Issue 43 Vol II, July 15, 2007

T H I S  O U R  C A N A D A

Canadian Health Care:
Sluggish Emergency Services
Khushwant Toor

THE Canadian Medical Association estimates that the country requires 2,500 medical graduates annually but is producing 2,200 a year. 1 in 9 Canadian-trained doctors are treating Americans – the equivalent of two medical schools worth of students, according to a study in the “Canadian Medical Association Journal”. Canada is the second largest source of immigrant doctors to the U.S., after India. Canada has 2.1 physicians per over 1,000 residents, ranking it 25th out of 30 countries.

A colleague asks another fellow staff member in the office. “You don’t look fresh this morning, are you o.k. - oh I had to take my friend to the emergency department yesterday night at the Hospital and ufff! Man! We had to wait for 6 hours before we could see a doctor”. “Oh really (says the first one) I know I have been through this quite a number of times. Emergency departments are really slow, last time I went there with my mother we had to wait for 4 hours, there is something wrong with the whole health care system”.

Often you hear this conversation among different circles in Canada. People dread to go to emergency departments of hospitals especially in big cities like Toronto. Recently I had to take my wife to the emergency department of one of the hospital in Toronto (William Osler Hospital in Etobicoke, Ontario) for a severe stomach ache. Here is what all the typical emergency patients experiences.

It was Friday night around 8.00 p.m., after about two hours of debating and taking into consideration the waiting time we had undergone during our last visit, we finally decided that we have no choice but to go to the emergency department in the nearest hospital. We could not wait as the pain was severe and our family doctor would only be available next Friday, as during the other week days she is busy seeing her patients at multiple other locations. From these other locations our file is not accessible and the doctor insists on seeing us on the prescribed location.

As soon as one enters an Emergency Department at the hospital a Triage nurse checks your blood pressure etc., notes down your sickness symptoms and asks you to wait for registration with a broad smile on her face as if you will be taken care of within a minute or two. It took us about an hour before we were called in for registration. All the health care cards were swiped and a band tied on to the wrist of my wife to identify the patient. After registration we were sent to the minor treatment department which already seemed packed with patients even sitting on floor in the corridors.

My wife asked another lady already sitting in the minor treatment department, how long have you been waiting the reply was over 3 hours. We gathered all our patience and sat there quietly. Meanwhile, more emergency patience walked in. A small child was brought in by his parents with a sprained ankle, an elderly lady came in with severe gas problem unable to sit or lie down and constantly crying hai, hai, hai. Another mid aged lady who could barely walk due to a problem with her leg walked in slowly. Agonising wait for all.

After two hours in the minor treatment department, I walked up to the nurse and asked her; sister we have been here for about 3 hours now in the hospital and have not yet been attended to. Came in a smiling reply; “when did you come in. I said just before 8.p.m its now over 11 p.m. She checked our chart and said no you came in a few minutes after 8 p.m. and we have patients who came before 7 p.m. and are still waiting. You will have to wait for your turn. I asked her how we will know about our turn, I have not heard any names being called for. Oh don’t worry we will call your name.” Without any further complain I just came back and sat down on the floor.

After following up with other nurses twice, an hour latter, my wife’s name was called. I could see the happiness on her face after hearing her name as if she heard her name announced in the pass list after clearing her degree exams. She was given a bed to lie down. After checking her blood pressure and temperature the nurse took a blood sample and informed that the test results would arrive after an hour.

While we were waiting for the blood test results, a gentleman lying on the next bed got up and asked the nurse how long it will be before he could see the doctor. Came back the pleasant reply again I don’t know you have to wait. He mentioned that it has been long now and he has to go home as the last bus would leave in about 10 minutes. The nurse reluctantly answered him there is no way doctor can see you in the next 10 minutes. The gentleman further asked the nurse “can you do me a favour I cannot wait any longer or I will miss my last bus and I don’t have money to call a cab. If there is something seriously wrong with me kindly give me a call at my home phone number and I will come back tomorrow to pick up prescription.” Off he went frustrated and worried about his health.

Listening to this conversation another couple sitting outside in the corridor also decided not to wait any longer and try their luck with the family doctor next day. My wife and me looked at each other but then decided not to leave in frustration and wait for the blood test results at least. At 1.20 a.m. the nurse informed us that the blood test results are in and everything looks normal, the pain could be related to work stress or due to minor urine infection. She further asked us to wait for the doctor. At about 2.00 a.m., I asked the nurse when would the doctor see us. The pleasant reply was I don’t know may be another half an hour.

About half an hour latter I went to the head nurse to ask for the doctor. She replied there is only one doctor in the emergency; he is busy with other patients, we will have to wait. After feeling a little frustration in my voice the reply from the nurse meant who the hell cares just keep waiting. At close to 3 A M we were feeling extremely sleepy and were both worried about the full day of work next morning. Our patience ran out and we both decided to leave without seeing the doctor. We asked the nurse to call the doctor but she refused, as she cannot not, she was little concerned but could not console our frustration.

While leaving the hospital I asked the Registration Clark if there is any suggestion box or a complaint box in the hospital. The reply was I don’t know you may check near the front reception (which was closed at that time). While going towards the front reception I noticed a doctor with a white gown walking out of the building. I asked him doctor we came here at about 8 p.m. and it is over 3 a.m., till now we have not been attended by any doctor what is the matter, is there shortage of doctors or what? His polite voice made us sympathetic towards him. “There is only one doctor in the emergency department today and I was supposed to get off duty at midnight and I got off at 3.a.m. now. But don’t you worry I will call my colleague to check you immediately”.

We were asked to go back to our bed and the doctor brought the doctor on duty to attend us immediately. The doctor on duty checked my wife’s report and prescribed a generic pain killer and asked us to follow up with our family doctor the next morning if pain persists. Thereafter we were out in 2 minutes. We had to wait 7 hours to get a doctor see us for 2 minutes and prescribe a generic pain killer. On the way home we both reassured ourselves never to come to the emergency department again.

Early next morning our receptionist at the office asked me “you don’t look tired today, are you O.K.” I had nothing to say but laugh.

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