Fixing the healthcare system in Québec
After years of denial, the Québec health minister finally admitted that there isn't a shortage of doctors in Québec and that the health care problems are administrative in nature.
I believe there are relatively easy ways to fix the health care system, and I hope one day someone will listen to my ideas.
Here are they, in no particular order:
- Doctors in private clinics have multiple billing limits: per week, per month and per trimester. All of the weekly limits reset on Thursday mornings, creating an artificial shortage of doctors on Wednesdays. The expiration should be spread along the week, along the month and along the year in the same way our license plates expire on different months of the year.
- Doctors in private clinics should be allowed to work occasional shifts in hospitals, giving them a salary for their work which doesn't count toward any limits.
- Areas without any hospitals should have at least one big clinic designated as a primary emergency healthcare facility for which no limits on acts would be imposed on doctors such as is the case right now for hospitals.
- Instead of only building massively big hospitals, the government should build "emergency" hospitals which are small hospitals consisting of only an emergency room, a small trauma ward, an x-ray lab and perhaps a maternity wing. The idea isn't to create a full hospital with multiple floors to house long-term patients, just a small emergency room where patients in cardiac arrest, car accidents or even just any condition too severe for a clinic might go without driving too far. But the kicker would be that those hospital would be financed like clinics and not like hospitals: they wouldn't have a yearly budget but instead, would finance themselves on the acts performed.
- Next to each and every hospital, build an hospital run clinic (like at the Maisonneuve hospital) with a unified front desk determining if a patient should be seen at the hospital (priority 1 to 3) or the clinic (priority 4). This would free hospitals from patients who shouldn't even be in the hospital in the first place.
- Create a new position in hospitals to follow up on clinic diagnostics. If you go to a clinic and the doctor diagnoses you but needs the resources of the hospital (such as to make a cast), you currently have to get a new diagnostic from the hospital, wasting time and resources.
- Create first level treatment positions which would allow nurses with special training to begin treatment of certain common problems. A urinary tract infection usually requires a simple pee cup test with a test strip. If performed by a nurse early during the waiting period, the patient might elect to go home if negative instead of wasting hours in the waiting room.
- Split the waiting rooms in two independent areas: one for sickness and one of injuries. A person with a broken elbow isn't contagious, for example.
- When possible, create two lines of treatment: one of fast responses and one for slower ones. Many conditions require only a one or two minute consultation and allow to fast track many patients. This wouldn't be a full time position: if a hospital has 2 doctors on staff, they could each fast track quick patients 15 minutes per hour