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LETTER: What I would do if I were Minister of Health in B.C.

A Surrey physician offers a prescription for improving health care in B.C.
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One Surrey physician offers her ideas of how she would fix B.C.'s health-care crisis.

Editor,

As a community family physician and physician leader for over two decades, I have daydreamed about what I would do if I was Minister of Health for a day. My ideas are mirrored by the OurCare project community participants across our country. The list is long, but here are some principles and examples:

1. Make our health-care workers’ jobs easier

It’s easy to pay lip service to health-care worker wellness with surveys or free meditation apps. But how about making their daily work just plain easier? I would assign every hospital clinician a tablet so that they could make chart notations directly into the electronic medical record instead of the antiquated use of paper and pen. I would load those tablets with software that automatically dictated their notes for them so they could spend less time on clerical work and more time providing patient care. Unit clerks could help coordinate care and ensure that investigations are completed instead of performing duplicate duties as writing out medication lists. Physicians would no longer wander around looking for the paper chart with the patient’s vital signs or the emergency room physician note.

We would all feel a lot less frustrated. We would all spend less time logging in and out of whatever computer terminal we could find. The savings in paper, printers, document scanning would easily pay for the cost of the hardware and upgrades in wifi that would be required. Not only that, patient quality would improve because of decreased opportunities for errors. 

2. Make health authorities accountable and link services to how they make sense.

I would install efficiency experts in each health authority to review processes to remove the bottlenecks and ensure that every single staff member is contributing to the maximum. I would demand they minimize bureaucracy to maximize resources on direct patient care. I would streamline and unify supplies and equipment under a provincial procurement department so that we could bulk buy gloves, swabs and other supplies and make sure that there is consistency across the province so that healthcare providers who work in various settings don’t need to re-learn what swabs and are for what in each different locale. 

Mandate electronic medical record connections between all health authorities so that patients can be assured that no matter where they are in the province, their health care providers can review their health-care data. 

I would move child and youth mental health care from the Ministry of Child and Family Development where it is underfunded and forgotten. It needs to be re-united under the Ministry of Health so that we can provide the wraparound care those children and families deserve. 

3. Give patients tools to stay healthy.

The savings from decreased health authority bureaucracy would be spent giving patients ways to stay healthy. Like free blood pressure monitors for low-income patients so they can pro-actively monitor their blood pressures. Easy and free access to lifestyle programs to educate patients about different ways of eating and exercising to stave off diabetes and other chronic conditions. There are free programs already created and available — we just need to create access for patients.

4. Adapt and expand the current urgent primary care centres into community health care centres.

Community family physicians are experts at running cost efficient and comprehensive clinics. Give them the capacity to transform current and future care centres into beacons for all patients: providing after-hours care for attached and unattached patients; helping unattached patients become linked with permanent primary care providers; co-location of multiple team members such as social workers, counsellors, dietitians, nurses, home health providers, and physicians so that patients receive the care they need from the right clinician from the start and can access it from a single door instead of multiple ones. 

5. Banish fear.

There is a reluctance to try radical solutions. Our health-care system is imploding in front of us — unless we want more of the same, we must try different ways. For example, offering virtual ER services to rural emergency rooms so that we can ensure that all emergency rooms — rural and suburban — have 24/7 coverage. There are not enough human resources to continue to provide healthcare like we always have. We must push through the fear and use every technology we can to maximize efficiencies—from digital scribe software to incorporating patient wearable data. We can keep patients healthier with less effort if we approach things differently. 

Stop creating solutions based on the next election cycle and instead embrace the Indigenous philosophy of thinking for the next seven generations. What kind of health care system do we want for our future generations? One that continues to be a Ministry of Disease or one that is the Ministry and creator of health?

Dr. Tahmeena Ali, MD, CCFP, FCFP
Chair, past-president, BC Family Doctors