Free healthcare. That is the shining star of our nation’s healthcare system. In any international discussion or comparison of our system, Canadians pride themselves on the fact that access to essential health services is not prohibited by an individual’s ability to pay. Taxes collected from those who are financially better off, are redistributed to cover healthcare costs of the whole community, regardless of how old, how poor, how unfortunate, or how sick someone is.
Except that was not exactly the intention of those who shaped our healthcare system: we were not supposed to have unlimited, all-you-can-consume healthcare for everyone.
Roy Romanow, the former Saskatchewan premier, planted the seed for the formation of the Health Council of Canada (HCC) in 2004. The idea was to have a national body that will monitor and report on health dollars transfers from the federal government to the provinces. In a healthcare system fragmented into 14 pieces, the HCC was promoted as the duct tape that will hold the system together; the vehicle through which we can move towards a truly national healthcare, guiding health professionals, administrators, and patients alike.
Too bad most of us have never even heard of the HCC; never knew of its work or effects over the past 9 years; and will likely not miss it at all when it is to be disbanded next year.
The bombing of innocents at the Boston Marathon will forever be remembered alongside similar tragedies such as 9/11, not only for the resulting gruesome injuries and deaths that’s been engraved into our minds by the media, but for the sheer shock of witnessing something so unfathomable actually happening in reality.
But as shocking as it was, the local healthcare response was surprisingly prompt, efficient, and effective. What we witnessed in the immediate aftermath of those 2 deadly bombs exploding, was a clear demonstration of several important learning points for the rest of us.
Guest post by Shawn Mondoux.
Suppose that you had worked your entire life and put away savings, small amounts from each paycheck that had gone into a fund that you were accumulating over 20 or more years of work. The goal of this money was to cover the cost of a dream trip with four of your closest, most intimate friends. The four of you had been pooling your money, together and in equal parts, into this same pot of money. You had bought a luxury RV which was waiting for you in Whitehorse, and you would be driving to the southernmost tip of South America … some may call this the trip of a lifetime.
The money you had put aside was going to pay for all of your expenses: food and sustenance, gas, tolls, fines, fixes, fun, etc. There was a single catch to all of this: The person who decided how to spend the money was the driver. The driver chose the restaurants, attractions, and roads that you travelled. Everybody wanted to be the driver. The driver was elected among the three other friends and one could only remain the driver if they balanced spending on their own desires with the desired spending of their friends. Together, in whitehorse, you had collectively decided on a rough budget for each category of expenses. The goal was to stick to the budget and you would make it safely to the tip of South America.
It recently came to my attention that the UK has been deploying a public health message with regards to ER wait times; more specifically, it looks like a public education campaign aimed at redirecting “inappropriate” visits away from emergency rooms. The premise is that many minor and non-life-threatening conditions can be (and should be) treated outside the ER, and that the onus is on the patients themselves to basically triage their own ailments.
Although at first glance this may sound like a reasonable solution to ER wait times, it may actually be inappropriate blame-shifting without supporting evidence.
It is a very interesting social phenomenon how some healthcare workers have come to put up such an emotionally charged and adamant fight against getting vaccinated. This issue reached a head with the recent battle in British Columbia over trying to make it mandatory for frontline nurses to get the flu shot.
I call this a “social phenomenon” because the surprising resistance is exponentially spurred by forces beyond any solid scientific evidence, despite repeated urgings from infectious diseases experts and leading health authorities worldwide.
Before we go any further, we need to be clear: this is an issue of patient safety, and how to provide the best patient-centered care. Refusing to get the flu shot as an individual is different than refusing to get the flu shot as a healthcare professional (but more on that later).
Okay, enough already. It seems like the media’s flavor of the week is focused on determining what a doctor’s annual income is, and whether that magical guess-timation is too high or too low.
The underlying assumptions driving this hunt include: 1)coming up with an average annual income (gross/net) would somehow be reflective of individual physician practices or be meaningful in any shape or form, and 2)even if the previous assumption is correct, that exactly how much physicians are getting paid is clouded in a cloak-and-dagger manner.
We are wasting too much time and effort asking the wrong question.
Guest post by Linda B.
I have been a nurse for 12 years. All of them practiced in Canada, most of which have been in critical care. I started with a college education and a specialty certificate. Within the year I will be a master’s prepared Nurse Practitioner (NP), and almost everyone I know asks me what’s next…? I could stay right where I am – at the bedside in the Intensive Care Unit in a tertiary care hospital – but I would not be able to fully utilize the skills I will have acquired as an NP.
Truthfully, in my unit I would not be able to practice as an NP at all. Despite being certified for independent practice by my licensing body, I will not have the ability to independently order a medication or Xray, or communicate an unknown diagnosis to a family.
Defined as someone “having the faculties impaired by alcohol” (or a more practical version: “When you have to hold onto the grass to keep from falling off the earth“), those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors.
Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine at home and falls down the stairs repeatedly? You betcha. What they all have in common is an apparent complete oblivion/ignorance to the source of the problem, and the associated ill effects on themselves.
Sometimes I wonder if the healthcare/political/legal system itself is “drunk”, in its own oblivion and inaction towards the impact alcohol abuse is having on our society.
Guest post by Shawn Mondoux.
I have been asking myself where is the biggest bang for your buck when it comes to patient satisfaction. This basically gets down to a more fundamental issue which sums itself up as “how much does the patient want to know about and be involved in their own care?”.
The difficulty is that there is no single answer to this question. Doctors like to simplify issues into neat categories, each of which have a clear management plan. This doesn’t exist for the many personalities and emotional complexities of each individual patient. And thus, in order to increase patient satisfaction, we must give of our most sparse commodity: time. Time to learn about our patients, and time to develop tools for communication.
E.
