How do we help health care?

How do we help health care? I believe it’s by not being so bloody Canadian and unquestioning. We need to complain! We need to light a fire under the asses of those in charge.

Flipping television channels I saw a teaser campaign for a news program which promised “to put health care under the microscope and grill the minister over wait times, budgets and treatments.”

Big deal, when hasn’t health care been under a microscope? When has anyone done anything but talk? That’s the problem. It’s all talk, talk, talk by people who aren’t hurting and who are protecting their own territory. The system has been studied to death.

It’s a magician’s agenda: with slight of hand and maybe a pretty assistant to divert the audience’s attention, they continue with their usual bag of tricks and look-busy optics.

I think we have been duped. We have let those in charge define the agenda and the focus of any questions. For example, when it comes to budgets, we are constantly told the system is under-funded, they need more money, or need to cut services, limit treatments, close ERs, freeze wages. They don’t mention cutting administrative costs.

According to Halifax’s Chronicle Herald health care administration in Nova Scotia is more than one percent above the national average. One percent doesn’t sound like much, but when you’re talking a budget item that runs to billions of dollars, one percent is serious money; money which could pay for nurses, drugs and therapies we’re told we can’t afford.

According to Canadian Business magazine, “If the Canadian health-care system were a corporation, it would be among the biggest in the world.” It consumes over $183 billion. The magazine also says if health care were a business it would be the “worst-run industry in Canada”.

In a telling paragraph, Canadian Business says, “As costs and dissatisfaction mount, most Canadians believe the problem is rooted in either insufficient funding, demographic overload or corporate profiteering. But according to a growing chorus of health economists, policy analysts and doctors, the real issue is mismanagement — horrible, pervasive inefficiency that is preventing the system from running even close to as well as it could.

“More than anything, they say, the failure to adopt even basic business management principles is what’s standing in the way of preserving universal health care for generations to come.”

We’re paying all this money for health care and according to a  2010 study by the Commonwealth Fund were ranked last out of six public systems surveyed. We are behind the Dutch, Brits, Australians, Germans and New Zealanders. Only the United States delivered worse care to its patients.

The waste is throughout the system. Unfortunately, I spent six-to-14 hours a day for 252 days in our local hospital. Elsewhere on this site I’ll focus on some of the waste I saw.

What was really an eye-opener for me is how poorly our hospital is thought in the community. Let me quickly add that’s not directed against the nurses or support staff. Nurses carry the burden of the work and no one in administration pays any attention to them. But whenever I mention the hospital, I hear one horror story after another. Whether I am in the bank, book store, at the farmers’ market, the dentist, our mechanic’s, no one has a positive experience.

Here are just a couple of first-hand stories I have been told:

*    One woman took her husband to the ER because of a crippling head pain. The doctor diagnosed a migraine, gave them some pills and sent them home. The real problem was an aneurism, which almost killed him.

*     One man told me his daughter died because ER doctors said she had a headache. It was a tumor.

*     An RN, without a family doctor, went to the ER where she passed out from the pain. After she was revived a doctor told her not to use the ER as a walk-in clinic.

*     Another RN went to the same ER. She was given Percocet and sent home. After she vomited it and returned to the ER they eventually found blood clots in her leg and lung.

*     An RN in the same hospital told me of having a patient suffer a stroke in front of him. That was at 1 pm. It wasn’t until 6 pm that that patient was seen by a doctor.

*     I was called at 7:45 am on a Saturday morning (September 26th, 2009) because the doctor was disappointed in our family member’s condition. I was at the hospital within 20 minutes, by which time the doctor was gone. We noticed something, which related to a previous condition that required surgery, so asked for a doctor to see our family member. We were told the doctor on call would be in at 2 pm. We had the doctor called and the message was the same: the doctor would in at 2. We asked for other doctors in the hospital to check on our family member and told no. We were so desperate we considered calling 9-1-1 from the hospital or rolling the bed into the ER. The doctor eventually showed up at 2:30, but we went 6.5 hours in a hospital bed with no access to a doctor! The doctor on call was three counties away! How can you be on-call if it would take over an hour to drive to a patient emergency?

*  Just prior to Christmas 2010, a family friend’s 49-year-old daughter-in-law was attached to a pump to remove fluid build-up from around her lungs. Two days after attaching her to this pump the doctors realized it had been improperly installed. Instead of removing fluid, the pump had been forcing air into her body, increasing patient discomfort. If your goal is to remove fluid from the body, why isn’t someone monitoring the fluid outtake? How does a mistake like this happen? Why does it take two days to realize the mistake? She was dead in a month.

*We had to go back to the ER for an emergency procedure. Two weeks later the extended care home where our family member resided was still trying to get information about the dressing and when it should be changed. Originally we were told it was good for a month. Two weeks later we were told it had to be removed after the first week otherwise there is a risk of infection. And oh, by the way, there may be part of a previous device left inside the patient! Can this corrode and cause an infection? Could this float and cause a tear? What are the implications?

* When we were in the ER for the above-mentioned procedure, I was asked if I brought the tube that had accidentally been ripped out of the patient. They couldn’t find a new one so were willing to re-insert the old tube! There was no mention of sterilization or if the old tube had been damaged. It didn’t build confidence.

* In December 2010 and January 2011 a family friend took her 23-year-old daughter to the ER six times in five weeks for abdominal pains. Each time she was given medication and sent home. On the fourth visit the doctors upped the medication to a narcotic. This gave her immediate relief, followed by the shakes. On the sixth visit to this same ER a different doctor visiting from another hospital saw her and wondered why she was given narcotics and why no one had scheduled an MRI. The parents are finally hopeful a cause and treatment are at hand. If and when they get an MRI done. So far they have waited four months for an appointment!

* An LPN told me that her father-in-law was taken to the same hospital we use. He was diagnosed with an internal bleed. They treated this bleed with blood thinners. The patient died within three days.

* In April 2011 a 64-year-old woman who is diabetic was in this hospital for an operation on her leg. She had a circulation problem. That was done on a Monday. By Tuesday she had contracted pneumonia. The following Monday her blood sugars crashed to 2.6 and the family told me they almost lost her. The very next morning, after this woman almost died and while still suffering from pneumonia, the hospital called her daughter-in-law to come pick her up “immediately” because the hospital was releasing her! There was no advance notice that she would be released this soon. This patient and her family live a three-hour drive from the hospital. The daughter-in-law tried to explain she was at work, her husband was at sea and she had two small boys to care for. The nurse’s response? “Not my concern.”

At another Nova Scotian hospital:

* One of our hospital cleaners told me her sister-in-law had a double organ transplant at the province’s largest hospital, the Victoria General. Because infection is such a concern the cleaner was upset that her sister-in-law, who had an open wound, was placed in a room with dried blood on the walls. She spoke to cleaners at that hospital. She asked to speak to the head of housekeeping and told that person was away and no one was in charge. So after five days of waiting for someone to do something she took antiseptic wipes and cleaned the blood off the wall herself, which she showed to the nurses. The nursing supervisor told her she had no right to do that and only the next-of-kin could request action.

This morning, February 8, 2011, the CBC news reports that doctors and nurses at the VG have failed an audit. They wash their hands 40% less than those in other hospitals in the province. One health care official says that 30% of hospital infections could be eliminated by proper hand washing. Is it any wonder that the cleaner I mentioned above would be concerned for the safety of her sister-in-law given the greater chance of infection at this facility?

* I have had a note from another young woman who didn’t want me to use her story for fear of retaliation by her health care authority. They misdiagnosed her husband’s injury so now he may never work again. She was turned away from one ER and had to drive to another hospital to be seen and treated. Why?

*     Another man told me how, after weeks of constantly being at his wife’s bedside, his daughters, doctors and nurses convinced him to go home for the evening to rest. He called the hospital every hour to check on his wife. Each time he was told she was fine. Early the next morning when he called she was gone. It turns out that all those times he had called to check she wasn’t fine. She had twice died and been defibrillated back to life. No one at the hospital told him that. They had over seven hours to contact him. He lost the opportunity to be there and comfort her as she passed on. It was cruel.

*     20 years ago we had an elderly family member transferred to Halifax by ambulance. She was in such bad condition – broken collar bone, broken hip, malnourished – that when her daughter arrived at the hospital, the police were waiting to arrest her for elder abuse. The problem: this woman had come directly from the Hants Community Hospital in Windsor where she had been a patient for the previous three months! The patient’s daughter started a lawsuit, but died before it could proceed. Now, that seems a long time ago, right? Well, in the spring of 2010 a young manager at one of our banks told me about her grandmother who was patient in that same facility. Her grandmother experienced rapid weight loss. When the family got her moved out of that facility, she gained weight and was able to return home.

Nothing seems to change. Health care professionals talk and make comforting pronouncements, but so what? Things just continue on as usual.

In the 2010 mid-term elections in the United States, candidates spoke of taking back their government. I believe it’s time for Canadians to take back health care. We need to set the agenda and put the system under our microscope.

We need to do it in a way that we can’t be ignored. Our system is used to being treated in a differential manner and resents anyone who asks questions. If I hadn’t challenged what I was told I would now be visiting a graveyard instead of a nursing home.

Our system is a monolithic monopoly. We’re told we’re entitled to a second opinion, but when a health care authority controls all the facilities in a region, where do you go for that opinion?

And our system uses the jackboot of privacy laws to keep us in the dark. Theoretically the privacy laws exist to protect the patient and public. But in practical terms it allows health care administrators to exempt themselves from public scrutiny.

Right now health care operates under a system of divide and conquer. We are made to think we’re alone or unique in our problems and issues with the system. They imply it’s our ignorance that is the problem. But we’re not ignorant; we know when something doesn’t pass the smell test. It’s just that by the time we leave the hospital whether with a happy or sad end, we are so worn down, so emotionally beaten up, frustrated and exhausted that we’re more than happy to walk away and put it behind us. Sadly, that just allows the system to do to another family what it did to us.

So we come to the question: how do we help health care?

We take charge of the situation and complain. We share our experiences so we can build a body of complaints that health ministers can’t ignore. We tell them where they are failing us. I think we need to have numbers of complaints to make anyone listen. On September 3, 2010, I wrote Nova Scotia’s Minister of Health an eight-page letter of complaint, and included 10 pages of supporting documents. As of November 16, 2010 –  ten weeks later – I haven’t had a peep from the Minister’s office. (*) They haven’t even acknowledged receipt of my letter.

My experience is that unless we go with volume, with numbers of complaints, no one will listen. So let’s give it to them.

Here’s what I hope people will do:

I hope you will share your experiences so I can build that body of work to take to the various ministers.

I want to respect everyone’s privacy. So use this site to contact me and tell me what you can and only what you know first hand. When it happened, what hospital it was at. If you look at the examples above you’ll see what I am looking for.

For future reference or if I need to clarify something I would like a contact email and phone number.

I am not going to post emails and correspondence on the site. I don’t want to turn this into a place where people slag off individuals. I want a civilized discussion about the system. If people have comments that will add to that, then, with their permission I will post those. But I don’t want to get anyone – including me – sued for a reckless comment.

I believe in universal health care. I just want to make it better. And I think we can do that within existing budgets. It’s worth a try.

Allan Lynch

Nova Scotia

(* Finally on November 18th, I had a response from the Minister. She sounds sincere, but I believe she is incorrect in some of her assumptions on how the system works or who is responsible for what. Years later in a Facebook exchange I learned that the Minister felt her involvement would have been seen as political intervention in patient care. This is a bullshit position her department came up with. I had the legal authority to make medical decisions for the patient, we had been been blocked in care and I resorted to the Minister as an act of last hope. The Minister conveniently over-looked the interference  of a health executive who refused us an MRI on the basis “it wouldn’t show the problem”. Seven months and 17 blood transfusions later we found a cancer that would have been shown on an MRI. The health executive was wrong, the Minister was wrong, the patient suffered and died prematurely because these two women couldn’t be bothered to act.)

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9 Responses to How do we help health care?

  1. BJ Morgan says:

    My husband and I have spent a lot of time at the DECH in Fredericton recently with ailing parents and friends. The parents are in their 80s. The friends in their 70s
    Without going any detail it seems to us that anyone over 70 has an invisible expiry date stamped on their body somewhere. The system is in no hurry to help them with their problems, and then in the case of one friend discovered the problem too late . She now has stage 4 cancer.
    People deserve better than this.

  2. Kate Pocock says:

    Allan, Good for you! Thanks for stepping up to the plate on behalf of all Canadians. I watched firsthand as my sister went through 11 years of cancer. Many similar experiences. And also watched my 19-year-old son with a back injury wait for months for an MRI. At first they said a year! When our local Liberal candidate came calling, I complained about health care. “Well you don’t want a two-tier system, do you,” she asked. What?? We already have a two-tier system, I told her, one for people, and one for dogs.
    Heck, the local vets were using the local hospital’s MRI during the night for their dog patients. If you were a dog, you could get an MRI no problem. Sure, you had to pay for it. But I would have gladly paid rather than wait for months while my son, an otherwise productive member of our society, lay wasting away for months on his back.

    Mismanaged is right. If our hospital administrators were in business, they would be fired for being less than competent. While travelling to other countries, I am constantly impressed with foreign service, and what our health care could be. At a Swiss hospital, the doctor consulted on a Blackberry, knew the medication right away, and said that if we waited, we would get a complete printout of tests. How long? Half and hour. We went and had a coffee, and were presented with a printed report of all our tests, and given an immediate recommendation. In France, the waiting time in hospital to see a doctor was about half an hour — and that for a non-emergency case. As a country, we deserve better!

    I had hopes with the Roy Romanoff (spelling?) report and the months spent in talking to Canadians and the resulting plan. What became of that plan? We should resurrect the best parts, and institute a plan of action on behalf of all citizens. There are many talk shows devoted to this subject, lots of talk, but not much action. I hope that you can start a groundswell.

  3. Stay the course, Allan, stay the course. I’m proud of you for stepping up to the plate on this issue, which we all know is much more serious than the system, including well-meaning government members, are willing to admit. I’ll continue to mention this site in my tweets, etc. In fact, I must do that again right now!

  4. Anne Treadwell says:

    While my husband and I were in our doctor’s office a few months ago, a young woman (clearly in distress) came into the waiting room and asked the receptionist if she could possibly arrange to see the doctor, who is relatively new to our area. On being told he could not take any new patients, she explained that she had recently had a baby, who had died shortly after birth. She needed follow-up care (I guess SO!) but did not have a doctor and could not find one. The receptionist said that unfortunately her only recourse was the Outpatients Department at either of two hospitals, each 45 minutes away. This situation has haunted me ever since.

  5. Ray says:

    As a dual citizen living in the States, and remembering what the last weeks of my Grandfather’s life were like in Edmonton, I worry when I hear American politicians holding up Canada’s healthcare system as a model they want to follow. Would you mind if I put a link to this page on my blog?

  6. Allan I think your doing a great job over in Great old Canada, we in good old England are facing some terrible times ahead, the public no longer trust the government over where our NHS health system is going, good luck and as I’ve said on my blog If you need to sread the word your more than welcome to do an article anytime on my blog, contributor’s welcome….

  7. I posted a longer description earlier: please check out the Patients Association of Canada, they are a strong national presence for patients rights and concerns.

  8. As someone who has tried to navigate the Nova Scotia healthcare system since 2007 I have to agree that there is a lot more wrong with the system than just a lack of money. The entire system seems in need of an overhaul from the ground up.

  9. I’m impressed. You’re truly well informed and very intelligent. You wrote something that people could understand and made the subject intriguing for everyone. I’m saving this for future use.

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