Canada needs a more efficient health care system

TheGlobeandMail.com – news/commentary/editorials
Published Sunday, Dec. 18, 2011. Last updated Monday, Dec. 19, 2011.

The number of doctors – there are nearly 70,000 – and their salaries are both at all-time highs. More Canadians have a family doctor than in years past, proof that progress has been made. But access to them is among the worst in the world. How can that be?

Only half of Canadians are able to see their doctors the same day they become sick. Queues for specialists are especially worrisome, with 41 per cent of patients waiting two months or more, according to The Commonwealth Fund’s study of 11 countries.

Canadians shouldn’t fool themselves into thinking poor access is the inevitable consequence of a publicly-funded health care system. Patients in the Netherlands and Germany have rapid access to specialists, much like Americans where private care prevails. Our system is simply not efficient.

New research shows that the average family physician in Canada billed the public purse $239,000, while the average specialist billed $341,000. Alberta leads the way with the most generous compensation in Canada, according to 2010 figures.

The Ontario government has already signalled it wants doctors to accept a two-year pay freeze when their contract comes up in March, something that is likely to have strong public support.

The next question is about the service patients are receiving for the almost $19-billion a year they spend on physicians.

The privilege of being doctors who have a monopoly on providing medical care carries with it an ethical, social responsibility. That should include making patients the centre of care; there are many ways to achieve that.

More physicians should have advance access scheduling, where slots are kept open for sick patients. Demand for doctor services could be reduced by eliminating unnecessary follow-up visits or handling minor issues by e-mail or telephone. Physicians could blitz backlogs by working extra hours or hiring help.

Triage systems – especially for surgery – could save patients and surgeons unnecessary visits and whittle down backlogs. Patients wait months to see a surgeon only to learn they are not eligible for an operation. Having other health professionals triage patients early on would get them the right care at the quickest time, an initiative in which governments could assist.

Canadians have paid top dollar to buy change in the health-care system. They have bought more doctors, but they haven’t yet got a more efficient system.

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