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We discuss treatment options, prognosis in detail with each patient-Dr Booth

An average medical oncologist in Canada will see 12 to 20 patients each day and approximately 175 new patient consultations are seen each year. Medical oncologists in India see 50-80 patients every day and they may get 500-1,000 new patient consultations a year.

Dr CM Booth, division of cancer care and epidemiology, Queen’s University Cancer Research Institute, Ontario, spoke about the similarities and differences in cancer care treatmentin India and Canada. Excerpts from the interview.

In India, where almost 75% patients approach private hospitals, patients or relatives have to bear the cost as very few have insurance scheme and government doesn’t offer free cancer treatment for everyone. How different is cancer care in Canada and who pays for treatment?

Canada has a single-payer universal healthcare program. There are no private hospitals or cancer centres. Cancer care is delivered in government hospitals with no charge to the patient or family.

How many patients does an oncologist in Canada see on an average and how much time they spend with each patient?

An average medical oncologist in Canada will see 12 to 20 patients each day and approximately 175 new patient consultations are seen each year. Medical oncologists in India see 50-80 patients every day and they may get 500-1,000 new patient consultations a year. Given the incredible patient volumes in India, it is inevitable that Indian oncologists will have lesser time to spend with their patients than their Canadian counterparts.

In India, a family member or caretaker has to come with patient during treatment. But with families turning nuclear, this is becoming increasingly difficult.

How different is the situation in Canada?

This is a challenge in Canada as it is very common to see patients at the cancer centre with no family or support. In this scenario the healthcare system needs to provide more support, including booking of tests, tracking down appointments and reports etc. During my time in India, I noticed the much-greater involvement of the patient’s family in day-to-day care. This has tremendous benefits for the patient and system.

You have said in the paper that in RCC, the treatment protocol is not discussed with the patient sometimes. It is discussed with relatives. Do you lay emphasis on discussing cancer treatment protocol with the patient?

In Canada, the standard practice for oncologists is to discuss the treatment options in detail with each patient as well as prognosis of their cancer (i.e. chance of cure and life expectancy). During my time in India, I observed that these conversations took place less commonly than in Canada. This is not meant to be a criticism of the Indian system. I witnessed many examples of excellent quality and compassionate care during my time in India.

I think the conversations about prognosis is less common here due to two reasons. First, these conversations take time and given the tremendous number of patients that are seen each day, it is difficult to have these lengthy conversations. Second, my impression is that many families in India specifically ask the oncologist not to discuss the diagnosis and prognosis with the patient. This is a very rare scenario in Canada where we discuss diagnosis and prognosis with almost every patient.(TNN)

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