HEALTH

A LOAD OF TROUBLE

KATE LUNAU July 21 2008
HEALTH

A LOAD OF TROUBLE

KATE LUNAU July 21 2008

A LOAD OF TROUBLE

A new poll shows the E.R. is health care’s 'darkest spot’

HEALTH

KATE LUNAU

Suzanne Davis has made her home in the area of Digby, N.S., for over 30 years. But last year, after falling into a coma due to what she calls a medical error, she started thinking about moving back to the U.S. “A nurse practitioner [accidentally] switched my medication,” says Davis, who takes pills for anxiety. After going into seizures, the 58-year-old was airlifted to Halifax, where she remained in a coma for three days. Although Davis is now “good as new,” this ordeal wasn’t her only trying experience with the health care system. Her 23-year-old daughter suffered for over a decade from fainting spells that doctors failed to diagnose, only to finally discover she was hypoglycemic. And her elderly mother, who recently battled cancer, was forced to travel three hours to Halifax every week for treatment (she’s now recovered). Davis opted not to leave Digby: “This is my home,” she says. Her feelings for the health care system are less warm. According to her, “it’s going down the drain.”

By now, such sentiments about the Canadian health care system are familiar. But it turns out they’re also far from the norm. A new study from Angus Reid Strategies suggests that Canadians are actually pretty happy with the care they’re receiving; in fact, the system’s heaviest users are among the most satisfied. But there are people who fall through the cracks. A whopping three-quarters of user complaints come from just 12 per cent of the population—a “stunning” result, says pollster Angus Reid. And while Canadians are generally pleased with basic services (like doctor visits), they become increasingly critical of more complex procedures, especially hospital stays and emergency room treatment. “If

you get placed in the right part of the system, everything goes well,” Reid says. If not, “you’re in a load of trouble.”

For most Canadians, “family doctors are the gatekeepers of the system,” says Canadian Medical Association president Dr. Brian Day. And while 83 per cent now have a physician, according to the poll, “that’s still one in six who don’t,” Day notes. Those Canadians who complain the most about health care—dubbed “the disaffected” in the studyare likely to have the weakest relationships with their physicians. For them, “interaction with family doctors is disastrous,” the study notes. Among the disaffected, only nine per cent were happy with their last visit. The aver-

age Canadian spends about 20 minutes with his or her doctor, Reid notes. For the disaffected, it’s less than 15. Day sees this as directly related to the physician shortage: “Doctors often can’t [afford to] spend enough time with patients,” he says.

Yet the “darkest spot” in Canadian health care, according to the Angus Reid report, is the emergency room. Overcrowded and often understaffed, they remain unpopular with just about everybody: 43 per cent of Canadians were unhappy with their last visit. In Quebec and British Columbia, it’s even worse: over 50 per cent of users were dissatisfied. According

ONE IN 10 SAY THEY WERE AFFECTED BY MEDICAL ERROR

to Dr. Howard Ovens, director of the SchwartzReisman Emergency Centre at Toronto’s Mount Sinai Hospital, “one of the main drivers of patient satisfaction is how long they have to wait.” And people are certainly waiting: at Digby’s local hospital, Davis says, “it can take four or five hours just to see somebody.”

The one in 10 Canadians now caring for an aging family member is also unimpressed. Two in five such respondents were displeased with the service a parent or an in-law received in the E.R. Indeed, elder care is a growing concern for all Canadians. Although 27 per cent believe that contact with the health care system improved their relative’s health, one in five thinks it actually made people sicker.

For hospitals, overnight stays fared better than the E.R.—during their last stay, 77 per cent of respondents felt satisfied. (Interestingly, rural hospitals proved more popular than urban: 95 per cent of rural Canadians were happy with their last visit, while just 72 per cent of urban dwellers were.) But Day says these results are nonetheless cause for concern, especially because so many Canadians wind up sharing a room during their overnight stay. “It’s an uncivilized leftover from the Victorian open ward,” he says. “There’s no reason for it.”

As for medical error, Davis is far from alone in believing she’s suffered as a result of it. In this study, one in 10 Canadians reported being affected within the last year (the two most commonly cited mistakes are being misdiagnosed or prescribed the wrong medication).

Although demographically no different from other Canadians, the disaffected group—that small pocket who generates threequarters of all complaints—is far more likely to believe they’ve suffered: almost one-quarter say they’ve been the victim of medical error within the past year. These people aren’t “just complainers,” Reid emphasizes. “They’re genuinely having problems.” While Day believes some of these findings— especially those concerning E.R. and hospital visits—are cause for concern, there is good news: the fact that most of us are satisfied with the care we receive means we don’t have to throw out the baby with the bathwater. “There are people who [think] the entire system isn’t working,” Reid says. That’s not true. We don’t have to start over.” M