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?

Monday, June 04, 2007

Investigate While We Wait

Today I recalled an episode of a T.V. program called “Yes Minister” (comedy) in which a hospital in Great Britain had won numerous awards for its efficiency, but actually didn’t attend to any patients! The thought occurred to me while waiting for my wife, that it would be interesting to track the number of administrative and other personnel in the regional health authorities employ that are not patient service providers. I know that there was a time in the 1990’s when there was significant downsizing in this area. I also know that there was a rebound rehiring, shortly thereafter, as the Calgary and other Regional Health Authorities realized that they would need help in managing a system where there was increasing demand and decreasing resources (facilities and caregivers), available for direct patient care. But exactly what has been, and what is, happening up there at the top?
As I dropped my wife off at the Okotoks Urgent Care Center Laboratory, I observed a waiting room full of people, and people standing in the hall, all waiting for blood tests of some description. I noted two people in the urgent care area (a truly large waiting area about three times the size of the lab. area). On arriving that morning, there was nowhere to park in the patient designated parking area (with many parked on the street), but quite a few parking spaces in the “staff” designated parking area. Since I had to wait an hour and twenty minutes for my wife, I wiled away my time counting parking spaces; approximately 34 (including handicapped parking) for patients, and 64 designated for staff.
Later in the day as I planted my bedding out plants (a great time to do some idle thinking), the thought occurred to me that there are likely more people available for hire in the areas of “health management”, health education, public relations, and many other areas, than there are people available for direct patient care (doctors, nurses, technicians, etc). I wonder if there is an increasing part of our health care budget going to “manage” the areas of shortcomings. Some of this is, of course, constructive and necessary, but how far can we stretch shortcomings with better management? Has the department of public relations expanded in an effort to convince the public that there is not a problem with our health care system, there is only the PERCEPTION that there is a health care problem? And who the heck was involved in planning the Okotoks Urgent Care Center, and in particular, the parking areas? Was a doctor involved at all? Any community family physician could have told them they would need more space and staff for the laboratory area!
Why all the landscaping and public appeal at the patient’s entrance and none at the staff entrance? Could they not have taken some of the designated esthetics for the patient entrance and provided more patient parking? And where are all the people that belong to all the cars in the “staff” parking area? Behind closed doors, I guess, and certainly not working in the laboratory. And if you are thinking that this blog entry is quite disjointed and rambling, who says that random thoughts while gardening or waiting one hour and twenty minutes for a blood test need to be organized and pithy? Hey, maybe that’s the amswer? If everyone dissected our health care system, or better still, came up with solutions, while they waste a good part of their lives WAITING, maybe we wouldn’t be at this stalemate. Let’s face it; it would represent millions of hours of contributed thought.


Anonymous Lanny said...

I did wonder when I received a glossy PR pamphlet in my mailbox promoting our provincial healthcare system a few months back. Money down the drain, as far as I'm concerned and of little consolation to those on waiting lists in pain. Save the PR and the trees and invest in doctors and nurses.

Again, as you've mentioned, short term solutions that have short term vision on the government's part and esthetics and PR won't cut it anymore.

4/6/07 9:39 PM  
Blogger Al said...

The advantages of a monopoly are 1) A single payer system 2) No duplication of certain administrative areas 3) Cost savings in the areas of competative marketing, esthenics, and the need to make that fantastic first impression. Although first impressions are important (you've heard me praise Westjet), I wouldn't fly Westjet if they had a high crash statistic. Our clinics were basic: steps and/or ramp to front door and a bush on each side of the steps. Still, each practitioner was overloaded with patients. In healthcare, as you say, the money should be spent on superior care.

5/6/07 4:55 PM  

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