Wednesday 1 June 2011

Health Care Reforms

These are some easy fixes to help improve the health of all Canadians.

Prevention of illness:
  1. Teach everyone how to read the nutrition labels so they can make healthier choices in food.
  2. Remove 50% of the salt from processed foods by legislation.
  3. Remove all syrup based sweeteners from foods and beverages.
  4. Provide a nutrition component to all welfare payments that encourages individuals to eat healthy.
  5. Have cooking classes returned to grade 7 and 8 as part of a life skills course.
  6. Provide prenatal care to all pregnant women including nutritional support.
  7. Have after school recreation programs of a non competitive nature supplied to schools where more than 50% of the student population walks to school.
  8. Take junk food out of the schools, and limit the access students have to off schoolground activities during 9-4 pm school hours.
  9. Have good weight and height charts posted in every classroom and have a measuring poster attached to it, so that each child and adolescent can check their height and decide how much they want to weigh.
  10. Make a video that shares the information about the health costs of overweight, underweight, poor nutrition, included with the drugs, alcohol, and sex education program.
  11. Have little video vignettes that: (i) show that a temperature of 34-37 degrees centigrade bares watching but is not dangerous to an otherwise healthy individual; (ii) identify situations that require immediate medical attention; (iii) identify how to call telehealth and make that system link with the local hospital and ambulance system so that time is not wasted by calling, but in fact speed up my service path if I use that process and require emergency intervention; (iv) find a way to get an early referral to the family doctor or clinic if the telehealth nurse feels it is necessary. Have a video system available via email that a patient can be seen by the telehealth nurse if the patient has the video computer capacity.
Treatment Options:

Our present health system works very well for individuals that are in need of emergency and immediate intervention. Once the emergency is over things get expensive and fall apart. I believe we could use home computers more effectively for addressing client needs.

In the case of mammograms or patients that identify unusual bumps in their breasts, the Ontario breast screening should have the capacity to provide a mammogram at their next available opening, even if the patient was recently examined. Once the lump is confirmed, the Ontario breast screening program should be able to provide the second required mammogram and ultrasound within a short period of time a copy of the information should be sent and an appointment with a specialist should occur and then a plan of action should be set into motion. If the lump is surface the most efficient and cost effective method to deal with it is a lumpectomy, while a biopsy should be preformed if the lump is deeply embedded in tissue, since both of these procedures are surgeon driven and require the same procedure and process they can be booked in the next available space. If the results from the testing show malignancy the patient should be called for an appointment to see the specialist and should be provided with a preceding appointment with a patient support person who can walk her through the treatment options from the least to the most invasive and thus help the patient understand the extent of treatment available in the best to worst case scenario.

When the patient sees the specialist she will be able to discuss much more candidly the options and the specialists’ recommendations. If the results are not a cancer the patient is diverted from the system and any necessary follow up is done by the family doctor. (Since most surgeons do not have great bedside manners why subject them to using their specialized and costly expertise telling a patient the results were okay, the incision is healing nicely and come back next year). It takes a whole day of their time telling patients they are fine or they are being transferred to oncology. This process involves specialist, in a high cost setting. This process ensures access the least number of times but must be accompanied by a process that ensures the patient follows the steps, so a computer check in that calls attention to a patient who is not following through on the process would be necessary, so that the patient can be tracked down and put back on the assembly line.