It’s often like that now, those who work in the public network suggest we turn to the private sector. This happened to me recently for occupational therapy, the doctor told me: “either you wait a long time and you have to go to the appointment at a time that you do not choose, or you go to the private sector, it’s quick and you go when it suits you.”
I went to private, everything is sorted.
This is what Suzanne had decided, she wanted to be clear about it, she did not want to wait for many months before having a “barium meal”, an examination which consists of ingesting barium and following it by imaging at double contrast the trace of said meal. “This examination makes it possible to identify various conditions of the digestive system such as a blockage or narrowing of the digestive tract, ulcers, polyps as well as cancerous lesions,” we can read on the Proxim website.
Obviously, we always imagine the worst.
After searching the Internet, Suzanne contacted the radiology clinics she found. “I called Biron and Clinix, the Audet, Mailloux, Saint-Louis clinics and others. And everywhere I called, I was told that it was no longer covered by RAMQ. Last week I called back to check if the decision is still in force and yes, it is.”
He was not even offered to take the exam at his own expense.
At Biron Laboratories, they confirm to me that “Imagix, our affiliated company, no longer offers, since summer 2023, the following radiological examinations of the digestive system: double-contrast barium meals and barium enemas.” Same thing at Clinix. “Unfortunately, we do not do this type of examination in our clinics.”
Even at the Audet clinic, which indicates on its website that it offers the barium meal, has not been doing it since last year.
Suzanne was misinformed, the RAMQ had nothing to do with it.
IPAM “guilty”
The “culprit” is the Institute for the Relevance of Medical Acts, IPAM, an organization created in 2020 as part of an agreement between the government and the Federation of Specialist Physicians of Quebec (FMSQ). “Its mandate is to identify and adopt measures aimed at restricting or eliminating inappropriate medical procedures, performed at excessive frequencies or not in accordance with good medical practices,” we can read on the website.
So we decided that the barium meal and the barium enema were going to be phased out, that they could now only be offered in hospitals. Even if they don’t supply on demand.
On the phone, the general director Jean-François Foisy explains to me that “with the Association of Radiologists of Quebec (ARQ), we made the decision to abolish components of code 08154, which means that it can no longer be the subject of complaints. We assessed that it was not required in clinics, that it could be replaced by something else, such as an endoscopy.
Even more, clinics could not even offer these imaging exams at their clients’ expense. “When the IPAM repeals an exam code or certain components of an exam code, they remain insured, but with a rate of $0. This means that the doctor who wishes to continue carrying out this examination will do so pro bonothat is to say at his own expense, without the possibility of billing the patient and/or RAMQ,” Mr. Foisy continued in writing.
For volunteering, we’ll come back.
At Imagix, like others, we took note of the decision. “The ARQ informed us of this decision, which came into force in August 2023. Thus, we respect these recommendations and no longer perform these examinations.”
Anguishing wait
Result: for a little over six months, Suzanne Poireaut has been on the hospital waiting list without any possibility of taking this exam elsewhere. However, if the doctor prescribed it, it was because he considered it necessary to find out what was wrong. And he is clearly not the only one whose patients find themselves in front of Gros-Jean.
Suzanne has absolutely no news, she doesn’t know when her turn will come. “Every month, the hospital calls me because the doctor wants to follow up following this examination. […] The more time passes, the more I worry about not knowing…”
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