What do we do?

What to do?

I think there are three things we do:

  1. Complain. If you see waste in the system, send your provincial auditor general a note. If you are unhappy with the care you or your loved one receives, write the hospital administration (they may not do anything, but we start by laying a paper trail). And write the Minister of Health and copy that to your MLA. I have a niece in government who tells me that complaints are so rare that they use a formula to determine how many other voters have experienced the same problem or feel the same way about a topic. So it pays to complain.
  2. Share your ideas and stories with us on this website.
  3. Cut off their fundraising.

Health care is driven by money. That seems to be all administrators pay attention to. It’s the only language they understand. After all it pays them. When you read about belt-tightening in health care when has it involved the administration? (*) Where I live we have six vice presidents to oversee two small hospitals and three clinics. There are as many people working in the finance department (58 + managers) as in the labs (69). In fact, the are more people working in administration than nursing staff on the floor. One hospital has 120 nurses – not all of those are RNs. Doctors Nova Scotia says 19 percent of the province’s $3.5 billion budget goes to physicians. So a lot of the budget gets eaten up by non-medical costs.

Across Canada health care authorities and foundations constantly have their hand out for more money. One Nova Scotia health foundation recently asked the provincial government for permission to access patient files so they could directly appeal to former patients and patient’s families for donations.

Where are the cutbacks in administrative costs?

I think to make our point we stop the discretionary portion of their cash flow. We stop donating money and supporting their fundraising efforts – which are conducted by paid fundraisers – until we see provincial health care administrative costs reduced. In Nova Scotia if each health authority dropped their administrative costs to at least the national average that would probably free up a million dollars in each authority, if not each hospital.

Each morning when I read the obituaries, I see a line about donations in memory to be made to the charity of your choice or a particular group which had meaning to the deceased. This is a societal evolution. Years ago we would send flowers to a funeral home to show our respect for the deceased and their family. Then someone realized we could show respect and do good by diverting flower money to charity. Perhaps it’s time for a new evolution. Perhaps now obituaries can direct donations in memory to certain charities and specifically ask mourners not to donate to health care foundations or authorities.

I know that seems harsh for a Canadian or Maritimer, but the long-term effect could be very good. It is a tangible way to show we are not happy, that the status quo is not acceptable and we expect change. Sadly the only way in our society to effect change is to make the comfortable uncomfortable.

Society rewards these health care administrators with perks, privileges and pay. It’s time they did more than smile for photographs in the annual report and lobby politicians for more money.

Change starts with us.

(*) In the interests of accuracy, three days after I asked when had we ever heard of health authorities cutting their own administrative costs, an article appeared in the Halifax Chronicle Herald under the headline: South Shore Health cuts nine managers (Saturday, November 27, 2010, page A13).

The article says this cut, which included a vice president, will save half a million dollars annually out of their $74 million budget. That’s a cut of .7 percent.

The article says these cuts, added to others, “eliminated a total of 12 positions.” But did they? Dismissed staff can apply for open jobs with the authority and on the day this article appeared the South Shore Health Authority’s website (www.ssdha.nshealth.ca) listed 21 open positions: 10 managers, four supervisors, two district supervisors, plus a pharmacist, one RN, one paramedic, one physiotherapist, and one lab technician.

With 16 management positions up for grabs it’s hard to understand how they saved money and streamlined administration.

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3 Responses to What do we do?

  1. My first time here I failed to realize you were collecting health care stories. I am 55 years old, (that age when you start to see more health care needs!) So, I supply a couple of horror stories here:

    1. The patient had a head on collision with a tree stump while tobogganing, the impact being great enough to throw her somersault style over the stump. This patient had been a St. John Ambulance attendant for a few years and knew well the risk of “hair line fractures”. Such injuries can go undetected until movement suddenly leaves the victim a quadriplegic. She went to emergency of the only hospital in this Ontario town. The doctor in emergency before checking pupil dilation, coordination or any other action, grabbed the patients head and gave it a sharp turn right to left and left to right. Then asked, “Did that hurt?” The patient gave a shocked reply,” Aren’t you glad it did!!” There was no discussion and the patient would have had no way to prevent this doctor from destroying her. It was just DUMB luck for the doctor AND the patient!

    2.The patient is booked for a total knee replacement in an Ontario Hospital with a doctor of “great renown”. A letter arrives a couple of days later requesting an extra payment of $50. (known here as extra billing and NOT LEGAL!) The letter said that if you are too poor to pay “it will not affect the quality of your care…” That line alone was enough to remind one that in fact, it may! The VISA cheque was promptly sent because it had taken TEN YEARS to get the operation and a chance to walk pain free again. No patient, about to be cut open by a doctor, is going “make an official complaint” with their name on it. They will need the doctor’s services through recovery.

    Immediately and on-goingly from the point of waking after surgery, the patient complained constantly about excessive swelling and pain from heel to hip. Nothing was done even as physiotherapy went from good to to bad. At the start the patient could bend the knee 95 degrees. She was not able to do this again, period. Hospital staff just kept saying “every surgery is different, some pain and swelling are to be expected.” The patient had twice before been operated on that leg and never experienced such frightening pain and swelling. She said “I did expect some pain and swelling but NOT THIS!!” It was so swollen that it felt like a bump on it might cause it to explode. (generally measuring 16″ the swelling measured about 30-32″!) 76 hours in hospital and discharged with no answers and not one staff member willing to do a Doppler test or white cell scan to insure there were no blockages or infections. The patient returned to the hospital emergency the day following discharge with all thesame complaints. The emergency doctor was “very surprised” that a doppler test had not been done prior to discharge and promptly ordered one. (It was clear) Over a year later the patient had not regained use of the operated knee. Her GP suddenly gets focused and asks, “How long has it been?” Patient: “Over a year.” Doctor: “OH!, hummm, that’s not good.” End of story: The knee had been infected from the start! Now the patient will have to go back and have the job redone AND dependance on the good leg and a cane had caused the “good leg” to start breaking down and shoulder strain on the cane shoulder has caused constant irritation and pain in the shoulder.

    A minor complaint on the TKR treatment was the handling of the nurses. Because it seemed to much trouble to put a proper fit on the commode for the first trip to the toilet the patient complained that she did not think she could use the toilet with out making a mess. The nurses insisted she use it as set up, they were not going to “waste time” adjusting it to fit. (2-4 minutes) Sure enough, the patient came away from the toilet drenched in her own urine and a little annoyed. No wash up, no fresh johnny-coat, just dumped back into bed. The patient then realized her slight irritation about the situation had put the nurses in a really foul mood and the patient could hear it being taken out on ward mates. Thinking to make life more pleasant for the others sharing the ward, THE PATIENT APOLOGIZED TO THE NURSES for not being happier about the toilet trouble. Instantly the nurses were all brightness and sunshine again. (WHO, OWED WHO, AN APOLOGY? AND WHY WERE THEY PREPARED TO MAKE EVERY PATIENT PAY FOR THEIR IRRITATION WITH PATIENT #1?!!!)

    The problem with complaining is it is always AFTER a problem has appeared. One really wants to avoid the problem in the first place. The truth to tell, needing medical help scares the heck out of me. I always worry I will be worse off. I will not go to emergency unless I am pretty sure I may die if I do not. Then I feel my chances are about 50/50.

  2. Just a couple of other notes:
    I have had a two-month-old infant at emergency diagnosed with the flu, it was an obvious groin hernia. The specialist said, “I guess those doctors don’t see a lot of baby hernias.” My GP said, “A little experience is a wonderful thing.” We all opted to do the operation ASAP because waiting for the child to reach six months (preferable if possible) might have meant he would not reach the sixth month!

    A infant with a concussion and projectile vomiting: The doctor asked, “Is he always this color?” (White as death) I said “No, only when 150 lb dressers are dropped on him!”

    A pediatrician insisted corporal punishment was the cure for an ADHD child.

  3. PS: that was a 2 month not 23 month child.

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