With no family doctor, Lochaber woman paid virtual care service to get mammogram results

A Lochaber, N.S., woman says she paid to access her followup mammogram results when the breast screening clinic failed to tell her how or when she would be contacted with her results — because she doesn't have a family doctor. 

Jennifer DeCoste says she felt it was urgent to get her results after a second mammogram last month at St. Martha's Regional Hospital in Antigonish, which was followed by an unexpected breast ultrasound on the same day. 

She says the ultrasound technician told her to call the Nova Scotia Breast Screening Clinic in 48 hours for her results. But DeCoste says the clinic told her they couldn't release her results to her over the phone and she'd have to go through a doctor.

"I explained, I don't have a doctor. There's no one to call," said DeCoste, who lost her family doctor when he moved out of the province last year. 

She says a walk-in clinic was not an option because there are none in her area that allow orphaned patients to book appointments directly. 

The emergency room wasn't an option because it could mean waiting for hours, says DeCoste.

"Let's say it was 10, 12 hours. The breast screening clinic would've been closed by the time a doctor got around to making that call so that it doesn't seem like that's even a viable option."

'No care in the health care'

After worrying about how to get her test results, DeCoste says her husband remembered the Maple app.

Maple is a pay-for-use virtual care app available in Canada. 

DeCoste says she logged on and had an appointment with a doctor based in Nova Scotia within a few days. 

"I never spoke to a person and it cost $50 just for the consultation. And we're texting back and forth for 20 minutes. That person made a phone call, got the results, texted it back to me and it was extremely cold," said DeCoste.

"It felt like there was no care in the health care."

DeCoste declined to speak about her test results, but says she is going for additional screening. She says she still doesn't have any questions about her health answered. 

Nova Scotia Health standardizing process

Nova Scotia Health sent a statement to CBC saying patients in the eastern zone get a phone call for non-urgent results.

"For critical results (emergency or urgent) patients typically receive a phone call very shortly after the study is reviewed and would typically be directed to an emergency department."

The health authority says it is continuing to work on strengthening and standardizing its approaches provincially.

It also says a new process was recently put in place at St. Martha's and they're making sure staff are aware of how to communicate with patients. 

It says a private clinic in Antigonish was converted into a Nova Scotia Health primary care clinic in June. 

"Currently, this clinic only books appointments for referrals from the emergency department, diagnostic imaging, women's and children health, oncology, and virtual care Nova Scotia. Appointments cannot be booked directly and there are no walk-in appointments."

'Not a new problem'

DeCoste says she understands Nova Scotia Health is working on new ways to communicate with unattached patients, but said it's not a new problem. 

"As it continues to get worse with retirements and out-migration of doctors, policy changes are not keeping pace with patients' needs," she told CBC through a text message. 

She says the only clinic in Antigonish still requires a non-emergency trip to the ER for a referral.

"That leads us back to the fee-for-service models with the Maples app as the only option for most rural unattached patients. Those without financial means continue to have no access to care."

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