Rethinking health-care solutions

Regarding the Guardian editorial of Oct. 30, “Medical school is not a cure for wait list,” I agree that it is a poorly conceived solution and is akin to suggesting that we can solve our affordable housing crises by creating a school of architecture at UPEI.

The editorial raises an important point about the correlation between having a medical school and alleviating doctor shortages. With due respect to Islanders concerns and the immediate issue at hand, I would add that there is considerable research that suggests there is no relationship between physicians per capita and avoidable mortality, or that having more doctors materializes into a healthier population.

In addition, creating a medical school would certainly result in a significant increase in the share of the provincial budget to health care; although again, there is no relationship between increasing health-care service spending and improving the health outcomes of Islanders.

Perhaps a better frame for this discussion is to ask what the key demands of Islanders are for physician services, and how can those demands be met within a broader population health promotion policy perspective. Well-trained physicians and strategically organized and integrated primary health-care systems are critical determinants of a population’s health, but are not the only factors.

I do not know of a single medical school that can train doctors to prescribe a treatment for poverty, inadequate housing, aging, at risk behaviours, social inequality – discrimination, food insecurity or climate change; however, these factors all have a significant impact on our health. Unfortunately, the more our health-care system grows, the fewer resources we will have to address critical social determinants of health as well as generate an array of initiatives which improve the health and wealth of Islanders, e.g., early child development programs, affordable housing and innovations in sustainable agriculture.

From a social policy perspective, the Gross Domestic Product (GDP) is an economic “health” indicator that should not be the only measure of a society’s success, neither should the number of physicians be the measure of a society’s health. I believe that our expectations of, and pressures on, physicians are perhaps a key retention/ recruitment issue as is our failure to effectively organize/use allied health professionals (e.g., nurse practitioners, physiotherapists, psychologists). By creating a population health promotion policy to drive an integrated/collaborative primary health system (which we do not have), we have a better chance to promote the health of Islanders as well as ensure sustainable, appropriate access to physicians, a scarce and critical health human resource.

In the context of climate change, our individual and collective action to “reduce” dependency on non-renewable resources and consumption practices is central to successful mitigation/adaptation strategies. Similarly, if population health promotion can be viewed as a health system mitigation/ adaptation strategy, policy efforts by government must be comprehensive in nature to not only ensure timely access to critical health services by all Islanders when needed, but also to invest in generating population health outcomes as renewable resources.