Suffering symptomatic of the disease of the health system

News 10 February, 2018
  • Photo Chantal Poirier

    Dr. Hugo Viens, special Collaboration

    Saturday, February 10, 2018 05:00

    Saturday, February 10, 2018 05:00

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    The message from Emily, shouting of truth and despair, cannot leave you indifferent. Past the first shock, it deserves however to be followed by a genuine reflection. Unfortunately, it does not seem to be the direction taken by the debate. Most editors and observers are content to see further, and always the proof that all the ills of the health system come from the doctors. Less bonuses, more nurses. The equation seems so simple. Add the resources and everything will be better.

    Really ? If only that was the case. But this is to forget that our health care system, including the organization date of the 70s, is no longer able to meet current needs. The elderly are more numerous, chronic diseases multiply, and care needs too !

    Around the healing and hospitals

    Yet, our health system still revolves around the curative and hospitals. Its funding also. Are the doctors in his heart. They are taught to make diagnoses and plans of care for cure of patients. Today, however, there is no cure for dementia. We do not cure to have the age of 92. On the other hand, we need long-term care. Of care that should be taken care of by teams. But because they have implemented these teams, we burn-out of nurses, left to themselves to take care of the patients always heavier.

    Have you ever wondered why the network is so heavy ? Why the network is overflowing all the time ? If we want to come to the assistance of nurses and patients, we must take the time to question ourselves on the way we consume health care. That is to say, wonder if we hospitalise the right patients ? And if yes, if we can’t prevent many of these hospitalizations, or even to accept that old age should not always be taken care of by the hospital ?

    A bucket without a bottom

    As long as you will not encounter these issues, you can always increase the resources, we will continue to try to fill a bucket without a bottom. For years, the QMA’s work which show that the solution is elsewhere. It is necessary to work on the relevance of the services, stop investing still more in the healing and work to better support the chronically ill, when they are still at home.

    By acting upstream, we can ensure that they do not décompensent, and therefore before their condition gets out of hand and that it is necessary to send them to the hospital. You still need a first line arranged for this type of intervention, with teams trained to use indicators to detect patients at risk to go to the emergency room.

    Then, one has the choice. We can add nurses to the hospital and give them more support to care for patients more heavy, but as always it will put an adhesive bandage on an infected wound. Otherwise, you can also tackle this scourge on our system and enable nurses to work in true interdisciplinarity and to go on the field with the patients, when they are not yet too heavy. Some IPS (nurse practitioner specialty) of the first line are already doing, as well as nurse, and this has been proven. This prevents the entry of patients into the system with the savings that this implies. So, instead of adding nurses to the hospital, let the nurses with autonomy in the GMF, for the support of the elderly and the chronically ill.

    Dr. Hugo Viens is president of the Québec medical Association (QMA). He is a specialist physician in orthopaedic surgery.