I go to work smiling every day....but this is only because I know that I will eventually prevail in my ongoing struggles with Alberta Health.
It appears that for a Family Doc, there is always an assault upon you. Whether it is patients with boundary issues, Insurance Companies not paying you, staffing and business challenges, government and regulatory College intrusion into your daily operations - it seems as if some person or entity is always trying to stab you in the back.
Add all of this on top of operations costs that exceed your capability to earn money, and a culture engineered by Alberta Health to make Physicians feel like criminals if they earn more than a 7-11 employee.....and it is no wonder that out of over 36 Physicians in my "Medical Building" just 3 years ago - there are now only 6 left. Once the leases mature in 2 years, there will be only 4 Physicians left in my building.
90% of all my stress and concerns of operating as a Family Physician would disappear if I simply chose to stop participating in government insured medicine. But then I would only really be able to treat rich people that don't mind paying personally to see me, and I don't want to abandon my patients.
For example - somewhere in Northern Alberta a couple of years ago, it was found that a few nurses were using the same needle to mix up medications. No patients were contaminated and it should not have been a great big deal. But the government went nuts due to misperceived public pressure - and threatened the College into an unreasonable action.
Physicians in Alberta now have to follow this new "Infection Prevention Standards Protocol". To implement to new protocols, each Physician's clinic will need to invest at least $10,000 in capital costs, never mind staffing costs - which would easily double that figure.
For example - to simply remove sutures, a Physician has to use sterile tweezers. No problem, right? Seems simple. The problem is that the tweezers now have to be sterilized using both biological and chemical indicators ($10 each for a test and control), quarantined for 24hr before use (means you need at least 3 sets of tweezers) and you have to go through a very meticulous audit system to sterilize a simple set of tweezers.
According to the law in Alberta - you cannot charge the patients the cost of the tray....you are supposed to personally take the loss as the Physician.
Physicians have been taking out sutures in Alberta for over a century without any problems - but the now the College (ie. "Government") is telling us how to do it better.
Only the cost was never considered.
How foolish!
To sterilize a simple set of tweezers now costs the Physician about $60 (probably more). An office visit earns a Physician about $30. Therefore, the Physician has to pay about $30 out of their pocket to take a patient's sutures out.
Can you guess what is happening?
That's right - Physicians are sending patients to the E.R. to wait 20 hours to get their sutures taken out. Others are saying "screw the College - they've totally lost their minds and I no longer respect their decrees" and are doing what they've always done.
More disturbing, however, is that lots of Docs are going back to the 1700's and are resorting to trying to pick up the ends of sutures with their fingernails and using a handheld disposable scalpel to take out sutures.
Patients are returning to my office weeks after sutures were supposed to be taken out - with retained sutures that have to be surgically debrided. And no, as a Physician you will not be paid to do the surgical debridement (which needs another tray).
So what is a Physician to do?
Moronically implemented governmental and collegiate policy appears to have cast one aspect of medicine in Alberta backwards in time by over 300 years.
Many Family Physicians in Alberta are doing the only thing they CAN do - they are closing shop and leaving. It is increasingly hard to find a Family Doc in Alberta that will take you on and will be there for you for the next few decades.
But I still go to work smiling because of something that should be obvious to Alberta Physicians........
Each one of us has thousands of people supporting us that would much rather get rid of a bad Government than a Good Doctor!
Leadership review of the current Government happens in November....will be interesting!
;-)
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