A Cape Bre­ton doc­tor says the next gov­ern­ment needs to bet­ter de­ter­mine who and where health re­sources are to be de­ployed through­out the prov­ince.

Nova Sco­tia Health Author­ity has mud­died the waters

Cape Breton Post - - Cape Breton - Dr. Robert Mar­tel Guest Shot Dr. Robert Mar­tel prac­tices pal­lia­tive care in Arichat, Rich­mond Co.

The short­age of health-care pro­fes­sion­als in ru­ral com­mu­ni­ties is a global prob­lem that poses a se­ri­ous chal­lenge to eq­ui­table health-care de­liv­ery.

The lack of enough physi­cians in ru­ral ar­eas and in some re­gional cen­tres has be­come the prime fo­cus of this elec­tion cam­paign. All party lead­ers have vowed to re­cruit more for the prov­ince.

The de­tails are skimpy, but the de­sire is strong. Peo­ple have a right to be skep­ti­cal af­ter decades of fail­ures.

In Nova Sco­tia, we are told we have more physi­cians per capita com­pared to the rest of Canada, but many re­cent publi­ca­tions dis­pute this.

This frus­trates the 100,000 Nova Sco­tians with­out a fam­ily physi­cian. Where is the health hu­man re­source plan to ad­dress this is­sue?

Nova Sco­tia is com­pet­ing for health hu­man re­sources with all other prov­inces. Throw­ing money at the prob­lem is a failed global strat­egy, a fact that has ap­par­ently es­caped the no­tice of both the politi­cians and the Nova Sco­tia Health Author­ity (NSHA).

In a well doc­u­mented study by the Cana­dian So­ci­ety of Ru­ral Physi­cians, fi­nan­cial in­cen­tives ranked fifth in a list of 10 fac­tors af­fect­ing re­cruit­ment and re­ten­tion of ru­ral health-care pro­fes­sion­als, be­hind these sim­ple ob­ser­va­tions: Med­i­cal stu­dents from ru­ral ar­eas are more likely to re­turn to their ru­ral roots.

Mar­i­tal part­ners of those physi­cians, whose own roots are ru­ral, en­hance the chance of ru­ral re­ten­tion.

Spouse em­ploy­ment, col­le­gial sup­port and group prac­tice are pow­er­ful en­ablers of both re­cruit­ment and re­ten­tion. To solve the prob­lem of ac­cess to timely care, it is nec­es­sary to look at the real is­sue:

physi­cian­cen­tric care mod­els. To­day a dif­fer­ent real­ity ex­ists and ev­i­dence has shown that physi­cians are not al­ways the most ap­pro­pri­ate care providers for all health prob­lems.

It is a fact that peo­ple still want to live in ru­ral Nova Sco­tia. In­deed, the de­sire for baby boomers to re­tire to an­ces­tral lands is on the in­crease.

Baby boomers bring three things with them when they move back: high ex­pec­ta­tions, sig­nif­i­cant fi­nan­cial re­sources and critical an­a­lyt­i­cal skills.

They are pre­pared to use all of these to lever­age ser­vices, as was in ev­i­dence in Syd­ney Mines and in Digby in re­cent weeks. Vo­cal, ed­u­cated, net­worked and tech­no­log­i­cally savvy, this will be a for­mi­da­ble group to pla­cate with the usual plat­i­tudes.

As medicine has be­come more com­plex, team-driven and tech­no­log­i­cally ad­vanced, the strug­gle to pro­vide timely, ev­i­denced based, cost-ef­fec­tive and ap­pro­pri­ate health care has be­come more the ex­pected par­a­digm than it was in the past. Why pro­pose 1980s so­lu­tions for 2017 prob­lems?

The NSHA has mud­died the waters by mov­ing the dial to a col­lab­o­ra­tive

model of care for fam­ily prac­tice, iron­i­cally with­out col­lab­o­rat­ing with ei­ther the con­sumer of health care or the front­line provider.

They have failed to com­mu­ni­cate the mes­sage and their sin­gle­mind­ed­ness around who and where health re­sources are to be de­ployed has alien­ated the very cham­pi­ons they need to bring about this trans­for­ma­tional change in health-care de­liv­ery. In ad­di­tion, they have failed to share the ev­i­dence that this model is cost-ef­fec­tive.

It can­not be left to cur­rent providers to come up with a plan to im­prove ac­cess to health care. They are too in­vested in legacy prac­tice to be suc­cess­ful on their own.

But nei­ther can their in­put be de­val­ued as it has by the Health Author­ity.

“Why pro­pose 1980s so­lu­tions for 2017 prob­lems?”

Ru­ral res­i­dents of Nova Sco­tia want ac­cess to ev­i­denced­based medicine and they care not who pro­vides it, as long as it is up to date, timely and has pos­i­tive out­comes.

Some­body has got to get out of the way.

Let’s start by gov­ern­ment pro­vid­ing the en­vi­ron­ment and let­ting non-gov­ern­ment con­tent ex­perts de­velop a busi­ness plan to make it hap­pen.

Newspapers in English

Newspapers from Canada

© PressReader. All rights reserved.