On a rant

The entire city is buried under a whirling blanket of snow and in order to put off, as long as possible the inevitable clearing of the walks, I will offer you my thoughts on this week’s health care news. I’ve already fed the cat, watched the snow blow, read my emails, checked facebook, fantasized about the latest real estate listings that have popped up in my inbox, checked out the upcoming conferences I won’t be able to attend and reviewed the amazon site for books I might like. What else can I do?

It’s been an interesting week in health care news. The Health Quality Council finally released their report into allegations made by the Raj about how the newly formed AHS (newly formed in 2008) was muzzling physicians and allowing politicians to jump the que in the supposed lines for health care. Oh yeah there was also the 200+ something Albertans who died while waiting for treatment for their cancer. So now they will have a judicial inquiry because if you can’t get people to voluntarily tell you about the patients they had who died waiting for surgery, compelling them by subpoena will work to get the information you want. If that doesn’t get results, well water boarding is always an option. Of course the whole thing – like so much in healthcare – is focusing on one aspect and missing the mark on the problems in health care. Doctors muzzled and unable to advocate for their patients? Consider that nurses, the ones who spend more hours per profession at your bedside and the ones who are uniquely positioned to know what the hell is going on with you on an intimate, personal level, have been muzzled for decades by physicians and administration. I dare say the same is true for all the health care professions since silence is the norm in health care.

A 2005 study conducted by the American Critical Care Nurses and Vitalsmarts found that most health care workers observed a co-worker taking a break from best practice and safety standards in delivering care to you and your loved ones but less that 10% of them spoke up and said anything. Why not? Well the culture in health care leads to a fear of speaking up. This is not new behaviour as a result of AHS domain, this is health care culture behaviour. And to be honest, it is in good part human culture. Speaking up violates the tribal rules of Stick-together. If we point out the mistakes of others, someone will point out our mistakes and no matter how much you insist you would want to know if you made a mistake, the gibbering monkey-brain lodged deep inside your skull does NOT like being singled out as doing something wrong. On top of that we have the human tendency to look for a scapegoat (see the above mentioned pointing of fingers at AHS). We determinedly look for someone to blame. Someone with a cookie in hand perhaps, or someone with a portfolio of health and a tile attached to him name. The reality is that this is no one individual’s fault and no judicial inquiry or investigation can fix it. A change in culture comes from generations of changing behaviours and attitudes. Another band-aid will not solve the problem.

In other news migraine suffering mothers have colicky babies. Or is it colicky babies have migraine suffering mothers? Could it be that colic, that dreaded syndrome of infancy, is in actuality childhood migraines? Of course the news report focuses on the headache aspect of the migraine syndrome – which is often not the best part. How about the abdominal pain, visual aberrations, somatic disturbances and my personal favourite, Alice-in-wonderland syndrome? As a colicky infant (according to mum, and who is going to dispute her?), grown into a child with constant stomach aches and trips down the rabbit-hole, gown into a dizzy, scintillation scotoma watching mum, I can verify the chain of events. Sure, I could blame my mother for continuing to feed me cow’s milk and wheat foods, but really, isn’t that just looking for the simple answer of Blame the Mother?

Oh and then there is the looming drug shortage. No, not the drugs from your UN-licensed pharmaceutical dispenser, the ones you get from your local shoppers. Sandoz Canada, the company that builds a large number of the drugs we use daily, has received a Stop It order from the FDA. Now, I can hear you asking, FDA? what the fuck do they get to say about a Canadian company manufacturing in Quebec (or if you didn’t ask, you should have). Simply, Sandoz makes drugs and ships to US and Canada and the FDA has some serious concerns about the plant’s inability to keep the microbiological contamination of the products down to a minimum. Now news reports says Sandoz won’t tell what drugs are effected, but insider information suggests that the list includes a good number of those medications we hold dear in health care. But don’t worry, we can always go back to what we did before – give you a bullet to bite on and bleed you. Perhaps you would be better served getting your medicinal products from the UN-licensed dispenser after all.

Oh and back to Alberta, the fearless opposition has again turned to pointing fingers about the ER wait time and demanded yet another inquiry. Seriously? How many of these do we need to have? We know the system is broken. We know people wait too long in the ER. we know EMS crews can’t off load fast enough and are held up in the ER when there is not a nurse, or a bed available for their patient. So until the public stops using the ER as their primary care facility this problem will exist. And as long as the public has no other option but to use the ER as their primary care, the problem will exist. And as long as there are not enough long term beds in the province, the problem will exist. The problem is not in the ER. The ER is simply the flashy front door of the madhouse. Sure, they can cure you in one hour at those efficient hospitals we all remember from days gone by – Chicago Hope, Mercy and what ever ER George Clooney worked in, but in real life it takes hours to get a radiologist in to blow open your carotid artery or review your brain scan. It can take a full day to get a neurologist down to see you about the dizziness you have had for 3 weeks but has suddenly become urgent, not because of any change but because there is nothing good on TV tonight. And don’t even think of dragging your 14 year old daughter into the ER and demanding we drug test her because she is acting unreasonable. She is 14, she is a raging hormone running on red bull and fried foods and we can’t legally do it.

And then there is the headline of shame that Canada doesn’t track the number of deaths nationally from percription drug overdose. Tsk, tsk. the news media in their fervor for something to whip people into a frenzy over have discovered that in BC there were, get ready for it – approximately 150 deaths from narcotic over dose per year between 2000-2009. Whew! In Ontario the number is higher. This is a health issue apparently because these predominately young and predominately men are offing themselves accidentally by snorting, shooting and otherwise intentionally abusing a medication they shouldn’t even have in their possession.

Well that’s it – there is so much more but I need to stop reading the news, it is altering my brain chemistry. Peace Out.

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