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Never-ending triage

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Jody Vance: Fixing our healthcare system needs to start with how most people first access it.

M*A*S*H. I record and watch it when looking for comfort. Especially if I’m under the weather, it’s my binge watch of choice.

Recently, while convalescing, I caught one particular episode, where Radar became Hawkeye’s patient. When Hawkeye was too hung over to operate, the team struggled to keep up with an epic lineup of wounded.

That’s when it hit me: we are living in a constant state of triage here in BC. Our healthcare workers have a non-stop exhaustion hangover, with no relief in sight.

This is not a pandemic problem; our healthcare workers were maxed long before COVID. Our issues started ages ago and one key problem is that far too many people simply cannot find a family doctor. Finding one is like Charlie unwrapping Willy Wonka’s Golden Ticket.

(Yes, I just went from M*A*S*H to Wonka, it’s been that sort of a week.)

How many times have you been asked “do you know any doctors taking patients?”

I’ve lost count of how many dear friends begged me to twist the arm of my GP to take them on, as a favour. And I do, every time…..and bless him he always says yes…but I digress.

My son’s paediatrician sent out “the note” last year, saying “pick up your files at this website.” Bye.

Gulp. Explain that to the kid who’s worshipped his doctor since early days. Now do it with elders facing the winter of their lives, with their file flapping in the cloud.

This is urgent.

Canada’s healthcare system is far from perfect. Full stop. However, one need only require urgent care somewhere things are private payer based to know just how devastating that can be.

There is middle. I know there is. It is a struggle to find it.

Speaking of which, for far too many, it’s next to impossible to actually find a physician to audition for.

Auditioning. For. Doctors.

I had an exchange with a few fine folks on Twitter this week that shocked me – people who hadn’t seen a doctor in decades. DECADES.

How on earth does that work, I asked. “I do walk ins.” Walk-in clinics are intended to be the place for a quick consult on a Sunday. Get in, get assessed, get a prescription, get out.

Once again I was ill-prepared for the stories that came at me. People sitting in Emergency Rooms for hours on end, in a pandemic, to get their prescription filled. No.

Clogging up a system of exhausted frontline staff for (badly needed) migraine meds? No.

Don’t even get started on the overtime problem. It’s a myth that hospitals are suddenly short staffed due to unvaccinated. Yes, it’s made things worse, but it was an already massive problem years in the making.

The chaos of our medical system isn’t a COVID problem but rather the result of head-in-the-sand management.

I say this without malice. There is no “one” to blame, it’s systemic.

Just like paramedics and dispatchers, nurses and personal care workers in long-term care — doctors are in incredibly short supply.

My middle goes to prioritizing preventative medicine. Screening, annual physicals, tests, and so much more – things not happening at the walk-in clinic.

There’s always an uproar around a multi-tiered system, but look, it’s already here. Those with means have GPs. I count myself super lucky to have a trusted physician, and would be so stressed to be without him. In a public system, this should be a right.

There is no magic wand to make that happen, but there is potential relief. It starts with the angels who walk among us, nurses. Specifically, nurse practitioners. Do you know the difference between a RN (Registered Nurse) and a NP (Nurse Practitioner)?

Nurse practitioners have additional education and experience, and are able to do things like diagnose and treat illnesses, order and interpret tests, and prescribe medications. (And coincidentally, next week is National Nurse Practitioner Appreciation Week.)

They may not be doctors, but they can fill a lot of the same needs that require urgent attention – both generally, in our system; and for individuals, every single day.

Think about the difference it could make if people could find and stick with one NP in place of a GP – and more to the point, access the meds and perhaps labs that could prove preventative, or even life-saving.

There was a time where walk-ins were a convenient supplement to a family doctor. That evolved into patients going for quick service to clinics and saving the laundry list for GPs. The trouble with this, I’m told, is that all doctors gets paid the same per patient, but GPs pay for the shingle in ways clinicians do not.

Switching up our system need not be an Us vs. Them battle between clinics and GPs, nor should it get so bad as what we’ve seen with pharmacies vs. physicians. Maybe, just maybe the answer is staring us right in the face: adding more Margaret Houlihans (or Seans, Bhinders, or Kyles) and rewarding extra nursing skills with more money and security to help stabilize our M*A*S*H unit type triage.

Jody Vance is a born and raised Vancouverite who’s spent 30 years in both local and national media. The first woman in the history of Canadian TV to host her own sports show in primetime, since 2011 she’s been working in both TV and radio covering news and current affairs.

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