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Doorstep diagnoses: when friends and neighbours want medical advice

The cottage season will be coming soon and I will have lots of people on my doorstep looking for advice or treatment, and wanting to avoid the long drive into town and the even longer wait in our northern Ontario emergency department.

Over the years I have been asked to treat urinary tract infections and slivers (the patient’s mom even brought tweezers so I couldn’t use my usual ploy of pleading that I didn’t have the proper equipment).

I have dealt with a dislocated shoulder from a waterskiing accident on our flat peaceful lake on an early Sunday morning. My useful advice was to go to emerg and take your health card, and don’t eat or drink.

I have had only one true emergency in 32 years, thank goodness. It involved a neighbour who was choking. I calmed him down and that helped him clear his airway himself.

I have treated poison ivy and sunburns, gently emphasizing prevention.

I had to get firm with a neighbour who wanted me to look after her husband after he was discharged from the hospital post MI. I told her I was on my holidays and could help with emergencies but he would be better off in his home town with his own family doctor and cardiologist.

I once had a mom from Baltimore with a baby who had gastroenteritis. This was before e-mail and Google, but she brought over a fax from her paediatrician on how to care for the baby. I told her to try clear fluids and to go to the ER if it got worse.

I tell everybody to get a local family doctor and give out potential names, but the doctor shortage makes it tough.

And remember, you can only treat family in emergencies when no other doctor is available. A local MD was just suspended for four months by the College of Physicians and Surgeons of Ontario for giving routine care (not prescribing narcotics) to his family.

Stuff I keep in my first aid kits in my cars, boat and cottage include 4×4 gauze bandages and tensors, a mask for assisted respiration, adrenaline and a syringe, and a needle for anaphylaxis. I also have antihistamines, cortisone cream, otitis externa drops and a salbutamol inhaler.

How do you deal with medical problems in remote areas?


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