By Stephanie Kovala
If you’ve ever waited at an emergency room you might be thinking; “wait a second… health care waits for patients? How is this possible?” It seems that whenever health care is brought up, the conversation orbits the great debate of wait times (yes yes – as in patients waiting for health care). And it’s true. Wait times in Canada are amongst the highest.
But consider this: health care waits for us too. The whole system is designed to wait – wait until we get sick and then take care of us. The beds, the expensive equipment, the doctors, nurses, knowledge and technology… all ready and waiting for an illness to treat… all used or applied in a reactive way to our nations health woes. Maybe that’s the problem. And maybe examining this unique scenario of ‘dual waiting’ is key to finding a solution.
When you think about health care, what words come to mind? Answers generally include the following: Sick. Patient. Doctor. Emergency. Hospital. Treatment. Waiting. Medicine. Ambulance. Tests. Needles. MRI. Nurses. Scans. Cure.
The interesting thing about those words is that they all connote illness. People can’t help but associate health care with illness, treatment, and, ultimately, the need to be sick – its what we’ve been trained to do. And there’s good reason why.
If you take a look at Health Canada’s website under the ‘Health Care System’ section, you’ll find information about the system (Medicare) providing medically necessary hospital and physician services.
Heck – even the name ‘Medicare’ sounds so medical. In the UK, their system is called the ‘National Health Service’!
To drive the message a little further, think about mainstream media and the news you’ve heard regarding health care in Canada. Most of the topics revolve around long wait times, shortage of hospital beds, rural patients travelling great distance for care, the deficit, not enough doctors, medical breakthroughs, and the advancement in complex treatments. Not all of these topics are negative, but all are medically based and assume reactive approaches to care.
All of this sums up a pretty simple point: our system emphasizes taking care of sick patients. Medicare is fundamentally based on a medical model of health delivery.
The problem is that in a time of aging baby boomers and chronic illness, patients have flooded the system to a point that is unmanageable. And thus the patients’ wait begins.
To prevent us from having to wait for health care, Medicare needs to stop waiting for us to require it. In other words, focusing on a fundamental shift from a reactive to a proactive system is key – and, to give Health Canada a little credit, this is beginning to happen. (In small ways.) (Slowly.)
So what can be done to transform Medicare from a system that waits for sick people to literally crowd its door, to a system that encourages health and prevents people from needing medical services? We know this needs to happen… but how?
These following ideas aren’t meant to solve the massive problems in Canada’s health care system, but rather help drive the necessary shift from reactive to proactive strategies:
1. Measuring clear priorities in health as is done in the UK and Ireland
- Defining regional health issues and targets would help local hospitals and health agencies better focus and measure their efforts to improving health and preventing illness. Thus instead of organizations running potentially unnecessary programs, they will have a clear direction, goals, and a better chance at positively affecting health by creating targeted health promotion and prevention programs.
2. Implement systems that require prevention and promotion
- Linking doctors’ salaries to the health outcomes and improvements of their patients as is done in the UK, would position prevention strategies at the forefront of care. Having doctors refer patients to nurse practitioners that are in place to help patients set goals and self-monitor health would also support the shift to a proactive system.
3. Shifting Canadian perceptions of health care
- We know the system needs to focus on promotion and prevention, but we have not done a good job of portraying this to the general population. Health care can team up with patients, and gain their support, by being explicit about the need to shift to proactive approaches. Canadians think that wait times are a huge problem because they are… but also because the media says so. The problem is further perpetuated when the government scrambles to find quick fixes to wait times – which ends up urging Canadians to continue thinking in terms of reactive solutions. Meanwhile, the necessary shift to a proactive system doesn’t make it to the front of people’s minds. If the government and the media addressed the positive work of the system with regards to prevention and promotion, perhaps patients would better utilize these services.
Perhaps if Canadian health care didn’t wait for us, we wouldn’t have to wait for it. Nevertheless, until brave, new, dedicated champions dramatically transform the foundation Medicare rests on, from a reactive to a truly proactive system, Canada’s health care system won’t be the only one that waits.
This article is published under the Bright Ideas project, a joint Ivey International Centre for Health Innovation and NationalHealthWatch.ca initiative aimed at promoting ideas of future leaders and generating dialogue. Over the course of the next three months, Bright Ideas will profile blogs from Ivey health stream students.
The views expressed in these blogs are the opinions of their authors, and do not necessarily reflect those of the International Centre for Health Innovation or NationalHealthWatch.ca.