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

[Smallc]

In the experience of everyone I have ever spoken to or heard of in my entire life. How about that? No, of course not.

Of course not, because I (and even you) have no way of verifying that.

A closed mind doesn't consider such input when it deviates with his own narrow preconceptions.

Your experience is no more special than anyone else's, therefore, it's irrelevant.

And yet even the "official" government statistics are wildly unacceptable except to someone with exceedingly low standards who twists and turns and desperately wrings every possible concession out of them to try and make the system look better.

I'm not sure why most of them are unacceptable. Most hospitals are running 6 hours for minor problems from entry to exit. That isn't at all unreasonable. More complex cases should take more time, though I would expect they spend less time waiting, and more time in treatment/under observation.

[wyly]

I know there's going to be waiting, and I know there will be a longer wait than for anything else I have to wait for in real time but I think 4 hours is too long.

...I know from experience wait times in ER's vary from zero to seemingly forever, how do you staff an ER to deliver the demand for instant gratification, think of the horrendous extra cost involved having a surplus of MDs and nurses standing around waiting for patients to show up in quiet periods in anticipation of rush of patients...there is a shortage of MDs that isn't a fault of hospitals that's a lack of funding for university training facilities and demographics so where are the MDs to reduce times?...and not any MD can work in an ER they have to be trained to do it and most MDs do not want to be trauma doctors, so the mythical taxi driving immigrant MD who specializes in rheumatology isn't qualified ...

it's great sport here for forum members to complain about wait times in the ER but a shortage of ideas to understand the situation or solve it...so what's your solution?

[P. McGee]

LITTLE delay ? That's an immediate threat, and I would hope that they would be taken immediately ?

I went to ER with a severe injury 20 years ago and got immediate treatment, which is as it should be.

I'd like to get away from this particular example if possible, but he was already in the care of paramedics and hooked up to monitoring equipment and oxygen in cases where we waited for a few minutes to be admitted (local hospitals). The immediacy of the threat had been addressed already by the paramedics, so overall we were satisfied with the quality of care. Any time the paramedics have to stand around waiting for a patient to be admitted is time they can't be out there responding to new 911 calls though, and quite a few times I've seen paramedics waiting with other patients for 20 minutes or more at local hospitals.

My original point was just to contrast our experiences with quite urgent complaints (minimal or no delay with no negative impact on patient care) with other ER visits where the complaint was of less urgency (sometimes a wait of an hour or two, but still no real impact on patient care). There is always going to be room for improvement, but my feeling is that the bigger problem is the shortage of ER alternatives to deal with less urgent complaints (family doctors and walk-in clinics), rather than ER departments being unable to keep up with life-threatening emergencies that come their way.

[Michael Hardner]

No, it is a real cost increase. In medicine, inflation increases faster than the growth of the economy.

Sorry, I thought that your quote here:\\

Cost doesn't decrease overall over time anywhere, whether we're talking private or public. You can decrease costs for a while or in some areas, but overtime, you can't escape inflation, especially while you're trying to increase the level of service.

referred to 'infation', which I thought was different than real cost increases. In real terms, many costs go down over time.

[Michael Hardner]

Two hours does NOT sound fantastic. Walking in, being triaged, and seeing a doctor within ten minutes sounds fantastic - as happened to me 15 years or so back when I went to the ER after banging up my chin on a sidewalk.

The medical system in France sounds fantastic. Two hour waits when you're in pain do NOT.

People need to stop lowering their expectations, for Gods sakes.

Good point, but that would be a 50% reduction in service time. I do wonder what the ER service times are elsewhere. I will Google that when I have a better connection.

[Michael Hardner]

...I know from experience wait times in ER's vary from zero to seemingly forever, how do you staff an ER to deliver the demand for instant gratification, think of the horrendous extra cost involved having a surplus of MDs and nurses standing around waiting for patients to show up in quiet periods in anticipation of rush of patients...there is a shortage of MDs that isn't a fault of hospitals that's a lack of funding for university training facilities and demographics so where are the MDs to reduce times?...and not any MD can work in an ER they have to be trained to do it and most MDs do not want to be trauma doctors, so the mythical taxi driving immigrant MD who specializes in rheumatology isn't qualified ...

it's great sport here for forum members to complain about wait times in the ER but a shortage of ideas to understand the situation or solve it...so what's your solution?

Yes, you're right - but they sill have to staff the hospital to accomodate people at current service levels, so there are costs, service levels, and so on. These things can be planned for, measured and reported on.

The goal should be zero wait time, understanding that the goal itself isn't attainable but constant improvement is.

We could conceivably talk about ideas to improve it, but the actual costs, and details aren't shared with us as they should be.

[wyly]

Yes, you're right - but they sill have to staff the hospital to accomodate people at current service levels, so there are costs, service levels, and so on. These things can be planned for, measured and reported on.

yes and that's the fault of provincial government where I live...blowing up and closing hospitals(Calgary), hiring freeze on medical staff, lack of funds for universities to expand training programs and this in a province that had huge surpluses, there seemed to be a deliberate attempt here to hamstring healthcare and push it toward privatization...

The goal should be zero wait time, understanding that the goal itself isn't attainable but constant improvement is.

agree absolutely...

We could conceivably talk about ideas to improve it, but the actual costs, and details aren't shared with us as they should be.

agree again....

[Argus]

Your experience is no more special than anyone else's, therefore, it's irrelevant.

My life experiences (of which you have little) inform me on topics so that I can more easily discern the difference between BS and more credible truths.

I'm not sure why most of them are unacceptable. Most hospitals are running 6 hours for minor problems from entry to exit.

You don't even know how they're defining minor. And to most reasonable people - with standards - waiting around for 5 1/2 hrs in order to see a doctor for ten minutes is NOT acceptable. You simply have never seen good health care service so you accept this as normal. I have seen and experienced better, and, as in almost everything else, am thus wider than you.

That isn't at all unreasonable. More complex cases should take more time, though I would expect they spend less time waiting, and more time in treatment/under observation.

[Argus]

it's great sport here for forum members to complain about wait times in the ER but a shortage of ideas to understand the situation or solve it...so what's your solution?

Import France's system.

[Smallc]

My life experiences (of which you have little) inform me on topics so that I can more easily discern the difference between BS and more credible truths.

I haven't seen any evidence of you being able to do that yet.

You don't even know how they're defining minor. And to most reasonable people - with standards - waiting around for 5 1/2 hrs in order to see a doctor for ten minutes is NOT acceptable. You simply have never seen good health care service so you accept this as normal. I have seen and experienced better, and, as in almost everything else, am thus wider than you.

You don't wait as long in Manitoba, actually. Still, Ontario wait times are going in the right direction, and are now in reasonable territory.

[wyly]

I haven't seen any evidence of you being able to do that yet.

You don't wait as long in Manitoba, actually. Still, Ontario wait times are going in the right direction, and are now in reasonable territory.

whiners will always harp on the worst experience and make it sound routine....of my personal experiences which should I claim is normal, my zero wait time on one ER visit or the multi hr visit in an ER waiting room that looked a triage in the center of a war...

I'll bet the longest waits in ERs happen at night and weekends when walkin clinics and MD offices are closed...

[Michael Hardner]

yes and that's the fault of provincial government where I live...blowing up and closing hospitals(Calgary), hiring freeze on medical staff, lack of funds for universities to expand training programs and this in a province that had huge surpluses, there seemed to be a deliberate attempt here to hamstring healthcare and push it toward privatization...

I like the fact that you (apparently) support state healthcare, and are also not happy with the status quo.

I would rather have more of us that support public healthcare admit that the system could be better, rather than comparing it to the (I believe worse) US system.

[Michael Hardner]

Still, Ontario wait times are going in the right direction, ...

I apologize if you've already explained this - but where does this information come from ?

[Smallc]

I apologize if you've already explained this - but where does this information come from ?

I would refer you to the opening post, even though I know you choose not to believe those numbers.

[Michael Hardner]

I would refer you to the opening post, even though I know you choose not to believe those numbers.

As I indicated, we need independent verification and not self-reporting, and certainly not self-reporting by the minister herself at a media event.

That being said, I re-read the article and it seems they were talking about a subset of all ERs - a subset of ERs which were part of a specific program so it seems that the subject line of this thread isn't correct, across the board.

[Smallc]

The overall trend is down with this subset included in the whole. The program has been successful and is being expanded.

[Michael Hardner]

The overall trend is down with this subset included in the whole. The program has been successful and is being expanded.

Where did you get that information then ? It's not in the link in the OP.

[wyly]

I like the fact that you (apparently) support state healthcare, and are also not happy with the status quo.

I would rather have more of us that support public healthcare admit that the system could be better, rather than comparing it to the (I believe worse) US system.

it's a common topic of discussion with my MD friends, each one of them support our public health system but they all have issues with the way the elected officials can screw it up...I have no doubt if we could solve some of the problems we could have the best healthcare on the planet by a good margin... Edited September 20, 2010 by wyly

[Smallc]

Where did you get that information then ? It's not in the link in the OP.

No, it isn't. It's an assumption.

[Michael Hardner]

it's a common topic of discussion with my MD friends, each one of them support our public health system but they all have issues with the way the elected officials can screw it up...I have no doubt if we could solve some of the problems we could have the best healthcare on the planet by a good margin...

Ask how many of them would be in favour of importing low cost medical professionals to take on some of the work.

[wyly]

Ask how many of them would be in favour of importing low cost medical professionals to take on some of the work.

sure, but first what do you mean by low cost? if they're qualified to work in Canada as MD's how can you pay them less?

I've heard of suggestions to off load some of the work by shifting some more routine stuff to nurses, pharmacists and midwives ...is that what you are referring to?

somehow we have to lessen the load on MDs if we can't train enough to meet demand...I looked into MDs per 1000 for Canada and France, Canada tails 2.1 to 3.3, our MDs are over worked...as well France is a much more compact country than Canada not much bigger than the Yukon so that even people not in the metropolitan areas don't have to travel far for medical care as many Canadians do...

here's a coincidence, on my trip to France this summer I met a Parisian ned student who intends to practice in Montreal when he completes his study as a surgeon...he apparently is not put off by our version of socialized healthcare...

[Wild Bill]

No, it isn't. It's an assumption.

Are you saying that while Argus or my life experiences are anecdotal and imaginary, your ASSUMPTIONS are valid?????

[Smallc]

Are you saying that while Argus or my life experiences are anecdotal and imaginary, your ASSUMPTIONS are valid?????

It's an assumption based on the evidence n the article....but no, it's no more valid.

[Michael Hardner]

sure, but first what do you mean by low cost? if they're qualified to work in Canada as MD's how can you pay them less?

By writing a smaller number on their pay cheques.

I've heard of suggestions to off load some of the work by shifting some more routine stuff to nurses, pharmacists and midwives ...is that what you are referring to?

That can be done as well. We could also create new roles to offload the work. Or we could import physicians from other countries and pay them less.

somehow we have to lessen the load on MDs if we can't train enough to meet demand...I looked into MDs per 1000 for Canada and France, Canada tails 2.1 to 3.3, our MDs are over worked...as well France is a much more compact country than Canada not much bigger than the Yukon so that even people not in the metropolitan areas don't have to travel far for medical care as many Canadians do...

The MDs do, I believe, have a say in how many doctors are put on the market in Canada.

[Michael Hardner]

It's an assumption based on the evidence n the article....but no, it's no more valid.

Smallc, I'm not wagging my finger here, but can you understand now why such articles are poor vehicles for healthcare performance information ?