AV: What does our healthcare system do very well?
Triage. My mom remarried a few years ago, and the gentleman she married has a heart condition and has ended up in emergency more than once. They always triage heart conditions—I can speak from his experience—to the top of the list. He has gotten exceptional care and he’s still here, still caring for my mom, as a result of a strong public healthcare system. The biggest value is the public component. It doesn’t matter if you have a fur coat or no coat at all; you show up to the ER and you’ll be treated
AV: What most needs improvement?
We’ve put significant investment over the last few years into mental health and substance use; we’d really languished behind the rest of the country. With harm reduction—especially the opioids crisis—the evidence says it’s important to bring in supervised consumption.
AV: If the evidence is clear, why did it take until almost 2018 for Alberta to open supervised consumption sites?
Before 2015, Conservatives in Ottawa and in Alberta let ideology drive their agenda. For us, evidence—and wanting to keep people alive—drives our agenda. It’s tough, knowing that people are engaging in illegal behaviours. But everyone who has died in the opioid crisis is loved and deserved a chance to live a full life. It took some time to get approvals from Health Canada, but the sites are now open. We did them in partnership with community. Edmonton, for example, has four sites, all driven around social agencies and healthcare facilities that reduce the risk for workers and volunteers and for the people who use substances.
AV: What’s the biggest misconception the public has about our healthcare system?
One of the things I was most surprised by is how many of our physicians are still paid on fee-for-service. There are a lot of salary models; each provides for a different relationship and a different encounter with your healthcare professional. Sometimes as a patient I felt things were moving quite quickly in my doctor’s office, and I didn’t totally get why, but having looked at some of the mechanisms for reward and compensation, now I get it. We’ve done some work on that and brought physicians to the table a couple of times around improving return on investment.
AV: So, for the person who goes to their doctor, what’s the difference now?
Not every physician has stepped up to be part of a different compensation model, but many are moving along that path. Something else that’s changed is around primary care networks (PCNs): doctor’s offices working together to do wraparound services. So, if people want dietary counselling or need to discuss medications with a pharmacist or access occupational therapy, these allied health professionals are part of this network. Not a lot of Albertans know that they can get primary care without having to go to a hospital, that their community doctor or nurse practitioner can connect them with these resources.
Interviewed by Evan Osenton. Evan is the editor of Alberta Views.
Find the full article in the November 2018 issue of Alberta Views.