This article was in the local news today — http://www.theguardian.pe.ca/news/local/updated-entire-health-pei-board-of-directors-resigns-over-concern-with-government-direction-212349/

Okay, first of all, this article says the changes will align Health PEI with other systems across the country; second, the changes will increase accountability within the health care system; third, they will create stronger linkages to community; fourth, they will clearly define roles and responsibility for both the ministry and the health authority. I don’t see how any of that is bad. No healthcare system should be isolated from the people they serve; no healthcare system should exist without great accountability, since our lives depend on it; no healthcare system (or any other system) should operate without clearly defined roles and responsibilities.

While MacBeath thinks Health PEI has done a phenomenal job in creating a single and unified health system for the island, that does nothing for the actual delivery of health services. Ask any islander who has sat in the emergency waiting room for anywhere from 3 to 12 hours before being seen by a doctor or even a nurse; emergency room intake clinics with only one in operation; emergency room doctors being caught asleep instead of attending to patients; emergency room staff chatting or doing things other than attending to patients, while patients wait to be seen; patients with critical symptoms who are sent home; patients who are unable to make an appointment with their family doctors without having to wait anywhere from one week, if they are fortunate, to three weeks, a month, or even more if not — usually, by then, the conditions patients need to consult their doctors about could have worsened considerably or disappeared; islanders who still do not have a family doctor despite having grown up on the island; family doctors who do not listen to their patients’ concerns and dismiss them summarily without even checking them; the conspicuous lack of specialists; the inability to keep emergency rooms open 24/7 all over the island; the inability to be admitted into a nursing home or long-term care facility without a waiting list; the absence of dental care for all islanders; the limited vision care; the lack of mental health professionals; and the list goes on — as far as I am concerned, these all sound like gross mismanagement and an inability to deliver quality services worthy of a first-world nation, in which case it is a good thing the board has resigned.

Don’t get me wrong. I respect and admire doctors for their skill and their service. I grew up around hospitals and physicians in a third-world country where I never had to wait more than an hour, at the worst, in an emergency room in a private hospital where my health insurance covered everything; where I could see my family doctor on the same day I showed up at the clinic; where specialists were not difficult to find or access. I’m not saying that system was perfect, because most health care was private, and what was provided by the government was equally excellent if difficult to access because of the sheer density of the population being served.

I am fortunate to have a caring, concerned family doctor–I am fortunate that I already have a family doctor! I am fortunate that I have not had to be a frequent visitor to the emergency room, and the few times I had to go on my own, without being brought by an ambulance, I had to wait no more than an hour before an intake nurse saw me and only somewhere between three to six hours before a doctor saw me.

I wonder how doctors and nurses can take an oath to heal and serve yet tolerate this appalling lack of quality service or even selflessness that is needed in their professions. I wonder why it is so difficult new doctors or doctors from out-of-province to set up a practice here. I wonder why some doctors are able to tuck away over a million dollars in salaries and vacation once or twice a year, leaving patients without anyone to see. I wonder why booking with some specialists has to be done up to a year in advance. I wonder why islanders even have to go off island to see certain types of specialists. I wonder why there is an ambulatory clinic where you can’t just ambulate in to be seen when you have the time or the need for attention to something that is not an emergency. I wonder why we can’t communicate directly with our doctors by email — they don’t even give out their email.

If copying the systems in other provinces brings us up to the standards of other provinces so that ER waiting times can be cut down to an hour or less; so that every islander has a family doctor; so that ERs are open 24/7 all over the island; so that patients always see their health service professionals genuinely concerned about their health instead of idling away time while ER patients wait; so that triage procedures are followed; so that we have all the specialists we need on island; so that every member of the healthcare system is accountable to the islanders , whose taxes pay their salaries; so that hospitals are operated with absolute efficiency and no complexity — because the best management system is that which makes the complex seem effortless and simple, rather than cumbersome and difficult. If the health care system is delivered by the government, then by all means, it should be directed by the government. Why should they resist improvement and change, when it is crystal clear to every islander that it needs improvement and change? A mass resignation like this shows a lack of concern for the community they should be serving.

Let them be reminded of the Hippocratic Oath they swore to, which, nowhere, says that they should enrich themselves, vacation in southern countries, limit access to their services, and allow patients to wait hours on end suffering varying degrees of pain, discomfort, and anxiety from simply not being attended to.

A Modern Version of the Hippocratic Oath

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Diatribe over.