The Emergency Room Crisis... (&I'm eating a cookie!)

[The Law]

http://www.theglobeandmail.com/news/national/prairies/emergency-room-overcrowding-putting-patients-at-risk/article1807108/

 

 

 

The G&M has an excellent article about the overcrowding of Canadian ERs. I thought it would be cool to see what peoples' ideas are for helping to alleviate this problem and what the future holds for ensuring the sustainability of our emergency care system. In the article, they also mention a funny "cookie" incident that y'all (especially those of you in Alberta) might wanna check out.

[emma3]

That was seriously funny (in an unfunny way). Must have been a good cookie..

[The Law]

My favourite parts are when he shoves the cookie in the reporter's face and then later when the reporter asks him "why do you want your message to Albertans to be, 'you're eating a cookie?!?!'"

[emma3]

haha! He really did not care about answering those reporters questions. The reporters were just baffled.

[Robin Hood]

1. We need more doctors.

2. We need more efficiant funding.

3. We need to amend the Canada Health Act and make it more efficiant.

[Karma]

Unbelievable... he's clearly not the right person for this position.

[Renin]

1. You should give ER docs a cookie.

[Leon]

In Alberta, it was only after a revolt by Dr. Sherman that the government responded, although it has tried to play down the crisis by saying it is adding about 200 acute care beds and, eventually, 1,300 long-term care spots.

 

What exactly is meant by the govt "adding 200 beds"? I'm guessing it's going to provide funding for those additional beds?

 

I wonder how long this system is going to last. The hospital system's inefficient, there isn't enough space in existing hospitals and the education system doesn't produce enough doctors either.

[Renin]

I think they need to create an in-between place for people who aren't well enough to go home, but not sick enough to be admitted. Like an observation unit.

 

Usually obs units are only about 10 beds, so all the other observation patients end up in the hallway. No one should have to spend days in a hall... but there just isn't physical room to put everyone.

 

Also, there should be more incentive for family doc's clinics to be open in the evenings and on weekends so that people can go see them without taking time off work.

 

I think if I was a GP, I'd open extra early (maybe 5:30?) so that if people are really sick and wanna come in early, then they can.... but I have a feeling it wouldn't be as popular as staying open, say, until 7:30 or 8:00. But I'd like to have a life too

[Lactic Folly]

Heh, Renin, it's probably safe to say that you would be more of a morning person than your patients. IMO the best time to go to the ER (if there is one) is first thing in the morning.

[Renin]

Heh, Renin, it's probably safe to say that you would be more of a morning person than your patients. IMO the best time to go to the ER (if there is one) is first thing in the morning.

 

I'm not a morning person. I'm unwilling to open my clinic from 9am to 8pm. I deserve to have a life too. I would be willing to be open from 5:30 am to 4 pm, then go home.

 

If you're that sick (but well enough that you don't wanna miss work), you can drag yourself out of bed early to go see a doc before you go to work.

[Mourning Cloak]

I think they need to create an in-between place for people who aren't well enough to go home, but not sick enough to be admitted. Like an observation unit.

 

The big problem in my province is a lack of community beds. Beds for people (usually elderly) who can't live on their own by any stretch (need some level of nursing) but don't need to be in the hospital.

 

We have lots of people sitting in hospital because the isn't anywhere for them to go. The story is usually the same: grandma really can't cope on her own at home, or maybe she sort of could, but one day something happens (she gets pneumonia or has a fall or whatever) to precipitate admission to hospital. She gets fixed up and really now she's ready to be discharged (medically), but she can't go back to living at home by herself. But there's no where for her to go in terms of the community.

 

These patients (and there's lots of them) need to go to a long term care situation, but somebody has to die to make room for them. And since they're in a hospital bed, the guys in the ER can't come up into the ward. And since the patients in ER beds can't get out of the ER, you have people sitting in hallways outside the ER. It's odd, but we could improve the hospital bed situation by increasing the number of beds in long term care (nursing homes).

 

The other problem is that the ER is being treated as a walk in clinic that's open 24-7. A lot of the stuff that comes in the ER door isn't an emergency, or anything like it. It's really stuff that any family doc could assess and handle, but if your family doctor isn't part of a call group off to the ER you go. Where you sit for seven to eight hours because you shouldn't even be there in the first place. NB: When you pick your personal dentist, veterinarian and family doctor, make sure they are part of a call group.

[leviathan]

I'm not a morning person. I'm unwilling to open my clinic from 9am to 8pm. I deserve to have a life too. I would be willing to be open from 5:30 am to 4 pm, then go home.

That's a long day for one person any way you look at it, and you'd probably hit your cap way before then (if Manitoba has one?). Most clinics around Vancouver are open until 8 or 9pm every day; they just have multiple doctors working different shifts to cover all hours.

[ploughboy]

1. You should give ER docs a cookie.

 

Cookies for emergency physicians -- I like it!

[leviathan]

Cookies for emergency physicians -- I like it!

 

Crazy Australians. I wonder what Mel Herbert would say about this incident.

[Renin]

That's a long day for one person any way you look at it, and you'd probably hit your cap way before then (if Manitoba has one?). Most clinics around Vancouver are open until 8 or 9pm every day; they just have multiple doctors working different shifts to cover all hours.

 

I plan on taking between 1 and 3 pm off to go shopping.

[The Law]

I'll join you rennie, and give you a cookie.

 

You know, I, like many others are really fearful about the future of health care in our country. It's the enormous elephant in the room that all of our politicians are ignoring. There are a lot of things that are going wrong and need to be addressed, especially considering most of these problems will be exacerbated by an increasingly older population down the road. I think it's extremely frustrating that health care is always one of the top concerns of Canadians and absolutely nothing is being done to try to tackle the problems we face. I know there are those who think that the government is trying to address the concerns of the citizens, but I really do not think things are moving fast enough or that the small band-aids the provinces have applied are going to last.

[seeking1]

One of the more immediate answers in my mind is produce more nurses and well-trained at-home workers for the elderly. You can't really suddenly inject money into the medical schools and expect them to produce a bunch of new doctors within 5-10 years, it takes a while. I think the problems being faced by a lot of people could be better managed by a mid-level.

 

Also, as others were saying, infrastructure. As in, more hospitals with more staff in places. Like my home city of Vaughan, where a seemingly eternal debate about where they should put the hospital that doesn't exist yet is going on.

[RyanMaverick]

Good point seeking.

 

That's actually a fantastic area for the mid-levels to expand into and take over - long-term care.

[leviathan]

I just read in the Medical Post that Duckett was just fired! What do you guys think? After watching the video it seems he was saying there was a scheduled media session in 1/2 hour, so if that is true then I think he has the right to not be bothered before that. Too bad they don't have a sense of humor.

[NewfieMike]

The way he went about it was pretty inappropriate, but I also agree not getting fired worthy.

 

Especially because they now have to pay his 575K salary for the next year + moving expenses.

[bloh]

Duckett was definetely being a giant douchebag. It's not even the cookie comment that is offensive but the fact that he shoved the cookie in the reporters face with that awful grin on his face; it's unacceptable.

 

Since we're speaking of unacceptable things, we can **** into the act of firing him. That was even more stupid. Why are we firing (and wasting massive amounts of money) based on one particular instance? If he's had numerous professionalism problems, then sure, fire away. But this is just a ****ty knee-jerk reaction that is costing the taxpayers quite a hefty severance package and further incompetency while we switch leadership.

 

 

It's absolutely disgusting when decisions are made based on stupid politics and not on what's good for the system. We should be firing people based on their competence and overall professionalism attitudes and not dumb knee-jerk reactions for the sake of publicity

 

But that's what you get when you have ****ty, incompetent inbreds at the helm (Mr. Stelmach).

[osmosis]

Duckett was definetely being a giant douchebag. It's not even the cookie comment that is offensive but the fact that he shoved the cookie in the reporters face with that awful grin on his face; it's unacceptable.

 

Since we're speaking of unacceptable things, we can **** into the act of firing him. That was even more stupid. Why are we firing (and wasting massive amounts of money) based on one particular instance? If he's had numerous professionalism problems, then sure, fire away. But this is just a ****ty knee-jerk reaction that is costing the taxpayers quite a hefty severance package and further incompetency while we switch leadership.

 

 

It's absolutely disgusting when decisions are made based on stupid politics and not on what's good for the system. We should be firing people based on their competence and overall professionalism attitudes and not dumb knee-jerk reactions for the sake of publicity

 

But that's what you get when you have ****ty, incompetent inbreds at the helm (Mr. Stelmach).

 

+1.

 

totally...

dead...

on.

 

the province of AB, it's health care system, post-secondary educational institutions, and social services are forever screwed as long as farmers and uneducated red-necks continue to run the province.

[apache]

The gov fired him to save their ass, he's highly unpopular in Alberta, and there's a new party in alberta that might challenge the conservatives. I remember Raj (the former assistant to the health minister and an ER doc) looking like an idiot on video conference last year defending the health board and what they were doing against the liberal leader and an ndp mp who actually showed up, now he's protesting their policies and people in his party are saying he's mentally ill... I remember Duckett responding with his usual arrogant rhetoric to a bunch of questions from classmates last year, and now he's on his way out over a cookie, lol... what a gong show, I'm glad his ass is out of here! I shadowed a bunch of ER last year and remember listening as docs had to discuss how to "sell" a bunch of ridiculous things to patients and their families because of lack of beds and docs.

 

The way he went about it was pretty inappropriate, but I also agree not getting fired worthy.

 

Especially because they now have to pay his 575K salary for the next year + moving expenses.

[apache]

i'm going to deny i have a bsc or md, cut my vocabulary in half, not show up to public debates (or have impostors impersonate me on the radio (hello rahim!)), and routinely tell reporters to screw off while i shove cookies in their faces when i campaign to be elected... as long as i belong to the conservative party i'm sure ill get a seat!

 

+1.

 

totally...

dead...

on.

 

the province of AB, it's health care system, post-secondary educational institutions, and social services are forever screwed as long as farmers and uneducated red-necks continue to run the province.