Sooner or later, most human beings will end up in some emergency department somewhere in the world.
What happens when you do depends on where on the face of this planet you break your leg or have a heart attack.
How far do you have to travel to this hospital, how well-equipped is its emergency room, how long will you have to wait and will the medical staff be competent?
The experience is obviously going to be different if you’re in a war-torn, Third World country or a big city in the UK, or downtown Vancouver, or Maple Ridge.
I’ve had the opportunity to visit a good number of countries in the course of my career and I always make it a point to find out about their health care system.
Even more revealing has been the opportunity to have actually worked as a physician in four different countries.
Working side-by-side with fellow physicians who were trained in medical schools that are in many ways unlike any in Canada, taught me that one can get equally or better results utilizing different methods.
The other day I was comparing notes with a colleague who trained in the UK. Here in B.C., the standard is to have 80 per cent of the patients admitted to an emergency room looked after and discharged from the department within 10 hours. The standard in the health authority where he worked was that 100 per cent of the patients had to be dealt with within the time span of four hours. That is a far cry from what we are expecting from our health care system, and the amazing thing is that they are meeting the standard most of the time.
Moreover, the cost of health care in the UK is considerably lower than our’s as a percentage of the GDP. The quality of care is at par and the delivery is likely better, certainly where it concerns the use of the electronic medical record.
Can we learn something from these considerable differences? If we are willing to look and listen, then I am sure that we can improve our performance.
When I asked my colleague to provide some more details, he explained that if they met the standards, that both the department and the whole hospital would receive substantial extra funding. As they say, money talks.
In B.C., the Coastal Health Authority has instituted a similar incentive pilot project for some of the downtown hospitals, with promising results, even though the efficiency is still not meeting the provincial standards, let alone those of the UK.
Also, the organization and staffing was different where my colleague trained, and judging from the results, better than we do it. We still use near medieval technology for even the most basic functions.
In essence, a hospital is not much different than a hotel in providing accommodation and services. Why does it take such a long time to register at a hospital when we all have a Care Card with a magnetic stripe? Worse yet, if one needs to visit again, then the whole procedure is repeated of getting all your information as if you just landed on earth from outer space. Compare that with any of the hotels I use: they only need my phone number and, bingo, they have my name, address, billing information and a host of other information on the computer screen. Even the grocery chain stores anywhere on the North American continent have your information once they swipe your loyalty card at the check–out counter.
Then after the hurdle of the registration desk, you all too often get treated as if you are a complete imbecile. I still see people who are perfectly capable to walk from A to B in a hospital being put on a stretcher and pushed by a porter to their destination. Why not ask the porter to accompany the patient on foot. It is faster and more efficient.
Better hotels are a lot cleaner than hospitals and therefore safer to boot. Hotels have figured out what each procedure or service costs. Hospital administrations have no idea. How can anyone manage without good data?
The list goes on and on and the taxpayer does not really get good value for money.
The Canadian Medical Association is interested to receive feedback and suggestions from people who have been “through the system” where they see what and how can and should improve our health care system.
Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.