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, May 26, 2006

Our Pride or Our Shame, Your Call

I may have to stop reading the first few pages of the Calgary Herald or watching news reports. For the last week to ten days the feature story has been the death of Captain Nichola Goddard. Indeed, her death is and has been a tragedy and my sympathies go out to all who knew her and loved her; but surely, in battle, one should expect casualties. Are expected deaths more noteworthy than unexpected deaths? If that be the case, the deaths of the many Canadians waiting on our many and long “risk lists” should make front page news daily. Is anyone even keeping score?
It would be interesting, for instance, to know how many people in Canada who are waiting for coronary angioplasties, die of a heart attack before the procedure is done. Even if they do not die, but suffer a heart attack, there will be heart muscle damage and life expectation will be shortened. I’m sure there is ample statistical evidence; otherwise there would be no need for anyone to have the procedure done. The physicians involved in categorizing patients into emergent, urgent, semi-urgent, and elective, are doing their best with the information available to them, to minimize the risk of waiting, but the correct word is “minimize”, not eliminate since their decision is a medical “opinion”. And in my experience, the intervention cardiologists generally conclude that they would feel more comfortable within a shorter time frame. In other words they recognize the “risk” involved in the waiting time interval.
Hospitals and health regions, to my knowledge, have always had wait time definitions (emergent---within 24 hours, very urgent----within three days, urgent----within ten days, semi-urgent----within three weeks, and elective----within six weeks). These time intervals may have varied slightly from hospital to hospital or region to region, but generally were based on the opinions of the medical staff with the “know how” and some agreement from the administration. There is also general agreement of this group of “experts” that the wait times suggested are generally not adhered to; not through negligence or lack of compassion on the part of the care givers, but through lack of capability and capacity within the system (e.g. lack of operating room time, hospital beds, and skilled staff/nurses).
So why is it that we have read volumes in the newspapers about Captain Goddard untimely demise and nothing of other Canadians untimely demise? Is it because she was fighting for a just cause and Canada could take pride in her ultimate sacrifice; perhaps it is because she is the first Canadian woman to die in a military struggle (I must admit, I do not know if that last statement is accurate)? Today, Nichola’s father said that he wished to underscore the fact that Nichola was more than a soldier; she was a wife, a daughter, a loving and real human being.
Is the main stream news media trying to turn public opinion against Canadian involvement in Afghanistan, or is it an attempt to generate some Canadian pride.
But surely the lives of the people who are dying waiting for their angioplasties are equally significant. They are someone’s wife, mother, father, husband, grandmother, brother, etc. Why do we not have front page headlines on these people? Is it perhaps that the news media doesn’t know of these sacrifices? If so, what happened to investigative journalism? Or would we find that the Health Care System that we now hail as our pride would actually be the subject of our greatest shame?


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