Woman dies during “routine” plastic surgery
A woman died recently during routine plastic surgery at a tony Westmount clinic.
I know I’ve asked this kind of question before, but: when you choose to undergo voluntary private surgery like this, and something goes wrong, they whisk you to a public hospital, as described in this piece. Does that happen on the public dime or do you or the clinic have to buy insurance that will pay for your care which you only need because you voluntarily underwent surgery?
Also, in this piece, check the name of the coroner’s spokesman. It’s been noticed here before by an eagle‑eyed commenter.
Ephraim 11:19 on 2022-12-14 Permalink
If I understand it, officially, it should be billed… but reality is an entire different story. The same as with car accidents, they should be billed to the SAAQ, but how many people say they were in a car accident when they arrive at the hospital and/or know that they bill the SAAQ for it?
Blork 12:01 on 2022-12-14 Permalink
I think it goes against the principle of universal health care if you or the clinic has to buy special insurance to cover that. From a healthcare POV you’ve sustained an injury. Full stop. It shouldn’t matter if it’s because something went wrong during plastic surgery, or if something happened while playing hockey, or if a piano randomly fell on your head.
It would be different if every elective plastic surgery included a trip to the public network, but that only happens when something screws up, which might be due to the surgeon making a mistake, or an underlying condition in the patient, or some other reason. But I don’t like the idea of the government lording over injured people and deciding who gets treatment or not (or who has to pay or not) based on subjective judgments like “plastic surgery is vain, so you have to pay” or “soccer is not the national sport, so you have to pay.”
MtlWeb 12:33 on 2022-12-14 Permalink
As Blork explains, all patients requiring acute/urgent/critical care will receive prompt services via our health care network; those with a RAMQ file are fully covered; those without RAMQ (i.e. tourists) will be billed directly and/or to their insurance provider. The private clinics (surgical/medical) are not equipped to fully manage any significant adverse complication that may arise in their center during a procedure/visit (cardiac/respiratory/circulation/neuro, etc.); they are certified to initiate care but the patient will be transferred to the nearest ER via ambulance. Same approach if the complication presents once the patient is at home – he/she will be instructed to go to the ER.
Kate 12:33 on 2022-12-14 Permalink
I suppose I feel that normal life or sports should be covered, but deliberately choosing the risk of surgery is a bit different. Also, look at it from the private clinic’s point of view. They’re doing medicine of a kind, but confidently expecting the public side will take care of any major mistakes.
It’s a microcosm of our kind of capitalism: when things go well, investors pocket the profits, but when there’s a calamity, they turn to the public purse to bail them out.
Blork 12:58 on 2022-12-14 Permalink
But given that such surgeries are typically safe and without complications, is this any different from choosing to go rock climbing, or choosing to be a vegan or choosing to take the subway? All of those things are usually done without problems, but sometimes things go wrong.
Also bear in mind that while many plastic surgeries come from vanity, many can be therapeutic on some levels. Things like breast reduction can help people with back or neck problems (but that doesn’t mean you can just get it done on-demand in the public system). There’s also the fuzzier idea of “self esteem” or whatever in terms of people “fixing” aesthetic things that bother them, and (arguably) provide a better quality of life after the surgery.
And most private clinics do more than just vanity projects, so then you open up the problem of having bureaucrats rating surgical procedures based on what they perceive to be necessary or not. Please, let’s not go there.
steph 13:14 on 2022-12-14 Permalink
l’ordre professionnel des médecins québécois polices all practicing doctors. Malpractice/liability insurance fees are covered our tax dollers and their professional dues. (( I say “and professional dues, but that’s actually also from our tax dollers). The order also pays for lawyers that defend doctors when they screw up and a little person tries to sue. They certainly protect their own, think of it as a ‘doctors blue wall of silence’.
https://montreal.ctvnews.ca/no-fault-medical-malpractice-insurance-quebec-doctors-like-the-idea-1.4591187
Ephraim 16:43 on 2022-12-14 Permalink
We are supposed to have 2 tracks and you aren’t supposed to be able to use the private track to skip the line in the public track. For example, if you go to a private doctor who diagnoses you with gallstones, should you be allowed to go to the public system to deal for the operation having a referral from a private doctor? Or should you have to see a public doctor to diagnose it and then get the referral. If we allow people on the private track to skip the line, aren’t they simply abusing the public system?
The exception to this is supposed to be radiology. Which ironically is also used by the SAAQ and the CNESST to get people treated faster by not having to wait in the public system radiology system
dhomas 18:06 on 2022-12-14 Permalink
This is a bit of a slippery slope. Many people choose to smoke, despite knowing the adverse effects. They still get treated by our public system if they get, for example, emphysema; they are not refused.
Maybe we should educate people as to the dangers of plastic surgery (“you could die!” see above), like we do for smoking (smoking in Canada is down from close to 30% in 2000 to about 13% in 2020)? Or maybe some folks who get plastic surgery have self-esteem or other mental health issues that could be treated in other ways than going under the knife?
jeather 18:20 on 2022-12-14 Permalink
The actual loophole about public/private that needs to be closed is doctors who flip back and forth to tell patients that, well, you COULD wait for (me to return to) the public system, but if you pay tens of thousands I will do it now while I am private again.
Kate 12:31 on 2022-12-15 Permalink
In August there was a news story about a man denied a liver transplant because he was almost certainly going to go on drinking, making the effort (and the sacrifice by family members) an exercise in futility. So the medical profession does draw a line sometimes when faced with a patient that’s brought their own troubles on themselves.
However, I’m not saying the MUHC should have said “This is a vanity project gone wrong, we’re not going to revive her.” I’m saying that commercial surgical clinics ought not to operate under the assumption that if something goes awry, they can be saved by rushing their patient into the public system. If you were hurt in an accident, how would you like to be kept waiting on a gurney while a facelift case was whisked into line in front of you?
Blork 14:36 on 2022-12-15 Permalink
“…if you go to a private doctor who diagnoses you with gallstones, should you be allowed to go to the public system to deal for the operation having a referral from a private doctor? Or should you have to see a public doctor to diagnose it and then get the referral.”
The problem here is that we’re weighing idealism against practicality. Imagine finding a lump on your body and being told it will take four months to see a specialist about it, but you find out you can see a private doctor right away for less than the price of an iPad. The private doctor finds a tumour that needs to be removed ASAP, but then the public sector says “we know you have this potentially fatal tumour but you still have to wait four months to get the rubber stamp from our doctor before we can even think about putting you on the waiting list for the surgery.” That is Kafkaesque, and is not the kind of society I want to live in.
dhomas, I think the fatality rate from cosmetic surgery is significantly lower than from smoking.
Kate asked “If you were hurt in an accident, how would you like to be kept waiting on a gurney while a facelift case was whisked into line in front of you?”
The medical system is not supposed to make value judgements or to operate on the basis of people’s annoyances. If the facelift patient’s need is more urgent (in this case it was life threatening) then they go ahead of someone whose issue is not life threatening. Full stop. The circumstances that brought the person to the ER don’t matter. This is why, for example, if a mass shooter gets shot by the cops and survives, that person is in line at the ER for treatment just like the people they shot. This is also why people suffering from illicit drug overdoses get treated the same as anyone else instead of having the judgment “they did this to themselves” applied. As uncomfortable as that is, that’s what makes us civilized.
Joey 18:47 on 2022-12-15 Permalink
To Blork’s point, the Supreme Court ruled in 2005 that unreasonable wait times violate the charter (the Chaoulli decision), finding that Quebec cannot forbid private healthcare if the public system leads to unacceptable wait times.