What’s Up, Doc?

What’s up? Well, waiting times in Canadian emergency rooms are up, for one thing. In fact, waiting times for everything medical in Canada.

What else is up? Violence and abuse toward medical personnel is up. Overcrowding is up (Canada ranks 31st of 34 OECD countries in hospital crowding). The number of Canadians without a family doctor or NP is up. I could go on, but I don’t need to, because you already have your own list.

This is not to say that other countries don’t have health care issues, as well. But in Canada we used to sneer at the Americans, confident and cozy in our excellent public health care system. Everyone got first class, compassionate care, on a timely basis, on the public dime. It was a point of pride.

Today there is universal agreement that the system is broken. Our little local hospital shut its emergency department for almost a month this summer, in the height of tourist season. Why? Because it was down to one-third of its former staffing.

From Timmins to Halifax, only one of my four kids has a physician for their families. Karen and I have a nurse practitioner, and we were one of the last to get on her list, four years ago.

I sit on the board of a local clinic. Very recently all the clinics in Ontario were told to extend their hours and see more patients. But, of course, with no increase in budget. The computers are the same ones with which the clinic opened ten years ago, and barely able to keep up with new medical records technology. But no room for upgrades in the budget, which is set by the province, and frozen. Sorry.

I don’t need to go on about the symptoms of a sick healthcare system. Our local Dr. Drummond wrote in McLean’s magazine (https://www.macleans.ca/longforms/er-doctor-healthcare-crisis-canada/) about his heartbreaking experiences at Perth’s hospital. You have your own stories.

How did we get here? I don’t want to write a book, but let’s start with just four simple things.

Lack of planning is probably the first. Everybody read The Pig in the Python (https://www.amazon.ca/Pig-Python-Prosper-Aging-Baby/dp/0761512756) back in the ‘90s, everybody knew the Boomers were aging their way through the demographics, everybody knew we’d all get old and rickety as a huge cohort. Everybody knew that the Boomer doctors and nurses would age and retire, just as demand would begin to soar.

More geezers, less doctors. There were no plans to infill the gap. At the same time, the path to becoming a medical professional got longer and more costly. We’ve seen this coming for a quarter century. Like, duh.

Which leads to the second reason: artereosclerotic bureaucracy on both the medical and the political fronts. Instead of streamlining and compressing the formation of medical professionals, and finding an efficient way to fold foreign-trained meds into our system, we’ve made entry to medicine and to nursing ever more complex, costly, and lengthy.

Some years ago I had a client who trained as a doctor in Houston, Texas, then returned to his home in South America where he ultimately became the head of emergency in a large city.

When he came to Canada, he got a job.

In a flower shop.

Ultimately, after considerable grief, expense, persistence, and time, he was licensed in Ontario, but it was uphill all the way. His is one of thousands of such stories.

The third reason is lack of political will to fix the problem. The best plan that the provinces seem to have is say that we have no problem, then try to steal docs and nurses from the other provinces. The best plan the feds have is to blame the premiers.

The truth is that it’s going to cost us, and cost us dearly, to restore our health system to health. It won’t fix itself. We may have to change some priorities. Maybe we can dispense with the $5000 government bragging rights billboard in front of the $100,000 clinic upgrade, or the $2000 return flight from Toronto for the Minister to open the clinic and crow about government generosity. It’s time for Ottawa and the provinces to stop the smarmy political posturing and commit to the hard work and cost of fixing this.

But there’s a fourth reason for our medical crisis, at least, and that’s disrespect. We no longer honor or cherish our medical professionals. As a matter of fact, we no longer honor or cherish any professionals. As a further matter of fact, we no longer honor or cherish anybody who puts themselves out for us. We’re rude to the grocery clerks and rude to the Amazon delivery guy and rude to the intake staff at the hospital.

And that’s something which is within your control, and mine.

This has been a long rant, but this is a discussion we all need to have before our medical system fails more of us than it already does.

Remember the old saw about the best time to plant a tree? Twenty five years ago. And the second best? Today.

We didn’t get ahead of this twenty five years ago, as we should have. But today is available to us.

This is a hobby horse I’m prepared to ride. And you? Love to hear from you.