Tuesday, 13 February 2018

Just an MD on the front lines of healthcare

I have tried really hard not to blog about this.  I hear a voice in my head telling me to suck it up.  I have a good job.  I love my work.  But, at this rate, no one on the front lines of healthcare will survive the onslaught of the ever increasing demands of an ageing population in the setting of shrinking health care resources and a government that doesn't give a damn about me or you or our health.

I now spend 10 hours a day at my job.  I work through lunch with no breaks.  I spend 3 hours of the day smothered in paperwork.  I could use those hours to see real patients but our professional lives have become overwhelmed by regulations and legislation.  Everywhere I turn, a new guideline pops up, smothering any creativity or intuition I once used to care for my patients.  Patients that once required 10 minutes of my time now need 30 minutes.  Don't get me wrong, I love my ageing patients.  Their complex health issues require all my intellect and problem-solving abilities.  That is exactly what I signed up for.  But, it is becoming increasingly difficult to keep up.

Today, I saw four people whose specialists have found ways to abandon the system.  I don't blame them at all.  It now takes 12 months to see a dermatologist, 6 months to see a psychiatrist (if you can find one), 8 hours or more, to see an emergency room doctor, 18 months to have a joint replaced and 8 months to be seen at a pain clinic.  Three out of 10 referrals I make come back with a notice that the specialist is overwhelmed and can't accept the referral.  My staff spends hours looking for alternatives.  They are as dedicated to their work as I am.  I have stretched and extended my scope of practice to make up for these deficits, ineptly trying to pull together the unravelling strings of an imploding system.  Your government is more than happy to leave me in this spot.  They have to pay that specialist five to 10 times more than they pay me.  Cheaper healthcare is their goal, not better health care.

Your average family doctor belongs to a really good bunch of people who set out to tackle a career that involves the constant care of others.  We love that work.  We love our patients.  We are deeply concerned about their needs and search for ways to meet them.  We care for our patients over the course of their lives.  We have the privilege of delivering their babies and watching them grow into adulthood.  I know the intimate details of the lives of 2,000 people and every detail is kept in strict confidence.  I celebrate with these folks and I grieve with them.  They bring me their greatest joys and their lowest moments.  Every day, thirty people need my full attention, 15 minutes at a time.  By the end of the day, I have made thousands of decisions that directly affect the health of my patients.   We become that unseen part of every family that is critical to their health and wellbeing.  I fully understand the weight of this responsibility and I carry it on my shoulders with great humility and respect.

But, you have a government that disrespects the health and well being of every person who works in this system.  If we can no longer manage, people will die.  It's as simple as that.

I don't know how to change this mess we are in.  I am too busy trying to survive.  There is no time for activism.  God help us when 8 million baby boomers become increasingly ill and frail.  That will finally sink the ship.  Reckless mismanagement will finally sink the system and people will die needlessly.  My guess is, they already are.


  1. Boom! Nailed it. Respect your honest, transparent, front-lines description of the times we are in.

  2. Your perspective is honest, insightful and meaningful. Something is definitely not working...and it's not you!