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Comment: Teams can help provide better health care

A commentary by a retired physician who lives in Saanich.
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Equipment in a doctor's exam room. TIMES COLONIST

I could not fail to respond to the heartfelt June 15 letter “Crisis in health care means long hospital waits,” which had such positive suggestions. The writer clearly explains the current situation with a sensible, doable solution.

I have been retired for about five years, and in that time have become “a patient” on the other end of the stethoscope so to speak. I now have to try and coordinate appointments with rheumatologists, cardiologists, dermatologists, ophthalmologists and endocrinologists.

The care I get from the specialist is unquestionably quality, when eventually I get through the layers of bureaucracy and reception staff, to access these physicians. It is very interesting to look at this now from a different perspective.

The present physician shortage is not about to go away anytime soon. Every new physician is really not available as a productive practitioner until about eight or 10 years out of high school. In the meantime there is a desperate shortage causing anxiety, pain and suffering and even life-threatening diagnostic delays.

Though I do not like newspeak I cannot find any other way of putting this other than that we now have to start thinking “outside the box”.

The writer made a very sensible suggestion that the laboratory could run much more quickly if a clerical worker or two could be added to the team so that the phlebotomist could get on and take the blood, while the secretarial staff checks the paperwork is being taken care of. I think this is essential. Making appointments for blood work test is difficult, and I to have sat in the reception area for hours watching my parking fees increasing and just waiting … and waiting … and waiting.

It is OK for me in that I am relatively asymptomatic, and now, retired, have lots of time on my hands.

In the U.K., when I was a resident, there was an ongoing competition with hospital employees to suggest economies both in time and in pounds sterling. There was a prize for this.

I distinctly remember the hospital porter who suggested that the mail going to medical offices around the central hospital should be rationalized by collecting all the outgoing mail and delivering all together just once a day. The savings were surprisingly enormous. I wish I could remember what prize this porter had. Would such brainstorming work here?

As a patient I have found it to be quite frustrating trying to telephone a physician’s office. Almost always I get a recorded message stating the calls will be returned within the next two days. When the call is returned I probably do not have access to my diary and so an inappropriate appointment may, for example, be made.

The only reason that I can see for the staff not answering the phone directly is that the physician’s office is understaffed. This is understandable since the physician has to pay the entire cost of any extra secretarial staff.

I suggest that under the current dire circumstances, offices should be subsidized to employ one or even two more reception staff. It is so much better to be able to talk to a human being to explain changed appointments or making reasonable inquiries.

Returning phone calls is not efficient use of time and not satisfactory contact for the patient.

Another great cause of anxiety is the fear of running out of prescriptions and trying to get repeats. This will involve lining up for hours with no certainty of obtaining the prescription in the end. Some medications can be very dangerous to stop abruptly; but what is the alternative for the patient?

I suggest that as groups or teams of physicians are developed – which to some extent is happening at the moment with the divisions of family practice – that a clinical pharmacist could review these medications and renew the prescriptions.

A physician should be available to review some of these quickly, and or discuss with the pharmacist potential problems. Certain medications demand certain specific tests, and the pharmacist should be enabled to order these. This would take a great deal of pressure off the walk-in clinics and hospital emergency rooms.

Patients have been remarkably forbearing and long-suffering. They are beginning to discover that the physician is not the omnipotent deliverer of health care.

Patients are accepting care from nurse practitioners, paramedics, podiatrists and physiotherapists amongst several other disciplines. If these are combined into clinics or teams then there should not be one million British Colombians needing the care of a primary health care practitioner.