Dear Health Care System: How to regain my trust

Our ControverSunday topic last week was vaccines. There were some very interesting posts and perspectives about this. I encourage you to read them all.

Accidents will happen.

lililly

The Mothering Life

Ramble Ramble

A Letter to Xander

One of the most interesting things that twigged in my mind after reading posts and comments was the issue of ‘trust’ in our health care system. Kate from Lillily said:

“but I’m really not about to walk into my doctors office (who has over 30 years of experience treating kids) and say “you know what, I think you are wrong” because of something i read on the internets or heard from some celebrity’s lips.”

“and most importantly I think, I TRUST my health care system”

This got me thinking. I am less enthusiastic then Kate about vaccinations. To her first point about not going on the advice of the internet or a celebrity, I totally agree. Since when do we think we are the experts just because we read stuff on the web that may or may not be true?

It’s the second point that I found myself thinking about. Maybe the problem for me is that I don’t totally trust my health care system. I trust parts of it. But there are many aspects of health care that I am uncomfortable with. I don’t want to be. I know the people that work in health care are brilliant, kind and want to do best by their patients. I LOVE our family doctor and trust her to no end. But the system has some serious flaws and makes some serious mistakes. I think the result is negatively impacting their image to the public and may be the cause of this rise of parents questioning the systems wisdom.

So:

Dear Canadian Health Care System, the following is a list of how to regain my trust. I want to believe in you, I really do, but if you could just address a few things it would make it soooo much easier.

1) Over prescribing

I strongly recommend you look at your policies regarding prescription medication, as too many people are given too many drugs. I know you are trying to be cautious and don’t want to end up with someone sicker in a couple weeks. I get that. And it may work in the short term. However, in the long term it is not benefiting anyone. One clear example is antibiotics. As I child I remember I became quite attached to that banana flavoured elixir. I was one of those kids who got ear infections, bladder infections, tonsillitis, sinus infections. I am sure I got antibiotics at least 3 times a year. (Mom- feel free to confirm or deny). As an adult in university I had a 5 year bout with ongoing sinus infections. I strongly believe that the reason I kept getting sick is because they kept on giving me the antibiotics. (More later on how I ended the cycle.) Recently my daughter had an ear infection. Being cautious of antibiotics as I am, I asked the doc if we really needed to give her the drugs. He said because she is under 2 they typically do prescribe antibiotics for an ear infection. However, because she was not running a fever we could opt to wait for 3 days and then come back and decide then. We did. It cleared up. On its own. No drugs.

Health Care system: Please quit it. Give us drugs only when we really need drugs. Period.

2) Tendency towards interventions

Along the same lines, there is a tendency of doctors to step in and offer all kinds of interventions, rather then let things work themselves out. A great example of this is c-sections. A lot of women end up having c-sections they didn’t want. This is often caused by doctors being to quick to induce labour and then too quick to offer all kinds of labour related interventions, rather then letting the women go through the process in her own time. As someone wisely suggested- doctors seem to feel they have more ‘control’ over the risks in the operating room, rather then in the labour room. This trend needs to change. Our bodies are amazing and we need to give them a chance to work as they were intended. We are very lucky to have the range of medical interventions that we do and we should be so thankful that we do. They have saved many lives. But please use them sparingly rather then willy-nilly.

4) Symptoms rather then cause

You see, when the system is set up in a way that family doctors only have 10 minutes per appointment, it is understandable that they focus on just treating our symptoms and getting us out of the office. They just don’t have time to do anything else. The problem is then we just come back with more symptoms. This focus on symptom treatment in our health care system doesn’t make us healthier. It just covers up the symptoms of the problem, at least for a while. Sometimes that is all we can do, but I suspect often there is an other way to go if we start to investigate cause.

4) Treatment rather then prevention

Along the same lines…. What is up with the lack of preventative medicine? It is way more expensive to give someone knee surgery rather then physio. But our health care system focuses so much on treatment that prevention is largely ignored. Again, to my point above- they don’t have time for prevention. And I get that it is often not well received. Telling people that they need to change their lifestyles is usually a waste of time. We should strive to led healthier lives, but we don’t. We should be willing to accept some of the blame. That must be so frustrating to our doctors. But we need to find a way to look at our government services as a whole. To look at the big pictures and figure out how to really encourage healthy lifestyle. You can’t do this through the health care system alone. All of our health is impacted through all our social services, plus our policies surrounding the environment, food, and taxation(to name a few). Think of the money we could save our health care system if we really made an investment in people’s health throughout their lives? If we reduced the chemicals in our environment? Made sure food had proper labeling and forced restaurants to list nutritional information on the menu? If we provided better tax intensives for active living and looked at ways to lower costs of healthy food?

5) Alternative medicine

Seriously, you guys need to get on the ball with the Natural health crowd. I am not suggesting doing away with all western style medicine and all becoming reiki practitioners. What I am saying is that you need to recognize the value that natural health can provide. It’s approach is low cost and effective. Especially in certain circumstances. Take my discussion on antibiotics above. Remember how I told you that from childhood to my university days I struggled with many many infections of one kind or an other. I haven’t had an infection in at least 7 years. Why? Probiotics. That’s right, the stuff in yogurt. Except I take it in pill form because you get a much higher concentration that way. And how hard would it be to teach every doctor in Canada to recommend, heck even prescribe, probiotics following a round of antibiotics? I can tell you right now it would save millions in prescription medication costs. And I am sure there are a hundred other ‘common sense’ recommendations that our doctors could learn from the natural health crowd. Simple, easy and safe ideas.

Not to mention the fact that natural health is currently often self-administered via the knowledge gained from the web. Do you really want your patients self diagnosing and administering herbal remedies? As you often warn us, this is not without risk, especially of interactions with our traditional medicines. Wouldn’t it be better to bring the natural health stuff into the health care system fold and make sure it was being used properly and safely? Instead of just sitting back in your offices and warning us all about the dangers of taking all sorts of vitamins without any professional advice- why don’t you suggest them? Admit that natural health supplements can be effective when used properly and get on the bandwagon. Help us learn to use them effectively.

6) Fear

Here the thing that really gets me. The fear mongering. H1N1 was a prime example. Alberta heath services went on and on warning us of  how deadly H1N1 was. Then, they start up the vaccination program and recommend that babies and pregnant women come first. But they don’t turn anyone away. The result: 8 hour line ups that no baby or pregnant women can bear to wait in. Not to mention those who flocked to their doctors and emergency rooms the minute they started coughing, likely spreading H1N1 to more people. Are you surprised? You scared the daylights out of us. Then you do an about face, change your vaccination program and put out an ad campaign about washing your hands, staying home when you are sick and how ‘not all bugs need drugs’ in a desperate attempt to calm the fears. Consistency people, consistency.

Don’t scare us. Explain clearly and calmly what the risks are. Take a serious, but measured approach. Please.

6) Don’t placate us.

Like it or not, we parents do a lot of research. On the internet. Which I agree is not a reliable source for medical knowledge. But it means that instead of just agreeing with what is suggested to us, we are going to have some questions. So don’t just pat our heads and tell us something is safe. Don’t just repeat it like a mantra. Tell us clearly and calmly how you know it is safe. Take the time to explain it to us. I am sure you get tired of explaining what it took you years and years to understand to parents who think they are experts after an evening’s binge on the internet. But just humor us. Nothing frustrates me more then hearing over and over again “It’s proven safe” to every intelligent, well thought out question I have. Sure, it may certainly be “proven safe,” but give me at least a qualifying statement. Something like:  “There were four twenty year studies conducted by independent, non-pharmaceutical organizations into the long term impacts of this medication and all three studies showed that there were no detectable long term impacts.” Or, “This particularly treatment has been used, in it current form, for over 10 years. I have used it in my practice regularly and have yet to see any adverse reaction in my patients. I have no doubts to its safety.” Would that be so hard?

Obviously, most of these suggestions are aimed at the Health Care System, rather then individual health care providers. Honestly, I am not trying to shoot the messenger. I know how hard doctors, nurses and practitioners work. Over work, in fact. They are some of the most hard working and caring people out there in our society. But the system needs to sit up and take note of the growing lack of trust. And we, as citizens, need to push our government to start moving on some real, meaningful health care reforms. We are lucky enough to have a public health care system, but that doesn’t mean we shouldn’t want it to function more effectively and in a way that gains the trust of its patients.

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2 responses to “Dear Health Care System: How to regain my trust

  1. Amber March 3, 2010 at 11:03 pm

    I think part of the problem with prescriptions, is that many patients WANT prescriptions. It’s the reason placebos were invented, to make somebody who wanted a pill but didn’t really need one happy. It puts doctors in a tough spot, I think, and as patients we need to accept our share of that responsibility. If we don’t want drugs, we can always discuss alternatives, but I bet that few of us do.

    But I totally hear you on the fear-mongering and the lack of attention to preventive medicine and alternative modalities. The weakness of Western medicine is that it doesn’t treat patients as whole people, it treats them as pathologies. Sometimes, what someone needs more than anything is just someone to care. Respect us, treat us like grown-ups, and we’ll return the favour.

    • amoment2think March 4, 2010 at 6:32 am

      I totally agree- there are many people who seem to feel like they aren’t getting care unless they leave with a prescription. So we certainly need to take responsibility for part of that problem.

      Yes, exactly- Western medicine can do some amazing things, but it would be a whole lot better if it recognized the patient as a whole person, as you say.

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