One week ago, I sat in a packed walk-in medical centre with my child, waiting restlessly to see a doctor on a Sunday. I had hoped the clinic would be faster than the nearest hospital, and while our visit was urgent and could not wait until a weekday, it was not a life or death emergency. I watched a steady stream of sick grownups as they wandered in to sign the waiting list and claim a chair, only to cough, sneeze, and sputter back out the door to brave the frigid minus 20C winter to have a cigarette.
Over the course of two hours in the waiting room, people showed up to see the doctor, and while they waited, bought candy, potato chips, chocolate bars, and of course, cigarettes from the adjoining pharmacy. In between bouts of respiratory distress, these sick adults ate candy, devoured bags of chips, blew their noses, then huddled outside against the glass windows to take long drags of their smokes.
Meanwhile, at least six infants under the age of one waited with varying degrees of illness, one coughing so badly the indifferent receptionist finally noticed the child needed urgent medical attention, and ushered mom and babe into an examination room. Either that, or she was worried she’d get whatever the baby had. This particular clinic does not triage, meaning to assess patients for their level of emergency and slot them in accordingly. Excepting clear life or death emergencies, everyone signs the sheet, and waits their turn, regardless of age, so a child with a broken bone waits as long as a grownup with a sore throat. That visit there were 30 people in the waiting room, and the entire ordeal took three hours. On a return follow-up visit, there were 10 people in the waiting room, and it still took two and a half hours.
This is not unique to my province. In a 2004 international survey, 48% of Canadians asked said they waited two or more hours to see a doctor on their last visit to an emergency department. Last year, a Fraser Institute study found there were only 2.3 doctors for every 1000 Canadians. There is no question that doctors are struggling under a rising workload. Many doctors aren’t taking new patients, because they can barely fit in the patients they have. It has become the norm for someone sick to wait an hour or even two hours, just to see their family doctor for five minutes.
However, much of the problem remains people overtaxing our health care system with frivolous visits, the kind of people who run to the doctor for every sniffle and sore throat. Doctors universally agree that viruses like the cold and flu can’t be treated with antibiotics. The only thing that works is time, rest, and letting nature take its course. If you’re sick, you should stay home so you don’t spread your germs, just like your mother always told you. And you should probably have some homemade chicken soup with plenty of green vegetables and skip the Doritos.
Precious medical resources are also used up by people on a self-induced slow suicide via tobacco, poor diet, lack of exercise, and a general apathy and lack of responsibility for their own health. Grownups with coughs who feel well enough to go outside and pollute their lungs with carcinogens should be a lower priority than kids who need doctors. And, while all citizens deserve medical care, it’s hard to have much sympathy for adults who fill their sick body with junk food, sugar, and candy when their immune system is already compromised, and then gripe about waiting two hours to see a doctor in an emergency clinic. Meanwhile, someone else’s sick child has to wait that much longer for antibiotics for strep throat, or a cast on a broken bone.
We live in one of the most advanced countries in the world. We have a health care system that many Americans believe is wonderful, because it’s free. Except, our neighbors south of the border are attracting the top talent among Canadian-educated doctors, because of lower taxes, higher salaries, and most of all, innovation.
For example, in the US, medical care customer service is a top priority. Medical care is either covered by employer insurance, directly purchased private insurance, and certain public insurance for low income, elderly, disabled, and poor citizens. Having a system where people pay for treatment also means they expect quality and promptness, and in most cases, Americans get it.
Take Oakwood, Michigan for example. Hospitals promise patients they will see a doctor within 30 minutes or receive free movie tickets and a written apology. During the hectic flu season, patients receive same-day or next-business-day appointments with doctors. Northern Nevada Medical Centre, in Sparks, Nevada, promises patients a nurse will see them within 15 minutes or their visit to the emergency room is free. Other hospitals offer a guarantee of a nurse visit within 15 minutes and a doctor visit within 30 minutes of arrival. In the States, because health care is private, competition is fierce. Many states have four hospitals all within 30 minutes of one another. The result? After Oakwood started their 30-minute guarantee, Sinai-Grace Hospital in Detroit started a 29-minute wait time guarantee. So did its sister hospitals Detroit Medical Center, Huron Valley-Sinai Hospital, and Michigan Orthopaedic Specialty Hospital. Patients who are kept waiting past the guaranteed time receive tickets to the New Detroit Science Center, the Charles H. Wright Museum of African American History, or a Detroit Tigers game.
Who knows if a strategy like this will work in Canada? Years of poor management cannot be solved simply. But either way, it’s time for new strategies and a fresh approach. With the average family losing 50% of yearly income to taxes, including a 65% to 70% publicly funded health care system, sick kids should not have to wait three hours for medical treatment.
Incidentally, in Alberta, health care insurance premiums are mandatory, which means, essentially, if you live in cow country, you don’t get free health care. Surely a little of this money could be diverted to medical clinics strictly devoted to meeting the needs of children 18 years and under, with less than an hour wait time. Let the grownups have their own clinic. Just please, don’t promise them a free pack of smokes if they have to wait more than three hours.