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LETTERS: Family docs not the sole solution
Re: The family-physician dilemma in B.C., Feb. 6 column.
Although I applaud the Ministry of Health and BC Medical Association’s attempts to improve access to family physicians, I have doubt this effort will make much of a difference to the health of our health-care system.
Almost every week, I hear of overcrowding in hospitals or people affected by slow health care.
Health care has become so complex, we need to consider doing things differently.
The group BC Emergency Doctors states that up to 94 per cent of emergency-department patients already have a family physician. So what is the problem?
As a home-care nurse, I see a variety of issues.
First, although you may have a family GP, it is near impossible to see them in a timely manner.
Second, those with chronic health conditions, who are on multiple medications, rarely receive the time they need to be fully assessed. I had one patient who became short of breath but had to wait three days to see her GP. The next day she ended up in emergency.
Often I see patients who are elderly and dealing with dementia. My first visit is usually spent organizing medications. GPs don’t see this, so many patients miss medications that are essential to staying out of hospital.
As columnist Chris Bryan states, he was left waiting for hours while his GP was delivering a baby. I highly doubt his GP would have had the time to help an elderly person organize their daily regimen.
Further, there are areas of practice that GPs just don’t have time to keep up on, such as wound care and immunization. I propose the BCMA and ministry of health consider the use of registered nurses and nurse practitioners, working in a team with family physicians. RNs and NPs have wide scopes of practice, as well as a mandate to educate our patients.
Further, I’d like to ask why GPs are still performing women’s exams, STI counselling, wound care and immunization practice. These are all topics nurses are well educated in and sometimes more educated than GPs.
I have heard of a number of teams of doctors and nurses or other health-care professionals that work effectively together. In fact, a doctor at an orthopedic practice in Ontario loves working with advanced-practice physiotherapists, as they ensure patients really need to be seen by a doctor. He says patients are educated about surgeries and recover faster, as they are better prepared, both physically and mentally. More importantly, their wait list for surgery has been reduced.
There are some GPs who employ nurses in their practice. Unfortunately, because the nurse’s salary has to come from the GP, there is little incentive to hire more.
We need to create a system where the right professional takes care of the right scope. If we do this, perhaps we will free up time for GPs to see patients who really need their expertise and thus decrease visits to emergency, which leads to decreased overcapacity in hospitals.
Zoe Menge, Surrey