So it seems Ontario ER waits are improving....

[Argus]

That's the most recent time I've ever been to the ER. If I had a more recent story I'd bring it up. My point was just to counter their anecdotes with one of my own.

I remember 12 odd years ago going into the ER at 2 in the morning, being seen right away for a bad gash on my chin, getting x-rayed, and stitches, and sent home within an hour.

Sadly, that is ancient history. That sort of service is reserved for countries with better health care systems.

[Argus]

But for serious ailments I was through triage within about 10 minutes in a bed by 20 minutes, and saw the doctor within 30 minutes. I believe that is pretty normal for people who go in for serious issues.

Define serious. I went in with my mother on three separate occasions, by ambulance, and we didn't see a doctor on any of those occasions for 8 hours, and didn't get out under 10 hours. All three for broken bones. From people I work with who live across the river in Quebec, the situation there is far worse. They come over here for better health care and shorter waits. Even their clinics have 8hr waits.

[Smallc]

I knew his anecdote was nonsense. And he's just confirmed it was ages ago. Even the government's own figures, which are undoubtedly massaged to give them the best possible message, say that at best, average wait times are in the 4-6hr range - AT BEST. And yet he says 30 minutes is the most he's ever waited.

Well, other than a Winnipeg ER in the evening, I can tell you that what he says is true of Manitoba as well....today. That's why ER waits aren't measured here, because they were never as bad as in Ontario and Quebec (though they were worse than they are now).

Ontario and Quebec seem to have more problem with touch points (ERs and clinics) and fewer problems with specialized care. It seems though (last I heard) that both are fixing the problem slowly.

Anyway, saying the system is bad is false. It's a good system that sill needs tweaking.

Edited July 31, 2010 by Smallc

[charter.rights]

Define serious. I went in with my mother on three separate occasions, by ambulance, and we didn't see a doctor on any of those occasions for 8 hours, and didn't get out under 10 hours. All three for broken bones. From people I work with who live across the river in Quebec, the situation there is far worse. They come over here for better health care and shorter waits. Even their clinics have 8hr waits.

The last time - around this time last year - was for gall stones. I went in about 10:00PM, and was in a bed by about 10:20PM. Not only that I saw a surgeon at about 2:00AM and had surgery scheduled for 10 the next morning.

Other times in the last 10 years or so, I have been there with my kids and with my wife for their issues. Never had a really bad experience save and except at one hospital one time with a couple of jerks behind the desk at the nursing station. The hospital heard directly from me about that.

BTW. Broken bones are not a serious issue that would bump you up in line. They always take the more serious people ahead of broken bones etc. In fact in many cases they can't even do anything about broken bones until the next day or two. The swelling has to go down before they put the cast on.

Edited July 31, 2010 by charter.rights

[Sir Bandelot]

I was fortunate to start working in the system when it was still in the "olden days". This is before MBA's ran the administration. The Admin was run by doctors. But not just any doctor, it took one who had excellent talent as a manager, as well as being an MD. Those kinds of people were rare, but that's the reason why they were also paid well for what they had to do. At the time, the same people who ran the hospital also still saw patients in the clinic.

Why was this better than what we have now? Because they understood the nature of the medical operations much more than an MBA could. The MBA knows how to run a business, perhaps, to maintain a level of efficiency in production and throughput. Yet hospitals by their nature cannot be run like a business and still maintain a level of excellence in providing personalized health care. By necessity there must be some in-efficiency. Because we are dealing with human beings, not products on an assembly line.

What does it take to give real, personal human care? It takes people who are willing to sit down with a patient who is terribly ill, spend extra time with them, even sometimes their own personal time, listening to them, tending to their needs, consoling them. The people who do this are in a different class than most of us, who work for a paycheck. And I have seen, over the years how the MBA's came in and re-engineered the work environment in the hospitals, reduce staff levels, reduce resources, which upset the health care worker because it made their jobs harder. But the thing most people do not know is, despite the added difficulty put upon them, the ones who were in it because they care did not stop doing what they do, they still spent their personal time doing what was necessary to help the patient. Because they knew, they were dealing with a human being. Someone who had a family, who was going through a hard time with their illness. Meanwhile the administrators go home at 5pm, enjoy their martinis, and their fat pay check. But to those of us who care about the job, what had to be done must still be done.

And that's the secret amost of you people don't know about. I swear I see it happen every day.

Edited July 31, 2010 by Sir Bandelot

[Wild Bill]

And that's the secret amost of you people don't know about. I swear I see it happen every day.

No doubt you will be told that your experience is merely anecdotal and therefore untrue, Sir Knight.

However, I for one believe you!

[Shwa]

No doubt you will be told that your experience is merely anecdotal and therefore untrue, Sir Knight.

However, I for one believe you!

Here is some more anecdotal information from another health professional:

Why ER wait times are what they are

In other words, even though patients think nothing is being done for them, the examination is already in progress.

[Wild Bill]

Here is some more anecdotal information from another health professional:

Why ER wait times are what they are

Interesting! Personally, I or anyone in my family has never experienced tests while we were waiting but I suppose it happens some where, some time.

[Shwa]

Interesting! Personally, I or anyone in my family has never experienced tests while we were waiting but I suppose it happens some where, some time.

Never had your blood pressure taken when you arrived in ER?

[Wild Bill]

Never had your blood pressure taken when you arrived in ER?

Only once, when I was reporting a possible heart attack. There have been many other occasions for myself and my family and no, no BP was taken while we were waiting.

The only thing that ever happened to my wife was when I brought her in with a high fever they immediately took her temperature. However, afterwards I asked them if she could have some Tylenol or something during her wait and they said OK. Of course, that brought the fever down. An hour or so later they checked her temperature again and stopped paying much attention. Another lady waiting nearby seemed more experienced with the way things worked. She told us that once my wife's fever dropped she was no longer in a higher risk category. She advised us to let the fever rise in order to get attention or we would be waiting there forever! We did so and a couple of hours later they took her temperature again and with it being higher they then finally got a doctor to see her.

When the doctor saw her there was a flurry of tests! This was in the middle of the SARS epidemic. It turned out that my wife was in no real danger and I had much respect for the wit of the doctor. I can't really say the same for the ER procedures but since it was a personal experience it was merely anecdotal and likely was just a product of false memory syndrome!

[Argus]

Here is some more anecdotal information from another health professional:

Why ER wait times are what they are

I don't give a shit what's being done behind the scenes. When you have to wait ten hours to see a doctor it's not working. Okay? I don't care if you have a hangnail. You should be seen by a doctor within half an hour in every single case barring a major disaster.

[Smallc]

I don't give a shit what's being done behind the scenes. When you have to wait ten hours to see a doctor it's not working.

That's not what the wait times say at all.

[Guest TrueMetis]

I don't give a shit what's being done behind the scenes. When you have to wait ten hours to see a doctor it's not working. Okay? I don't care if you have a hangnail. You should be seen by a doctor within half an hour in every single case barring a major disaster.

Your setting up an impossible standard you know that?

[Argus]

That's not what the wait times say at all.

I don't care that the stats say that on average you get to see a doctor within 4 or 5 hours. My experience has been 10 hours. And I think 4 or 6 hours is ridiculous, as well.

[Smallc]

That's not what the stats say either. You wait that long if you're not in a bad situation. You're only waiting for hours if you're not all that sick. Oh, and I don't care about your experience.

[Argus]

Your setting up an impossible standard you know that?

Wait times in France are virtually non-existent.

[Smallc]

Wait times in France are virtually non-existent.

ER wait times exist everywhere.

[Guest TrueMetis]

Wait times in France are virtually non-existent.

I would love to see your source on this, I really would. Come on, show me the source that says wait times are none-existent for people who go to the ER with a hangnail.

[bloodyminded]

I don't care that the stats say that on average you get to see a doctor within 4 or 5 hours. My experience has been 10 hours. And I think 4 or 6 hours is ridiculous, as well.

But my experience has never been ten hours, nor half that...mind you, I consider my personal experience to be a lot less that the sum of everybody's personal experience. Evidently you disagree with the basic truism.

For example, my personal experience tells me that 43-year-old men who smoked for 25 years have healthy lungs.

Of course, I had to wait several intolerable minutes in the waiting room to discover this.

Edited August 3, 2010 by bloodyminded

[Wild Bill]

But my experience has never been ten hours, nor half that...mind you, I consider my personal experience to be a lot less that the sum of everybody's personal experience. Evidently you disagree with the basic truism.

For example, my personal experience tells me that 43-year-old men who smoked for 25 years have healthy lungs.

Of course, I had to wait several intolerable minutes in the waiting room to discover this.

BM, this argument is getting ridiculous. Some of us are taking a good experience just in their own community as indicative of the whole. If I were a politician charged with defending our health care system, I would maintain one community hospital somewhere that is perfectly run and constantly point to it as the example of how things are working!

My repeated experiences are more similar to Argus'. We both live in Ontario. No one is trying to deny that Winnepeg may have higher levels of service or other parts of the country.

What I want and what I assume Argus and every other Ontarioan wants is high levels of service at EVERY hospital in Ontario! The problem is looking more and more like it is not really about the money. Somehow the bureaucracy involved seems wasteful and outright loopy at times! Certainly the pay scales are far above that of the private sector. Not so much for the nurses as for all the less skilled workers, like dishwashers and floor sweepers.

[Michael Hardner]

I was fortunate to start working in the system when it was still in the "olden days". This is before MBA's ran the administration. The Admin was run by doctors. But not just any doctor, it took one who had excellent talent as a manager, as well as being an MD. Those kinds of people were rare, but that's the reason why they were also paid well for what they had to do. At the time, the same people who ran the hospital also still saw patients in the clinic.

Why was this better than what we have now? Because they understood the nature of the medical operations much more than an MBA could. The MBA knows how to run a business, perhaps, to maintain a level of efficiency in production and throughput. Yet hospitals by their nature cannot be run like a business and still maintain a level of excellence in providing personalized health care. By necessity there must be some in-efficiency. Because we are dealing with human beings, not products on an assembly line.

What does it take to give real, personal human care? It takes people who are willing to sit down with a patient who is terribly ill, spend extra time with them, even sometimes their own personal time, listening to them, tending to their needs, consoling them. The people who do this are in a different class than most of us, who work for a paycheck. And I have seen, over the years how the MBA's came in and re-engineered the work environment in the hospitals, reduce staff levels, reduce resources, which upset the health care worker because it made their jobs harder. But the thing most people do not know is, despite the added difficulty put upon them, the ones who were in it because they care did not stop doing what they do, they still spent their personal time doing what was necessary to help the patient. Because they knew, they were dealing with a human being. Someone who had a family, who was going through a hard time with their illness. Meanwhile the administrators go home at 5pm, enjoy their martinis, and their fat pay check. But to those of us who care about the job, what had to be done must still be done.

And that's the secret amost of you people don't know about. I swear I see it happen every day.

Interesting take on this, SB. A competent re-organization (there are lots of them that are poorly executed) needs to take into account service levels as well as the personal aspect. If there are too many administrators with easy jobs, doing nothing - that's a sign of a poorly executed re-org.

I don't know that all MBAs are great at doing a reorganization, but I don't think it would be a good idea to have doctors running a reorganization. That's a specialized skill-set.

[Michael Hardner]

I'm heartened by the renewed interest in this topic !

[Argus]

That's not what the stats say either. You wait that long if you're not in a bad situation. You're only waiting for hours if you're not all that sick. Oh, and I don't care about your experience.

I suggest you read the stats again. It says you wait that long for less severe cases. For more severe, more complicated cases you wait longer, not shorter.

[Argus]

ER wait times exist everywhere.

I'd suggest you read up on France's system.

[Smallc]

I suggest you read the stats again. It says you wait that long for less severe cases. For more severe, more complicated cases you wait longer, not shorter.

Ummm no, that's not what it says. It says for more complex cases you spend more total time in the ER.