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?

Thursday, April 27, 2006

Stanley Cup Health Care? Not Likely

The Stanley Cup playoffs are upon us; and with them the highly priced color men (and women) comment as to who is playing well, who seems “off their game”, what needs to happen to improve scoring productivity, etc. Most of these teams have psychologists to consult if their players aren’t at their “peak”. A friend of mine works part time with Olympic competitors. Movie stars have their own personal trainers, psychiatrists, and lord knows what, because their work is so stressful.
Generally, I think most people would agree that physicians have a stressful job. They probably also would agree that we would like our physicians to be at least as alert and “enthused” about their job as the average entertainer, and if they are a brain surgeon, or a cardiovascular surgeon?------Sorry, I want them to be more on their game than Gretzky, or for that matter, any of the top NHL hockey players, at least if your cutting in my head or in my chest! It is generally agreed that most physicians work more than the 40 hour week. So what kind of “support system” do they have in place? Well, Alberta does have a program that is a “crash watch” system. If you feel suicidal or such, there is a number you can call, and probably jump the queue waiting to see a psychiatrist. Occasionally, some kind folks would put on a “family retreat” where participants would learn how to establish priorities. But ongoing personnel within the system to encourage, support, and make us feel that we are contributing and are appreciated---forget it! My patients were a tremendous help and frequently showed their appreciation. But the system, mostly paints us as the problem. Even Mister Harper recently suggested that if there were a private parallel system all the doctors would stampede in that direction for more money---and would encourage their patients to vacate the public system. Nice picture you painted of us, Mister Prime Minister. Meanwhile, in the U.S., Presidents are often quoted as saying “We have the best and the hardest working physicians in the world”. All too often we Canadian physicians hear from our health “planners”, “if your not part of the solution, your part of the problem”. Unfortunately, others will decide, and have decided, what the solutions will be and what constitutes “contributing”, and we physicians have been, and are, relegated to the sidelines as a “special interest” group.
Recently, on another blog site, I enumerated some terrible examples of bad medical care with correspondingly terrible outcomes. One blogger said: “those are Doctors errors in judgment, and have nothing to do with the system. How naïve can one be? Today, on another blog site, a teacher expressed the concern that most teachers don’t care anymore, and are just going through the motions. I’m still optimistic enough to think that most teachers and physicians (and nurses) still care. Unfortunately, we often feel exhausted from swimming up stream. Everything seems to have to be “negotiated”. We never feel that we are in any kind of control of our lives or our work. And recognition from the public or our “masters” seems to be doled out in tidbits, if at all.
I used to explain to my patients with stress symptoms the following: “Our ability to endure stress is like a bank checking account---you put money in and you take money out. No matter how much money you start with, if you take out more than you put in, month after month, year after year, you will eventually end up being overdrawn and will get a nasty note from your banker. In our day to day lives, we do things, and things happen, that put money into our emotional account to make us feel “good”. Unfortunately, we also do things and things happen, that withdraw from our emotional account----a loved one dying would be a large withdrawal, criticism could be a small withdrawal, but they all add up. Over time it is necessary to balance our books. For those people that care, realizing their efforts are falling far short of their ideal is a significant day to day withdrawal on their emotional bank account. Not getting appropriate recognition for the efforts put in can be a withdrawal. Is it any wonder that one of the coping strategies would be to turn down the “caring” process? (It will decrease the size of the withdrawals) It sometimes has to do with survival.
So it is easy to say “these are human errors and have nothing to do with the system in place, but it is also stupid. When I was working at my peak, one of my darling children (I think she was five at the time) asked my wife if I actually lived in our home. I left for work before the children were up in the morning and got home after they were in bed. They would often bring my meals to my office. (I think she thought I lived in my office). Delivering babies, being on call, business and hospital meetings often took up the week-ends, so she saw me on occasion but almost never in the “domestic” sense. I think it was shortly after that, I quit doing obstetrics. Fortunately, I was blessed with a wonderful wife that was supportive emotionally, and in a very active way in our day to day lives. (actually raised our four children, looked after the finances, the home, etc.----and did a great job). Unfortunately, many physicians’ emotional bank accounts become overdrawn as evidenced by high divorce rates, high suicide rates, and high drug addiction rates. Is there someway of measuring apathy rates or fatigue rates? But never mind, as long as the hockey players have ongoing psychological support so they can perform well. We all know the positive results that winning these playoff hockey games will have on our health and life expectancy!


Blogger Lanny said...

This is why socialism doesn't work. It takes away people's pride and the individual is lost.

28/4/06 5:36 PM  

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