For the first time in history, the entire Ontario Medical Association executive resigned on Monday. To many, this act symbolized sacrifice for the greater good of the OMA board, council and 34,000 doctors across Ontario.
But what does it mean for our patients?
This government has denied and dismissed an inconvenient truth: our health care system is broken. Patients see it, as do the health care workers who serve them. Yet few talk about it. Here’s why: if hospitals protest, their funding is compromised. If nurses protest, they are fired. Doctors truly are the last line.
And nothing fires physicians up more than suffering.
The statistics are worrisome: for a population its size, Ontario has the fewest hospital beds, the worst nurse-to-patient ratios, the lowest number of physicians. Yet it has the highest number of bureaucrats.
These statistics codify a terrible reality:
- My patients wait months now to see specialists; many wait years to get surgery.
- Caregiver burnout is escalating and long-term care is only accessible via crisis wait-lists.
- Hospitals cannot find beds let alone pillows for admitted patients. Waits in emergency departments are standing room only.
- Palliative patients are wait-listed for home care.
- Surgeries — even pediatric and cancer surgeries — are cancelled on a near-weekly basis.
- Patients now wait two months on average for a cancer diagnosis; many wait longer for treatment — and yes, some die from the wait.
This is what a health care system in crisis looks like.
As less and less of the health care budget is invested in the fundamentals of care, more and more is diverted to bureaucracy. This is what happens when government policy ignores the voices of patients, caregivers and front-line providers.
Bill 41, the Patients First Act is an obvious example. It passed despite widespread protest by doctors, nurses, OPSEU, caregivers, patient advocates and health system pundits. In an interview with TVO’s Steve Paikin, Health Minister Eric Hoskins claimed Bill 41’s massive bureaucratic reorganization will produce “savings”. Yet Hoskins would not promise to reinvest these “savings” back into patient care. That is poor policy.
Bill 87, the Protecting Patients Act, is another example. Its goal makes sense: tighten regulations around sexual misconduct. The problem: Bill 87 is an end-run around the necessity of investigation and proof.
As a woman, I believe that physicians found guilty of sexual misconduct should be punished. But Bill 87 skips legal process: any physician accused of any offence will be reported publicly, fined heavily and could have their licenses suspended, in some cases without notice.
Presuming guilt before innocence is not justice.
If the Liberals pass Bill 87, basic care will suffer — from throat swabs to doctor visits to clinical exams. To avoid a witch hunt, doctors will stop examining breasts for lumps, testicles for cancer, groins for hernias, hearts for murmurs, abdomens for aneurysms and lungs for pneumonia. This is not fear-mongering. This is the measured analysis voiced by physicians across Ontario.
Already, hospital administrators recommend nursing supervision for all patient encounters. For family doctors paying $100 000-$150,000 in annual overhead, an extra nurse is an impossible expense.
Good medicine will collapse under fear. Healthy doctor-patient relationships build on trust that goes both ways. We must foster an environment where patients can trust doctors, and doctors can trust patients. Bill 87 is a giant leap in the wrong direction.
Medicine is my calling. It’s why I drive out at midnight to resuscitate a father of two. It’s why surgeons in my community do a week of call straight. I still remember the first premie I saved. The first brain tumour I diagnosed. The first heart I cradled at 3 a.m. in the cardiac surgery suite. The first time I cried from overwhelming fatigue in the ICU. The first time I intubated a 3-year-old with a face broken in a car crash. The first time an obese patient lost enough weight to stop their blood pressure medication. My first palliative patient. My first house-call. The first patient who said, “I trust you.”
Being a doctor is a call to duty. The consequences of poor government policy are severe and intolerable. So now, doctors will unite like never before to speak truth to power. People value their health care and their doctors. They will not let the Liberal government steamroll their care without a fight. It’s time for this government to submit to the will of its people.
Dr. Nadia Alam, a family doctor and anesthetist in Georgetown, is an advocate for physicians, patients and the health-care system. She serves on the OMA Council and will join the OMA board this spring.
Dr. Nadia Alam, a family doctor and anesthetist in Georgetown, is an advocate for physicians, patients and the health-care system. She serves on the OMA Council and will join the OMA board this spring.
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