Commentary  Best medical research, worst medical care

One understaffed clinic cares for all out-of-province students

We’ve all been there — anxious and embarrassed over some bodily function that is just not going right, searching WebMD, and hoping it is nothing serious. Luckily for some people, they have family doctors to turn to for medical advice and assurance. Out-of-province Canadian students at McGill, however, often do not have that comfort to fall back on. Many are left with only two resources: turn to the McGill Health Clinic, or pay out-of-pocket at a select few other clinics until their insurance reimburses the cost.

With over 40,000 students at McGill, twenty per cent of whom are out-of-province students, I have observed an average of three secretaries at reception and three nurses in office per day. Looking at McGill’s own statistics of growth, there has been an obvious disregard of the student to clinic ratio (20,000:1, including international students). As for staff, the administration says they have a chief of staff and a “roster” of twenty-three doctors, but they fail to realize student care is not a game. Even for football, the “roster of players” cannot choose to not show up to a game; they have a guaranteed schedule. Having no permanent physicians on staff there is no guaranteed appointment schedule, especially if there are emergencies at the doctor’s actual job. Students don’t want these “second-stringer” doctors.

On top of the unpredictable appointments, there is also no guarantee of having the right doctor ­­— one who is trained and familiar with your specific condition. Out of province students, cannot afford to be given inaccurate referrals — an inaccurate referral could mean a student paying for tests that cost a month’s rent ($100 to $500), and still not being properly diagnosed. McGill’s disregard for student health has resulted in an inefficient, overbooked, and understaffed clinic.

The average out-of-province student, who often faces financial constraints, cannot simply turn to another publicly run clinic or seek a RAMQ card, as some believe. Plenty of clinics in Montreal refuse to take insurance from other provinces, knowing that what can be covered varies widely from province to province. Since it takes a minimum residence of three months, an often lengthy bureaucratic process, and sacrificing one’s home-province insurance to attain Quebec health insurance, many out-of-province students are wary to make the switch, especially in their first year, which is often filled with uncertainty and vulnerability. In addition, the compulsory student services fee does not provide alternative medical insurance other than access to the McGill clinic.

Setting appointments with the provided clinic can make students feel hopeless. Normally, when booking doctor’s appointments, a ten to fifteen minute wait on the phone is a sad reality. McGill students, however, sometimes wait thirty minutes — which often means making a call at 10:01 a.m. (phone lines open at 10:00 a.m.), listening to Johann Sébastien Bach for forty minutes, and then hanging up. Students are familiar with pre-recorded apologies about not being able to answer the phones, or being told that there are no appointments available for the foreseeable future as a result of an overburdened “drop-in” system. If lucky enough to speak with staff, students can expect a two-to-four week wait for an appointment with a doctor.

When experiencing symptoms of one of the ailments that the McGill Clinic considers “urgent” enough for drop-in attention (i.e. STI’s, fever, yeast infection), the search for an appointment has become almost competitive. Some students hustle into the SSMU building to wait in queue at 7:00 a.m outside the clinic. Once the doors open, drop-in slots for the day are quickly booked and are often full by 9:00am, but require students to come back at various times of the day for their “same-day appointment.” Nurses are available to consult and triage throughout the day, upon request. During weekends and holidays there is no service, and it is not uncommon to experience delays because of lack of replacement staff.

In theory, this appointment, drop-in, and triage system currently in place could work; however, McGill’s understaffed performance covers the gaping wound of the clinic’s problems with a tiny Barbie band-aid. To make care more accessible and easy to navigate, permanent doctors should be on staff, and the nurse triage program should be expanded to help with the appointment-setting conundrum. It would be effective and reassuring for students to outline their concerns to a trained professional and be referred to the correct resource, whether it be the clinic or otherwise. Nurses have the knowledge to properly prioritize conditions and give doctors information on their patients. Drop-in patients would benefit with shorter wait-times and backlogging, and appointment patients would finally get appointments. Thankfully, the clinic is allegedly hiring a Nurse Practitioner to be a permanent medical resource, but this is not enough. McGill Student Services should also consider a second clinic — to have one dedicated to urgent care, and one to appointments — or at the very least, an affiliation with a publicly-run clinic.

With their alternative options being severely limited, out-of-province students rely upon the McGill Health Clinic, and it is currently failing to meet their needs. The school must make some changes, whether it be a second clinic or larger body of staff, to make sure every student receives proper medical attention.