Halifax doctor ties health-care woes to poor use of medical professionals

Nova Scotia politicians and administrators are sorely lacking in creativity when it comes to the province's health-care system, a Halifax emergency medicine physician said Wednesday.

Blaming the problem on the long wait-list for family doctors, set at 37,339 people as of Nov. 1, 2017, is short-sighted, Dr. John Ross told the CBC's Information Morning.

The real obstacle to improvement is the failure to use other medical professionals — nurses, paramedics, pharmacists and physiotherapists — to their full potential, he said.

It's an organizational or "engineering problem," rather than "a human resource limitation," Ross said.

'Really good' professionals underutilized

There are a lot of medical professionals in Nova Scotia who are "really good" and "not working to their full scopes of practice," he said.

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The EHS LifeFlight program, which provides critical care by helicopter, is an example of appropriately utilizing health-care expertise, the doctor said.

Those teams include nurses and paramedics who connect with physicians remotely when they require additional medical advice.

There is no doctor on board those helicopters, and yet those teams care for the "sickest patients" in the province, Ross pointed out. He questioned why that model can't be used in other situations.

Connect to doctors remotely

"We've failed to leverage technology," even "old-fashioned" technology such as the telephone, said Ross, who also works with a company that provides medical services by telephone to remote locations including oil rigs.

Nurses, paramedics and others can usually get advice they require from doctors by phone, he said.

"If you start adding things like video and even still images, you can get a lot done remotely."

Ross said we need to start asking, "do we really need to have the doctor there or not?" 

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Collaborative care needs to be more widespread

Collaborative emergency centres are an example of a creative model that's working in Nova Scotia right now, Ross said.

The centres use a team of paramedics and nurses to staff an emergency department overnight. A physician is available to provide medical advice by telephone if needed.

Ross said no one is thinking outside the box at the Nova Scotia Health Authority.

We keep "flogging the same old tired model and it's driving me crazy," he said.

No one from the health authority was available Wednesday to comment on Ross's statements.

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