What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Friday, April 07, 2006

Health Regions, Container Gardeners

The Provincial Department of Health and the Regional Health Authorities could never be gardeners. This thought occurred to me today as I was doing a bit of spring clean up and transplanting some seedlings.
It has always amazed me how, we as gardeners, have our own ideas about gardening as novices (even with, and maybe because of, all the books we read in the beginning), but after many years, we find out that Mother Nature and all the varieties of plants we work with, have her and their own ideas. As I have worked on this property over the years, various annuals that I planted originally in one place, have decided to become “native” and come up voluntarily with no help from me, in a totally different area. Surprisingly, the number of plants that I need to start each year has decreased significantly as each variety has found its niche in my yard, requiring less support from me in weeding, fertilizing, watering, pruning, and planting. I don’t even have to buy the seeds. My wife swears that I wouldn’t have to even start plants anymore, perhaps just do a bit of thinning in areas of overabundance.
I, of course, like our governments and health regions, still feel that I need to control everything. Fortunately, over the years, I’m slowly learning the lesson that our health bureaucracy has not: Everything does not have to be micromanaged. In fact, masterful inactivity, allowing each plant the opportunity to establish itself where it thrives naturally, seems to work best. As a gardener, the best thing I did was to give each plant the opportunity and a variety of options, and over a few seasons, my yard has become a mosaic of colorful, happy vegetation.
So now, to express my need for control, I do quite a bit of container gardening. I probably have about fifty hanging baskets and pots of various shapes, sizes and colors. For each pot I carefully pick out the type of soil, the fertilizer, the plant material, and the location of each container. Then I spend all summer running around watering and fertilizing the pots. If I want to take a few days off in the summer, I have to hire someone to water my container plants while the rest of the yard looks great and could care less about my presence or absence. Furthermore, my choice of plant material and location of pots just doesn’t turn out so well on occasion, and many of the varieties that thrive in the yard, just die in the containers. But I’m slowly learning; It would seem everything on God’s earth moves to where it is comfortable. We humans should focus more on facilitating. I would think that in any situation, the more options, the more likely comfort will be found.
So I have concluded that our administrators and legislators of the health care system are container gardeners at best, and not good ones at that. They are big on elaborate containers, trying to put the care givers they want into those containers and then put administrative micromanagement in place to ensure survival of the “arrangement”. Unfortunately, as they have found out over the years, this is costly and there has been increasing dissatisfaction. Much of the dissatisfaction is from attempts to micromanage the community, and this has made community care “uncomfortable”. Laboratories, diagnostic imaging facilities, and other resources were essential for the community health care industry to thrive. As these “dried up”, community care has slowly wilted and may soon die. The response of our administrators in Calgary seems to be to create some new pots, the eighth and eighth downtown center, and the south of Anderson Road Health Center. The cost per patient seen in these facilities is twice that of private clinics that once existed throughout Calgary, and offer the same services.
In fairness, there probably are a number of care givers that can live in “containers” and be micromanaged. But for many of us, the freedom of the “back yard” is preferred, unless of course it has been covered with asphalt.

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