If you ever suspect that your doctor, nurse or other health-care provider forgot to use the hand sanitizer, by all means raise the question. But, in reality, most patients in your situation are reluctant to do so. Surveys going back almost a decade found that Ontario patients didn't want to be placed in the role of a police officer to ensure that doctors and nurses wash their hands.
For the last 30 years or so, Canadians have repeatedly flagged healthcare as the most important national concern and the issue they want their political leaders to prioritize. Surveys and studies and polls and panels -- there have been plenty -- all come up with the same finding: Canadians care about healthcare.
For almost 30 years I've tried to help Canadians understand their health system and their medical care. In that time, I've seen tremendous advances in medicine. Modern medicine has become so specialized that many physicians treat specific syndromes and body parts, and the patient herself gets lost in the process. We have filled our temples of medicine with such bedazzling hi-tech tools that we've forgotten that we should treat people where they live. In our desire to cure, we over-treat.
Desensitization, which involves gradual reintroduction of a drug, starting with very small doses, makes it possible for some people to take a medication that would normally trigger an allergic reaction. The procedure, of course, must be done under direct supervision of a health-care professional in case you develop a severe reaction.
I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology. I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.
Contrary to the insinuation that the College of Physicians and Surgeons of Ontario is out to protect doctors and keep the public in the dark, they are, in actual fact, out to protect the interests of the public first and foremost. Is the general public, with their lack of medical training and limited knowledge of how the health profession works, really in a position to sift through and understand medical information better than the trained doctors and highly-skilled and trained health professionals who have been appointed to investigate these matters?
A case emerged in response to an audit of Cambie Surgeries, a private for-profit corporation by the B.C. Medical Services Commission. The audit found from a sample of Cambie's billing that it (and another private clinic) had charged patients hundreds of thousands of dollars more for health services covered by medicare than is permitted by law. Dr. Day and Cambie Surgeries claim that the law preventing a doctor charging patients more is unconstitutional.
Experiencing a medical emergency is an incredibly stressful experience for patients and their families. This stress should not be compounded by worries about getting an ambulance bill they can't afford. As physicians, we know the importance of the first few minutes of an emergency situation, and the crucial role of Emergency Medical Services (EMS) in saving lives. And yet ambulance fees remain a significant barrier to people receiving necessary care across Canada.
A federal election could be called any time in the next few months, judging by the media coverage and the ramping up of political activity. Many issues have been crowding into the media headlines in anticipation of the election -- but with a notable absence of any consideration of healthcare by our political parties. Apparently the subject is still on the minds of the electorate though, at least amongst my own circle of friends, colleagues and neighbours, many of whom note the leading edge of our baby-boomers have now turned 65.
In a public healthcare system, too often system failures end up as fodder for Question Period battles rather than impetus for learning. When investments have been made in new models of health service funding and delivery that don't work out, it can be difficult to proclaim failure as a means to move toward success.
The need for people also to make advance directives (often called living wills) and to discuss them with family is greater than ever as medical technology advances, but there is a serious legal problem. You may have an advance directive signed in perfect health clearly stating your wishes, but if and when you become incompetent, current law in some provinces permits your next of kin or power of attorney to ignore it. Surely new legislation must recognize and prevent this potential abuse that most people would find offensive and unacceptable.
The continuum of patient-centred care could include a consistency of health care professionals familiar with a patient's case and who are buttressed by the flow of relevant patient history and investigations. Patient centredness by the professional care-giver would target care, communication and common ground or a shared understanding between those receiving the care and those providing it.
The dismal record of for-profit hospitals illustrates the problem with running hospitals as businesses. The for-profits have higher death rates and employ fewer clinical personnel like nurses than their non-profit counterparts. But care at for-profits actually costs more, and they spend much more on the bureaucracy, a reflection of the high cost of implementing shrewd financial strategies. Canadian hospital administrators don't have to play financial games to assure their survival.
QUESTION: I had a major operation at an Ontario hospital. At an appointment before the operation, the doctor told me about what to expect from the surgery and the possible risks. Then he asked me to sign a consent form. I didn't really understand everything he said, but felt pressured into signing the form
Mental illness is one of the biggest predictors of inequitable access to care in this country. We know that having a mental illness means that you are far less likely to get the healthcare you need than someone without a mental illness and that mental illness is a bigger predictor of poor access to care than low income.
As January comes to an end, those who vowed to eat better in 2015 have probably already given up. Not very surprising, considering that most people grossly underestimate the amount of calories they consume, and underestimate their fat, salt and sugar consumption, even after consulting nutrition labels.
Although advertising of prescription medicines to the public is generally banned in Canada on public health grounds, shifts in administrative policy have allowed two types of ads since late 2000: "reminder" ads that mention a brand name, but make no health claims; and "help-seeking" ads that mention a condition, but do not state a brand or company name. We have identified six main weaknesses in how Health Canada regulates this advertising.
While policy should be evidence-informed rather than belief-based, the complexity of health-system change makes it difficult to draw a straight line from one evidence-based improvement to health-system change as a whole. Improving the quality and quantity of evidence-based decision-making is perhaps the greatest challenge in systematically devising policies for bending the cost curve.