To swab, or not to swab - The Orca

To swab, or not to swab

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Jody Vance: Testing for strep throat has become both simpler and more complicated.

There is something undeniable about a sore throat. It’s the first “uh oh” of the onset of common cold, flu, or worse.

My mom was scientist. She was a Lab Technician; the person who managed and processed test samples for doctors. Her workday consisted of drawing blood, collecting urine, administering swabs, on and on. She was also the person who created cultures from samples, put them under a microscope, and identified what was up.

Girl knows her bugs. Her favourite tool to wield was The Swab.

Thanks to Mom, I’ve had about 10,000 throat swabs in my life. Whenever I wanted to ditch school, I’d complain of a sore throat. A Lab Tech Mom could not, in good conscience, send their kid to school to infect others. Inevitably, she would let me stay home…but not without a swab of my throat.

Most days, I knew my time at home would be limited. Once she had the swab cultured and under the scope (usually by lunchtime) she’d call: “get your butt to school, you’re fine.” Curses, foiled again!

The swab is the simple test for Streptococcus A, a bacteria that can go from a sore throat —> to something far more serious FAST.

Until recently, finding out if your sore throat is actually Strep Throat took days. It meant a doctor’s appointment. Even a rush would take at minimum 24 hours.

In 2020, advances in testing have seen that wait time reduced to a minuscule 10 minutes.

At first, those quick tests were available at doctors’ offices — but were then moved to pharmacies, joining flu shots and other vaccines, quite simple to administer and manage.

At first blush this seems like a fantastic idea – or at least, it hit me that way. No more need to waste precious doctor’s time on a simple test. Then, a doctor need only write a prescription for a positive test – also a quick process. Everyone wins, right?


This throat swab test battle was brought to my attention last week when my son woke up with a “really sore throat.” I called my local Shoppers Drug Mart, and was told to come by anytime.

Out of an abundance of caution, I decided to get him swabbed. Much to our surprise, the swab came back positive for strep. We were told to call our doctor to get a prescription – he would need antibiotics.

Luckily his doctor is literally across the street. We marched straight there; after all, we only needed a “quick prescription” — the test results are in, after all.

We found out fast just how mad these swabs make doctors and their staff.

Really mad.

At the reception desk, in the empty waiting room, as I requested a quick script, the gatekeeper looked at me as though I’d hurled the worst of insults her way.

First came being chastised for not having called to ask for an appointment. Then I was told that my son’s doctor “isn’t even in until this afternoon.

Naively, I lobbed a query “might another doctor manage the prescription between appointments, given the positive strep test?” (Ours is a teaching clinic.) The gatekeeper was unabashedly angry. Realizing that she couldn’t possibly be angry at me, a mom with a pale kid suffering with strep throat, I took the high road. I apologized and took my boy to sit to wait patiently, in the empty waiting room. Momma Bear was not leaving without meds.

Shortly thereafter, our angry receptionist barks, “come with me.” She was swallowing a bitter pill. We soon found out why.

Our doctor greeted us with, “sorry about that – frustrations run high around this test.”

Here’s how the story goes: Pharmacists get paid for the test. Doctors do not get paid for a faxed-in prescription, paid 1/2 if a patient phones in for a prescription, and get paid full if a patient comes into the office for an appointment.

The bigger issue here involves walk-in clinics. Doctors at walk-in clinics get paid the same as doctors in GP offices per appointment. However, there are stats that show (according to our doctor) that patients with minor issues go to walk-in clinics and save their GP visits for larger (read: longer) laundry lists of issues. Because of this, walk-ins can often see many more patients per hour.

If you’re keeping score, it’s a competition with money on the line: GPs vs walk-in clinic doctors vs Pharmacists.

From the outside looking in, one might assume the arms of our healthcare system would work together. That going to the pharmacy for a swab frees up precious appointment slots. That walk-ins took the heat off the Emergency Room.

Knowing what I know now, it looks as though things are simmering. We need to address this. Healthcare should be a team sport.

Jody Vance is a born and raised Vancouverite who’s spent 30 years in both local and national media. The first woman in the history of Canadian TV to host her own sports show in primetime, since 2011 she’s been working in both TV and radio covering news and current affairs.