Premature Optimism

Toronto unions 416  and 79  are on strike and all the media can seem to grasp is that that means no garbage  and certain daycares are closed.  There was a day spent on people complaining about low income daycare being union and on strike while city hall’s day care is private.  And a few articles about parents scrambling for child care or taking their kids to work.  But that isn’t even close to the real problem.  Parents should have back up child care given that daycares won’t take kids that have a fever, vomiting, diarrhoea, pink-eye, or lice.  Most people can manage to deal with a few weeks worth of garbage or take it to the dump, and residents should be capable of keeping their streets clean.  There are far more important services than garbage.
The real problem is the public health nurses and public health dentists aren’t there for those who need it –the cities dental clinics are closed, the Sexual Health Clinics are closed, the Works (needle exchange) is closed, no phone calls/home visits for new moms or at risk pregnant women.  There is no one checking restaurant safety.  No one is checking water quality at some beaches. There is no one checking safety standards at the non-city pools; no one is checking spa safety.  There is no one fixing drinking fountains or turning on splash pads (those on a timer remain open as long as they work).  If there is another apartment building emergency (loss of power, damage from gas explosion –again, damage from grow op), there’s no one to find emergency housing.

I am sure that there are unscrupulous restaurant owners; the ones who don’t really care if they get a yellow rating that are taking advantage of this strike.  They aren’t checking fridge temps, or getting repair people in as quickly when there is a problem.  They aren’t storing things properly, and aren’t cleaning as often as they would normally be.  Without restaurant, pool, and spa inspections someone is going to get sick.

People in need of cheap or free birth control –can’t wait; and I’m not sure that Planned Parenthood can pick up the slack.  People that need STD testing, particularly those that don’t have health cards (the homeless, some prostitutes, and new immigrants) or teens that need confidential services unavailable from their family doctor, can’t wait.  Pregnancy counselling can’t wait.  Counselling for people in questionable relationships, or in crisis over their orientation can’t wait.  Sex ed normally can’t wait, I really doubt anyone is going to not have sex just because their questions aren’t answered.

Normally when you go home with a new baby there is a public health nurse that calls and checks up on you and will come to your home unless you decline the visit, and if you do they normally call you a few more times.  For women that use OBs and go home within 24 hours after birth this may be the only way jaundice is caught, and it’s often the only way breastfeeding problems are found.  Yes babies should be taken to a doctor within the first 2-4 days but not all people can or know that they should.  .  Public health nurses also help catch post-partum depression.  Parents of multiples also get other assistance from public health nurses, often on a weekly basis.  Public health nurses also provide pregnancy and nutrition support for those that need it.

Most doctors also know about as much about breastfeeding as they do about quantum gravity –almost nothing.  A doctor can’t find a breastfeeding problem but many, if not all, public health nurses are qualified lactation consultants (not to be confused with far less trained lactation nurses).  These public health nurses will also visit women in their home as often as needed to help with breastfeeding, and they help staff breastfeeding support clinics which I am sure are scrambling without the assistance.  I can only hope that hospital staff are smart enough to make sure every woman is leaving with the number for La Leche League and any other breastfeeding mentoring agencies in Toronto.

Public health nurses also run some of the classes for children and babies where they catch developmental problems that may be missed in a short doctor’s visit.  Who knows what else public health nurses normally do on a day-to-day basis that is being sorely missed by some segment of the population?  It’s sad that the CP24 can write a story about a raccoon stuck dangling by its tail because of the delay caused by most of Toronto Animal Services being on strike but can’t seem to find some new mom struggling, or someone in need of STD testing or birth control.

I haven’t even missed two pickups yet, and let’s face it we’ve all had a week that the garbage didn’t make it to the curb or didn’t get picked up.  In fact, recently two weeks running the garbage collectors refused to pick up my green bin because they couldn’t see the bag lining it.  At least once a month only half my recycling is taken because it gets stuck in bin and as the staff stay in the truck no one notices (or cares).  So the garbage situation is pretty much business as usual at my house –though at some point this week I’m sure we’ll run the diapers off to the dump.  And while it really sucks that many splash pads and all wading pools aren’t working –we’ll muddle through.

Low-income people that need sexual health services, dental services, nutritional service, and other services are really suffering.  Moms and babies without support are really suffering.  As usual the poor, the homeless, the newcomers, the minority that really need the help are being ignored in favour of the vocal majority who are merely inconvenienced.

Five million Canadians are currently without a family doctor-and things are only getting worse

What s the big deal with a family doctor anyway?  I have been going to the same walk-in clinic for 10 years now.  When the doctor I preferred needed to take a leave of absence I was not left orphaned I merely saw other doctors in the practice.

Yes  my  doctor only makes so many appointments and on specific days of the week, however for emergency appointments I can just show up  rarely have I had to wait more than an hour (which some people regularly have to wait when they show up for a scheduled appointment with their family doctor).  If my preferred doctor is working when I show up then I always get to see him, otherwise obviously I just take whoever is available.  No matter which doctor I see they have access to my complete medical file.

When I do get into see my regular doctor  he is quite the chatty guy, I am never rushed.  I have had appointments stretch to half an hour for no particular reason.  He has no problem if I show up with more than one health problem at a time.  Sometimes I even have to remind him that the waiting room was pretty full so we probably shouldn’t be discussing celebrity gossip.

Why is it in multi-doctor practices it is so hard to get an appointment if your doctor is busy that day?  Why when one doctor leaves do the other doctors have the option of NOT seeing those patients?  If you have an appointment slot available and a patient that wants an appointment, particularly if all their medical files are sitting right there what the heck is the problem?  I understand that there is an optimal patient to doctor ratio in a practice but surely if a practice looses a doctor they would try to replace them.  I can t see any other business getting rid of clients instead of replacing an employee.

I truly do not understand those who have to turn to the ER, I have never had any problem finding a walk-in clinic in my entire life.  Even when visiting my mom in Belleville, ON and my toddler had an accident it was never a question of going to the ER it was merely a question of which walk-in clinics were open at that hour of the night.  Maybe there are places without walk-in clinics available but otherwise there is no excuse for abusing ERs.

Walk-in clinics are truly the unsung heroes of our medical system; maybe we should be putting more money into them and more money into educating patients about where they are and what to use them for.  Maybe hospitals shouldn’t be afraid of getting sued if a patient comes to the ER and they send them to a walk-in clinic a few blocks away  heck give them a cab chit its probably cheaper than wasting ER time.