Tuesday, December 1, 2015



The joke among snowbirds at the first flocking in Florida, or with friends gathering for the first eggnogging, is that you are only allowed to talk about your health for the first 15 minutes.
During a lifetime of reasonable health, if you don't count gout and some screwy wiring in my heart, I used to look on such accounting of operations with rum-and-coke indulgence.
Then on a trip home from God's waiting room in Florida, I drove into what I called in a lengthy Sun series, hospital hell.
Three months in four hospitals, punctuated with trips in ambulances, including an air ambulance home from West Virginia. I lost the ability to stand or walk or joke about health. Then a year later, two operations a day apart in two more hospitals.
After a career which included medical reporting, important jobs and lengthy service on a hospital board, I ended up as just another file number stuck on me on a gurney lost somewhere in a hospital corridor.
And this bothered more than just me and the family. Some insiders too!
As Todd Penner, a noted surgeon at Western and prof at U of T,  said a year later when he wandered around in my innards ruined by peritonitis for more than two hours, much longer than expected, if a connected guy like me is gamed by the system, what hope is there for Joe Canuck who doesn't even have a family doctor.
 He will get screwed routinely by the system even if he manages to hitch a ride.
After decades of journalism, you do acquire certain access. I didn't infuriate everyone I wrote about. So after my hospital hell, I could vent. I talked to the health minister twice about painful glitches. I suggested changes in the Sun. I could howl at the moon.
It had helped over the years that my family doctor and friend, Bernie Gosevitz, has clout. The proof of that came when 12 hours after he diagnosed atrial fibrillation, a wonderful and famous cardiologist was checking me out.
It almost made up for the endless delays and months when specialists were too busy to see me.
I won't let anyone forget those horrible two month in St. Joseph's, where the staff were too few and too tiny to handle anyone over six feet and 200 pounds. And some were lazy, hiding from patients.
So the three bed sore ulcers around my tail bone became so enormous and deep that afterwards community care access nurses (CCAC) came 128 times to the house for treatment and I spent almost a year tethered to an air  pump machine which was a helluva less fun to sleep with than my wife.
I survived, even when the travel insurance company tried to renege on $85,000 in American health costs and I had to use every gambit in journalism, including flaunting my doctors and their titles in health organizations and at U of T, to scare the hell out of the insurance goons..
Now I've just used up my 15 minutes to talk about my health.
I just took Mary to three medical appointments in one week where she always waited at least two hours past the appointed time.
I finally got an eye appointment with a specialist six months after it was requested. I showed up early because I had another medical appointment in 2 1/2 hours. Didn't work. Three hours later, after I bugged technicians, I made it in. He was nice enough to sort of apologize. I replied that I was now too late for the next specialist and added sarcastically "you take out cataracts but she takes out hearts."
Hope he forgets that before he operates, but then that won't be for months.
I have defended OHIP and Canadian medicare in some heavy-duty confrontations with some major Americans - once with one of the original seven astronauts - and I will continue to do so. It is incredibly satisfying that you can no longer be ruined by hospital bills, that everyone, eventually, gets cared for.
Yet there are so many things that could be fixed to make it all run better, including penalizing financially any doctor or  clinic who keeps a patient waiting more than two hours without a good excuse that they would have to document to the ministry.
There can be a competent and pleasant doctor at the end of the wait but the system in which they are the stars cares most about their time and to hell with the rest of the human race.These long waits are agonizing and exhausting for many patients and seniors. It can ruin their week if not the month.
Eric Hoskins, the current health minister, seems to be an able doctor with good ideas. He says a major restructuring of community health is underway, which may kill the current CCAC system,  Good! I found the CCAC system on weekends to be unhelpful and on wonky auto pilot. The evidence was obvious that it was a cumbersome, expensive system speckled with careless waste.
I tried for months to find out what each visit cost so I could write about the large cost just because a careless hospital gave me bed ulcers.
A flood of figures poured over me. I was confused, which I suspect was the idea.  I finally concluded that it was $70 for 30 minutes, which was ten minutes for me and the rest for the forms, but it could have been more.
It all adds up to the current $2.5 billion annually, for around 713,500 ''clients." Perhaps if they called them patients, they would be more patient with better care.
The Auditor General's latest report dealing with the inept stewardship of the province said patients are still waiting too long, some for up to a year, just to be assessed by the CCAC.  I remember my assessor. He showed up in the evening, five hours late, and interviewed me while I was sitting on the hospital toilet.
The AG, Bonnie Lysyk, pointed out that her watchdogs criticized this wait five years ago.
Dipika Dameria, the associate minister for long-term care, reacted typically recently when the Star showed her pictures of gaping infected bedsores in nursing home "inmates." You know, she was saddened and troubled. It has to change, she said. The ministry will strengthen compliance, she said.
Sorry but I'm not impressed. I've heard that from countless ministers.  I remember stories like this when I was a kid reporter half-a-century ago. The name of the game for operators is to keep costs down as much as possible to make more money.
There always will be a few who will want to cheat and cut corners by reusing dubious sheets and not having enough staff etc. There has to be regular inspection to catch them and an easy way for families to blow the whistle on incompetent care.
Hey, I know what I'm talking about. If a modern downtown Toronto hospital can give me bedsores that were so deep that doctors marvelled at the depth, what hope is there for no ugly holes in patients in a cheating nursing home.
There have been horror stories abounding about this for years. I can testify as a long-time board member of the modern Runnymede Health Centre, which grew from a rehab/chronic care operation in an old school while health officials kept trying to shut us down.
The relatives of our patients were ecstatic about our stewardship in long-term care, despite the humble surroundings, because they knew how grim and costly many alternatives were.
The auditor's report critized a host of issues in elderly care, including lengthy delays in investigation and inadequate follow up after complaints of violence or abuse.
 Let's not forget, Dr. Hoskins, that any review of Ontario health care must included the parking costs at Ontario hospitals. Even the Canadian Medical Association says medicare is being harmed by the high parking charges because patients cut short their visits to clinics and some families just can't afford to visit their incarcerated loved ones.
It isn't as important as hospitals not having enough nurses or other staff but to me the costs of parking on hospital grounds is almost as galling as the municipal parking enforcers who infest streets around hospitals and prey on the vulnerable - the patients and their families who never have a quick visit because doctors treat everyone's else time with contempt.
I know of a lawyer who after the doctor kept him waiting for three hours past the appointment time, billed him for three hours. We should raise a monument to him. It will be needed quite soon, I imagine, because the medicrats are not going to rush to save him from passing. His bitching could grow into reforms if it was allowed to spread.

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