When a system is failing there are stopgap measures one can put in place to keep it running - albeit much less efficiently than if it had a complete overhaul. We have all kicked various motors or rebooted our computers or pleaded to inanimate objects. Sometimes effective in the short term, but eventually the things that these objects or machines can’t do increase and accumulate and the system fails.
It’s not that we don’t know we’d have better results if we looked after the whole system rather than the most obvious ‘quick or simple fix’. After all, the evidence is there. Whether it be a machine or a health care system, we have the evidence that investing in knowledge (how do I keep my machine/health in good shape), prevention (are we doing regular maintenance), early intervention (check out those noises), and proper use (the right tool for the right task) makes a difference in the longevity, efficiency, and effectiveness of a system.
So how do we know if a system is failing? In Health Care the signs include a high level of turnover or dissatisfaction in staff, long waits for urgent care, a lack of health promotion and prevention services, professional territoriality and limited scope of practice, top down governance, and an increasing call for more and more high cost professionals whose job it is to offer services to fewer and fewer people. The care model gets tipped on its head and we are no longer investing enough in promotion, prevention, early intervention, and efficient use of a wide range of professional and paraprofessional expertise.
It’s not that we don’t need more doctors but perhaps what people mean when they say “I need a doctor” is in many, if not most, cases, “I want the security that comes with knowing my (and my family’s) physical and mental health needs are being met”.
If we understand that this is the task, or desired outcome, of our system we will build and support a medical system that will be more upstream, patient centred, comprehensive, wellness focused, and successful in matching the need of the individual with the appropriate program or professional.
Susan Hartley is the Green Party of PEI's Shadow Critic for Health & Wellness, and the Green nominee for District 2 - Georgetown-Pownal in the upcoming provincial election.