she said.

She can’t find other lupus patients in town, and getting appointments to see specialists in the territory has also proven difficult, said Lavoie.

She waited more than a year to see a neurologist, she said.

And when she saw an expert in joint pain, he told her to read a 10-year-old report, she said.

After getting a referral to an Outside rheumatologist, the territory denied her coverage because there was a visiting specialist in the Yukon.

The visiting specialist system works, given our small population and the amount of work available, said Dr. Rao Tadepalli, president of the Yukon Medical Association.

But recent events have, once again, hampered Lavoie’s medical treatment.

She’d found Dr. Emil Bekhit at the Second Avenue walk-in clinic, and he’d been her doctor for five years. She trusted him.

But then Bekhit left.

He transferred her files to Dr. Ihab Abdelmalek at the River Valley Medical Clinic.

When she went to make an appointment with Abdelmalek, she was told he was on his way out, so she met with Dr. Ayman Gerges twice and Dr. Shahid Syed once.

Gerges has already left and no one at the clinic will say how long Syed is expected to stay.

All these doctors came to work in the territory under a special licence program the territorial government enacted in 2001 to increase the number of doctors practising here.

The program gives foreign graduates a temporary licence for up to five years.

In that time, the doctor must successfully complete a two-day exam with the College of Family Physicians of Canada.

But the program ended in March 2010.

“Most of them came only to get their foot in the door and then they left,” said Dr. Rao Tadepalli. “So that program wasn’t really working for the Yukon.”

Patients should have been warned the doctor may not have been permanent, said Lavoie.

She wasn’t told anything about the special licence program, its five-year window or that her doctor could be leaving, she said.

“The walk-in clinics are always full,” said Lavoie. “Surely I’m not the only one that is naive and ignorant to the fact that these aren’t doctors that are staying. A weight lifted off me when I finally got in with Dr. Bekhit because I felt I finally had a doctor, and that was after five years of having nothing.”

It was during a recent meet-and-greet with another family doctor in town that Lavoie found out her previous four doctors had to pass a test to continue working in Canada.

She called the Yukon government’s hotline and listened to the recording that informs people which doctors are currently accepting new patients.

When she met with one, they asked her why she made the appointment.

She listed her doctors and told the new physician they’d left the territory.

The doctor told her about the required test, she said.

And, in the end, she was told she would not be accepted as a patient.

Lavoie believes it was because she is a smoker, takes pain medications, anti-stress medications and narcotics.

It is unusual for doctors to deny patients on smoking alone, but drug-dependency does raise a red flag, said Tadepalli.

Citing confidentiality, Tadepalli can’t address specific cases. But generally, patients with drug dependencies and other addictions can be a problem for doctors, he said.

“It can be very dodgy terms to why they are on the medication,” said Tadepalli. “When things don’t add up, it’s a bit of a challenge.

“In a small community, how much service can you provide? At the end of the day, you try and believe the patient and you can get caught in between.

“Those sort of patients, if they don’t get what they want, they just shop around. And I would say that in a modern society there will always be a group of patients that will be unable to form a physician-patient relationship.”

Lavoie has heard the “shopping around” argument before, and it is not true, she said.

“There’s a lot of pain,” she said. “I am on pain medications, narcotics. I just want to be with a doctor who can give me the attention I need.”

This group of “difficult” patients will still receive care, said Tadepalli.

“That’s why the emergency rooms and things are there.”

But Lavoie has been to the hospital’s emergency room several times, especially during the five years when she didn’t have a doctor, she said.

“I was going to emergency just for my prescription refills,” she said. “And I was getting heck there because emergency isn’t for prescriptions.”

Patients cannot rely on a doctor to fix them, Tadepalli added.

“At some stage, public health care will be something about public responsibility too – how much are you responsible, too?” he said. “It’s very frustrating to provide care for these people and then listen to the rant.

“At the end of the day, we want healthy physicians and healthy patients. The entitlement that’s there in the Canadian public can get to doctors. It’s frustrating and that’s what makes the physicians burn out.”

The territory currently has a doctor “gap,” said Tadepalli.

Many have left, two have just opened practices and two more are expected in four or five months, he said.

But doctors cannot be forced to accept new or more patients, said Pat Living, spokesperson for Health and Social Services.

“Physicians are independent business people who run their own practices,” she said. “They don’t work for us.

“And we are confident that, with the number of physicians expected to move to the Yukon in the next two to six months, that the departure of the international medical grads will balance out.”

But there will always be some people who find it difficult to find a family physician, she said.

And if the situation in the territory gets really dire, there is the option of hiring physicians on contract, she said.

But it isn’t dire yet.

“We are not experiencing a huge number of calls (from people who can’t find doctors), but we have had a few,” said Living.

Lavoie was one of them.

She has also written to the Yukon Medical Association and Health and Social Services Minister Glenn Hart several times.

She has never heard back, she said.

“I would like to stay with one doctor until I die,” said Lavoie. “I am fighting for my life.”

The government hotline for doctors accepting new patients is 867-393-6980.

Contact Roxanne Stasyszyn at