In response to recent articles on Healthcare system challenges
Published in The Guardian, August 17 2013
We are making progress. It is progress occurring under the headlines and below the media’s radar but productive change is being made as a result of the work to improve our health care system.
The Medical Society as the collective voice of the physician community needs to keep the public informed and encouraged that their physicians are engaged in addressing the challenges of our system and recognize how important this work is to each and every one of us.
We recognize that some rural communities are still dealing with a real and perceived sense of loss. The best answer we can have is to build something better than was there before and progress is being made on that front as well.
For example, I can report that the conversation at almost all levels in Health PEI and government continues to identify the need to renovate the primary care foundation at the rural level and in the cities as well. Ambulance systems are receiving the attention that reinforces their key role to insure all Islanders have access to appropriate emergency services. As a product of working on the CEC model MSPEI members working within Health PEI are lobbying government to establish an on-line medical control system which connects a qualified ER physician with ambulance services on a real time basis to direct care on scene. This is a critical component to allow delivery of life saving interventions. MSPEI and the Department of Health and Wellness’ Health Information Management division are joining forces to make submissions to Treasury Board for procurement of an Electronic Medical Record. The creation of one patient/one chart capability is a critical tool to achieving system efficiencies and promoting quality care in an integrated system. The PBMA exercise, a budgeting tool used within healthcare systems to find efficiencies, is ongoing within Health PEI. It engages those who work in healthcare to come up with ways to work better and reduce the growth in healthcare spending. The Medical Society is partnering with the College of Family Physicians and Health PEI to sponsor a Primary Care Summit this fall which is intended to produce a physician driven strategy and deliver a definitive primary care plan to move the health care changes toward the goal of a better system.
These are but a few examples, among many, of products of people’s effort and creativity who are working within the system to promote positive change. I can say with conviction that they are truly the silent majority who will never grant an interview or air their grievances in the press.
In my role as President it is important for me to track reports in the media and function as the spokesperson for the Society when requested. I once wrote in an editorial piece about respecting conflicting perspectives. However, when confronted with a distorted perspective I believe we are obliged to comment. I feel the conversation about improving our system needs to clarify the following points:
First, recent articles seem to imply that Health PEI is trespassing on a doctor’s privilege for determining patient care. I was asked personally for comment on how doctors were reacting. The truth is Health PEI is doing what we want Health PEI to do so we as physicians can focus on taking care of patients. We need them to do more of it if we are to reach our mutual goals of improving the system. If a screening tool or prevention strategy has been shown by high quality research not to provide any protection than this is a cost that the system can reclaim. Our role as physicians is to share this information with our patients to ensure them that we are offering the highest quality of care. Health PEI is the structure to identify these areas and communicate it to us and by extension to our patients.
Second, Health PEI is not the government. The government are the politicians who are responsible to determine how our tax dollars are spent. Since over 40% of our wealth is being consumed by healthcare in our province, I understand their investment. Health PEI is the structure endorsed by government and the physicians, nurses, allied health professionals and their unions to manage the system. Health PEI is the ship carrying healthcare providers across a stormy fiscal sea. It is our vehicle for healthcare delivery in the province. The government is paying for the trip so they will tell us where they want to go (policy) and we respond to the wisdom of their plan (collaboration). In this metaphor it is apparent that blowing holes in your ship by attacking Health PEI isn’t in a physician’s best interest as it leads to sinking. Better to realize the symbiotic relationship we have with Health PEI and work to strengthen that relationship because to be successful in this enormous project only underscores how much we need each other.
Ours is a system of checks and balances that has the advantage due to our size of being frequently personal – we often know the people involved in key decisions. Unfortunately that also means the balance between government, Health PEI and the physician community is too easily perturbed by political interest, the angry and the aggrieved leading to distortion and confusion in the media. Those frustrated parties must always be heard and their perspectives respected but the end game of health care reform is a better system.
The MSPEI will remain committed to motivating, engaging and supporting its physician members and along with its key partners, Health PEI and government, to keep trying to transform our system. We need to keep our focus on that goal and, in cases where we disagree, pay for our success with the currency of productive compromise.
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