In Canada, if you know a doctor as a result of being an old school chum, whatever, you can get into see him right away for that knee surgery you need. If you don't know a doctor and you fall and seriously injure your shoulder, you wait a month or two to see a surgeon with a necessary referral from you private practictioner. You have to wait another eight to ten months for the operation itself. In the meantime, you can hardly move your arm without pain and your private practioner gives you pain killers which you then become addicted to.