By Aleysha Haniff
Last February, Andrew Asare spent a long night wracked with three times the pain of a normal headache. It started with a vicious pinch in his neck, like a vise clamping down from the inside. Then the jolts of pain skittered up to his head and he knew that if he didn’t get help soon, he wouldn’t be able to function.
“That would be the end of the day for me. I would have to go to bed,” Andrew said. When the pains started, he wasn’t able to handle school for a while. A year ago, he broke down and had to reschedule some of his April exams.
The fourth-year information technology management student has gone to the Ryerson Medical Centre repeatedly to deal with stress. His muscle spasms are triggered from stress about school, about work, about finding work after school. He also has migraines and ulcers caused from balancing the different elements of his life.
On that night, the pain was so bad he had no choice but to see a different Ryerson doctor who prescribed muscle relaxants that left him feeling weak and funny for a few days.
“I think it’s difficult for both of us [with a new doctor] because they have to get to know me and I have to get to know them,” he said.
When he met with his regular physician for a followup, Andrew was referred for massage therapy and recommended lifestyle changes, long-term care that’s changed his life.
Since it opened in 1953, the clinic has been plagued with empty coffers. The clinic has no room and no money improve its services for the 28,000 students who study at Ryerson. Tucked away from a thriving campus, the tiny medical centre tries to function in a long-outgrown space that strangles its ability to provide the care patients like Andrew expect — and need — at Ryerson.
In 1976, former health director Dr. Donald Barr, the clinic has always run a deficit. Last year, about one-fifth of the clinic’s $500,000 budget could not be covered solely through Ontario Health Insurance Plan (OHIP) charges. Student ancillary fees, taken from the portion allotted to student services, were used to make up the balance.
“It’s an ongoing problem and it’s an ongoing problem at every college and university,” said Dr. Su-Ting Teo, director of student health and wellness, who has run the medical centre since 2007. “There’s just restrictions in terms of what we can do to actually cover all the costs of running the clinic.”
Dr. Teo has worked at Ryerson since 2000. Her passion for treating mental health problems has been sidelined because of her newer administrative duties. Her desk in Jorgenson Hall is neat, decorated with a dozen tiny vials tucked into a plastic egg carton. Though she’d love to do more, she can only see patients one day a week.
There’s an ebb and flow to traffic at the medical centre, Teo said. Around midterms, people get sick. Students need medical notes. The centre buzzes with patients. But around finals, at Christmas and over the summer, there’s no one to treat and no money to be made.
“Unfortunately, the costs are still the same,” Teo said. “You still have to pay for the staff, no matter how low or high your volume is.”
There’s no set amount the clinic receives from students, said Teo. Instead, the clinic takes what it needs to cover any shortfall – and there’s always a shortfall. The medical centres focuses on staying afloat instead of investing in resources like nurses that could make it better.
At her first trip to the medical centre, Sophie Powell asked to see a doctor to get a note excusing her from her textiles exam while she battled the flu. She was told someone could get to her in a couple days. But by then, it would have been too late.
Sophie, then a first-year fashion communication student, wrote the exam anyway. She barely passed.
“If I had felt better, I would have been able to study a lot better,” Sophie said. “It [the exam] was two hours long and just too much to handle when you’re sick.”
Now in her third year of fashion communication, Sophie has only gone back to the medical centre once. On that visit, she expected her doctor to be more attentive to her needs. She is, after all, a patient for a clinic geared toward her age group.
“She was nice but it was kind of quick,” she said. “I think she was just rushed.”
With a staff of one director, one full-time doctor and team of part-timers, the medical centre recorded 10,500 visits in the 2007-2008 school year. The number of visits has increased each year since then, Teo said.
“The medical centre needs space to have more physicians, to have consistent physicians,” Teo added. “If you have a little more money, it’s easier to attract people.”
At the University of Windsor, full-time undergraduate students pay $18.70 a semester for their health services. In return, they receive a clinic just for them, with two full-time doctors, two part-time doctors and two nurses.
Without a designated health fee, Ryerson can’t afford the perks that make doctors flock to jobs.
“When you’re able to charge anywhere from $3 a student, and this is the higher range, $150 a student for a health fee, then you have some dedicated funding to make sure that you’re also… improving the service or dealing with space or more physicians,” said Teo.
Like any department, salaries take the largest portion from the medical centre budget. At Ryerson, doctors also receive benefits as union members, which costs money as well.
Even organizational tasks like filing charts could change with an influx of cash. Making health records available electronically would mean the centre could give up paper charts that have a habit of disappearing.
At one point, Teo had to hire new doctors every semester. Even now, the average doctor only stays for two to three years — shorter than an undergraduate student’s stay at Ryerson. These physicians tend to be at the beginning or the end of their medical careers since they’re the groups willing to work very little over summer break.
“It might not necessarily be the money itself that is what attracts the better doctors,” she said. “But the money can help provide resources to the physicians that makes this a much nicer, more attractive place to work.”
But the money can help provide resources to the physicians that makes this a much nicer, more attractive place to work.”
A clinic filled to maximum capacity is only the latest problem in a health centre that was shunted around campus until it found a permanent, albeit problematic home.
In 1956, when former health director Dr. Donald Barr started at Ryerson, the clinic shared a floor with gymnasium classes in a recreational facility at Church and Gould streets where physicians had to struggle to listen to heartbeats amid the thumping and jumping nearby.
The medical centre currently shares a cramped corridor with the theatre school. When they’re busy with a play, students decked out in hard hats and harnesses roll rumbling dollies back and forth. Otherwise, the hallway is empty. The medical centre could almost be mistaken for a chemistry lab, just another door among a row of lockers.
As early as 1971, the clinic was fighting for more space at Kerr Hall West 181, where it still is today. The room remains largely unchanged other than some renovations to optimize what little space it has. The rooms are brighter and friendlier than they were 40 years ago, but no bigger.
“We’re pretty much hitting elbows, trying to work in that space,” said Teo. “Lots of people are healthy and go to walk-in clinics [instead], which isn’t always ideal for them.” A walk-in clinic lacks preventative care, but the medical centre does have to refer patients to them if there’s no room for appointments.
Only a few doctors can work at a time because there’s only room for three. But like nearly everywhere on campus, there simply isn’t extra space for expansion. The Ryerson Medical Centre was built to handle 6,000 to 7,000 students, not our current student population.
As times have changed, so has OHIP coverage. Mental health services like counseling brought zero fi nancial profi t four decades ago. Today, with an increased awareness of psychological and preventative health, the Ryerson medical centre receives about $50 from OHIP for a counseling session.
Lindsey Glazier, a fourth-year radio and television arts student, uses the medical centre almost weekly to help her deal with depression and anxiety. She also has sarcoidosis, an autoimmune defi ciency disorder that can cause the body to attack joints and lymph nodes.
“I think they’re better than most,” she said. Glazier actually switched to the medical centre from her family doctor in Hamilton. “They always assess my needs. They always work it out together [with me].”
But one issue, according to Dr. Teo, is the time spent dealing with mental health issues.
According to Dr. Shree Bhalerao, director of medical psychiatry at St. Michael’s Hospital in Toronto, substance use and head injuries can complicate diagnosis. It can be diffi cult to distinguish between adjusting to new experiences and dealing with a mental illness.
In the time it takes to assess one person for mental illness, a doctor could take five patients with less complex health problems like a cold. In pure financial terms, that translates to about $150 from OHIP.
Beyond the 50 minutes it takes to examine a patient for mental illness, Ryerson physicians spend huge chunks of time contacting psychiatrists, the Access Centre, even individual professors.
All this effort goes unpaid and it leaves less time to see more patients. But there’s little choice for a medical centre dealing with a population that struggles with emerging mental illness, stress and independence.
In the 1970s, Dr. Donald Barr expected his medical centre would stay in Kerr Hall for the next 50 years. But he couldn’t have predicted the prestige attached to the Ryerson name that has boosted enrollment numbers to the point where students write exams in a convention centre instead of on campus.
Under Ryerson president Sheldon Levy, the resources we used most have expanded to new buildings in the downtown core. Funding has poured in for the Student Learning Centre and a refurbished Maple Leaf Gardens.
According to Heather Lane Vetere, vice-provost students, the medical centre could need a larger sliver of student fees in the future to counter the annual deficit. That would mean a referendum, which she’s unwilling to try until it’s clear the medical centre can’t function without student fees.
Campus life isn’t complete without a facility that understands students better than anyone else, and the health centre has tried to promote itself at events like orientation. A clinic isn’t as glitzy as a new athletics complex, but just as important for student health. The question is if student will support something often overlooked, even if it needs their money to thrive.