Last Bastion of the Fax Machine: The Canadian Medical System (Also: An Aviation Medical in Seven Months)

By May 22, 2015Aviation, Technology

If you read about the process of learning to fly, you’re bound to come across advice to get your aviation medical examination early. I thought I was doing it right; I scheduled my medical as soon as I decided to pursue the license and as a healthy, athletically active person I thought it would be simple. Little did I know.

I don’t feel like publishing my medical history on the Internet—that just seems weird to me—but I’m happy to report that I now hold a Transport Canada medical and am fit to fly airplanes. To get it took approximately seven months, most of it waiting for the medically competent, taxpayer funded, but glacially paced Canadian medical system. Waiting for an appointment with a specialist; waiting to get an appointment for tests; waiting for doctors to interpret results; and waiting for administrative staff to fax documents.

Wait, faxing? Permit me a bit of a rant here.

The first thing you do is request the aviation examiner’s office to send your records to your General Practitioner, who will coordinate with the necessary specialist. They email a form to print, sign, and return via email. Not fully modern but I can deal with it. Then you call your GP because there is apparently no directory for doctors to find out how to send each other documents. You discover that “they don’t do email” but you get a fax number. You email that to the aviation examiner’s office and wait for them to send the documents. When that doesn’t happen, you call. When it still doesn’t happen after a couple of days you walk over and get a photocopy made while you wait. Take those back to your office and fax them to the GP. Congratulations, you now have your documents at your GP. What you’re supposed to do if you don’t have a company fax machine to poach off of I’m not sure.

After you meet with the GP the fax madness continues. Somehow the full complement of documents never seems to make it from the GP to the specialist (I imagine my confidential records sitting curled up in a roll of thermal paper behind the fax machine). The specialist’s receptionist concedes they have email but it’s not for patients because I would obviously abuse it (some people surely wrecked it for everybody else didn’t they?). Near the end of the whole process, the Transport Canada document that started the whole thing is lost from my file and has to be re-faxed. And of course if you have a question for a doctor there’s no way to call them on the phone and talk to them. I discovered the most efficient way to talk to a doctor is to compose a short letter (remember those?), print it out, and fax it!

I’m lucky to be old enough to know how a fax machine works. Think of the children. What will they do? A fury of negative hashtags may give some comedic relief, but I’m not sure it’s going to get any results.

It seems to me that a few basics were skipped along the technological path for our medical system. We have very sophisticated medical systems for diagnosis, treatments, surgery, and teaching. And we have fancy electronic medical record (EMR) systems. But despite this, doctors can’t securely send a PDF? I realize that encrypting email is generally a pain for most non-techies, but this seems like it would have been a good candidate for a government or private company to build a S/MIME or GPG infrastructure just for the medical system. As much as email is maligned for the “modern” tools of today (i.e. we were told there would be flying cars but instead we got Twitter), it is still a workhorse for communication. And secure email is not a new technology by any stretch. It’s hard to believe that this gap still exists.

I’m not sure I see much hope for this on the horizon. There will continue to be plenty of gold-plated electronic medical solutions and maybe there will be some interoperability someday. But until then, keep a fax machine in reserve because the Canadian medical system is the last bastion of that old school piece of technology.