Doctor refusing to give referral to MRI because of cost

chinook79 wrote: ↑ Long story short, my family member was diagnosed with cancer and after lengthy wait, we still don't know what stage of cancer it is. After several trips to doctor, and nothing being progressed, we decided to do our own research and found out that the reason why we don't know the stage of cancer is because of not doing MRI. Without MRI result, we can't even schedule a surgery. When confronted, doctor was saying that MRI is expensive... ****... when it comes to cancer, it's all about early detection and removing it as fast as possible which means life of death. This ******* doctor has been denying MRI because it would cost health system mere $4-500. It would be about $2,000 or less for private system and MRI can be done immediately, but unfortunately, there's no private healthcare available in my region and travel is restricted with quarantine requirements due to pandemic.
We ended up finding another doctor who is willing to schedule MRI but to deny MRI to confirmed cancer patient because of few hundreds of dollars to healthcare system boils my blood. This is so wrong.. Is there anyway to make formal complaint or even sue this *******?

You're free to file a complaint with the regulatory body that deals with doctors.
You can also get a lawyer and sue. Whether it is successful or not... needs professional legal advice.

chinook79 wrote: ↑ Long story short, my family member was diagnosed with cancer and after lengthy wait, we still don't know what stage of cancer it is. After several trips to doctor, and nothing being progressed, we decided to do our own research and found out that the reason why we don't know the stage of cancer is because of not doing MRI. Without MRI result, we can't even schedule a surgery. When confronted, doctor was saying that MRI is expensive... ****... when it comes to cancer, it's all about early detection and removing it as fast as possible which means life of death. This ******* doctor has been denying MRI because it would cost health system mere $4-500. It would be about $2,000 or less for private system and MRI can be done immediately, but unfortunately, there's no private healthcare available in my region and travel is restricted with quarantine requirements due to pandemic.
We ended up finding another doctor who is willing to schedule MRI but to deny MRI to confirmed cancer patient because of few hundreds of dollars to healthcare system boils my blood. This is so wrong.. Is there anyway to make formal complaint or even sue this *******?

not to discredit you, but i'm not sure how you would be able to produce evidence the reason your family member was not sent/referred to MRI due to the doctor for whatever reason being cheap with not his money

as for suing, i don't see what you can sue for as you are not out of pocket any money or suffered measurable actual monetary damages. if you had to pay for a MRI elsewhere, that will be actual monetary damages, but you went to another doctor who referred your family member to a MRI

My experience has been the opposite. In fact, doctors are more than happy to give our imaging referrals as it gives them more evidence for making a diagnosis.

Where does OP live?

If it's colon cancer a colonoscopy may work.
Ultra sound of an organ may work as well.
MRI off course would be the best.
Maybe see another doctor.

If you have cancer, you should not be managed by some family doctor in clinic. You should be referred to centre that has clinic specialized in the care of your type of cancer. They usually take charge the investigation and treatment.

Sorry to hear about your situation. Are you sure there isn't a miscommunication somewhere? Your Dr. basically handed your family member a death sentence which doesn't make a lot of sense. What was their plan?

When I was diagnosed 5 years ago, I had an MRI within a week and 3 weeks later I was in surgery.

gh05t wrote: ↑If it's colon cancer a colonoscopy may work.
Ultra sound of an organ may work as well.
MRI off course would be the best.
Maybe see another doctor.

HghSsociety wrote: ↑ Sorry to hear about your situation. Are you sure there isn't a miscommunication somewhere? Your Dr. basically handed your family member a death sentence which doesn't make a lot of sense. What was their plan?

When I was diagnosed 5 years ago, I had an MRI within a week and 3 weeks later I was in surgery.

colon cancer is only thing that makes sense in terms of the deferral and timeline posted by OP. Often even after diagnosed with colon cancer, they will do nothing unless it spreads and it's quite slow growth and easy to remove so they will just monitor it until it shows signs of expanding and then they'll go in and remove it. Kind of like kidney small kidney stones, they won't go in and remove it but just monitor it annually

I am the opposite experience. When I did an ultra sound and the saw something that looks like a kidney stone I got a MRI right away. In fact after the surgery I was schedule for another one few months after and then again 6 months after. And I was told I need to get one yearly as well.

Hard to believe your doctor will not get you one. Also the reason could be CoVID19 a lot of hospital are not doing normal surgery or check up.

My first recommendation would be to find a Facebook group or discussion board that specializes in the type of cancer your family member has to get an understanding of standards of care and how this specific cancer is managed in your region. You need to be talking with people dealing with the specifics of the type of cancer.

Second, yes you can file a complaint with the hospital or the licensing agency but if your goal is to get care that wouldn’t be the route I’d recommend.

Third, my question would be is the doctor refusing the treatment due to cost or did they say the recommended standard of care doesn’t recommend an MRI due to cost? In a lot of cases the treatment a patient may want is not actually what ‘best practices’ recommend and most doctors won’t step outside of the recommended practices (even if it some cases it benefits the patient).

I have cancer. Every step in the process I have had to advocate for my care. Each person in the health care system is doing their piece of the puzzle but when you put them all together sometimes the system sucks.

I have had four ultrasounds. I have had to call the ultrasound department multiple times to get each one booked. In one case I actually had to get myself referred to another hospital (because of covid) to get it done. I had two biopsies. Same thing. My surgery was postponed by 3 months due to Covid. Same thing - had to keep on top of the hospital without being perceived as hostile.

Post surgery there are blood tests that matter. My level of one thing was high (makes it more likely that the cancer would come back). My doctor was comfortable to wait 6 months to see if it came down. I wanted my meds changed immediately. I went to an ND with all the research done, paid to have the tests run privately, sent the results to my specialist, called 3 times. Because the specialist is right that I was being treated within the standard of care. But I wasn’t happy with that. I wanted the most aggressive/ best treatment. So I did the leg work to make sure my specialist listened.

I have an ultrasound coming up. I was concerned so I called and advocated for an appointment to discuss. My cancer is an aggressive subtype. If my doctor doesn’t follow up as quickly as I want, I’ve already planned how to get the tests done privately.

Should we all get perfect care from the public system when we have cancer? Absolutely. But it just isn’t reality. Doctors work within a system. I have had to figure out how to work with them, how to advocate for myself and how to know when to apply pressure and what pressure is effective.

In the case of my blood levels, I could have called once a week for 6 months expressing concern and the dr would have continued to say I was overreacting. And there is a good chance everything would have been fine. But by producing blood results I forced the doctors hand diplomatically. And worst case scenario, the change has no negative or positive impact. Worst case scenario if we hadn’t made the change is the cancer would have come back faster.

chinook79 wrote: ↑ Long story short, my family member was diagnosed with cancer and after lengthy wait, we still don't know what stage of cancer it is. After several trips to doctor, and nothing being progressed, we decided to do our own research and found out that the reason why we don't know the stage of cancer is because of not doing MRI. Without MRI result, we can't even schedule a surgery. When confronted, doctor was saying that MRI is expensive... ****... when it comes to cancer, it's all about early detection and removing it as fast as possible which means life of death. This ******* doctor has been denying MRI because it would cost health system mere $4-500. It would be about $2,000 or less for private system and MRI can be done immediately, but unfortunately, there's no private healthcare available in my region and travel is restricted with quarantine requirements due to pandemic.
We ended up finding another doctor who is willing to schedule MRI but to deny MRI to confirmed cancer patient because of few hundreds of dollars to healthcare system boils my blood. This is so wrong.. Is there anyway to make formal complaint or even sue this *******?

Reading between the lines, this has an air of "I read it on the Internet and told the doctor but he doesn't agree" to it.

You make it sound as if the doctor has said "oh, you have cancer - that's nice - let's not do anything about it".

There has to be more to the story because not referring someone known to have cancer for the appropriate treatment or diagnosis in a timely manner is obvious malpractice.

My first recommendation is to double check what the doctor actually said. I've never met who cared about a healthcare cost that is billed to the province. Do you live in Canada?

Oncologist?

If this is true it’s egregious af! Someone help this person and his family out.

I mean in situations like this my gp would recommend a specialist. He’s never had a problem doing it which is why I put up with his droning about his anecdote for 15 minutes every time we visit him.

mbg wrote: ↑ Reading between the lines, this has an air of "I read it on the Internet and told the doctor but he doesn't agree" to it.

You make it sound as if the doctor has said "oh, you have cancer - that's nice - let's not do anything about it".

There has to be more to the story because not referring someone known to have cancer for the appropriate treatment or diagnosis in a timely manner is obvious malpractice.

Agreed. One of my family member always insist going to the ER anytime someone is feeling sick. Ah, no.

It’s very frustrating to say the least.

Someone I know has been in so much pain for 3yrs now with 0 diagnosis. The family doctor has been pushing back on the MRI until a specialist had suggested that it may need to be done for a proper diagnosis as all options have been exhausted.

This person I know went for her MRI and got turned back ON THE DAY OFF. Why? Because the doctor forgot to indicate something on the form which was very crucial. She was assured that a certain test was not necessary when it was. When confronted the doctor's office gave her a hard time to get it rescheduled.

This MRI appt has yet to be scheduled by the hospital.

A complaint will be filed one day. Our HC system is better than most in the entire world but it has major flaws that not everyone in the world knows about.

Why is the family doctor referring the MRI?
The family doctor should be referring the patient to an Oncologist, as they're the specialist dealing with cancer.

I'm dealing with a long time knee injury and was referred to an Orthopedic surgeon, who scheduled me for an MRI to determine my next step of surgery.

to clarify, this isn't first time happening to our family (from two different doctors, one years ago, and now again). Previously, the doctor specifically stated that MRIs are expensive and when different family member was diagnosed with potential cancer, we were told to wait 3 years for MRI or go pay for MRI ourselves in private sector. We ended up going to private sector route and thankfully it wasn't cancer.
Years later, another family member was diagnosed with, this time, confirmed cancer. Again, but different doctor, kept delaying doing MRI. Having horrible experience in the past, and flying around looking for private sector for paid MRI not being much of an option during pandemic, we did our own research when things weren't being progressed further and when we still haven't been told of stage of cancer after lengthy wait. We need to know what stage of cancer it is in order to be able to schedule surgery and consider options available.
We ended up switching doctor and thankfully, different doctor immediately scheduled MRI as well as surgery date. If we only listened to one doctor, and waited for nothing for months, it would be difference between life and death for us.. for what.. mere few hundreds of dollars for proper diagnoses ($2-$4k in private sector)

About a decade ago, we lost one of our in-law from breast cancer while being delayed for years for proper treatment and diagnosis. Last year, one of our closest family lost their 20 year old daughter only hours later after being discharged from ER stating nothing is wrong with her when she was screaming for pain. They are now dealing with lawsuit as it was easily preventable if only doctor properly looked at her when she went to ER.

When I posted my original post, I was furious to find out that we waited crucial time because one doctor didn't want to schedule a MRI for no good reason other than few hundreds of dollars. We have no interest in suing the doctor, at least not yet, although we wish she was more compassionate and trustworthy. After all, we are trusting our health and life on their hands, and seeing them putting $ and not even much if I may add, before patient's life is simply unacceptable IMO. We have more important battle to fight right now than to deal with a bad doctor.

As for family doctor referring the MRI, not everyone lives in a big city with luxury of having multiple doctors and specialist available. This was one of the reason why we need to get MRI ASAP so that further action can be planned and taken (possible relocation, preparing to deal with kids, etc..)

There are many good doctors in our healthcare system especially knowing that if they choose to, they can easily double their salary simply by going south of the border but opted to stay in Canada. However, there are also bad doctors whose priority isn't always the patient's life. I hope that no one would be going through what our family is currently going through, but if anyone does, I highly recommend that you do your own research as well, not just listen to one doctor and waste crucial time waiting for nothing which could end up in deciding factor between life and death.

Maybe someone at this cancer advocacy network can help?

https://survivornet.ca/connect/about-us/

First off, sorry to hear you're having a rough go.

Not to prod, but just trying to get you some explanations. What type of cancer are we talking about; and how has it been diagnosed to date? Clearly they've found it somehow - perhaps that is enough and further imaging won't change management?

What has the doctor done/recommended so far? Have they referred your family member to a specialist of some sort, etc.? Perhaps they've set referrals up already, but just haven't communicated that properly?

There are a lot of crummy doctors out there, but I find it kind of weird that cost (which isn't even direct cost to them) is really that big of a factor to the doctor, especially for something like cancer. There are thousands of unnecessary MRIs that are referred for each day, so there certainly has been pressure from health authorities to decrease that, but certainly not for items that can immediately change management & mortality.