X-ray visits to emergency centres frustrating some N.S. physicians and patients, doctor says

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Dr. Mike Clory, the emergency department chief at Cobequid Community Health Centre, says the fact that Nova Scotia X-ray clinics no longer take walk-in appointments means patients are coming to emergency centres for X-rays instead.  (Anjuli Patil/CBC - image credit)
Dr. Mike Clory, the emergency department chief at Cobequid Community Health Centre, says the fact that Nova Scotia X-ray clinics no longer take walk-in appointments means patients are coming to emergency centres for X-rays instead. (Anjuli Patil/CBC - image credit)

When Nova Scotia put a stop to walk-in appointments at X-ray clinics two years ago due to COVID, it exasperated the situation for emergency departments at hospitals in the central zone of the province where patients would go instead, says an emergency doctor.

Dr. Mike Clory, the emergency department chief at Cobequid Community Health Centre says the number of patients waiting for X-rays has been a major problem.

Before the pandemic, people who needed a general X-ray could walk into an X-ray clinic with a requisition from their family doctor and have the procedure done on the same day. They now have to book an appointment at one of the nine centres that offer diagnostic imaging across the province, which Clory says can mean up to a three-week wait.

To cut that wait time, Clory says patients often head to emergency departments for X-rays.

"I know family physicians are frustrated by this, patients are frustrated by it, and the emergency departments are frustrated because people come in, they have to register, and then they're there for an X-ray," said Clory. "You know, it's not really a true emergency."

Province using online booking platform

When the pandemic hit, Nova Scotia Health Authority (NSHA) launched an online booking platform for X-ray appointments in the central zone of the province to reduce the number of patients in clinic waiting rooms.

"This provided control over how many patients we could contain in the reduced waiting room space," the statement said. The health authority also launched an urgent booking line so physicians could book appointments.

NSHA says it has no plans to move back to walk-in appointments.

Clory says the patients who go to emergency departments for X-rays mean "more people that our triage nurse has to triage, so it's more work for them."

"And then it's more patients waiting to be seen by the doctors, and by the time we see them, they're frustrated with the long wait."

He says he'll often get comments from patients like, " 'I waited 10 hours to be told that you're not going to do anything for me because the X-ray is negative.' "

Family doctors must provide X-ray requisitions 

In early August, Rosemary Zwanenburg, a farrier in Lower Sackville, accidentally drove a horseshoe nail through her pinky.

When she went to the emergency room, it was already at capacity. The emergency doctor offered her a five-minute consult.

"His primary concerns would have been infection and then whether or not the nail touched the bone … and said that he would recommend an X-ray," she said.

While he wrote her a prescription for antibiotics, he couldn't give her a requisition for an X-ray, so he told her to come back the following day.

According to Clory, only family doctors can provide patients with X-ray requisitions.

For Zwanenburg, booking an appointment with her family doctor to get a requisition would mean another couple of weeks of waiting. So she just went home.

"I could tell that it had nicked the nerve. And that's what the doctor said, too," said Zwanenburg.

"I feel bad for the guy. I mean, clearly, he was working with constraints of like, availability of physicians."

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