Total eclipse of the health care system

Iwatched the April 8 eclipse from my back yard. It was a revelation on a couple of fronts. I was first surprised by the sudden drop in temperature which occurred when only a relatively small part of the sun was hidden. The second surprise was at how bright everything still was when all that remained of the sun, as seen through viewing glasses, was a thin orange crescent. Finally, I was surprised at how bright everything was during those brief moments that the moon completely hid the sun. It wasn’t the darkness I expected. It was more like the illumination on a winter’s night with a full moon, but much brighter.

I was glad to have seen it, but happier yet to have the sun return to its warm self.

Given that the Townships were in the direct path of the eclipse, the event became an occasion for a family gathering. Extended family came from the Maritimes, the West, and even New York City. There were brothers- and sisters-in-law and also the nieces and nephews of the next generation. Some were here for a day or two, while others stayed for a week or more. At one point almost three dozen congregated for a sitdown meal.

For the younger folk, the twenty and thirty-somethings, talk was often about jobs and careers, up-coming weddings, and the challenges of rearing young children.

For the septuagenarians—a rapidly growing demographic in the case of the extended family—talk inevitably came around to the topic of health and our deteriorating bodies. Given the complexity of human biology, it’s not surprising that lots can go wrong. Eyes that once saw clearly develop cataracts. Ears that were once sharp now need hearing aids. Stomachs that were once cast iron are now sensitive to even small quantities of particular foods. Once athletic limbs are now creaking with arthritis. Healthy cells now find themselves under attack from cancerous growths.

At one point, one of the uncles listed his health care providers. In addition to his GP, he counted off four other medical specialists who see him regularly, although not necessarily frequently.

“I must be costing the health care system a fortune,” he said.

“Oh, don’t think about it,” one of the nieces quipped, “you’re worth it.”

The topic of private health care inevitably came up. Here too there were surprises. One of the in-laws underwent podiatric surgery twice— once, several years ago—in the public health care system, and then a second time—on the other foot— with a surgeon practicing privately.

“The wait-time had gotten much longer,” she said, “and I didn’t want to wait, especially since nobody could tell me with any certainty how long that wait-time might be.”

As for the difference between care in the public and private system, there wasn’t any.

My own recent experience with hip surgery echoes this. The orthopedic surgeon who operated on me in a private clinic also works one day a week in a government-run hospital.

The difference for him, as a health care provider, is stark. The day that he spends at the hospital, he is normally scheduled for two operations. However, he said, it happens more frequently than not, that one of them will be postponed. The surgeon has to be available, but he needs a large supporting cast: the nurses who do the preop, the anesthesiologist and nurses in the operating room, the nurses and staff who come into play postop. If there’s a glitch anywhere, the patient can see his anticipated operation postponed.

When he operates in his clinic, the surgeon pointed out, he will perform as many as six operations in a single day (although four is closer to the norm). The difference is that he has a smaller and more specialized staff. Co-ordination and timing are easier to arrange. Everyone is on the same page.

At one point, one of the uncles listed his health care providers. In addition to his GP, he counted off four other medical specialists who see him regularly, although not

necessarily frequently.

“The wait-time had gotten much longer,” she said, “and I didn’t want to wait, especially since nobody could tell me with any certainty how long that wait-time might be.”

The difference is that he has a smaller and more

specialized staff. Coordination and timing are easier to arrange. Everyone

is on the same page.

Nor was my surgeon alone in working in both the public and private systems. Several of his nurses and staff also divide their time between the two, spending part of the week in a hospital setting and the other part at the private clinic.

The same people doing the same work in two different settings. Is there

a difference?

The same people doing the same work in two different settings. Is there a difference?