Fixing the healthcare mess

The primary function of government should be to achieve a healthy community with a good quality of life. Full stop. Here in B.C., we are failing to meet that goal. Challenges with our “universal” health care system shine bright on the list of fixable issues.

The first problem is lack of access. One in five British Columbians does not have a primary care physician. These practitioners are the foundation of our system. I could not have been an effective heart surgeon without support from good family doctors. Although the new Physician Master Agreement between Doctors of B.C. and the government is a step in the right direction, it isn’t enough. The mantra of “more, better, faster” isn’t always helpful, and money by itself doesn’t create an improved product or experience or achieve better outcomes. Without setting goals and accountability, calling this new arrangement a success is premature.

We must consider how care is delivered. Doctors should be doctors in an environment that optimizes their skills and talents. Doctors currently spend too much time administering, running a “business”, and chasing necessary ancillary support. We waste valuable patient time typing and writing. We aren’t given the chance to focus, listen, use our hands, or our minds. We don’t ask teachers to hire support staff, maintain the building, and administrate. We let them teach. Community care centres, where doctors work as part of a team of health professionals to meet the needs of people, would improve healthcare delivery in B.C., as they have done elsewhere.

Access to primary care is also about more than just the family doctors. We need to expand that coverage by engaging physician extenders such as nurse practitioners (NPs) and physicians’ assistants (PAs). NPs are a relatively new addition to the B.C. healthcare landscape, but woefully underutilized. While their training is extensive, their permitted scope of practice is minimal here compared to other jurisdictions. PAs are highly qualified and capable practitioners who currently are not permitted to work in B.C. at all. If our focus is on getting health care to people who need it, adding PAs and expanding the use of NPs makes sense.

The current state of healthcare cannot be properly discussed without at least addressing the pandemic and lessons we should have learned from it by now. COVID itself is not the problem, but it has undoubtedly unmasked (pun intended) and magnified pre-existing deficiencies and created new issues related to the prevention and treatment of non-COVID disease. That polls suggest voters don’t particularly care about COVID anymore illustrates the problem perfectly. It should be science, not polls, that are guiding public health policy, policy which should focus on making B.C. healthy and giving our kids a chance at a good life.

This starts with education, rooted in science, geared to empowering people to make informed decisions. We have failed in delivering proper education about the nature of this virus, the potential longer-term consequences of infection, and how people should assess personal risk. We still don’t have appropriate clean air strategies. Our messaging about personal protection is weak. Our testing is deficient, sometimes even non-existent. The availability of specific COVID treatments is incredibly and unnecessarily restricted. It is difficult to properly discuss “post-pandemic” healthcare before solving the pandemic.

I’m embracing the role of B.C. Greens Deputy leader as an opportunity to get people healthy and happy. Of course, I’d like to see more B.C. Greens elected, whenever that opportunity arises. However, my primary focus is not on elections. I want to concentrate on people, not on politics. We achieve that by fixing the healthcare mess – which is so intimately related to several other major issues of our time (climate, environment, housing, employment and income security).

I started to speak out on healthcare issues as a result of what I've experienced firsthand in our healthcare system: administrators putting optics ahead of truth, and self-interest ahead of patients. I felt that by staying silent, I was an accomplice after the fact. I left my role as a Cardiovascular and Thoracic surgeon because I could no longer stand idly by while the healthcare system itself fell apart. I realized that the only way to fix problems in the system was to step outside it and use my experience and knowledge to reshape it. The issues I worry about are the issues that concern most Canadians, and I’d be much happier if my kids didn’t have to continue worrying. That’s relevant. Time to get to work.

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