money in one area of health care

[Guest lots of thinking]

So, what if the question is, the federal health care minister gives you $100 million dollars to put into one health care program in Canada?

 

where would you put the money and why??

[Guest IRNBRUD]

MED SCHOOL SEATS of course!!!!!!!!!!!!!!

 

IB

[Guest macdaddyeh]

Good one!!!!!!!:lol But seriously, I DO agree, especially if we are facing a shortage of "crisis" proportions....

[Guest strider2004]

It would take at least 5-6 years before you'd see the results of that money. I vote for home care/long term care. Although $100 million isn't very much, it would definitely alleviate some of the burden put on hospitals right now. There are thousands of people across Canada waiting in hospital beds for long term care beds. Each day costs at least $800. Imagine how much we could save if we could transfer them to the long term care beds that they are waiting for. It would also alleviate the shortage of beds in emergency departments.

 

As for the primary care problem, nurse practitioners seem to be the way to go. If a FP could supervise several nurse practitioners, patient care could go more smoothly. It's already being done in some centres, let's make it more widespread.

[Guest PARTY cal]

I agree with medical school seats and long term care, however I think we need to switch out focus to some serious prevention programs. I think this currently makes up only 10% of the budget. There are some great programs out there, however they need more money and greater recognition.

[Guest therealcrackers]

residency positions. There are a large number of well-trained, Canadian-born and foreign-born medical graduates in this country who can't get licensed because they haven't completed enough training to satisfy the Royal College. Add to this the increased number of medical school seats in the last four years, and this country could use a large boost in the number of residency positions; that $100M could go a fair ways.

[Guest MayFlower1]

...hmmmm...$100 milllllllliooooonnn doooooollllarrrrrssss, eh?

 

I totally agree that using the money in the short term to help people get home quicker to free up in-demand hospital beds would be one good spend of the money.

 

However, upon thinking about it, $100 million bucks isn't a ton of money...I think I would use it to hire business-saavy consultants/doctors to understand how duplication and waste could be eliminated from the national, provincial and local systems and then implement programs to realize the savings. The savings from this elimination of waste/duplication would inevitably be larger than the original $100 million and would also free up additional human resource which could then be re-deployed.

 

e.g., here is a few areas I believe our healthcare system may be wasting/duplicating:

 

1) Telehealth - the cost of a single phone call to the telehealth network is about 37 bucks...I read it in the paper recently...this is more than a doc gets paid for a typical visit! My understanding is that after talking with telehealth, patients are often referred to their family physicans or to emerge anyway...hmmm...sounds like a ton of bucks being wasted here...you can't properly triage or diagnose over the phone. Telehealth has potential, however, my opinion is that significant hardware and software infrastructure is required (e.g., realtime broadband imaging...remote diagnostic tools...docs to do remote consultations...nurses or tecnicians to do patient intake, diagnostic testing and/or manipulation of remote diagnostic equipment, etc.)

 

2) Enhance triage in hospitals an only admit emergent problems. Consider impact of not allowing individuals presenting at ERs with with non-emergent problems to be admitted/use critical ER resources. They should be referred to their family physician.

 

3) Centralize purchasing in hospitals. In many, if not all, hospitals, different physicians purchase different sutures, supplies, etc., they use their "preferred brand". The amount of overhead in ordering, shipping, receiving, handling, etc. is astounding. Hospitals within a city should have standardized materials/medications/supplies and purchasing should be centralized.

 

4) Electronic medical records could eliminate duplication of tests, storage of patient files, doc/diagnosis shopping, etc.

 

5) Once the electronic medical record has been established, centralized wait/referral lists would be an extremely efficient means of ensuring people don't wait longer than they need to...diagnoses, histories, etc., could all be used to help triage patients and ensure they are being referred to the appropriate physician. At present, docs and their staff (hundreds of clinics, thousands of docs and support staff) do the wait list monitoring...in a fragmented way...can you imagine the cumulative cost of this? Wouldn't it make more sense to centralize this function?

 

 

These are only a few thoughts...there are tons more ways I believe the system could be made more efficient. This is how I would spend the $100 million.

 

Peter

[Guest mumfirst]

Quote from Mayflower:

 

"Enhance triage in hospitals an only admit emergent problems. Consider impact of not allowing individuals presenting at ERs with with non-emergent problems to be admitted/use critical ER resources. They should be referred to their family physician."

 

Mayflower, this of course assumes that there are available GPs in the area! I live in an underserviced rural area and shadowed an ER doctor at our local hospital for a couple of years. While I knew that we are short of doctors, I was aghast at some of the patients that were seen in the ER. The majority of patients are using the ER as a primary care facility - they have no other choice unless they want to drive a couple of hours to a major city to get a family doctor. It really is a critical situation.

 

The irony is that the government continues to pay $50/visit for someone to have their sore throat looked at, or a week old rash investigated, at the ER instead of spending money on recruiting physicians to these underserviced areas. Recruitment is the municipality's mandate.

 

Just my two cents!