'It’s devastating for their families': Saskatoon doctor wants answers on rejected psychiatric referrals
SASKATOON -- Dr. Marlys Misfeldt says she felt “absolute fury” when she saw that her psychiatric referral had been deemed unnecessary.
“This is not something that can be postponed. People die. I’ve had patients commit suicide. It’s devastating for their families, for their loved ones,” the Saskatoon family doctor told CTV News.
“And I just was angry. And I said, the people of Saskatchewan need to know that this is happening.”
She had referred a patient, who has anxiety and depression, to the psychiatric referral pool, in which patients are sent to the first available specialist to reduce wait times.
The fax she received rejecting the referral provided no explanation - only saying that “the specialist has decided that the referral is not required and has cancelled this referral.”
Misfeldt said she doesn’t know who made the decision. She wants a better explanation, or some guidance on diagnosis, treatment and medication.
“I'm only treating a symptom and not the actual cause, so of course they’re not going to get better. You know, I need that more in-depth skill that psychiatrists might have to help me make appropriate diagnosis and make sure that I'm treating the correct problem.”
Anxiety and depression sometimes can be easily treated with one medication, but they can also be tough to crack, she said.
“You need multiple medications. You might need something to help the antidepressant work. You may get the depression starting to feel better, but then they're flat, they still have low motivation. So you might need to add something in or the depression is getting better but now they have sexual dysfunction. So you might have to adjust that and take that one away and add something different.
“You might need something more for the anxiety, even though the depression might be improving. You have to mix and match medications like you would for high blood pressure, there's not a standard regime that's going to work for every single patient.”
When she has contacted the pooled referral system, she said she is told at least 300 people are on the waiting list and more psychiatrists are needed - and that the pandemic has reduced the number of people they can see while increasing referrals.
Misfeldt said she doesn’t know why there aren’t enough psychiatrists in the province. She raised the questions of whether enough money is available to hire them, if enough are being trained, or whether they’re being paid enough to keep them in Saskatchewan.
The Saskatchewan Health Authority has not yet responded to questions from CTV News regarding the pooled referral program or why specialists would reject referrals.