After working for three months in Saskatchewan, a recently graduated family doctor witnessed too many issues with the province’s health-care system to stay.
Article content
I’m a family doctor, and I have something to say.
Saskatchewan, your health-care system is in trouble. Here’s my take on why that is, and what can be done to change it.
I’m a 32-year-old female physician, a graduate of McGill University, working in Saskatoon for a three-month let’s-test-out-the-local-work-life trial run. I have family here, including access to the cabin at the lake. I came here fully open to the possibility of moving and working here.
Advertisement 2
Article content
Alas, I’m leaving.
Round 1: Let’s point out the obvious. The Saskatchewan family doctors‘ pay schedule is not competitive, even with your new model. In British Columbia, I am paid for my time as well as my visits. This incentivizes good medicine.
If I need to take 40 minutes for a memory-troubled elderly patient and the patient’s family, I’ll get paid for it. This also encourages me to keep better patient records, benefiting everyone.
In Quebec, the family medicine clinics are such that patients who do have a family doctor often also have access to a group of other professionals, such as a physiotherapist, dietician, social worker, pharmacist, psychologist, registered nurse and nurse practitioners.
Their model allows me to offload tasks and optimize each encounter.
Round 2: The system in Saskatchewan is a mess. There are many reasons why. Here’s one: Consultations are not systematically pooled. This means that when I refer a patient to a specialist, I am often picking one like I would a name from a hat, without a clue of whose list is longest and who does what.
In Quebec, consultations are standardized and funnelled, so that all “Bright Red Blood Per Rectum” problems can be triaged and prioritized accordingly. “Unintentional 30-pounds weight loss,” high on the list, “hemorrhoids,” you can wait.
Afternoon Headlines
Article content
Advertisement 3
Article content
Whichever specialist can and should see them next does see them — provincewide. Do I even need to explain how helpful this is?
Round 3: In Saskatchewan, you are trained to operate far too well with walk-in clinics. It’s more lucrative for doctors for see 45 patients in a day than 25. This model shifts care away from family practice. Moreover, patients expect a quick-fix visit.
Could you have guessed that it takes way more time (and energy) to say no to an antibiotic for a viral infection than it does to say yes? Let alone make sure you’ve had your Pap test. The walk-in clinic is the perfect recipe for doctor burnout and sub-optimal care.
Round 4: Your doctors are tired, frustrated and have all but given up on advocacy. Your patients are either fighting us (as we are the outward reflection of the system) or are giving up on themselves or their loved ones. And you know what? You Saskatchewan folks are so incredibly kind amidst all of this.
This is why I am writing this. No one wins here. This is not a battle of government versus doctors. There is no other here. This is your mom, your brother, your friend. This is for you.
Advertisement 4
Article content
You want more family doctors? You want better care, system flow, test access and specialist access? Stop creating rules about the number of minutes for which it is appropriate to say I provided counselling to the patient. See the forest through the trees.
Pay your family doctors like their work is valuable. Build the bottom of the pyramid, the carrot not the stick. The rest will fall into place.
It’s a been a true pleasure, Land of the Living Skies. May you consider getting it right.
Dr. Isabelle Richard is a Quebec-trained family doctor who is currently practising in British Columbia and Saskatchewan.
Share your views
The StarPhoenix welcomes opinion articles. Click here to find out what you need to know about how to write one that will increase the odds it will be published. Send submissions to letters@thestarphoenix.com or ptank@postmedia.com.
Recommended from Editorial
Our websites are your destination for up-to-the-minute Saskatchewan news, so make sure to bookmark thestarphoenix.com and leaderpost.com. For Regina Leader-Post newsletters click here; for Saskatoon StarPhoenix newsletters click here
Article content
