Tuesday, January 18, 2011

Alberta Health Care at an all time low

Well, I take care of my fair share of Health Care workers - ranging from cleaners to executives....and they all report the same thing. They are all highly demoralized. They perceive no leadership, vision, responsibility, support or competence from their leaders.

There appears to be no hope that things are getting better - at all. The state of Health Care appears to continue to decline, despite various occasional puff pieces handed to the popular media by one politician, adminsitrator or another. These politicians are not bad people - I actually admire them. Who on Earth would paint such tempting targets on their backs for paltry sums of money and the collective derision of society? They HAVE to be doing this because they believe that they are good people that are trying to do a good thing.

They just aren't doing a good thing.....

At the very least, these people are brave souls that are being tasked with a delicate operation with no training, tools or support. Albertans generally seem to want Health Care - but they don't want to pay for it (ie. they don't want to pay 50% taxes). Health Care is a bottomless pit of costs that will never end. The culture of "free health care" is admirable - but wrought with a risk of development of a sense of collective entitlement.

Ever been to Detroit? How about Greece this past summer? This is what a culture of entitlement gets you. Our politicians - at the very least - should be brave enough to acknowledge this and to make policies that provide care while fighting a culture of entitlement. It can be done - just ask the folks at the Mayo clinic in Rochester. This is a non-profit medical wonder that still makes billions in revenue every year. I'm proud to have met and worked with these Mayo folks. They really do "get it".

We can fix Health Care in Alberta by looking at successes like the Mayo model and building upon them.

This past week, I sent a patient of mine to the hospital with horrible abdominal pain. The initial hospital that I sent him to via EMR, said "no more people!". So he was diverted to another Hospital. He then spent more than a day in the E.R. waiting for a bed in a hallway. He made it into an E.R. bed after more than a day....then he made it on day 3 into a hospital bed in a shared room after a 24 hour hallway wait. During all this time, he was unable to eat due to his pancreatitis. He had to pee in a bottle under a sheet in the hallway whenever he sensed that nobody was really looking.....then he made it to his room once his spot was made available.

He stayed in that room for 5 days until they could take out his gallbladder. He did fine in surgery and his surgeons and nurses were excellent. But his room was filthy. His bathroom was filthy. The tap in the bathroom ran full time from a severe leak. Nursing staff stated that the leak probably leaked over 100 gallons per day and that this had been happening for at least the past 6 months....along with over a dozen other taps in the same hospital ward. This was just the tip of the iceberg on a list of maintenance items that were very necessary in this very busy hospital.

This lack of upkeep has drastically affected staff morale as well as patient well being - and I hate to think of how many hospital infections are caused by the increasingly filthy and improperly cleaned and maintained hospital wards.

Mr. S. went home early with the promise that he would follow up with me asap. I visited him several times in the hospital....and no, I don't think that my payment from Alberta Health for the hospital visits, will even cover the costs I paid for my parking.

So what do we do?

This is, in my opinion, the cure to the Health Care System in Alberta:

1) Attach all health care funding to individual patients and make hospitals and clinic compete for this funding.
2) Allow patients to top up this funding to be able to attend private medical services and clinics if they choose to.
3) Make sure that public hospitals and clinics meet and even exceed the capabilities and service options of the private clinics.....by funding these public hospitals and clinics appropriately.
4) Legislate long term health care plans for the people of the province - and keep this long term plan protected from political meddling. Keep this long term plan administered mostly by Physicians and Nurses. And a few "smart" members of the public.
5) Put the Physicians and Nurses back in charge. Of EVERYTHING IN HEALTH CARE. They are all amazing efficiency experts as part of their work and training, and they know VASTLY more about health care delivery than any politician or administrator. Put a few smart citizens on these boards to work with them.

Hope that helps.

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