Terence Carleton
A commentary by a North Saanich resident.
So a couple in Victoria have at last found a family doctor through placing an ad in the paper.
My wife and I have tried to get a family doctor since moving to B.C. two years ago. What we have been met with is the triumph of unimaginative deskbound bureaucracy over ‘boots on the ground’.
We have been ‘registered’ on the provincially administered waiting list since its inception. Wow; that makes us feel so good!
It goes without saying that nothing has happened and the waiting list continues to lengthen as doctors continue to retire because they are overburdened with paperwork on the fee-per-individual visit model, with which this province and others persist.
The B.C. government has had five years to correct this burgeoning problem and the only solutions that we, the citizenry and taxpaying public, have heard is that the health ministry is making more money available to help “solve the problem.”
Neither politicians nor the bureaucrats are listening. Money, whilst always important, is not the fundamental problem. It is about work load, and especially about the out-of-surgery paperwork for which doctors are not primarily trained.
Bureaucrats are trained in paperwork and they should be able to devise a system whereby everything is made as simple as possible. The well known KISS (keep it simple, stupid) principle.
We, the public, have heard no new ideas on health-care administration and delivery from government. There exist a number of other publicly delivered and administrative models that should be openly discussed and yet, with increasing dissatisfaction with the system, all we are hearing is the same tired old siren call for the mythical magic silver bullet of privatization.
We need only look to Britain to see how well this system works. It doesn’t. Their system is in waiting room crisis. Furthermore, nothing will change under Margaret Thatcher II, Liz Truss.
Other models include large family practice clinics with administrative staff for fee submission and triage to registered nursing staff for minor problems, freeing up staff doctors to do what they are trained to do.
Walk-in clinics function in this way but they are not locked into a network system of recording long-term patient care and history.
However, with modern network technology and cloud-based data storage this is easily doable by an imaginative government bureaucracy. Another model is to base all patient care around local hospitals, which already have office staff administration. Essentially an expansion of the current emergency department system.
The current ER system is being used in B.C. by many as a substitute for a non-existent family doctor. The result is a choking of the emergency departments with relatively minor health problems.
The Japanese health-care delivery system operates as family practice through the hospitals and, with impeccable record keeping, it works. Those two centralized systems can work in large, dense communities but in low-density rural regions something more local is required.
Galiano residents, for example, chip in to rent clinic space which is staffed by a nurse, who can also keep the books. The clinic is visited by two doctors from the mainland every week for a regular surgery.
Thus every resident has to wait no more than a few days for non-emergency consultation. Contrast that with me who has been waiting for many weeks to get appointments, not the actual treatment mind – just the appointments, for non-emergency hearing and sleep apnea tests.
The above models all offload the paperwork of fee-per-patient visit off the backs of individual doctors; the real issue behind our health-care delivery problems.
This has to be done and the politician that can make the most convincing case and proposed solution in that direction, at the next provincial election, will get my vote.
