Canadian hospitals devastated by Hurricane Woodrow
In addition to a slightly glum report on increasing retrospective public support for the Iraq invasion, the New York Times has an article, "Shuttered Hospitals Ensure Slow Recovery in New Orleans" that is pretty confusing for a Canadian. Visiting one emergency ward post-Katrina, the Times reports:
The uninsured, who had made up a small percentage of emergency patients at Ochsner, began accounting for more than a quarter of emergency room patients. Waiting times routinely topped an hour.An hour? A whole hour? Yep. Apparently that's up from "20 minutes". Hmm...well thanks to the saintly "Tommy Douglas" and his erstwhile successor Woodrow Lloyd -- Pithlord being president and CEO of the Woodrow Lloyd Fan Club -- we Canuckistanis spend our first hour in the emerg lining up for parking validation.The next two or three are passed trying to find a place to sit down that's close enough to follow the endlessly-looped edition of Oprah that is to be our sole companion for the next half-day or so -- if we are (un)fortunate enough to fall in class 2 (pre-rigor mortis) or class 3 (enough breathing to cloud mirror) under the triage regulations.
Now let's see if this comes up on Google!
9 comments:
I'd like to see some hard data on the average waiting times in Canadian emergency rooms. In my experience, and the experience of everyone I know, there's never been any wait.
My suspicion is that most claims about long waiting times are based on dubious anecdotal evidence. I'm not defending the existing system (let's see that 'two-tier' system already!), but I very much doubt that things are nearly as dire as some people like to pretend.
Ectoman: I would want more detail about the New Orleans hospital in question before I would dare to compare the stated wait time with Canadian wait times. For instance, who is waiting and what are they waiting for? Here in Canada at any rate, where health care is "free", lots of folks go to Emerg for relatively minor complaints that would ideally be dealt with in family doc's office or over the phone. The wait does not necessarily deter them (and yes, Akrasia, in my town at the ER of the University-centred tertiary care hospital waits on busy nights can stretch to several hours if you're non-urgent.)--what were called in Samuel Shem's masterpiece The House of God "LOL in NAD" (Little Old Ladies in No Apparent Distress) will go to emerg if they wake up lonely and confused in the middle of the night, and the wait will not deter them. They got nothin' but time.
Also (granted, I'm generalizing from anecdotes throughout this post) folks will go to the tertiary-care ER here rather than the often less-busy ERs at the other hospitals because they think they'll get better care at the teaching hospital.
If the triage nurse decides that you're good to leave with the mouldering pile of People magazines, you probably don't belong in the ER anyway. And she'd probably tell that to your face, but liability concerns preclude this sensible approach.
Well, the last time I went there I saw some sort of junior resident pretty promptly and the only other time, when I sprained (or for all I then knew, broke) my ankle I sat for quite awhile.
It is more the friends of friends who have had the extremely long waits, and from what I understand the delays are even worse for the friends of the friends of those people.
BKN is correct that Canadians use the Emerg as a kind of walk-in clinic, in part because walk-in clinics are now the only kind of GP service that many Canadians can find due to the fact that Tom'n'Woody's Free All-You-Can-Treat Medical System doesn't seem to be able to create sufficient incentives for people to enter into the grubby world of family practice.
Are the Yanks doing a better job of enticing med students to enter family medicine? Nuh-uh. It's a problem common to both countries, and attributable in large part to the fact that most med school teaching is done by specialists, who are forever denigrating the knowledge and skills of generalists. (There's a larger social phenomenon here: the fetishization of extreme specialization in all fields...) And there's the pay: GPs are very poorly paid compared to docs in procedure-oriented specialties. There was some talk in some provinces in the past decade or so, idle talk perhaps, of the GPs breaking away from the medical union and forming their own bargaining entity. But as I've mentioned in this space before, I'm married to a GP, so perhaps my views should be liberally discounted.
Yes, I'm sure that the disdain exists (much as our law faculty had nothing but disdain for people who wanted to be lawyers rather than, say, professional Hegelians), but wouldn't the market have a bit more influence on things in the U.S. (granting that it's a highly regulated system in its own right)? Are ordinary (insured) people wandering around for years trying to get on the patient list of a regular GP as, say, my mother did after our longtime family doc retired in the 90s?
I remember when I was living down in the U.S. in 2004, being at a party with some middle-aged woman who told me that her doctor had left ordinary practice to set up a special practice wherein for a fairly reasonable fee (a few grand a year) he would basically be at the beck and call of a smaller roster of patients, including (for example) accompanying you to all your specialist appointments to make sure your concerns were properly addressed. The idea that a family doctor would ever actually go with you to a specialist is a bit hard to get your head around up here.
Recently I was at a technician's appointment relating to my eye condition -- sent there by my opthalmologist Dr X. I was explaining to the technician some concerns that X seemed to have had, at which the technician seemed somewhat puzzled. I pointed out that I'd just seen X (who is also a surgeon at the hospital in question) out in the hallway 10 minutes earlier while waiting for the tech and said, jokingly, why don't we just ask him. Looking back, I'm not sure why, outside of a very overbureaucratized medical system, this would have seemed such a patently absurd thing to suggest -- but both the tech and I treated it as a joke and nothing more.
I just think that this would work better if it were market driven. Sort of like going to the dentist is almost a pleasure because it's his business, and a shrinking business, and so he's really attentive to service.
Here in Kitchener-Waterloo Ontario, home of RIM and many other hitech companies, I can personally attest to the extremely slow emergency services. My wife was diagnosed by her family Doctor with appendicitis at 2PM. He send her to emergency. I got there at 3PM and we waited & waited & waited.. she was finally seen at around 11:30 that night. That is fricking ridiculous.
Akrasia:
Are you kidding? I had a hard time figuring out if you were being serious or not, but it appears you are. Wait times in emergency rooms in Canada have been abysmal on a regular basis for many years now.
I can remember waiting about 4 hours for stitches, 2 hours when I had appendicitis, and 3 hours for a serious infection, only because I went shopping around when the first hospital I went to had an estimated minimal wait of 6 hours (these are various instances in Toronto and Montreal over the last twenty years). A friend of mine waited 8 hours for treatment of torn ligaments in Ottawa last year. I don't think I have ever waited less than 2 hours in an emergency room, and I believe the only people who wait less are the ones suffering heart attacks or other life and death situations.
Out of interest, I googled for the data in Canada:
Average wait times to be either admitted to hospital or discharged through ER in Quebec: over 16 hours.
year 2006-2007 ending March 31 2007.
http://www.cbc.ca/canada/montreal/story/2007/06/11/qc-hospitalovercrowding.html
Ontario April 2005-April 2006: "Ontarians typically waited one to four hours in the province's emergency rooms over a recent one-year period, although wait times in some larger cities stretched past nine hours"
"Toronto had the worst times in Ontario, with half of people in and out of the ER in four hours, while 10 per cent waited more than 12 hours"
http://www.cbc.ca/canada/story/2007/01/25/er-waits.html
There is nothing anecdotal about this disaster.
Why can't "Andy" post under his real name? Pyjamas media rules or simply pathetic?
Evan Lloyd (figure it out)
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