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Ontario’s health care system needs an overhaul — so says everyone who’s waited hours in their local Emergency Department or waited months to see a specialist or who can’t find a family doctor.
On January 31, the Premier’s Council on Improving Health Care and Ending Hallway Medicine released its first report. The snapshot it gave of the healthcare system was alarming. On average:
1000 patients per day receive medical care in the hallways and unconventional spaces — gymnasiums, offices and bathrooms — of hospitals across Ontario.
Patients are waiting 16 hours in the emergency department.
Patients are waiting 146 days, sometimes longer, to enter a nursing home.
Patients are waiting 6 days for home care after they go home from the hospital.
It’s not that we aren’t all working hard. I see doctors, nurses and allied health working so hard that they’re buckling under the workload.
A recent study by the Canadian Medical Association showed that 1 in 4 physicians is frankly burned out. And it’s no wonder — we work in a system where, no matter your individual expertise, patients suffer unacceptable waits, delays and shortages. And it impacts their recovery.
So many pieces of the healthcare system are missing or deficient that it makes it harder to provide the kind of care you want to provide.
All of this will impact physician recruitment and retention — at a time when urban and rural communities are starved for family doctors and specialists. I worry that Ontario is losing its competitive edge. Last week’s CIHI report showed that payment for physician services is now second lowest compared to other provinces.
More funding is needed, but it’s only the tip of the iceberg. What we need is a system that works smarter. At the end of the day, I want to work in a healthcare system that provides the right care for the right person right when they need it — not 5 months or 5 years down the line.
We must get this right. For that, we need doctors helping make the decisions that matter at each turn, from street-level to CEO. After all, studies show physician-led health care transformations are the ones that succeed.
The Premier’s Council is charged with finding answers to transform the system. This is only their first report so it is light on details. But it is a first step. And its focus is to create an integrated system.
With a properly integrated system, when someone falls ill, all the necessary pieces come together in a continuum of care to help the patient and their family. It is seamless. Effortless.
What we have now is a series of one-offs with different frontline providers and long waits in-between.
The report committed to expanding and integrating digital health networks. Doctors like me invest a lot of time and money in digital medical records to manage patient records. Some doctors are even able to hold virtual visits to improve access for people who live in rural, northern or under-serviced communities. But we’re not yet at the point where computer systems in one office, hospital or care setting can easily talk to another. So patients find themselves acting as messengers between providers in different care settings.
If we work smarter, I believe that we can find efficiencies — especially if the system works as a whole rather than in pieces. And the efficiencies won’t just be in time and effort saved for the patient, their family and the physician — it’ll equate to savings in dollars. Any savings realized from these efforts must be reinvested right back into the frontline services that patients desperately need.
And any suggested changes to the health care system must work in the real world of your doctor’s office and your local hospital.
This is why the health system reform ideas drawn up in Queen’s Park should be flexible enough to adapt to the local health care needs of a community — whether it’s in Toronto’s east end or whether it’s in Kirkland Lake. This is why we need the input of frontline physicians through the Ontario Medical Association. Health system transformation succeeds when doctors are at the decision-making tables.
(First published in The Huffington Post on February 15, 2019.)