Three Simple Steps to Fix Our ERs Now

We will bring you this Newsletter on Sunday. Given the cold and windy weather, we thought it would be a good day to share today rather than the usual Monday delivery.

Over a coffee the other day, Mary and I reflected on our 30 years in private healthcare and recent consumer experiences. We also asked, “What would a beehive do?” to fix our Hospital Emergency Room crisis.

We are somewhat unique in that, as retired Canadians in our late 60’s, we are healthy and take no medications but are still worried about our healthcare future. 

I have had lifesaving interventions on two separate occasions. Several years ago, with an appendix needing surgery during SARS, and some five years ago, with AFIB that required ambulance and emergency intervention in the ER, being shocked back to normal rhythm.

In our private mental health careers, we began using virtual visits with clients some 20 years before it became popular, and 25 years ago, we developed a platform that could securely share test results and health information with other professionals and healthcare providers.

Mary is a logistical expert who understands how to make healthcare hum. From ensuring clients receive what they need at an appointment to ensuring that staff are utilized effectively.

So, last Saturday, we took our collective experiences and a cup of coffee to summarize these three simple recommendations to improve our healthcare in Canada. We are 95% sure they would be effective. We are 100% sure they will never happen.

1. Universal practicing licensure. If you practice in Vancouver, why can’t you provide services to someone in the North, Quebec, New Brunswick, or Ontario? Each Premiere could immediately declare a universal pass for a doctor, nurse, or clinician to care for anyone in Canada without further licensure or regulation.

Think for a moment that you want to take a trip and drive across Canada. You start to plan your trip but are then told you need a driver's license issued by each province to drive through it. In each province, you must pay $1,000/year to have that license and special separate insurance. Most Canadians wouldn’t stand for that. You would argue that you are competent to drive in Ontario. Why couldn’t you also drive in Manitoba, Alberta, or Nova Scotia? You refuse and lobby to fight the dumb government restriction. Exactly what needs to happen in healthcare. 

 The Bees teach us about value investing, specialization, and geographical benefits. They all apply to this first and most important change we need.

2. Universal access to virtual care for all Canadians. I recently was able to use this service while in Nova Scotia. There are many platforms now accepted, including Get Maple*. It allows you to access a physician within minutes. The plan would mean that if I weren’t feeling well, my first choice (assuming it’s not an ambulance emergency) would be to schedule an appointment with a physician virtually. Within 30 minutes, I see a doctor.  The notes from that visit would be accessible should I need to attend the ER. Triage, if you will, would already be completed, and there would be no need for another triage when I arrive at the hospital. If I don’t need to visit the ER, the virtual physician can order a prescription or further tests or schedule a follow-up appointment within 24 hours or on an as-needed basis. The government would save the $323 emergency room visit that wasn’t needed. The exception would be when there is a health issue for a child. Parents need access to face-to-face care, as it is often difficult to get accurate information on their status virtually from a child. In those cases, parents should always be encouraged to seek out the services of a face-to-face physician in the ER.

3. Access and acceptability of home medical grade testing and monitoring. I use a Kardia* to keep track of my heart status. It is medical grade, and I can easily download a reading in real time while speaking to a virtual doctor. The system costs $99, with a minimal monthly fee for the advanced analysis. For the $99 and free app, a medical grade reading can be provided anytime. The federal government could make home testing purchases tax-deductible, or the province could also assist in purchasing these devices. As technology continues to improve, more and more testing can be done within the home, saving billions in health care costs.

These three, simple, practical, common-sense ways exist to improve our healthcare delivery. Doing the same thing and expecting a different result has not worked. I am sure the three suggestions we provide have been recommended in the past. 

Why would these three ideas never be implemented?

Because Provincial gatekeeping seems to be a significant barrier to Universal Canadian Licensure. These organizations have a personal interest in continuing with our dysfunctional system.

The Honeybees can teach us many more lessons to help fix our healthcare system. Let’s start with these three ideas and see if there is courage to change.

*Although I have used these products and services personally, I have no investment or financial interest in them, nor have we been paid to mention them in this newsletter. 

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