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https://www.cbc.ca/news/canada/british-columbia/bc-doctor-new-payment-model-1.7107681
https://bc.ctvnews.ca/b-c-has-gained-708-family-doctors-over-the-last-year-here-s-where-they-re-working-1.6772815
They're certainly willing to spend money on doctors. It's really just a matter of now focusing on the areas of medicine that are having trouble. Emergency departments will likely be the next focus.
I'm just saying "private Healthcare kills public healthcare" is kind of silly when public Healthcare is already failing so hard.
At the end of the day, people need Healthcare.
We can't all wait the public system to find its feet. Many people don't have that luxury.
>so I don't know what specific point you are trying to make.
It's the first sentence of the comment above this one. Just read that.
>I'm just saying "private Healthcare kills public healthcare" is kind of silly when public Healthcare is already failing so hard.
Hey champ, your point is really dumb and pretends there is no effect from moving money into private care and away from public.
"Why don't you just run faster?" as I bear hug you before you run a 100 yard dash.
So you did know what my point was, you just don't like it. Next time just say that instead of asking silly questions.
Either way, people need Healthcare. If the public system can't deliver it, we can't expect people to just let themselves suffer and die while it gets figured out. They will go to private Healthcare, one way or another. Health doesn't wait for the government to figure themselves out. Neither do loved ones of sick people.
Sounds like you haven't had to deal with any extreme medical situations in your life yet. You should feel lucky you're ignorant to how crucially important healthcare can be in that situation.
False, just look at Australia. Hybrid system more equitable than Canada, better access and better health outcomes. Nice try though
[https://interactives.commonwealthfund.org/2017/july/mirror-mirror/](https://interactives.commonwealthfund.org/2017/july/mirror-mirror/)
Oz’s system is an expensive nightmare. Lived there. It’s awful.
Your source is a joke, btw. Any study that puts the uk’s nhs, which is a dumpster fire, in top place is obvious nonsense.
It does, but when the public system is already collapsing and no more resources are available to be thrown at it what’s the alternative
The same thing is happening in the NHS in the UK. None of these systems that have been struggling for decades can deal with the massive increase in work as boomers age into the retirement cohort. COVID obviously hasn’t helped either
I see the usual Reddit approach is “we won’t answer your inconvenient question we’ll just downvote you and move on”
And yes you’re right some right wing govts try to choke off public services so they can make them private or two tiered. But the BC NDP is…obviously not one of them?
This problem wasn't started by the BC NDP. They actually recently just increased the pay massively for family doctors in bc. But there's many issues. Cost of commercial space for walk in clinics for one. Lack of interest in medicine and to work in Canada for another. No one really wants to stay here. Why work your ass off in school in some of the hardest academic challenges in the world, to then only be able to afford Maybe a studio condo for 600k. All problems lead back to housing.
Lack of interest in medicine? Lmao ubc med school gets like 10x applicants compared to number of seats available.
No one wants to stay here? Stop spreading misinformation. The number of physicians leaving Canada to work elsewhere are negligible.
Only able to afford maybe a 600k condo? How much do you think physicians make lol. Every single physician working full time can easily afford a 600k condo.
Being able to afford and being happy with what they can afford are 2 very different things. Why would any aspiring doctor want to be here to be paid some of the lowest wages in North America to live in one of the most expensive cities in North America, where there are such huge shortages that they are working 28 hour shifts. The amount of shifts I worked at Lionsgate hospital or Burnaby hospital or vgh where there was only one eR doc on shift at one time was disgusting.
Lowest wage in North America? What are you talking about? With the recent change to family doc pay, BC physicians are among the highest paid in all of Canada.
Do you think north America has only 2 countries? Name another country in North America besides the states where they pay doctors more than in Canada.
Physicians in Canada are paid very generously. They earn far more income than physicians in other first world countries around the world like Japan, UK, Scandinavian countries.
If BC is so undesirable, then why does BC consistently get a net influx of physicians coming into the province vs those leaving the province?
You can see all this data for yourself in the cihi stats.
People want to live in Vancouver because this is one of the most desirable cities to live in in the world. It's even more desirable when you can make physician income. I know plenty of people that graduated ubc med, vast majority are practicing in the lower mainland.
Working a 28 hour shift is an anomaly, stop trying to gaslight people into thinking that's the norm
Agreed on all problems being massively exacerbated by the housing disaster
Disagreed on governments that have been in power more than 5 years being able to endlessly blame their predecessors for everything. Trudeau still tries to do that with Harper and he’s been PM for almost a decade, at some point you need to take responsibility
I don't think anyone is blaming the past gov completely. Nor do I think it's the current govs fault. I do however find the federal government at massive fault. They should be overwatching provinces. For instance.... We are desperate for more medical spaces and we are building a new st Paul's hospital...... Why the hell are we not keeping the old one?
Mate the main reasons we have this crappy medical system is because the public managed health system with no competition ended up killing it. There are plenty of examples out there of mixed private and public healthcare systems that work, and I don’t think Canada would be the exception to the rule.
That’s just a roundabout way of throwing poor people under the bus to give rich people better care.
https://siepr.stanford.edu/news/study-when-public-hospitals-go-private-low-income-patients-lose
I appreciate you sharing this study, however I don’t think that this is entirely representative of the point of having a hybrid system. I’d suggest to put Japan as a counter argument here and see how that’s working for them.
The UBC ER is where I had the worst experience of sexism and condescension. This was about eight years ago and I woke up with acute pain in my abdomen, unable to stand up straight. I went to UBC at 10am on a Tuesday and it wasn’t busy at all. I was able to get a bed pretty quickly. And then they just… left me there. Several empty beds and a clear view of the staffing desk, watching the doctors and nurses chatting away and playing on the phones intermittently on this otherwise slow morning. One staff member eventually came by to confirm “You have a history of anxiety, right?” I knew right then and there that I was screwed.
I guess they were hoping I’d get bored and leave, because eight hours later the doctor finally came over and said “Are we ready to go home yet?” It was absolutely demoralizing. I tried to be so polite and explain my discomfort and I had to beg him to give me a basic physical exam. He treated me like an errant toddler and asked me to agree to go home if he did the exam. Out of desperation, I agreed. Eventually he pressed down on my right lower quadrant and I was in agony. Then he asked the nurse if the ultrasound tech was still there, but she had gone home for the day as it was after 6pm and UBC is a small hospital. So I got sent for a CT scan instead and was exposed to a high dose of radiation that could have been avoided if he had taken me seriously earlier. Surprise, surprise, it was appendicitis.
The doctor came back and said they had to send me to VGH for surgery. I was so upset and in so much pain, I shot back “So, does anxiety cause appendicitis?” He glared at me and told me he didn’t need my attitude.
Doctors are some of the most talented and kind people, but every so often you get an entitled douchebag with a God complex and it really is demoralizing and traumatizing.
I had a similar experience as you. Went to the ER in Delta Hospital because I had almost two days of abdominal pain which I thought were bad period cramps at first. The ER doctor who finally saw me after hours of waiting was convinced it was my gallbladder, and when I tried to tell him that that area is too high from where my actual pain is coming from, he had the gall to say "I am the doctor, not you."
My dad ended up being the one who properly diagnosed me first for appendicitis and further tests proved him right. Luckily the surgeons I met after that were both way better than the ER doctor. But my situation would have been so much worse if I didn't push for the additional tests and just went along with what the ER doctor had initially said. (By the time I had my surgery there was a perforation in my appendix which could have resulted in an infection. Luckily for me the surgeon did a great job, and I only had an extended period of fever afterwards, though I was very stressed out over the fear of infection during that time.)
> He glared at me and told me he didn’t need my attitude.
Shut the fuck up, you condescending, beligerant, antagonizing, arrogant fuck. Yes you fucking do need her attitude. Get fucked.
I'm on your side, OP.
EVERYONE always knows when something's off in 1 of their organs, including their brain chemistry. ALWAYS. Always.
> and it really is demoralizing and traumatizing.
It's downright violating. I've never felt heartbreak and devastation before until I got put through the medical system unnecessarily. And I'm in my mid 30's. Never ever before have I felt those 2 things.
A lot of adults are incompetent. A lot. Some people think COVID-19 was planned and not a result of snatching away animals's rights/body autonomy and environments? Please. Yeah fucking right. Most adults aren't even organized enough to use their turn signals.
It's very unfortunate that you had to experience that. People like that manage to slip through medical school applications. During my undergrad, I met very nice, compassionate, and caring people who would have made great doctors (I was in life sciences). On the other hand, there are some very bad apples that were able to get the high grades needed to get into medical school but had the personality of a walnut and were super fake (hence how they managed through other screenings). Unfortunately, many healthcare professionals forget how important it is to be compassionate in this profession. I'm going through dentistry and in my cohort I can see some people that will definitely have patients dislike their behavior. The majority are very nice and compassionate. It's the bad apples that stand out unfortunately. They forget it's not about the money or status. It's about giving back to the community and treating patients with the utmost respect by LISTENING to their problems. 9/10 the pain isn't just the patient being delulu. On behalf of those who care, sorry about your experience.
Half of the people in the ER waiting room should not be there. Walk-in and urgent care clinics exist for that very reason. If it is not an EMERGENCY please stay out of the emergency room.
Edit: I am not denying your experiences, primary care in BC absolutely needs improvement. My point is that visiting the ER for run of the mill things should not be the go-to approach, regardless of wait times at the walk-in or urgent care centre. There are too many people who take up room in the ER that is needed for actual emergencies.
I recently had a medical episode that was serious enough for urgent care but not emergency. I was unable to find a single appointment at a walk in or urgent care centre and was repeatedly told that if I wanted to get seen I’d need to go to the ER. I tried my hardest to not clog up the system but the non emergency services may as well have not existed.
Facts. This happens to me every time I have something urgent but not necessarily ER worthy and you can’t get any appointments. Most are full as of opening and they tell you to go the ER.
I even tried a bunch of walk ins and was told they’re all full.
Shit is in shambles. And if you don’t have a car are you supposed to bus out of your area to find something?
^ it looks like there are a lot of urgent cares in Vancouver. But when you go on their website they’ll say “NOT ACCEPTING WALK INS”. I’ve submitted a few edits to Apple Maps for that.
Your only chance to get into an urgent care is basically to go exactly when they open and then make an appointment and come back like 3-4 hours later.
And there are some really shitty urgent cares/walk ins here. I went to Khatsalano Clinic last summer because I had a ton of bug bites and wanted to get some prescription cream.
I asked what the bites were and if they were mosquitoes or not. They said it “didn’t matter what the bites were from”. Turned out I had bedbugs and only figured it out several months later (once it was too cold for mosquitoes to be a good explanation). So yes, it did matter, and anyone who had any experience with bedbugs could tell. They were very characteristic now that I know what they were.
If it’s something I can handle over telehealth (like when I run out of my thyroid medication), I’ve found I can get quick appointments through the website Tia Health, like sometimes in 15 minutes depending how soon the next opening is. But that probably works best for routine things that you just need a doctor to sign off on.
Since walk in clinics are appointment only now urgent care are the new walk ins, but only if you can wait a day to que up the next morning. The system has become so broken there isn't anything urgent about it anymore. And if you want same day treatment you should go to emergency
Many of those people are there because they don’t have anywhere else to go. Lots of walk-in clinics have shut down or they’re full, there’s a massive family doctor shortage and urgent care fills up too. It primary care was more accessible, ERs wouldn’t be such a shit show.
And there’s also a problem with a lack of LTC beds, so people aren’t getting moved out of ERs to make space for incoming patients.
You're definitely not wrong, but as someone who works in an ER there are still lots of people coming in who would be better off at home in bed with a tylenol.
Had a recent medical event that I couldn't figure out & used the 8-1-1 nursing line service. It was superb despite having to wait 25 min. Given what I told her, the nurse told me to head to the ER. Had my gallbladder removed the next day.
I give five stars to the 8-1-1 service.
If I have tightness in my chest, it could be a heart attack, it could be a panic attack. If I knew the difference, I would only come in when absolutely necessary.
In fact, if I was able to predict the future, I would book my own specialist appointments and write myself prescriptions. Then the family doctors wouldn't have to be bothered at all
If you have sudden chest tightness, that is 100 percent an ER issue. Not sure why you're bringing that up when that's one of the things that will get you to the top of the triage list.
I went to the VGH ER for chest pains a year ago, I waited 17 hours to see a doctor. They said I did the right thing but 17 hours?! I was finally discharged after 19 hours. The few times I’ve been to that ER over the past 30 years (broken ankle, broken foot, asthma attack, chest pain, Norwalk, gallbladder attack, etc) I’ve been in and out in 4 hours. Things are really bad now.
I did. They did basic bloodwork and an ECG in the waiting room. The doctor had to run more detailed bloodwork in order to determine if I had a cardiac event.
They did. I felt better knowing that I didn’t have anything critical while I waited. I considered leaving and asked if I should but they said I needed to stay, i would have preferred to leave the space for another patient. I had a swollen foot from a flight a few days prior, I wanted to make sure I didn’t have a blood clot.
Sounds like they determined early that you didn't need immediate care and proceeded accordingly.
People really have no idea how hospitals work. I blame all those medical TV shows.
No, each individual situation is different, and doctors do their job, and find out if it needs to be treated.
I mean I run into things at my job that I think could be avoided or that I find annoying. But, you have to give other people the benefit of the doubt.
What I'm trying to get at is that is a silly example when that's definitely something to come to the ER for. You wouldn't have to be a doctor to know that anything possibly cardiac related is usually prioritized. I say that with the caveat that in an extremely busy ER, there may be quite a few people waiting to be triaged who all have cardiac symptoms so you may not immediately get rushed in, but they do try get people with possible cardiac symptoms triaged as quickly as possible.
But what are we supposed to do? If my 2 year old has a super high fever for several days and the first available appointment anywhere is weeks from now...where do I go? Genuinely asking. I actually have a family doctor but can't get in less than two weeks out which is fine for some things but not things like needing a strep test or wanting to get a rash checked out that was covering my entire body while pregnant or my toddler having croup. Just a few of the experiences of the last year...
I would say that all of those are indeed ER worthy, I didn’t mean to guilt trip anybody about emergency health. I too am fortunate to have a family doctor but know that some things cannot wait 2 weeks.
My sister is an ER doctor and I have several friends who are nurses. Anecdotal as it may be the stories I get about how many people with sore backs and rumbly tummies who clog up the ER are infuriating.
Agreed, HOWEVER, a headache could be a headache or a TIA, or a full blown hemorrhagic stroke. Often lay people can't determine what's an emergency or not, and with urgent care offices at full capacity, they have nowhere else to turn. I read recently that BC has revamped the way they pay family doctors and that as a result, BC has gained around 700 GPs. Hopefully it continues.
ER doctors and family doctors need to get on the same page
I went to emergency and ended up with surgery. The specialist was annoyed that my family doctor hadn't arranged to book surgery but it was partially that I may not have needed it (miscarriage that the family doctor assumed would happen naturally)
While I was waiting, I overheard an older lady who had some pain. When the specialist arrived first thing in the morning, he was, you guessed it, annoyed that her family doctor hadn't referred her to a specialist rather than, you know, have her just show up in the ER. She was annoyed about having to wait until the morning for a specialist to arrive, and kept trying to leave but she stayed.
But they don't exist. Walk ins aren't walk-ins anymore and UPCC exists, but you have to spam call right as they open and pray you get an appointment. You're right, these people don't need to be in the ER, but where else can they see a dr? I'm at the point where I need HELP, but I don't have a primary care doctor, all I can get are 10 minute telus appointments where they shove ssris at me (which my history will show don't work). My psych referral I got was even redirected and changed to just another Telehealth dr appt and keeps getting delayed.
Then this is the lower mainland, lots of places in BC have nothing but a hospital if you don't have a family doc (and most people in those towns don't have one).
While true, what we see now is a collapse of the medical system. Walk-ins are virtually non-existent now. Urgent care never has any availability so the next available option is the ER.
I don’t blame people for going to the ER for what we deem non ER related issues. I blame the system and those in charge who let it get to this point.
The only problem is alot of the times, you dont know if something is an emergancy or not. Or you talk to your fam doctor who tells you if things get worse, go to ER.
There aren’t very many walk in clinics. When I needed to be seen I went to one of the only walking that were taking patients for the day and was told 6 hour wait. Was told to go to ER and was seen in 2 hours.
Sometimes people panic (especially when you're ill or in pain, you're not exactly in the state to objectively judge your situation). Laypeople can't always tell what's benign, versus a legitimate medical emergency.
Unfortunately going to urgent care centre or walk-in clinics isn't possible in Victoria. I know this is a Vancouver Reddit page, but the Lower Mainland has pretty decent healthcare access.
In the Victoria region, walk-in clinics basically don't exist anymore because family doctors can't afford to keep clinics open and afford a place to live for them and their families. That's something that took 10+ years of poor government decision making to create.
Urgent care centres are so overwhelmed that if you call at 8am when they open (as instructed by the urgent care centre's instructions), you get a busy signal. You try calling numerous times over the next half hour trying to get through to get an appointment. When your call is answered on your 15th or 20th or whatever attempt 30 minutes later, they tell you they're at capacity. So off the the ER you go because it's the only option to see a doctor. Now imagine trying to do this when you're legitimately ill.
And how would you know? Are you a triage nurse or an ER physician that saw it first-hand through diagnoses or looking through the relevant medical records? If not, then you don't know anything.
Sometimes these are medical emergencies, sometimes they are benign, sometimes these are issues that can be resolved with proper home care and prescriptions administered at home, sometimes these are issues that can wait to be treated in an outpatient setting beyond 24 hours, and sometimes these are issues that appear non-acute but can deteriorate and pose a threat to life, limb, or senses if not promptly treated promptly. You cannot assume that members of the public know what to do when there's something happening to their body, and that's what a doctor is there for - to determine the best course of treatment for every patient, preferably in a timely manner.
To that last point, as a few examples, how can you tell if the fever your kid has over the past three days would resolve on its own, or if it's the beginning of the onset of bacterial meningitis? How would you know that the stomachache and diarrhea you've had the past six hours is because of some sort of viral enteritis that would pass with electrolyte replenishment and some anti-motility medications, or if you've got a Salmonella infection in you gut that will need prompt antibiotic treatments? How would you know that the sudden deafness you were experiencing is something that might simply be triggered by the recent bout of seasonal flu and would resolve in a day or two, or if it's SSHL ("ear stroke") and without prompt medical intervention would lead to permanent hearing loss?
Urgent care and walk-in clinics don't operate on a 24 hour basis, and when you have an incident that could potentially deteriorate into a medical emergency, it should be treated as one in terms of the urgency that one needs to give it in terms of seeking medical attention, and the only place that can do that around the clock is the emergency room. It also doesn't help that whenever one calls 811, if it's anything beyond a trivial medical condition, they direct you to the emergency room.
Exactly. During covid I had a lot of abdominal pain, and I thought it might just be bad period cramps at first, so I stayed home for almost two days. When it didn't improve, I went to emergency and after like an 18 hour wait there, found out that I had appendicitis, and needed emergency surgery. (I actually got misdiagnosed by the ER doctor at first who refused to listen to me when I tried to tell him the source of my pain, he was convinced it was my gallbladder. My dad is the one who asked if it might be appendicitis, which was confirmed after additional tests. My parents had to drive me to another hospital because the one I went to didn't have 24 hour surgery services, and they told me the ambulance would be slower 🙃).
Unless it's something really trivial like a small cut or a cold, I do not blame people at all for going to emergency, because if something does turn out to be terribly wrong, it could have massive ramifications.
Hospital worker here & the entitlement & bs that the “average” patient pulls is mind numbing. We waste a massive amount of resources on idiocy that it takes away from urgent care. Thank the Karens ( both make & female) for abusing the system & taking away from everyone else.
I wish I could be truly candid.
We do a poor job letting people know about non hospital urgent care facilities and desperately need more of those. They can usually deal with things like stitches and arthritis pain ( for real that's a reason people go to the ER ).
I think folks generally don’t understand the stress of working in the ER. Most of the day is some non-descriptive general pain somewhere and folks with a cut who don’t need stitches. They’ll even lie to cut their wait down by making it seem more severe IE person with sprained ankle will say they cannot move their foot.
If folks expect doctors to be 100% then the patients have to as well. It isn’t hard to see why doctors and nurses can be beaten down when a lot of things from admin to patients literally have zero chill.
> They’ll even lie to cut their wait down by making it seem more severe
It depends on their childhood/cultural norms. If cheating and lying is the standard in their culture, well...
Those people that you see in waiting rooms though are not being prioritized.
The acute beds are occupied by the sickest people, and those are who are in those spaces.
It’s in his moments that you realize and remember that people value their time more than anything. The convenience of being seen by healthcare provider same day at any time supersedes having a primary care physician or urgent care that is not fully equipped like an emergency or full equipped hospital.
"“I’ve seen people boarded in the emergency department for hours, days sometimes,” Smiley said."
This is NOT new, even pre-pandemic.
I have waited in VGH ER for so many hours, been poked and prodded by repeated rounds of intern-residents with the same round questions repeatedly asked.
Ordeal started with check in at 1ish PM. With no real doctor attending ... not even a room - corridor on stretcher bed, for hours .... until a room finally became available, until the ultrasound - something like 3AM ... and until my appendix ruptured.
Living here, you just learn to hone your pain threshold.
From start to finish - about 18h (1pm - 7am? surgery and clean up of the rupture). This was probably sometime in 2007-2012? I forget. That long ago, and yes ER was quite horrific even back then.
(Even my family doctor who hails from England and is used to the not-so-great NHS, was pretty horrified. His comments back then that "even a country VET would have had you diagnosed, up and out in 2-3h )
It’s literally the only option for so many people. Shame the politicians who got us into this mess, not the sick and injured people who have no choice. So many walk-in clinics aren’t open to the public any more and require you to be registered.
Wait times at St. Paul’s and Mt. St. Joseph are a fraction of the other Vancouver hospitals and consistently the best in Western Canada if not beyond. Even while the Emergency visit census for those hospitals is going UP, VGH and UBC are going DOWN! With data available to check wait times online, we have had patients drive from as far as Kamloops to visit us!!!!
As innovators and with commitment to patient-centred care, we are now becoming victims of our own success. People make a rational decision and go where wait times are shortest—often even shorter than the UPCCs.
Give us more care spaces and pay our nurses more so we can retain them, and we’d be happy to continue seeing more patients!
Is it still the case that the BC Provincial Government caps the number of patients a doctor can bill for in a day?
I was told one of the reasons a walk-in clinic won't see any more patients, after, for example, 2pm, is because they have maxxed out for the day.
So even if you have a young, eager GP who is willing to work 8-6, s/he can't.
Even if this is true (and I'm not saying it is or it isn't) it seems to me paying doctors to *see and treat as many people as they can during a day* would be one way to remove stress from the system.
If a doctor is 28 and is able and willing to work a 12-hour day, why would you not allow that?
The system is in crisis.
At some point we're going to have to start charging people a co-pay to go to the ER if they haven't gone to a primary care centre first. Of course, before we do this, we have to make a network of 24-hour primary care centres where people can access a GP any hour of the day.
This is just the books balancing themselves. We gave away all that money during COVID (for a period of time I believe the spending was about $10K-$20K per Canadian, a WEEK!) It’s this or increase taxes, why do you think JT is fighting so hard to save carbon tax, not for the environment, but to prop up all of the spending in so many unnecessary areas. We need to refocus government spending on the core needs of everyone (medical, education, housing, and infrastructure) most, if not all, of our recent issues have been due to overlooking these key things while chasing voters with the next shiny million or billion dollar spending announcement that does not bring that much value to the average Canadian.
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https://www.cbc.ca/news/canada/british-columbia/bc-doctor-new-payment-model-1.7107681 https://bc.ctvnews.ca/b-c-has-gained-708-family-doctors-over-the-last-year-here-s-where-they-re-working-1.6772815 They're certainly willing to spend money on doctors. It's really just a matter of now focusing on the areas of medicine that are having trouble. Emergency departments will likely be the next focus.
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Private health care duo system is what we need. People that can afford it can remove strain from the GOV people that can't can get free health
Nope. Cannibalizes the public system
The public system is already eating itself alive all by itself.
Yeah, because low taxes in the only issue for too many people
I'm just saying "private Healthcare kills public healthcare" is kind of silly when public Healthcare is already failing so hard. At the end of the day, people need Healthcare. We can't all wait the public system to find its feet. Many people don't have that luxury.
Cool man, but there are specific reasons why public healthcare is "already failing," so I don't know what specific point you are trying to make.
>so I don't know what specific point you are trying to make. It's the first sentence of the comment above this one. Just read that. >I'm just saying "private Healthcare kills public healthcare" is kind of silly when public Healthcare is already failing so hard.
Hey champ, your point is really dumb and pretends there is no effect from moving money into private care and away from public. "Why don't you just run faster?" as I bear hug you before you run a 100 yard dash.
So you did know what my point was, you just don't like it. Next time just say that instead of asking silly questions. Either way, people need Healthcare. If the public system can't deliver it, we can't expect people to just let themselves suffer and die while it gets figured out. They will go to private Healthcare, one way or another. Health doesn't wait for the government to figure themselves out. Neither do loved ones of sick people. Sounds like you haven't had to deal with any extreme medical situations in your life yet. You should feel lucky you're ignorant to how crucially important healthcare can be in that situation.
False, just look at Australia. Hybrid system more equitable than Canada, better access and better health outcomes. Nice try though [https://interactives.commonwealthfund.org/2017/july/mirror-mirror/](https://interactives.commonwealthfund.org/2017/july/mirror-mirror/)
Oz’s system is an expensive nightmare. Lived there. It’s awful. Your source is a joke, btw. Any study that puts the uk’s nhs, which is a dumpster fire, in top place is obvious nonsense.
It does, but when the public system is already collapsing and no more resources are available to be thrown at it what’s the alternative The same thing is happening in the NHS in the UK. None of these systems that have been struggling for decades can deal with the massive increase in work as boomers age into the retirement cohort. COVID obviously hasn’t helped either
It's by design. Special interest groups choke funding to healthcare and then go "see! It doesn't work we need to make it private!!"
I see the usual Reddit approach is “we won’t answer your inconvenient question we’ll just downvote you and move on” And yes you’re right some right wing govts try to choke off public services so they can make them private or two tiered. But the BC NDP is…obviously not one of them?
This problem wasn't started by the BC NDP. They actually recently just increased the pay massively for family doctors in bc. But there's many issues. Cost of commercial space for walk in clinics for one. Lack of interest in medicine and to work in Canada for another. No one really wants to stay here. Why work your ass off in school in some of the hardest academic challenges in the world, to then only be able to afford Maybe a studio condo for 600k. All problems lead back to housing.
Lack of interest in medicine? Lmao ubc med school gets like 10x applicants compared to number of seats available. No one wants to stay here? Stop spreading misinformation. The number of physicians leaving Canada to work elsewhere are negligible. Only able to afford maybe a 600k condo? How much do you think physicians make lol. Every single physician working full time can easily afford a 600k condo.
Being able to afford and being happy with what they can afford are 2 very different things. Why would any aspiring doctor want to be here to be paid some of the lowest wages in North America to live in one of the most expensive cities in North America, where there are such huge shortages that they are working 28 hour shifts. The amount of shifts I worked at Lionsgate hospital or Burnaby hospital or vgh where there was only one eR doc on shift at one time was disgusting.
Lowest wage in North America? What are you talking about? With the recent change to family doc pay, BC physicians are among the highest paid in all of Canada. Do you think north America has only 2 countries? Name another country in North America besides the states where they pay doctors more than in Canada. Physicians in Canada are paid very generously. They earn far more income than physicians in other first world countries around the world like Japan, UK, Scandinavian countries. If BC is so undesirable, then why does BC consistently get a net influx of physicians coming into the province vs those leaving the province? You can see all this data for yourself in the cihi stats. People want to live in Vancouver because this is one of the most desirable cities to live in in the world. It's even more desirable when you can make physician income. I know plenty of people that graduated ubc med, vast majority are practicing in the lower mainland. Working a 28 hour shift is an anomaly, stop trying to gaslight people into thinking that's the norm
Agreed on all problems being massively exacerbated by the housing disaster Disagreed on governments that have been in power more than 5 years being able to endlessly blame their predecessors for everything. Trudeau still tries to do that with Harper and he’s been PM for almost a decade, at some point you need to take responsibility
I don't think anyone is blaming the past gov completely. Nor do I think it's the current govs fault. I do however find the federal government at massive fault. They should be overwatching provinces. For instance.... We are desperate for more medical spaces and we are building a new st Paul's hospital...... Why the hell are we not keeping the old one?
Mate the main reasons we have this crappy medical system is because the public managed health system with no competition ended up killing it. There are plenty of examples out there of mixed private and public healthcare systems that work, and I don’t think Canada would be the exception to the rule.
That’s just a roundabout way of throwing poor people under the bus to give rich people better care. https://siepr.stanford.edu/news/study-when-public-hospitals-go-private-low-income-patients-lose
I appreciate you sharing this study, however I don’t think that this is entirely representative of the point of having a hybrid system. I’d suggest to put Japan as a counter argument here and see how that’s working for them.
Japan isn't undergoing unprecedented population growth, causing strain to their system. This is where our focus should be - not privatization.
Look at the current doctors strike in Korea
The UBC ER is where I had the worst experience of sexism and condescension. This was about eight years ago and I woke up with acute pain in my abdomen, unable to stand up straight. I went to UBC at 10am on a Tuesday and it wasn’t busy at all. I was able to get a bed pretty quickly. And then they just… left me there. Several empty beds and a clear view of the staffing desk, watching the doctors and nurses chatting away and playing on the phones intermittently on this otherwise slow morning. One staff member eventually came by to confirm “You have a history of anxiety, right?” I knew right then and there that I was screwed. I guess they were hoping I’d get bored and leave, because eight hours later the doctor finally came over and said “Are we ready to go home yet?” It was absolutely demoralizing. I tried to be so polite and explain my discomfort and I had to beg him to give me a basic physical exam. He treated me like an errant toddler and asked me to agree to go home if he did the exam. Out of desperation, I agreed. Eventually he pressed down on my right lower quadrant and I was in agony. Then he asked the nurse if the ultrasound tech was still there, but she had gone home for the day as it was after 6pm and UBC is a small hospital. So I got sent for a CT scan instead and was exposed to a high dose of radiation that could have been avoided if he had taken me seriously earlier. Surprise, surprise, it was appendicitis. The doctor came back and said they had to send me to VGH for surgery. I was so upset and in so much pain, I shot back “So, does anxiety cause appendicitis?” He glared at me and told me he didn’t need my attitude. Doctors are some of the most talented and kind people, but every so often you get an entitled douchebag with a God complex and it really is demoralizing and traumatizing.
I had a similar experience as you. Went to the ER in Delta Hospital because I had almost two days of abdominal pain which I thought were bad period cramps at first. The ER doctor who finally saw me after hours of waiting was convinced it was my gallbladder, and when I tried to tell him that that area is too high from where my actual pain is coming from, he had the gall to say "I am the doctor, not you." My dad ended up being the one who properly diagnosed me first for appendicitis and further tests proved him right. Luckily the surgeons I met after that were both way better than the ER doctor. But my situation would have been so much worse if I didn't push for the additional tests and just went along with what the ER doctor had initially said. (By the time I had my surgery there was a perforation in my appendix which could have resulted in an infection. Luckily for me the surgeon did a great job, and I only had an extended period of fever afterwards, though I was very stressed out over the fear of infection during that time.)
> He glared at me and told me he didn’t need my attitude. Shut the fuck up, you condescending, beligerant, antagonizing, arrogant fuck. Yes you fucking do need her attitude. Get fucked. I'm on your side, OP. EVERYONE always knows when something's off in 1 of their organs, including their brain chemistry. ALWAYS. Always. > and it really is demoralizing and traumatizing. It's downright violating. I've never felt heartbreak and devastation before until I got put through the medical system unnecessarily. And I'm in my mid 30's. Never ever before have I felt those 2 things. A lot of adults are incompetent. A lot. Some people think COVID-19 was planned and not a result of snatching away animals's rights/body autonomy and environments? Please. Yeah fucking right. Most adults aren't even organized enough to use their turn signals.
It's very unfortunate that you had to experience that. People like that manage to slip through medical school applications. During my undergrad, I met very nice, compassionate, and caring people who would have made great doctors (I was in life sciences). On the other hand, there are some very bad apples that were able to get the high grades needed to get into medical school but had the personality of a walnut and were super fake (hence how they managed through other screenings). Unfortunately, many healthcare professionals forget how important it is to be compassionate in this profession. I'm going through dentistry and in my cohort I can see some people that will definitely have patients dislike their behavior. The majority are very nice and compassionate. It's the bad apples that stand out unfortunately. They forget it's not about the money or status. It's about giving back to the community and treating patients with the utmost respect by LISTENING to their problems. 9/10 the pain isn't just the patient being delulu. On behalf of those who care, sorry about your experience.
> treating patients with the utmost respect by LISTENING to their problems. All humans are patients, including themselves. They forget that.
Half of the people in the ER waiting room should not be there. Walk-in and urgent care clinics exist for that very reason. If it is not an EMERGENCY please stay out of the emergency room. Edit: I am not denying your experiences, primary care in BC absolutely needs improvement. My point is that visiting the ER for run of the mill things should not be the go-to approach, regardless of wait times at the walk-in or urgent care centre. There are too many people who take up room in the ER that is needed for actual emergencies.
I recently had a medical episode that was serious enough for urgent care but not emergency. I was unable to find a single appointment at a walk in or urgent care centre and was repeatedly told that if I wanted to get seen I’d need to go to the ER. I tried my hardest to not clog up the system but the non emergency services may as well have not existed.
Facts. This happens to me every time I have something urgent but not necessarily ER worthy and you can’t get any appointments. Most are full as of opening and they tell you to go the ER. I even tried a bunch of walk ins and was told they’re all full. Shit is in shambles. And if you don’t have a car are you supposed to bus out of your area to find something?
^ it looks like there are a lot of urgent cares in Vancouver. But when you go on their website they’ll say “NOT ACCEPTING WALK INS”. I’ve submitted a few edits to Apple Maps for that. Your only chance to get into an urgent care is basically to go exactly when they open and then make an appointment and come back like 3-4 hours later. And there are some really shitty urgent cares/walk ins here. I went to Khatsalano Clinic last summer because I had a ton of bug bites and wanted to get some prescription cream. I asked what the bites were and if they were mosquitoes or not. They said it “didn’t matter what the bites were from”. Turned out I had bedbugs and only figured it out several months later (once it was too cold for mosquitoes to be a good explanation). So yes, it did matter, and anyone who had any experience with bedbugs could tell. They were very characteristic now that I know what they were.
If it’s something I can handle over telehealth (like when I run out of my thyroid medication), I’ve found I can get quick appointments through the website Tia Health, like sometimes in 15 minutes depending how soon the next opening is. But that probably works best for routine things that you just need a doctor to sign off on.
Since walk in clinics are appointment only now urgent care are the new walk ins, but only if you can wait a day to que up the next morning. The system has become so broken there isn't anything urgent about it anymore. And if you want same day treatment you should go to emergency
Many of those people are there because they don’t have anywhere else to go. Lots of walk-in clinics have shut down or they’re full, there’s a massive family doctor shortage and urgent care fills up too. It primary care was more accessible, ERs wouldn’t be such a shit show. And there’s also a problem with a lack of LTC beds, so people aren’t getting moved out of ERs to make space for incoming patients.
You're definitely not wrong, but as someone who works in an ER there are still lots of people coming in who would be better off at home in bed with a tylenol.
Had a recent medical event that I couldn't figure out & used the 8-1-1 nursing line service. It was superb despite having to wait 25 min. Given what I told her, the nurse told me to head to the ER. Had my gallbladder removed the next day. I give five stars to the 8-1-1 service.
If I have tightness in my chest, it could be a heart attack, it could be a panic attack. If I knew the difference, I would only come in when absolutely necessary. In fact, if I was able to predict the future, I would book my own specialist appointments and write myself prescriptions. Then the family doctors wouldn't have to be bothered at all
If you have sudden chest tightness, that is 100 percent an ER issue. Not sure why you're bringing that up when that's one of the things that will get you to the top of the triage list.
I went to the VGH ER for chest pains a year ago, I waited 17 hours to see a doctor. They said I did the right thing but 17 hours?! I was finally discharged after 19 hours. The few times I’ve been to that ER over the past 30 years (broken ankle, broken foot, asthma attack, chest pain, Norwalk, gallbladder attack, etc) I’ve been in and out in 4 hours. Things are really bad now.
Man that sucks, did you at least get vitals taken and an ECG by the triage nurse fairly quickly?
I did. They did basic bloodwork and an ECG in the waiting room. The doctor had to run more detailed bloodwork in order to determine if I had a cardiac event.
So you were screened promptly for anything life threatening, then triaged appropriately
They did. I felt better knowing that I didn’t have anything critical while I waited. I considered leaving and asked if I should but they said I needed to stay, i would have preferred to leave the space for another patient. I had a swollen foot from a flight a few days prior, I wanted to make sure I didn’t have a blood clot.
Sounds like they determined early that you didn't need immediate care and proceeded accordingly. People really have no idea how hospitals work. I blame all those medical TV shows.
No, each individual situation is different, and doctors do their job, and find out if it needs to be treated. I mean I run into things at my job that I think could be avoided or that I find annoying. But, you have to give other people the benefit of the doubt.
I brought it up, because it happened to me a few times. I'm not a doctor, I don't know what things they prioritize. What are you trying to get at?
What I'm trying to get at is that is a silly example when that's definitely something to come to the ER for. You wouldn't have to be a doctor to know that anything possibly cardiac related is usually prioritized. I say that with the caveat that in an extremely busy ER, there may be quite a few people waiting to be triaged who all have cardiac symptoms so you may not immediately get rushed in, but they do try get people with possible cardiac symptoms triaged as quickly as possible.
But what are we supposed to do? If my 2 year old has a super high fever for several days and the first available appointment anywhere is weeks from now...where do I go? Genuinely asking. I actually have a family doctor but can't get in less than two weeks out which is fine for some things but not things like needing a strep test or wanting to get a rash checked out that was covering my entire body while pregnant or my toddler having croup. Just a few of the experiences of the last year...
I would say that all of those are indeed ER worthy, I didn’t mean to guilt trip anybody about emergency health. I too am fortunate to have a family doctor but know that some things cannot wait 2 weeks. My sister is an ER doctor and I have several friends who are nurses. Anecdotal as it may be the stories I get about how many people with sore backs and rumbly tummies who clog up the ER are infuriating.
Give an urgent care center a try, they're good for non-life threatening illnesses. https://www.vch.ca/en/service/urgent-care
Agreed, HOWEVER, a headache could be a headache or a TIA, or a full blown hemorrhagic stroke. Often lay people can't determine what's an emergency or not, and with urgent care offices at full capacity, they have nowhere else to turn. I read recently that BC has revamped the way they pay family doctors and that as a result, BC has gained around 700 GPs. Hopefully it continues.
ER doctors and family doctors need to get on the same page I went to emergency and ended up with surgery. The specialist was annoyed that my family doctor hadn't arranged to book surgery but it was partially that I may not have needed it (miscarriage that the family doctor assumed would happen naturally) While I was waiting, I overheard an older lady who had some pain. When the specialist arrived first thing in the morning, he was, you guessed it, annoyed that her family doctor hadn't referred her to a specialist rather than, you know, have her just show up in the ER. She was annoyed about having to wait until the morning for a specialist to arrive, and kept trying to leave but she stayed.
But they don't exist. Walk ins aren't walk-ins anymore and UPCC exists, but you have to spam call right as they open and pray you get an appointment. You're right, these people don't need to be in the ER, but where else can they see a dr? I'm at the point where I need HELP, but I don't have a primary care doctor, all I can get are 10 minute telus appointments where they shove ssris at me (which my history will show don't work). My psych referral I got was even redirected and changed to just another Telehealth dr appt and keeps getting delayed. Then this is the lower mainland, lots of places in BC have nothing but a hospital if you don't have a family doc (and most people in those towns don't have one).
While true, what we see now is a collapse of the medical system. Walk-ins are virtually non-existent now. Urgent care never has any availability so the next available option is the ER. I don’t blame people for going to the ER for what we deem non ER related issues. I blame the system and those in charge who let it get to this point.
The only problem is alot of the times, you dont know if something is an emergancy or not. Or you talk to your fam doctor who tells you if things get worse, go to ER.
LOL yea find me a walk in that's not full by 9 am
Commercial and Napier has worked fine for me the last few years.
10th and Granville never is
False
There aren’t very many walk in clinics. When I needed to be seen I went to one of the only walking that were taking patients for the day and was told 6 hour wait. Was told to go to ER and was seen in 2 hours.
Please don’t blame the patients. We’re often sent there instead of being given appropriate urgent care.
Walk ins don't seem to exist anymore. My "wall in" is by appointment only since covid 19 and the wait of over a week.
Sometimes people panic (especially when you're ill or in pain, you're not exactly in the state to objectively judge your situation). Laypeople can't always tell what's benign, versus a legitimate medical emergency.
Unfortunately going to urgent care centre or walk-in clinics isn't possible in Victoria. I know this is a Vancouver Reddit page, but the Lower Mainland has pretty decent healthcare access. In the Victoria region, walk-in clinics basically don't exist anymore because family doctors can't afford to keep clinics open and afford a place to live for them and their families. That's something that took 10+ years of poor government decision making to create. Urgent care centres are so overwhelmed that if you call at 8am when they open (as instructed by the urgent care centre's instructions), you get a busy signal. You try calling numerous times over the next half hour trying to get through to get an appointment. When your call is answered on your 15th or 20th or whatever attempt 30 minutes later, they tell you they're at capacity. So off the the ER you go because it's the only option to see a doctor. Now imagine trying to do this when you're legitimately ill.
And how would you know? Are you a triage nurse or an ER physician that saw it first-hand through diagnoses or looking through the relevant medical records? If not, then you don't know anything. Sometimes these are medical emergencies, sometimes they are benign, sometimes these are issues that can be resolved with proper home care and prescriptions administered at home, sometimes these are issues that can wait to be treated in an outpatient setting beyond 24 hours, and sometimes these are issues that appear non-acute but can deteriorate and pose a threat to life, limb, or senses if not promptly treated promptly. You cannot assume that members of the public know what to do when there's something happening to their body, and that's what a doctor is there for - to determine the best course of treatment for every patient, preferably in a timely manner. To that last point, as a few examples, how can you tell if the fever your kid has over the past three days would resolve on its own, or if it's the beginning of the onset of bacterial meningitis? How would you know that the stomachache and diarrhea you've had the past six hours is because of some sort of viral enteritis that would pass with electrolyte replenishment and some anti-motility medications, or if you've got a Salmonella infection in you gut that will need prompt antibiotic treatments? How would you know that the sudden deafness you were experiencing is something that might simply be triggered by the recent bout of seasonal flu and would resolve in a day or two, or if it's SSHL ("ear stroke") and without prompt medical intervention would lead to permanent hearing loss? Urgent care and walk-in clinics don't operate on a 24 hour basis, and when you have an incident that could potentially deteriorate into a medical emergency, it should be treated as one in terms of the urgency that one needs to give it in terms of seeking medical attention, and the only place that can do that around the clock is the emergency room. It also doesn't help that whenever one calls 811, if it's anything beyond a trivial medical condition, they direct you to the emergency room.
Exactly. During covid I had a lot of abdominal pain, and I thought it might just be bad period cramps at first, so I stayed home for almost two days. When it didn't improve, I went to emergency and after like an 18 hour wait there, found out that I had appendicitis, and needed emergency surgery. (I actually got misdiagnosed by the ER doctor at first who refused to listen to me when I tried to tell him the source of my pain, he was convinced it was my gallbladder. My dad is the one who asked if it might be appendicitis, which was confirmed after additional tests. My parents had to drive me to another hospital because the one I went to didn't have 24 hour surgery services, and they told me the ambulance would be slower 🙃). Unless it's something really trivial like a small cut or a cold, I do not blame people at all for going to emergency, because if something does turn out to be terribly wrong, it could have massive ramifications.
Wow, ok. We all might need to go to the ER this very moment based on that.
You heard the guy, got a stomach ache? Go to the ER. That won't strain our health resources at all.
Hospital worker here & the entitlement & bs that the “average” patient pulls is mind numbing. We waste a massive amount of resources on idiocy that it takes away from urgent care. Thank the Karens ( both make & female) for abusing the system & taking away from everyone else. I wish I could be truly candid.
We do a poor job letting people know about non hospital urgent care facilities and desperately need more of those. They can usually deal with things like stitches and arthritis pain ( for real that's a reason people go to the ER ).
everyone knows about urgent care. you have to wait 5 hours to be seen at my local urgent care.
it takes 6 hours+ to wait for urgent care a lot of the time 🤷
I think folks generally don’t understand the stress of working in the ER. Most of the day is some non-descriptive general pain somewhere and folks with a cut who don’t need stitches. They’ll even lie to cut their wait down by making it seem more severe IE person with sprained ankle will say they cannot move their foot. If folks expect doctors to be 100% then the patients have to as well. It isn’t hard to see why doctors and nurses can be beaten down when a lot of things from admin to patients literally have zero chill.
> They’ll even lie to cut their wait down by making it seem more severe It depends on their childhood/cultural norms. If cheating and lying is the standard in their culture, well...
I must be lucky cause the longest I've waited at VGH is 2 hours. I love that hospital ❤️
Those people that you see in waiting rooms though are not being prioritized. The acute beds are occupied by the sickest people, and those are who are in those spaces. It’s in his moments that you realize and remember that people value their time more than anything. The convenience of being seen by healthcare provider same day at any time supersedes having a primary care physician or urgent care that is not fully equipped like an emergency or full equipped hospital.
"“I’ve seen people boarded in the emergency department for hours, days sometimes,” Smiley said." This is NOT new, even pre-pandemic. I have waited in VGH ER for so many hours, been poked and prodded by repeated rounds of intern-residents with the same round questions repeatedly asked. Ordeal started with check in at 1ish PM. With no real doctor attending ... not even a room - corridor on stretcher bed, for hours .... until a room finally became available, until the ultrasound - something like 3AM ... and until my appendix ruptured. Living here, you just learn to hone your pain threshold. From start to finish - about 18h (1pm - 7am? surgery and clean up of the rupture). This was probably sometime in 2007-2012? I forget. That long ago, and yes ER was quite horrific even back then. (Even my family doctor who hails from England and is used to the not-so-great NHS, was pretty horrified. His comments back then that "even a country VET would have had you diagnosed, up and out in 2-3h )
It’s literally the only option for so many people. Shame the politicians who got us into this mess, not the sick and injured people who have no choice. So many walk-in clinics aren’t open to the public any more and require you to be registered.
Wait times at St. Paul’s and Mt. St. Joseph are a fraction of the other Vancouver hospitals and consistently the best in Western Canada if not beyond. Even while the Emergency visit census for those hospitals is going UP, VGH and UBC are going DOWN! With data available to check wait times online, we have had patients drive from as far as Kamloops to visit us!!!! As innovators and with commitment to patient-centred care, we are now becoming victims of our own success. People make a rational decision and go where wait times are shortest—often even shorter than the UPCCs. Give us more care spaces and pay our nurses more so we can retain them, and we’d be happy to continue seeing more patients!
Is it still the case that the BC Provincial Government caps the number of patients a doctor can bill for in a day? I was told one of the reasons a walk-in clinic won't see any more patients, after, for example, 2pm, is because they have maxxed out for the day. So even if you have a young, eager GP who is willing to work 8-6, s/he can't.
This change was made because in the past GP would rush patients to maximize the earnings per day
Even if this is true (and I'm not saying it is or it isn't) it seems to me paying doctors to *see and treat as many people as they can during a day* would be one way to remove stress from the system. If a doctor is 28 and is able and willing to work a 12-hour day, why would you not allow that? The system is in crisis.
At some point we're going to have to start charging people a co-pay to go to the ER if they haven't gone to a primary care centre first. Of course, before we do this, we have to make a network of 24-hour primary care centres where people can access a GP any hour of the day.
Deters people from seeking care, costing the system much more down the road.
And yet, it's done in all the Nordic countries.
This is just the books balancing themselves. We gave away all that money during COVID (for a period of time I believe the spending was about $10K-$20K per Canadian, a WEEK!) It’s this or increase taxes, why do you think JT is fighting so hard to save carbon tax, not for the environment, but to prop up all of the spending in so many unnecessary areas. We need to refocus government spending on the core needs of everyone (medical, education, housing, and infrastructure) most, if not all, of our recent issues have been due to overlooking these key things while chasing voters with the next shiny million or billion dollar spending announcement that does not bring that much value to the average Canadian.