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Do you think the Medical system needs to be revamped? (Discussion/Poll)


In the context of my Thread......do you think we need to re-vamp the medical system?  

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Now, this issue has been nagging at me, for alot longer than just covid. Who, but our selves, is an expert on ourselves. What I mean, is normally, we do the original diagnostic on ourselves, by saying, I don't feel good, or I think something is broken, etc. Then we check ourselves in to see a doctor. Then the medical system say, we will take over and you do not know anything. Now, that is true to some extent, and I have no problem with following the doctors orders, or being exrayed at the doctors request..............no problem with all that.

 

BUT!

 

I do have a problem, when a Diabetic has to see a doctor for a new prescription, when the old one is working well and I have been stable for years. It bothers me, when I need to go get a new order for an asthma medicine, I have been taking for years. I am the one who reports there is a problem, so does it not reason, that I can say, everything is ok?

 

Fast tract to the Covid anti-body test, where I need to get a doctor to order it, even though I have to pay for it. Come on, it is a simple test, which I instigate. I don't mind paying doctors for their expertise, but we need to rid the system of the needless costs.......why see a doctor, when you don't think you need his advise? In Mexico, you don't need to see him for everything, why here?

 

Just wondering what you think.............

Edited by janisahockeynut
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22 minutes ago, janisahockeynut said:

Now, this issue has been nagging at me, for alot longer than just covid. Who, but our selves, is an expert on ourselves. What I mean, is normally, we do the original diagnostic on ourselves, by saying, I don't feel good, or I think something is broken, etc. Then we check ourselves in to see a doctor. Then the medical system say, we will take over and you do not know anything. Now, that is true to some extent, and I have no problem with following the doctors orders, or being exrayed at the doctors request..............no problem with all that.

 

BUT!

 

I do have a problem, when a Diabetic has to see a doctor for a new prescription, when the old one is working well and I have been stable for years. It bothers me, when I need to go get a new order for an asthma medicine, I have been taking for years. I am the one who reports there is a problem, so does it not reason, that I can say, everything is ok?

 

Fast tract to the Covid anti-body test, where I need to get a doctor to order it, even though I have to pay for it. Come on, it is a simple test, which I instigate. I don't mind paying doctors for their expertise, but we need to rid the system of the needless costs.......why see a doctor, when you don't think you need his advise? In Mexico, you don't need to see him for everything, why here?

 

Just wondering what you think.............

I'm on high blood pressure, and diabetic meds. When I talked with my doctor I asked about it. He said my numbers were good, and he could take me off them. 

But there is health benefits to him keeping me on them. That was fair. One thing I hate about Covid is I can't see my doctor. I actually enjoy our visits. We chit chat, then he checks me out. Gives me the usual. "Get off your butt and get into a gym, even if it's once in a while..." Considering I had no warning when I had my stroke. I have no issues visiting him and getting my prescriptions renewed. I visit lifelabs, they check my numbers. The doctor reviews it. It's all good.

 

Is our system perfect? No. But it's fair. Rich people don't always jump the line. I think they need to hire less administrators, and hire more front line staff. 

As I've had tirades before. I would like to see Canada start manufacturing pharmacuticles, hospital beds, medical instruments, and sensors, everything. 

I would also like to see the return of orderlies. Nurses shouldn't be security guards on top of their normal duties. Orderlies with first aid training to keep patients stable until they can get more help I think is useful. It's a good way to move up to being a paramedic, or up the medical line. 

 

To be honest I had more issues with a glaucoma specialist I saw in Richmond. On first visiting this is what he said. "Ok so it's 3 appointments, twice a year for at least 2 years..."  He hadn't even looked at a report, or any of the results I just did. When I finished my second visit the receptionist asked when I want the next appointment.

I firmly replied. NEVER.  It's bad enough other specialists take two appointments with what my eye doctor does in one. But 3? That's just milking the system. 

So I stopped seeing him. I'm sad my last specialist she retired. The two new guys are fine, but the office is in chaos now, because they work between two office locations. 

 

 

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Posted (edited)
On 4/17/2021 at 7:50 PM, drummer4now said:

Please quit your complaining here in the US people are dying because they can't afford health care. 

 

 

It is not complaining.........just because a question is asked, don't assume

I asked for your opinion............not a statement about the states

IMO, there are some visits that we should not have to do, just to get what we know we need

It would save money and allow for more free medical that now costs

Yes, we have a great system, but that does not mean it can't be better

 

 

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1 hour ago, janisahockeynut said:

Now, this issue has been nagging at me, for alot longer than just covid. Who, but our selves, is an expert on ourselves. What I mean, is normally, we do the original diagnostic on ourselves, by saying, I don't feel good, or I think something is broken, etc. Then we check ourselves in to see a doctor. Then the medical system say, we will take over and you do not know anything. Now, that is true to some extent, and I have no problem with following the doctors orders, or being exrayed at the doctors request..............no problem with all that.

 

BUT!

 

I do have a problem, when a Diabetic has to see a doctor for a new prescription, when the old one is working well and I have been stable for years. It bothers me, when I need to go get a new order for an asthma medicine, I have been taking for years. I am the one who reports there is a problem, so does it not reason, that I can say, everything is ok?

 

Fast tract to the Covid anti-body test, where I need to get a doctor to order it, even though I have to pay for it. Come on, it is a simple test, which I instigate. I don't mind paying doctors for their expertise, but we need to rid the system of the needless costs.......why see a doctor, when you don't think you need his advise? In Mexico, you don't need to see him for everything, why here?

 

Just wondering what you think.............

People should not be their own doctors, nor in charge of evaluating their health for the purpose of refilling prescription drugs.

 

 

Your doctor does this because A: medical conditions, even lifelong one's, can change and need to be reevaluated, or newer medications become available that are more effective, and B: it can help manage a patient from abusing their medications.

 

Long term meds like ventolin for asthma usually get like 6 refills before you have to revisit the Doc. It’s not unreasonable to have to see your Doc periodically to keep your prescription meds going.

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35 minutes ago, falcon45ca said:

People should not be their own doctors, nor in charge of evaluating their health for the purpose of refilling prescription drugs.

 

 

Your doctor does this because A: medical conditions, even lifelong one's, can change and need to be reevaluated, or newer medications become available that are more effective, and B: it can help manage a patient from abusing their medications.

 

Long term meds like ventolin for asthma usually get like 6 refills before you have to revisit the Doc. It’s not unreasonable to have to see your Doc periodically to keep your prescription meds going.

You don't think your Pharmacist could not monitor? I mean if you have extended medical, your Pharacist and your extended Medical won'y let you order early, even 10 days ealy, so I don't think you can use that reason.

 

Also, I am not saying all meds, or all exams, or tests, but if you are willing to pay out of pocket, why not allow us the choice. I am an adult. I can make good choices, I have raised 2 kids.............

 

It is like the Doctors are protecting themselves...... again I don't need to see a doctor to get medication advise, a pharmacist can do that, and does in many countries........

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Do I think the system can be better?  Yes.  Unequivocally yes.  Hell yes.  &^@#ing rights.

 

How?  Well...

 

FIrst of all, it's too far above my pay grade for me to come up with the answer.  I also haven't got much of an understanding of the underlying system to be able to make meaningful statements of how to fix or improve the system.  My education only takes me so far, and my education did not cover health systems - theoretical or applied.  Besides, if I gave you an answer on how to fix or improve it, I'm pretty sure I wouldn't even want to participate in my own proposed system, because I can tell you right now that any answer I were to provide would be the result of me talking out of my ass.  :bigblush:

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I'm on both sides here.  My story....

 

My wife and I were initially expecting (fraternal) twins, but one day during middle of the second trimester her water broke.  We obviously panicked, went to BC Women's, but for whatever reason, they didn't have anyone on staff to really look.  No one to man the ultrasound machine.  This wasn't like in the middle of the night, but just around 7-8pm.... or we went to a smaller hospital like Burnaby... this is BC Womens... where they specialized in helping pregnant women.  

A doctor eventually came and just said that maybe one of the water for the baby broke... that we should just go home and rest, that if anything else happens, come back again.  The doctor said they'll schedule for a follow-up and scans next morning.  We were really rattled, but we just listened and went back home.

Next day, came in extra early, was told that no booking was made and that it will be first come, first serve.  We waited for about 4-5 hours and when I went up to the desk to ask again, the woman working there was like, "I know you've been waiting a long time, but you're not really a priority right now...."

Eventually someone saw us and confirmed that water broke, potential for infection, early birth, potentially losing both babies, etc.  Then told to rest at home, and start deciding on whether we should just get an abortion (for both).

Had to wait a few days to see our regular OBGYN as she was on vacation.... saw another OBGYN in the meantime.... he asked if we were opting for an abortion and we said we were still deciding.... the doctor replied, "what's there to think about?" in a dismissing manner.  

Eventually we did see our regular OBGYN, she literally just went from the airport to her office to see us.  She was asking if we needed more antibiotics... which we replied that she was the first person that even mentioned it.  She was a bit shocked that no one prescribed it to us as infection was a serious concern, not just for the baby with the broken water, but the other baby and the mother too. 

 

After that, we just told that mother need to rest and hope for the best.  A couple of weeks past, followed-up with the doctor that handled abortions... we declined as it wouldn't be fair for both babies, especially the one that's still fine.  While remote, there's still a chance that the baby girl can still make it.  We just had to wait for 3 more weeks and she would have met the 23 week threshold required for the hospital to save a preemie.  Unfortunately she only made it to 20 weeks before she decided that it just wasn't meant to be... 

 

My wife was then finally admitted to stay in the hospital.... even though we didn't know at the time, if she was back in Japan or even some places in the US, she would have been admitted to stay in the hospital immediately after her water broke.  That she should have been basically confined to bed rest 24/7.  Sometimes we still believe that if stayed at the hospital immediately, we wouldn't have lost our daughter.

To continue... my wife stayed at BC women's for about 5 weeks.  The quality of the nurses during that time varied... mostly good, but a couple that were less enjoyable to be around with. 

 

From what happened above... my answer will be YES, the medical system does need to be revamped.  We got ****ed a few times already.  Which ultimately resulted in losing our daughter.  Maybe hypothetically, nothing would have changed that... but there were lots of gaps and negligence in care.  

 

Now for part 2....

The other twin decided to come out at week 25.  Now for NICU care... I can say BC Children's perhaps one of the best in the world.  Almost every single nurse were professional and friendly (a few that weren't but they were infrequent).  Supporting staff were also great, the doctors were good too.  There are even volunteers that comes back to hold/cuddle your baby when you are not present (skin to skin is essential at such an early stage).  The brand new facility was also state of the art... each pod with TV, fridge, sofa bed, etc... to allow parents to be as comfortable as possible when being with the baby.  

If we weren't covered by MSP or if we were in the US... it would be between $10000 to $15000 per day.  My son stayed in the NICU for over half year.  To put things into perspective, my son's stay, if pro-rated after a year.... would have almost the same salary cap at Loui Eriksson. 

 

From this, the medical system we have in Canada is great.  

 

 

Part 3:

My son still needed assistance after returning home.  Oxygen support, CPAP, g-tube feeding, etc... so expensive machines, and pricey food, medical supplies, and round-the-clock care required.... fortunately everything was covered by the government.  Our machines would have costed about $10000-12000 if we had to pay ourselves, each feeding bag was about $10 bucks and they are supposed to be changed daily... he had a g-tube for almost 3 years.  Other random medical supplies costed a few thousands more.  The special food he was on goes for about $10 per pack... and he gets about 3-4 per day for a few years.  Then there was private nursing care he received so my wife and I can actually get some sleep at night... they aren't cheap, so plus a few tens of thousands of dollars more.  

 

The follow-up support we have on-going are a hit and miss.  Lots of information gaps between different groups, sometimes decisions are made and no one bothered to tell us about it, etc... but overall, not bad.  

 

From all this... the medical system in Canada is great.  

 

 

Overall.... the system here isn't good enough at times, but superb in other times.  I hear of stories where some parents don't have enough insurance coverage to give the best care to their preemies.... but yet on the other side, I hear of situations that matches what my family went through, but they got way better service and treatment.  Hard to complain about a medical system that provided more than $3 million to save your son... but why didn't they seem to care as much for the other baby?

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6 hours ago, drummer4now said:

Please quit your complaining here in the US people are dying because they can't afford health care. 

 

 

That’s such a reductive argument. Should we base what’s good on just being marginally better than the worst? We should always look to improve and make things better, I don’t think it’s bad to question and look where things need to be improved.

 

I live in the UK and wouldn’t trade the NHS for any other system , even though I know it means some drugs or treatments aren’t available here because of cost. 
 

The NHS is far from perfect and political meddling just makes things worse as they look for quick fixes rather than long term improvements (buts that’s an issue it’s most liberal democracies) 

 

My wife has medication she takes daily and has regular checkups with her consultant at the hospital, yet because of the way dispensing happens here, every 6 months she has to see a GP to get sign off on a repeat prescription that was written by a specialist consultant. The tests to alter that prescription cannot be done at a GP so it’s an unnecessary beurocratic step. However it may be relevant for others. Ironing out things like that saves time and money for all, which can be better allocated.

 

using your logic there a places with polio still so we are better than that so let’s not bother with any polio immunisation programs anymore 

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you've hit on a few things here @janisahockeynut. There are a number of things that can be improved, from prevention, the system capacity. and how its actually run. 

 

We don't do much in the way of encouraging people to stay healthy, with things like 5G and the large telecom's like Telus we might finally be on the cusp on monitoring people remotely and actually treat things before they are a serious problem. High blood pressure .e.g, is something many people feel no symptom from until its a serious issue. But this idea of monitoring people isn't new at all, I like to use this pic sometimes to make that point. The ideas been around for a long time, but our successive governments just don't put money into prevention measures.

iu-1.jpeg.cf22489c34c93851cda127d4d76a1ec4.jpeg

 

 

System capacity is another major issue, as we can see from Lancaster's story. We aren't being efficient in how we deliver a lot of services and we end up with many stories of people waiting too long to receive service. Usually once its delivered its good.

 

Our biggest issue imo is administration. Too many self-interested fiefdom's and layers of management. We have no need whatsoever for 6 health authorities. Just those barriers alone cause all kinds of unnecessary costs and delays. E.g., it was only very recently that BC had a system to track physicians working in one health authority vs another one. A doctor could lose privileges in one area, and go work in another and no one was aware of their history, so you had bad physicians moving around and no one was tracking it.

 

Look at our more recent example with Fraser Health having online vaccine booking, and Coastal had a botched phone system. Yes it all eventually caught up, but I guarantee it cost far more than was necessary and may have caused some family tragedies with needles delays. 

 

Just one of many examples, but it comes down to not being able to make the most efficient use of our tax money to provide the best services. We need a single, centralized and streamlined system, not the patchwork we have now. 

 

 

 

 

 

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10 hours ago, janisahockeynut said:

You don't think your Pharmacist could not monitor? I mean if you have extended medical, your Pharacist and your extended Medical won'y let you order early, even 10 days ealy, so I don't think you can use that reason.

 

Also, I am not saying all meds, or all exams, or tests, but if you are willing to pay out of pocket, why not allow us the choice. I am an adult. I can make good choices, I have raised 2 kids.............

 

It is like the Doctors are protecting themselves...... again I don't need to see a doctor to get medication advise, a pharmacist can do that, and does in many countries........

Famous last words right here

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1 hour ago, Jimmy McGill said:

you've hit on a few things here @janisahockeynut. There are a number of things that can be improved, from prevention, the system capacity. and how its actually run. 

 

We don't do much in the way of encouraging people to stay healthy, with things like 5G and the large telecom's like Telus we might finally be on the cusp on monitoring people remotely and actually treat things before they are a serious problem. High blood pressure .e.g, is something many people feel no symptom from until its a serious issue. But this idea of monitoring people isn't new at all, I like to use this pic sometimes to make that point. The ideas been around for a long time, but our successive governments just don't put money into prevention measures.

iu-1.jpeg.cf22489c34c93851cda127d4d76a1ec4.jpeg

 

 

System capacity is another major issue, as we can see from Lancaster's story. We aren't being efficient in how we deliver a lot of services and we end up with many stories of people waiting too long to receive service. Usually once its delivered its good.

 

Our biggest issue imo is administration. Too many self-interested fiefdom's and layers of management. We have no need whatsoever for 6 health authorities. Just those barriers alone cause all kinds of unnecessary costs and delays. E.g., it was only very recently that BC had a system to track physicians working in one health authority vs another one. A doctor could lose privileges in one area, and go work in another and no one was aware of their history, so you had bad physicians moving around and no one was tracking it.

 

Look at our more recent example with Fraser Health having online vaccine booking, and Coastal had a botched phone system. Yes it all eventually caught up, but I guarantee it cost far more than was necessary and may have caused some family tragedies with needles delays. 

 

Just one of many examples, but it comes down to not being able to make the most efficient use of our tax money to provide the best services. We need a single, centralized and streamlined system, not the patchwork we have now. 

 

 

 

 

 

I think having different health authorities makes a lot of sense. Healthcare is very different in rural northern BC than it is in New Westminster. The challenges that northern rural medicine faces are different challenges than more populous areas face. Access to care... training, hiring and retaining professionals... outdated systems, aging population, more individualized service to local indigenous population... I think there is a good argument for separate health authorities

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2 minutes ago, KristoffWixenschon said:

I think having different health authorities makes a lot of sense. Healthcare is very different in rural northern BC than it is in New Westminster. The challenges that northern rural medicine faces are different challenges than more populous areas face. Access to care... training, hiring and retaining professionals... outdated systems, aging population, more individualized service to local indigenous population... I think there is a good argument for separate health authorities

why does it need to be separate to be effective though? what good does that extra layer of decision making do for you? why have two systems for physician credentials? or purchasing? or capital planning? 

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My son works at a regional hospital. He tells me that many staff are disillusioned by management with zero accountability and no long term planning.

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1 minute ago, Boudrias said:

My son works at a regional hospital. He tells me that many staff are disillusioned by management with zero accountability and no long term planning.

our system doesn't value innovation in service. There's no incentive at all for administrators to make improvements, and add to that multiple layers of management and an inept Ministry of Health. You couldn't have a better system design if you want to kill innovation. 

 

That doesn't mean we need to jump to private, we just need to adopt better strategies. 

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10 minutes ago, Jimmy McGill said:

our system doesn't value innovation in service. There's no incentive at all for administrators to make improvements, and add to that multiple layers of management and an inept Ministry of Health. You couldn't have a better system design if you want to kill innovation. 

 

That doesn't mean we need to jump to private, we just need to adopt better strategies. 

Building incentives into the system would probably benefit. My son tells me they have meetings with NO agendas. Senior manager who took last 14 months of her employment before retirement, on sick leave.  No replacement and no directions. 

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4 minutes ago, Boudrias said:

Building incentives into the system would probably benefit. My son tells me they have meetings with NO agendas. Senior manager who took last 14 months of her employment before retirement, on sick leave.  No replacement and no directions. 

yeah thats the stuff I recall from when I was working as a consultant. 

 

In fairness to some of them, the system we have tends to beat any innovative impulses out of people. And then you get people into those roles that seem to thrive on the do as little as you can approach.

 

I know centralized planning has its downsides too, but its really ridiculous when it takes years to roll out programs due to having to push it through 6 different HA's. We're only 5 million people in BC, we don't need to be so top heavy. 

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Things could always be better.  There is always room for improvement.   But be careful not to throw out the baby with the bathwater. 

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54 minutes ago, Jimmy McGill said:

why does it need to be separate to be effective though? what good does that extra layer of decision making do for you? why have two systems for physician credentials? or purchasing? or capital planning? 

You would have a second layer of decision making either way, centralized system or not. Even if you took away the label of health authorities, theres no way a provincial system could operate with a "one size fits all" plan. 

The local health authority has insight into what the needs of their communities are. They (at least try to) spend money on what is actually important to community health, which is different in different areas.

 

I'm not saying that there isnt redundancy and waste in our system. I just dont think it's in the separation of health authorities. I think that leads to better outcomes 

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