Words Dr. Chris Pengilly (retired)
While Helping Fix the Healthcare Crisis
That there is currently a family doctor shortage is indisputable, but there is also a significant shortage of practitioners of almost every area of healthcare delivery.
The solution is simple – just hire a few thousand more doctors and many more of the other healthcare deliverers; but you know, and I know, that that’s not going to happen. It cannot. There are simply not enough dollars in the treasury, or qualified warm bodies available – medical progress, for which we are all grateful, has outstripped the ability to provide for it.
One solution is to make all healthcare practitioners more efficient, and therefore more productive. I will concentrate on family physicians, since my 50 years of general practice has left me with a decent knowledge of office visit stumbles that can waste hands-on time – which should be a very important part of every visit, be it a handshake, a pulse check or a full examination.
Let’s start with an office visit. Before coming to the clinic, prepare a legible list of concerns, clearly stating which is your major worry. This list is best given to the practice nurse, who will triage it. Some problems may be referred directly to other healthcare practitioners. Cardiovascular concerns will prompt the staff to measure height, weight and blood pressure prior to the patient seeing the doctor.
The family doctor can help as well. There is a growing mindset change. Single-handed practitioners are less efficient than a group working as a team. A new patient registering will state their family doctor as a clinic rather than a single physician. In a group of about eight doctors, one of the ancillary staff could be responsible for reviewing and reminding all the patients concerning immunizations, an area of healthcare that has been crowded out by Covid and anti-vaxxers, amongst other factors. Many immunizations, I am glad to say, are now being undertaken by pharmacists.
Another voracious wasting of clinical time is the chore of keeping tedious, but vital, written records. One solution would be for the clinic to employ a dedicated stenographer. They do not come cheaply but they do save a lot of clinical time. For many years I’ve used voice recognition, which has leapt ahead in the past five or 10 years. Recently there is even more remarkable electronic help – namely artificial intelligence. An office visit can be recorded (with the patient’s express consent) and at the end of the visit, within moments, a comprehensive safe permanent written record can be produced.
What can we as patients do to help the system?
When visiting the doctor’s office, clearly state what your main concern is and stick to that only.
Try using virtual office visits with telephone, FaceTime or Zoom.
Explore other forms of treatment using other health practitioners: diabetic foot care by a podiatrist, earwax and swimmers’ ear by an audiologist, athletic injuries by physiotherapist, nutritional concerns by a nutritionist, and pregnancy and neonatal care by a midwife.
Another way of avoiding or minimizing the need to see a doctor is to eat healthily, drink alcohol moderately and most importantly of all to exercise regularly. This can be doable. Walking for half an hour (three kilometres) three times a week will definitely be effective and is achievable.
We are all living longer and on the whole better, but this comes at a price. The later decades of life are medically costly. One obvious example is joint replacements, but there is a long list including cataract surgery, chronic disease management of diabetes, nonsurgical intervention for angina and rheumatoid type arthritis. Also in this group are the dementia illnesses, for which medical research is not successfully able to find a cause or a cure.
Life in Canada at the moment is chaotic, but through it all Medicare must be preserved. It will be preserved and we can all help out a little bit at a time.
