Doc’s response has patient on bended knee

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This article was published 22/09/2023 (764 days ago), so information in it may no longer be current.

After a successful knee replacement in North Dakota, a Manitoba truck driver experienced unforeseen hostility about his decision to have cross-border surgery.

Robert Murray, 59, had his knee replacement at Fargo’s Sanford clinic on Aug. 16 under the cross-border agreement with Manitoba’s Diagnostic and Surgical Recovery Task Force. But when the Woodlands resident returned home and sought subsequent treatment at his local emergency room, he said the on-call doctor wanted nothing to do with him.

Murray explained to the physician that he had surgery in the U.S. a few days earlier and was seeking medical attention because his surgical wound was still bleeding.

“He asked me, ‘Well, why are you coming here?’ That’s how the conversation started,” Murray said.

Then, he said the doctor suggested he get his passport and go back across the border so “they can fix their mistake.”

“He said no doctors would touch me here, because ‘Who are you going to sue?’” Murray said.

“I was stunned.”

Murray, a long-haul trucker who had been on a knee-replacement wait-list for more than two years, said he wanted to share his experience — which was positive overall — with other Manitobans who are heading out of province for surgery. He emphasized he’s “extremely grateful” to have had the surgery, regardless of one doctor’s opinion.

The provincial surgical backlog task force has sent 637 patients out of province for surgeries so far, and stated it developed “care principles” to ensure proper continuity of care for task-force patients outside and within Manitoba.

The principles were shared widely with physicians and surgeons and were approved by the College of Physicians and Surgeons and Doctors Manitoba, a provincial spokesperson stated.

Doctors are expected to treat patients with respect and they have a duty to provide medical care, regardless of the circumstances that brought the patient to them, said the College of Physicians and Surgeons, the regulatory body governing doctors’ professional conduct.

“He said no doctors would touch me here, because ‘Who are you going to sue?’ I was stunned.”–Robert Murray

If the treatment is not within their scope of practice, the doctor must refer the patient to another medical provider.

“In general, physicians expressing unwillingness to treat Manitobans who have had surgery in the U.S. does not seem to be a major issue currently,” a spokesperson for the college stated, noting the organization would review a complaint if one was submitted.

Murray said he’s not interested in pursuing a formal complaint. He wasn’t denied care but received the “bare minimum” and just wants others to be aware, he said.

“I would like to have a very positive message about my whole process and I am extremely grateful for it. My situation with an ER doctor will be taken as a learning curve for me and anyone venturing out of province for surgery,” he wrote in a followup email.

The Sanford Health clinic is one of three out-of-province medical agencies with which Manitoba’s task force has agreements to perform hip and knee replacements. Surgeons there use a glue technique to seal the wound post-surgery, rather than stitches or staples.

When a Fargo nurse changed Murray’s bandage post-surgery, he noticed some blood but was told not to worry unless it continued. The bleeding still hadn’t stopped by the time he got home, but his scheduled appointment with his family doctor was still a week away, so he spent the next four days trying to get his knee looked after.

Murray went to the Stonewall ER, waited for hours, and ultimately left without seeing a doctor. He then went to the Portage la Prairie ER, where his wound was assessed for signs of infection, and he was told to return to the emergency department if it kept bleeding. The next day, still bleeding, he went back to the Stonewall ER, where the doctor’s attitude left him stunned.

“In general, physicians expressing unwillingness to treat Manitobans who have had surgery in the U.S. does not seem to be a major issue currently.”–Spokesperson

The interaction, which the Free Press couldn’t independently verify, occurred at the Stonewall hospital on Aug. 20. The on-call doctor, a general-practitioner based in Hodgson, had travelled to fill in because of ongoing staff shortages in the Interlake-Eastern Health region. When reached by phone and asked about the incident, the doctor said he couldn’t comment.

A nurse cleaned the wound, and the doctor assessed it and told Murray it looked like it needed a stitch or two, but that he couldn’t put in the stitches. He instead applied medical tape and sent Murray on his way.

“He was dead serious. He wasn’t joking,” Murray said. “I was kind of stunned about that, thinking maybe it wasn’t a good idea to go out of province.”

The ER doctor also scolded Murray for not providing a list of the medications he was prescribed post-surgery, saying he had no way to access that information because Canada and the U.S. don’t share prescription details.

Murray agreed that was an important point, but said he felt the doctor’s comment that I should “grab (my) passport and return to the United States for medical help” crossed a line and made him feel as though he had done something wrong.

“There should have been no qualms, no comments, about helping,” he said.

Ultimately, Murray’s family doctor put in two stitches. Murray also had to ration prescribed painkillers before he was able to get his post-op prescription refilled. His recovery is progressing well — he no longer needs his walker and is looking forward to returning to work, he said.

Asked how the provincial task force is helping patients through the medical system before and after their out-of-province surgeries, a provincial spokesperson said the task force runs a patient navigation unit and a 24-7 helpline.

“He was dead serious. He wasn’t joking. I was kind of stunned about that, thinking maybe it wasn’t a good idea to go out of province.”–Robert Murray

The task force wouldn’t disclose how much Manitoba is spending on knee replacements in the U.S. or the total cost of out-of-province surgeries.

A spokesperson said “it negotiates significant discount on the usual tariff or price list” for the surgeries.

The task force also has a process for patient-lodged complaints and will work with out-of-province providers “to resolve issues and adjust to ensure the same issues are not repeated.”

katie.may@winnipegfreepress.com