Collaborative Care Centres are for Primary Care , and are not part of Emergency Centres. Important to keep the language simple and clear
I appreciate your writings Bill
I trust that you read Dr Martel’s recent article and my brief opinion piece
All of our efforts are really important. The Health System so needs strategic leadership.
“The right goal is that everyone should have timely access to primary care. This is accomplished by the collaborative emergency centres which include a variety of health professionals.”
Overall, I would say this pice offers good insights and potential solutions to the healthcare issues in Nova Scotia, but this particular quote is plainly incorrect. Collaborative Emergency Centres are not primary care, and do not contribute to continuity of care. That doesn’t mean we shouldn’t have Collaborative Emergency Centres, but we shouldn’t confuse them for what they truly are: a special classification of emergency care services. As-is, a CEC is a walk-in clinic without a doctor on site.
The solution needed for primary care is a collaborative practice model where physicians, nurse practitioners, and other health professionals work side-by-side to treat patients, with multiple physicians in the care group. Using Open Access scheduling they can ensure timely access to care, with patients typically requiring three days or fewer to get an appointment. The typical low-acuity patients arriving at the current Collaborative Emergency Centres are willing to wait up to a week for an appointment before attending emergency care. The issue is that physicians, working alone, and using a fixed appointment model, cannot respond quickly to patient demand. As you correctly point out, vacations wreak havoc on appointment wait times in rural practice settings.
I think the comment by Mr. Wedge puts focus on the real issue. There are too many academics involved in the discussion, and terminology abounds.
Who cares if it is called primary care, Collaborative Emergency Center, a special classification of emergency, walk in clinic, and so on. A citizen who needs immediate health care wants their needs to be taken care of effectively, efficiently and quickly. Regardless of the Terminology applied to the facility used, the current system is an absolute failure. And it does not need to be.
Lets forget the academic theories and the terminology, and start to apply some common sense. Most of the failings have been known for 30 years, whether it be family doctors, shortage of long term care facilities, unhealthy hospitals.
Academic and terminology arguments have gotten us nowhere. Time to try good old fashion common sense.
Politicians argue about rules for assisted dying. Meanwhile they accept the existence of facilities, or lack of, that have contributed to deaths, whether the citizen wanted to die or not. Explain that contradiction!!!
I think the Auditor’s report and Bill’ s summary are confirmation that “socialized” health care is a failure!!
Unfortunately the AG did not address our ” cherished belief” that entering the hospital puts us in a “safe and healthy ” environment that will contribute to our recovery. It would have been helpful if the AG had reported on the costs of hospital stays that are caused/ extended by unhealthy hospitals . Far too many people die or suffer for long periods with diseases which they caught in the hospital.
I am not to the point that we must abandon our expectations. Those expectations are reasonable. Unhealthy hospitals, citizens without family doctors, unused emergency rooms in some locations, etc. clearly indicate mismanagement. The solution to mismanagement is not to lower our expectations , but to demand change/ improvement.
Bill B has performed a valuable service identifying ” spending” issues in this province. We had enough cash to fund a $300 M to expand a shipyard, $10M for teachers pension plan, $30 M / year to create employment in the US for a ferry service….. The list is endless. But we cannot afford the cost of an efficient and effective health care system that meets our reasonable expectations???
Yes siree ! Fewer hospitals (certainly of the proven too big for us to look after variety)! Keep some to be teaching/researching from. Of the rest, the system, as you hint, needs to be directing people to ‘openings’, (many of which would be at ‘clinics’ (operated by the private sector) as they would be invested into communities. Family doctors would man these clinics and/or practice from their own spaces. Patients might have to travel (they do for everything else).
Until we get over the ‘not allowed to pay’ idealism, we will continue to suffer USSRish queues which result from ‘the government can do it all’ false conviction which has taken over slowly but surely, since the notion was ‘innocently’ legislated in 1966(!).
Other than governing, does government do anything well ? (Why hospitals ?)
Isn’t it time that healthcare was run for the patient, rather than for the seemingly overloaded (overtaxed!) system?
Technology has advanced since 1966! All the patient has to do is ‘connect’ with it. What once was the family doctor monitoring people, then diagnosing or referring for the appropriate cure, now appears to me to need ‘connecting tests’, most of which, while not yet available over the internet, certainly could be administered at a clinic.
With apologies for even suggesting that there might be a place in our system for the private sector to be of active service, rather than continuing passive queues.
Politics is not the venue where hospitals should be managed. Whether or not (and how) ill/injured folks get treated should not be influenced by whether or not a candidate (any candidate) can be successful at a polling booth..
Collaborative Care Centres are for Primary Care , and are not part of Emergency Centres. Important to keep the language simple and clear
I appreciate your writings Bill
I trust that you read Dr Martel’s recent article and my brief opinion piece
All of our efforts are really important. The Health System so needs strategic leadership.
Ruby. Blois | June 18, 2016 |
“The right goal is that everyone should have timely access to primary care. This is accomplished by the collaborative emergency centres which include a variety of health professionals.”
Overall, I would say this pice offers good insights and potential solutions to the healthcare issues in Nova Scotia, but this particular quote is plainly incorrect. Collaborative Emergency Centres are not primary care, and do not contribute to continuity of care. That doesn’t mean we shouldn’t have Collaborative Emergency Centres, but we shouldn’t confuse them for what they truly are: a special classification of emergency care services. As-is, a CEC is a walk-in clinic without a doctor on site.
The solution needed for primary care is a collaborative practice model where physicians, nurse practitioners, and other health professionals work side-by-side to treat patients, with multiple physicians in the care group. Using Open Access scheduling they can ensure timely access to care, with patients typically requiring three days or fewer to get an appointment. The typical low-acuity patients arriving at the current Collaborative Emergency Centres are willing to wait up to a week for an appointment before attending emergency care. The issue is that physicians, working alone, and using a fixed appointment model, cannot respond quickly to patient demand. As you correctly point out, vacations wreak havoc on appointment wait times in rural practice settings.
For more on the trade-offs of CECs, see the literature review section of my master’s thesis: https://dalspace.library.dal.ca/handle/10222/71506
Ben Wedge | June 12, 2016 |
I think the comment by Mr. Wedge puts focus on the real issue. There are too many academics involved in the discussion, and terminology abounds.
Who cares if it is called primary care, Collaborative Emergency Center, a special classification of emergency, walk in clinic, and so on. A citizen who needs immediate health care wants their needs to be taken care of effectively, efficiently and quickly. Regardless of the Terminology applied to the facility used, the current system is an absolute failure. And it does not need to be.
Lets forget the academic theories and the terminology, and start to apply some common sense. Most of the failings have been known for 30 years, whether it be family doctors, shortage of long term care facilities, unhealthy hospitals.
Academic and terminology arguments have gotten us nowhere. Time to try good old fashion common sense.
Politicians argue about rules for assisted dying. Meanwhile they accept the existence of facilities, or lack of, that have contributed to deaths, whether the citizen wanted to die or not. Explain that contradiction!!!
barry h | June 12, 2016 |
I think the Auditor’s report and Bill’ s summary are confirmation that “socialized” health care is a failure!!
Unfortunately the AG did not address our ” cherished belief” that entering the hospital puts us in a “safe and healthy ” environment that will contribute to our recovery. It would have been helpful if the AG had reported on the costs of hospital stays that are caused/ extended by unhealthy hospitals . Far too many people die or suffer for long periods with diseases which they caught in the hospital.
I am not to the point that we must abandon our expectations. Those expectations are reasonable. Unhealthy hospitals, citizens without family doctors, unused emergency rooms in some locations, etc. clearly indicate mismanagement. The solution to mismanagement is not to lower our expectations , but to demand change/ improvement.
Bill B has performed a valuable service identifying ” spending” issues in this province. We had enough cash to fund a $300 M to expand a shipyard, $10M for teachers pension plan, $30 M / year to create employment in the US for a ferry service….. The list is endless. But we cannot afford the cost of an efficient and effective health care system that meets our reasonable expectations???
barry h | June 12, 2016 |
Yes siree ! Fewer hospitals (certainly of the proven too big for us to look after variety)! Keep some to be teaching/researching from. Of the rest, the system, as you hint, needs to be directing people to ‘openings’, (many of which would be at ‘clinics’ (operated by the private sector) as they would be invested into communities. Family doctors would man these clinics and/or practice from their own spaces. Patients might have to travel (they do for everything else).
Until we get over the ‘not allowed to pay’ idealism, we will continue to suffer USSRish queues which result from ‘the government can do it all’ false conviction which has taken over slowly but surely, since the notion was ‘innocently’ legislated in 1966(!).
Other than governing, does government do anything well ? (Why hospitals ?)
Isn’t it time that healthcare was run for the patient, rather than for the seemingly overloaded (overtaxed!) system?
Technology has advanced since 1966! All the patient has to do is ‘connect’ with it. What once was the family doctor monitoring people, then diagnosing or referring for the appropriate cure, now appears to me to need ‘connecting tests’, most of which, while not yet available over the internet, certainly could be administered at a clinic.
With apologies for even suggesting that there might be a place in our system for the private sector to be of active service, rather than continuing passive queues.
Gordon a.... | June 10, 2016 |
Politics is not the venue where hospitals should be managed. Whether or not (and how) ill/injured folks get treated should not be influenced by whether or not a candidate (any candidate) can be successful at a polling booth..
Bob MacKenzie | June 10, 2016 |