A long post with a bit of fun on a not-so-funny subject – Healthcare. I find it helpful to find humour in things no matter how bad they get. That’s why I created this musical parody, to lighten the emotional load without diminishing the reality of the situation.
Even my summarized story is a long one (don’t get me started…) The shortest version of it - we lost our doctor when we moved to help care for my elderly mom, got on the need-a-doctor list for years, came off it temporarily and now find ourselves on it again (at the bottom).
Skip right to the song/lyric video as that’s the purpose of my post, and you’ll get it; but if you’re at all interested in what prompted me to create this and more of my own thoughts on the subject, read on below. Mine is only one of a myriad of situations, nothing special, but I do believe it reveals a glaring injustice in one part of the current system, and that was the motive behind my facetious but genuine musical plea.
As one of the over 150,000 people in Nova Scotia with no primary care provider, it’s a hellish place to be, in this stage of life. (6 million for all of Canada.) Who and what’s to blame, the opinions flood our timelines, but here we are.
For every “revelation” of how bad things have gotten in recent years, there’s others who have seen the cracks in the system get worse and wider for a very long time. Yes, we complain and rightly so, but we need to get busy on the future now, and implement real, viable solutions or it’s only going to get worse. If changing governments, hiring consultants and throwing massive amounts of money at the problem is the answer, it would have worked by now. (That applies to all the broken systems, but I digress…)
Personally, I’m in reasonably good health for my age. I think of a primary care provider as a partner in wellness – someone who's there for me in an urgent or acute situation, who helps me manage chronic but non-fatal conditions, but most of all keeps me on track and accountable with a reasonable schedule of preventative tests and self-managed lifestyle habits.
It’s like taking your vehicle in for regular checks and maintenance, knowing you might still need to call for a battery boost or a flat tire. (If you believe in just running it into the ground that’s a choice too, but the public purse isn't on the hook for old beaters when they go out to pasture.)
I’m not prone to feeling sorry for myself either, but here’s some background on why I’m calling “no fair” on our current situation.
I became a patient of a family practice with a great GP while I was attending college in Wolfville, back in the 70’s. That relationship lasted for decades, and when he retired, I was taken on by his young replacement. That’s the way it used to work, it still does for some, but not for all and not for me.
For years prior to retirement, I was the on-call relative for aging family members. I was the navigator and advocate for my elderly Aunt when she needed home care and then long-term care after developing dementia with challenging behaviours. I got her assessed and eventually placed in a home near my work at the time, convenient, but a difficult three-year experience for both of us.
Meanwhile, my mom’s cognitive impairment, failing eyesight and osteoporosis made her increasingly frail and prone to injury (but like her sister, pride and reluctance to accept any help prevailed). She had a good doctor and other medical resources, I interacted with all of them. My long career allowed me a generous amount of sick days and I used up most of them, for her more than me.
We managed long-distance with personal support when needed. After Mom broke her hip, the first of many bone fractures, she needed regular home care. We were lucky to find a caregiver who went from temporary to full-time to being like part of the family, but as Mom’s needs increased we expanded her home care to 24/7 and it still became more than we could handle. I finally made the decision to leave my job and we moved from the Valley to the South Shore. (The idea of keeping old people in their homes where they want to be, it sounds lovely – tell me how many people have the resources to do it in reality.)
That was in late 2014, and for the first few years, if we needed non-urgent medical care, we drove a three-hour round trip to our doctor in the Valley. He was willing to keep us on, as a temporary measure, but there was also my aversion to bad-weather driving across Highway 12 (another impetus for our move in the first place).
We went on the “Need a Doctor” List in 2018 and two years later we were assigned a Nurse Practitioner at the collaborative care clinic in Lunenburg. This was also temporary, they told us to remain on the list for a closer and permanent placement. It was still a one-hour round-trip from home but much better, we were relieved and grateful.
Going to the Lunenburg clinic brought back memories of my daily visits to my Mom, after she was placed there in the Alternative Care Unit. She was 94 and on the longterm care wait list for a year by then. She eventually got into Harbourview where she passed away within a few months. I have utmost respect for the kind, dedicated and over-worked professionals who helped us on that journey (not all but the majority). It’s another long sad story and that’s only the half of it.
We got a letter in 2021 telling us that our NP was retiring but another NP was taking her place. Then we received a call in early 2022 that we were finally being offered a placement with an NP in Bridgewater. We were told to take our names off the list, there would be no doctor, but we had a home after four years on the registry and we were happy with an NP.
Then in 2023 we got another letter, that our NP was retiring, again. There was no replacement this time, only a promise that they were trying and we’d get a call if they found one. Six months later, no luck so far. There was no effort to find a spot for us with one of the other nine doctors or other NP’s in the clinic, we were apparently attached to the retiring NP and not the collaborative care center. We were told to go back on the list.
So, I called 811 last year to get back on the list. The woman who answered the phone was terse, she’d heard all the stories and was not interested in mine. I suppose you can’t blame her, maybe she just didn’t like her job anymore, although civility is still valued by some of us.
She told me that our prior four years on the list is not taken into account, our place on the list now would be starting again at the bottom. When I complained that other people were assigned to new doctors at the same clinic during the time we were being dumped, she said “They were on the list. You were not.” The clinic only takes people from the list, in chronological order. To be clear, I’m happy for anyone who gets a care partner, that’s not the issue. I don’t expect to be put ahead of anyone with more urgent needs either, but do you think it sounds fair that we went to the bottom of the list again, in 2023? I do not.
There has been progress made in some areas over the past number of years. I know that people with doctors get frustrated with wait times and other flaws in our system, but there’s simply no substitute for someone who gets to know you and is invested in your wellness over time. Virtual care apps and tele-medicine have a role to play, as do mobile clinics and other points of contact depending on your need. I also believe whole-heartedly in allowing professionals to maximize their skills and act within a safe and reasonable scope of duties – EMT’s, Pharmacists and other medical professionals can take a huge amount of pressure off the Doctors and NP’s and make the whole system more efficient.
In my former career as an Operations specialist, I studied and implemented practical strategies around the practice of Strength Management, and trust me it works. It’s how you can create high performance teams who not only deliver efficient services, but who actually engage in and enjoy their job. Imagine that.
In the broader sense, it’s about looking at what’s right about a system or person, manage the weaknesses but enhance the strengths. Match up a person's natural talents with the skills needed to do the job, train them properly and pay them fairly to do it, pay them extra for doing it well. A variety of talents in a workplace is a good thing, they all contribute equally in a well-run system. Paperwork and data entry gets done by those who enjoy those tasks and are good at it, freeing up time in the people-facing roles for those who love and do that part best. Many leaders are “fire, aim, ready” personalities who want to create vision and get things done faster. That can result in back-tracking, but you can balance it out by listening to other team members who are good at research, planning and strategy. Finding the balance and working together is key, while being genuinely receptive to the suggestions that come from front-line employees and customers. Then implement the good ideas, get middle management out of the way, and let people do their jobs.
No amount of money thrown at a broken system is going to fix it, we’ve been trying for decades and it’s still not working. There’s incentive for politicians to align with private care providers, make us more like the US, but like everything else the people who can’t afford extra insurance or who will go bankrupt from a heart attack or cancer are going to be regular folks and not the profiteers. We may end up with no choice but to expand the already hybrid system but we shouldn’t have to accept that, not yet.
So back to the parody, I’m singing “Oh Tim” because he’s my current Premier and he did campaign on a promise to fix health care (and it is, ultimately a provincial domain). If you’re familiar with the song (Mercedes Benz), folks in Ontario can sing “Oh Ford” that’s even closer to the original.
I still love and want to live in Nova Scotia. (If you browse my other posts and songs, you'll see that clearly) I just wish our Department of Health and Wellness would live up to its name, and I believe it can. This is such a complicated topic, I’ve barely scratched the surface and already taken up too much of your time if you’re still reading. So much to be done for the benefit of all, but if I can be selfish for one more moment - “Oh Tim, can’t you find me a new physician? Pretty please? Thanks.” 😉