The Declining Health Standard BC Government, Health Officials and Media are Ignoring!

For months, BC’s Health Minister and top Public Health Officials were front-and-center publicly addressing the Covid numbers, outlining the dangers and introducing actions to fight the pandemic.

They even talked openly about how many elective surgeries were cancelled; how many hospital beds were occupied or available; even how to safely have sex as part of our new reality.

But there’s one very serious … and growing … threat they’ve been very quiet about: the deteriorating standard of BC health care as thousands of physicians hide from Covid … and their patients.

“Phoning it in” has become the new protocol for doctors’ “visits”.

Doctors are now paid to talk to patients on the phone instead of seeing them in their offices. That has become the new norm.

I get it. I understand.

Fearing the risks of Covid, you can’t blame doctors for opting for “treatment by telly” and distanced health care. And many patients are afraid to visit a doctor’s office.

But let’s keep it real: remote-control health care is second rate health care.

And we should all be concerned about how, long term, this new kind of health visits is affecting the health of British Columbians and, indeed, all Canadians.

With doctors no longer seeing and examining patients in person (except in very serious cases) the health of many British Columbians is being placed at higher risk.

How many times, previously, have doctors noticed something during an in-person visit: warning signs of something even more serious than the patient had originally come in about?

Just looking at someone’s eyes, skin, feet, throats, or into their ears etc. … can provide early warning signs of serious problems, before they erupt into major or even fatal conditions.

How long has it been since most patients … heart attack victims, hypertension sufferers, diabetics and those with other critical chronic illnesses … have had a doctor actually check their critical blood pressure or use a stethoscope to listen to their hearts?

Think about this: many British Columbians may have had their last in-person doctor’s visit way back in the Fall of 2019 or Winter 2020 … prior to the Covid March lockdown.

That’s now several months or even up to a year ago!

This cannot bode well for our population, especially the elderly, others with chronic health problems, even sick children.

And yet, with no end to the Covid pandemic in sight, “phoning it in” healthcare is now becoming a serious shortcoming of our health system.

But for some reason, the serious implications and risks of in-person doctors’ visits having been abandoned for several months now haven’t received much attention from our politicians, Health Officials … or even asked about by the media.

I can understand why the politicians and government health officials would stay silent on this growing dilemma … fear of upsetting physicians or not wanting to stir up public angst. As for media failing to notice or pursue the issue … maybe they’re waiting for the press release.

And yet, here’s how critical the issue is:

Setting Covid aside, the leading causes of death in Canada continue to be cancer and heart disease … 48.6 per cent of all deaths in 2018. (You can read the Stats Canada report here: https://www150.statcan.gc.ca/n1/daily-quotidien/200703/dq200703b-eng.htm .)

It’s dangerous for all Canadians … especially the elderly or others with compromised medical conditions to go for a year or more being “examined” by phone?

How can these conditions adequately be diagnosed in a phone call!

Without a doctor using a stethoscope? Without blood pressure being taken?

Impossible.

Not even lab tests can tell the whole story.

Especially for some of the other serious health problems that should be of concern.

” The third through tenth leading causes were, respectively: stroke, accidents, chronic lower respiratory disease, influenza and pneumonia, diabetes, Alzheimer’s disease, suicide and kidney diseases such as nephritis, nephrotic syndrome, and nephrosis,” the Stats Canada report says.

Is this the new BC health care standard? Expecting British Columbians to have early signs/symptoms of stroke or lower respiratory disease detected and diagnosed in a phone call?

Or should we just start crowding Hospital Emergency rooms to get an in-person checkup?

Our pandemic “conditions” are very likely to go on for another year … or more!

What does Dr. Bonnie Henry say about the implications of this situation? What do the various leaders/parties running in the BC election say about the dilemma?

It will be late 2021 before the 2020 statistics tell us if/how great a toll the reductions in health care has taken on us: not just the CAUSES of deaths; but also the NUMBERS and RATE of deaths as well.

But by then it will be too late for many.

It’s time for doctors to do what dentists, physiotherapists and even our barbers are doing: wear masks; sanitize frequently; and, get back to in-person visits … as a matter of course, not just the exception.

Harv Oberfeld

(Reminder: Follow me on Twitter @harveyoberfeld to get First Alerts of all new postings on this Blog.)

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12 Responses to The Declining Health Standard BC Government, Health Officials and Media are Ignoring!

  1. DBW says:

    This is concerning, Harvey. I am healthy and haven’t needed a doctor, but I am lucky.

    What can a person or a family member do to advocate for an in person exam?

    (Response: I think people should call their local MLA or local campaign offices of all their candidates and urge them to speak up on this. And maybe even phone the media and suggest they pursue the topic with all the Leaders to see what they would actually DO in the face of the declining service levels. h.o)

  2. nvg says:

    ‘dentists, physiotherapists and even our barbers’ Home visits by a doctor would be better, speaking from experience.

    (Response: I know a terrific doctor who does visit the home of an elderly frail patient I know. But generally I believe that would be asking too much. The time it would take for a doctor to visit people’s home would make the cost outrageous, severely limit the number of patients who could be seen each day … and also endanger to doctors’ health much more than having them see patients in their own sanitized premises. h.o)

  3. Richard Skelly says:

    To tell you the truth, Harvey, my wife isn’t finding phone consults that much more impersonal than in-person encounters with health care providers on the Saanich Peninsula.

    Let me explain:

    An estimated 700,000 British Columbians have no primary physician. Including my wife who, by any yardstick, is a complex care patient with a lupus-like autoimmune disease, so-far controlled diabetes and post polio. It’s been nothing but walk-in clinic doctors for years now since her GP retired. Walk-in docs are often temporary locums. Many of them prone to asking: “What’s your name again? And what conditions do you have?”

    A few years back, we found out about a provincial program that incentivized doctors (i.e. paid them extra) to accept complex-care patients…just as it was being cancelled for lack of take up. Doctors either didn’t know about the program or preferred to ignore it and just have lower maintenance patients.

    Sidney did have two walk-in clinics, but one closed a year ago as partner-physicians grew tired of trying to find new GPs. The remaining clinic often stops taking walk-ins after 10:30 a.m. At least for simple stuff, like renewing prescriptions, having a doctor call back
    sure beats sitting around in a waiting room. So we hope phone-in continues, at least for prescription renewals.

    (Response: Interesting. I had one “telly” visit (complete with e-mailed photo) a couple of months ago with my GP after a small problem arose … the issue has since mostly healed, but not completely. But I don’t want to bother/call him again. I also have a “phone in” next week with a specialist… where I expect there will be a brief chat about lab tests done a few days back and then I’ll get Rx renewals for probably another year … plus a requisition for more lab tests and another “visit” six months down the road. Readers know I am diabetic, suffer from hypertension and had a triple heart bypass in March 2018. But by my next “visit”, it will be 18 months since ANY doctor has actually listened to my heart, checked my blood pressure. And I have no doubt there are now a hundred thousand British Columbians in similar situations. Is that good health care? Is that the “new” standard in BC? Time for the government and Dr Henry to get doctors back to seeing patients in person and not just on Skype. h.o)

  4. D. M. Johnston says:

    I have a very dangerous chronic affliction, too hard to explain it here but if I have a flare up, I have about 7 hours to get to a hospital for treatment.

    I take good care of myself and have been seeing a doctor 3 times a year for check ups; this, until covid.

    Since last December, nary a phone call from my GP. No ordered test, do getting a “once over”.

    I assume doctors bill the same price of a phone consultation that they would for a personal consultation, so their pay packets won’t suffer.

    Here is the problem I see happening very soon, a wholesale “Boomer Remover” episode where so many pensioners have been ignored by the medical profession, who have recently ignored their oath in the profession and simply left this mortals coil.

    It seems no one in government gives a damn.

    What cowards we have running the show.

    It is the same for a few of my compatriots., as the medical profession has gone into hibernation.

    (Response: I sympathize. Read my response to Richard. As for billing, I’m not sure how that works: whether doctors get paid more for an in-person visit than a phone call; are they “seeing” more patients per hour by phone, because that takes less time … and thus maybe are even cashing in with the reduced level of care? Of course, I’m retired: can hardly wait to see the “working” media go after this interesting story … the cash numbers, the implications for patients and what the politicians are doing about it, or why not! h.o)

  5. Sandy Mulderrig says:

    Hi Harvey I think it is possible to get to see your Dr. at the office, as I had my complete physical done at my Dr. office. I guess you just have to arrange it. I hope you are doing well. Think of you all the time. Take care.

    (Response: Thanks … my St Paul’s roommate! :). I know doctors are seeing some patients … in special circumstances. However the rule of thumb with many BC doctors now seems to be visits by phone as the preferred option. Yes, that’s safer for the physicians and their staff … and probably preferred by fearful patients. But with the pandemic likely to be with us for another year, I believe the long-term impact on many … and our health system … can’t help but be a negative one. h.o)

  6. Rainclouds says:

    Got an appt with my GP Tues. Live.

    Meanwhile the NDP has announced more MRI clinics in Vancouver after absorbing the private ones a while ago. All good, except it simply moves the goat further down the python . Still loooong waits for surgery since the govt controls the operating rooms and the types of operations performed. Smoke, Mirrors, sleight of hand, of course ,the politicians get fast tracked………….

    The Day decision 2 weeks ago was a huge disappointment. 2 countries with no private to augment the public system N Korea and Canuckistan

    (Response: Best of luck Tuesday. I know I can get an in-person visit with my GP (who is exceptionally good) and even my various specialists if I ASK, and I share their concerns about Covid, but phone-in visits cannot and should not be a long-term response to a pandemic that will be with us for years. h.o)

  7. Gilbert says:

    During this coronavirus pandemic, Andrew Wilkinson has the opportunity to share his medical expertise. He can encourage early testing for those who have concerns, seek to hire more excellent nurses, and assure those in rural communities that they will not be ignored.

    John Horgan has called an unnecessary election, and the voters can send him a clear message by defeating his government. I want to quote the late Margaret Thatcher. I love what she said about socialism. “Socialism is great until you run out of other people’s money.”

  8. e.a.f. says:

    some of it can be handled by phone, i.e. renewal of prescriptions which have been going on for years, test results, but the rest, omg, some of us need to see a doctor at least a couple of times a year. Doctors need to check our blood pressure and listen to our lungs. In Nanaimo at least we have a new clinic staffed by Nurse Practioners, who see patients, in person.

    I understand why doctors weren’t keen on opening their offices during the height of the pandemic, but now, they could open, but what they would have to do is keep on schedule, not double book, etc. When people go to a doctor’s office, they frequently are running half an hour to an hour behind. Yes, that creates a traffic jam and not an option right now.
    Part of it is money, in my opinion. Doctor’s office waiting rooms are small and crowded. Bigger wait rooms, more rent. dentist’s waiting areas usually are larger and they don’t have people piled up.

    Went for X-rays and it was orderly, people were socially distanced with masks no undue waits. Doctors may also like the phone system because they can see more people and hence make more money. I’m not saying they’re greedy. they just aren’t paid as well as they once were. My Vet is paid more than my G.P. My hair stylist is paid more than my G.P. Then you add in all the expenses doctors have over and above rent, such as salaries, insurance, etc. If doctors don’t work they don’t get paid unless they have private insurance. They may not want to risk getting sick.

    Yes, I’d like to go see my doctor. Doctors need to re open their offices. they will have to hire additional staff to clean each consultation room after its been used and their staff may not be up for that. Most doctors’ offices today don’t have nurses working there. They have receptionist, who don’t know a hell of a lot about medicine or health, etc. If doctors offices have to adhere to the same rules hair stylists do right now, they are going to have a lot of additional expenses. Doctors may also not want to re open their offices because if a patient catches COVID at the doctors’ office they may well be sued.

    Recently went to my hair stylist and they’re adhering to the new protocols. What amazed me was how they were cleaning everything once a client left the “chair” or moved around the salon. They were paying more attention to meeting standards than many hospitals and doctors’ offices were doing prior to COVID. Of course the hair stylists are seeing fewer clients than they used to. If doctors’ offices had to adhere to the standards hair stylists do, they’d have to be paid more and hire more staff. . I haven’t seen my G.P. since Feb. By now I would have seen them in Aug. and this coming Nov. On the upside I’m seeing the cardioligst in Dec.. Just hope they know something about skin disorders, breathing problems, knee pain and shin splints.

    Many of us receive our annual flu vaccine at our doctors’ office. Will they be opening for that? Lets hope so or the pharmacies are going to be over loaded.

    (Response: I had forgotten about the lungs. You’re right: they must be checked in person. Yes, there are some things that can be done over the phone, but if the government was more forthcoming .. or the media even asked … I suspect there are now a hundred thousand British Columbians or more with serious chronic illnesses who have not actually SEEN a doctor for nine months to a year or more. That is not a good health care system, H.O.)

  9. e.a.f. says:

    Wonder if the non COVID death rate has gone up in the province since doctors stopped seeing patients in person. Perhaps some enterprising journalist could go out and do their job and find out.

    (Response: I don’t see the two things as being related. If there’s one area that IS getting a lot of attention it’s Covid. That’s why so much else is being put on the back burner … very disconcerting for many, especially elderly and those with chronic illnesses. h.o)

  10. RIsaak says:

    The healthcare fix is in!

    In early 2019 when my wife was close to passing from cancer, her home support was cut off (not capitulating and dying on the health ministry’s schedule) after 3 months of broken promises, outright lies and much disrespectful engagement. I wrote to Minister Dix, received a very apologetic, but responsibility evading response from some upper level bureaucrat. I then wrote more and received an apology from some mysterious employee of coastal health owning some of the conduct we had received, however they all want you to go through their multi-layered, semi-obtuse, complaint procedure which is just more of a make work project for the very bureaucrats who were in charge (apparently) when the highly suspect tactics were employed by coastal health employees. 3 attempts through friends who personally know our health minister, zero responses or any simple acknowledgement whatsoever.

    The minister’s mother is ill, she no doubt is receiving care free from the prospect of termination of services. One friend said at an event they were at with the minister in attendance and his mother, that he seemed very focused on his mother and her challenging medical issues.

    As my wife’s home support was being cut off, the health care workers were getting a big raise, the government was opening up our wallets to appease their friends who heavily lobby on the behalf of their union members, and my wife had her home support cut off after a 3 month battle to try to preserve them, many broken promises, (some pertinent questions never answered or addressed in any fashion).

    Then a quick visit from a home care nurse who was somewhat decent but in the end only wished to speak to me after my wife’s passing to “close the file”.

    I’d not trust anything anyone who works for coastal health in any administration, non-front line medical position. The multitude of half truths and some out right lies coupled with promises never delivered upon is fairly large.

    I know which health minister I would not trust or appreciate after the treatment foisted upon my wife as the health ministry suspended her palliative home support just 5 short days before she passed away.

    I will not be coming to read any responses, my mental well being has taken a huge hit in the past 2 years and the stresses visited upon me & my family require me to distance myself from this matter for self preservation.

    (Response: The media should take this Comment as a “news tip”: I have no doubt this is NOT the only case like this in BC. Plus, all it takes to expose the increasing dangers associated with all the remote phone-in doctors’ visits is one true inquisitive journalist to raise the issue of the implications/damages of thousands of thousands of remote phone “visits” om BC health as the pandemic goes on and on. The media should not just accept and question the daily press releases/numbers and what the government WANTS t talk about … but also how can it NOT affect people with chronic illnesses to have no doctor check their blood pressure, listen to their heart and lungs etc … for more than a year or more???? My condolences to Risaak …and my thanks for him, despite his hurt, to take the time to let us all know about the reality of what is going on behind the news releases and press conferences. h.o)

  11. Harry Lawson says:

    Harvey,

    Where to start?

    First of all my sympathies to RIssak many of us are living this nightmare.

    The standard of health care is truly geographic in BC ,even within in the same health authorities.

    We live in mission, we are finally having a in-person appointment for my wife mid October.

    The sad reality is if my wife could see her go on a regular basis, I am sure the last FOUR trips by ambulance to the emergency room could have been avoided . I do not know the unintended cost to the system ,I do know my unintended cost is about $380

    We also have to look at all the closures of health and rehabilitation services that once again varies by location.

    I am truly scared my wife won’t survive the pandemic,the frustrating thing is it won’t be the virus that kills her.

    (Response: I believe most of us are still frightened of Covid. We try to live our best to live safely … well aware that there are still risks in just going out for lunch or dinner, seeing family/friends or grocery shopping. Then you add to that the risks involved in going to a doctor’s appointment and you can understand why most of us initially were quite happy to deal with small problems and/or “regular” checkups by phone. But now that this pandemic has gone for six months and is likely to continue for another year … it raises new concerns the government has stayed silent about and I’m not aware the media has even noticed or asked about: the DANGER of having a hundred thousand British Columbians with severe chronic illnesses not even getting their blood pressure checked, not having their hearts listened or their lungs checked. Actually SEEING a doctor … not just chatting with one …is an essential part of good health care, and we are NOT getting that now. Someone should at least raise that issue with Dr Bonnie Henry! h.o)

  12. e.a.f. says:

    My heart goes out to RIsaak. I can’t imagine what it was like to go through that while his wife was dying. In my opinion there was no one in the ministry who gave a shit either.

    When COVID arrived, I fell down the stairs and fractured my tibia. Home care was just wacked out. Good luck if you need home care. Its like they don’t care, they don’t give a shit. Its a huge burucracy where no one seems to know what they are doing, where one dept. doesn’t know what they are supposed to do and the other can’t communicate anything to another. I know. I dealt with them. Now I was fortunate, I’d only broken my leg, but even the care workers were shaking their heads some times. there were days 3 people would come. there were weekends no one showed up. Now this is all in the middle of a COVID lock down. I could not get care aids to follow protocols Dr. Henry had laid out for care homes. Some had difficulty adjusting to our insistence they spray their shoes before entering the home or staying 6 ft. away from the sibling who opened the door. When I phoned to complain, they didn’t seem to care. There were improvements when I threatened to sue if my sister caught COVID. Told them I’d have signs out front of my house with “VIHA home care murdered my sibling” and invite the press. That did effect some change and they started sending care aids who did not work in care homes on the same day. they eventually even started wearing masks and gloves because I kept making the same promise–the sign.

    RIsaaks writes they withdrew care for his wife. Yes, they will do that. They want you to use private agencies. I told them I wasn’t going to do that, but if there were no care aids, I’d be calling the paramedics each day and I was ever so sure no one over there was going to be happy about that.

    As to my care, the aids themselves were fine, but it took 5 days for the first one to show up, even though I’d been clear, with the occupational therapists at the hospital, I required a care plan which went into effect from day one because I lived on my own–up a flight of stairs. . They kept wanting to know why my relatives weren’t there to take care of me. told them I didn’t have any. the parental units left Europe in 1951, no relatives. they still kept at it, so I finally told them they were killed by Hilter and then they stopped asking. they were repeatedly told the first floor of the house was lived in by my sibling, who had Parkinsons and could not walk stairs and required a care aid of her own, which they suspended because of COVID–they were all fired.
    What was clear was they wanted me to hire a private company. I was clear I didn’t want a private company. I wanted VIHA care aids which worked for the government. The co ordinator kept explaining it would cost me less. I kept explaining I didn’t care.
    They send care aids to help keep you house clean, but they aren’t allowed to use a vacumn. As a result, when a bowl broke and I wasn’t able to vacumn up the smaller pieces, I walked on it, foot bled like a water tap had been turned on. Called 911. Paramedics showed up, fixed the foot, cleared the floor of all the small bites of glass I didn’t see and cleaned the blood off the floor.

    Wrote letters of complaint and the process takes so long, by the time they were asking for details, my leg was healing, I could hobble, etc. and most of the issues had been resolved. The were adhering to Dr. Henry’s protocols.

    What all of this entailed was almost 3 months of yelling, swearing, promising the sign, writing emails to get what I wanted. For what? We hear they want people to stay in their homes, but they make it almost impossible. No care aids came for the first 5 days. By day 3 I called 911 and told them to take me back to the hospital. The paramedic was amazing. he removed my bedroom door so I could move my wheelchair into the bedroom and then wheel myself to the bathroom or kitchen. I could not use the walker to do that, too weak, leg too busted. The occupational therapist decided I ought to have a wheel chair I didn’t want and it could not get through doors. In 18 minutes the paramedic removed my door, so I could get the wheel chair into my bedroom, put water by my bed so I could drink–was dehydrated, got rid of the urine. My condition was such that moving during the night was not a smart thing to do, I’d have fallen, and lack of strength did not permit me to move more than a couple of times a day. did VIHA care? Not so much.

    I’m sure RIsaaks dealing with the dept. were far worse than mine because he knew his wife was going to die. It would have been a night mare for him. Home care needs to be improved. They need to stop the bureuracratic b.s. that they have and have some co ordinators/managers in place who know what they are doing and know how to organize because that was one thing that was clear to me, they couldn’t have organized a screw in a whorehouse. You don’t send 3 care aids to some one in one day, when all they need is one person for 20 minutes in the morning. they need to re think their policy of not vaumning and they need to re think their policy on refusing to cook–they’ll use a micro wave and that is it. Had the house not been equipped for COVID WITH 8 weeks of food, including pre made meals, it would have been a problem.

    These people need to understand many of us have no families or they are at the other end of the world, sick themselves, or too elderly to assist. Some clients who have care aids, you wonder what the aids are doing, because family members find the house in disgusting condition with feces where they ought not to be.

    One of the things which did make me laugh was there is Red Book in which there are instructions for the care aid. if its not in the REd Book, they can’t do it. It reminded me of Mao’s little Red Book because the organization operates like the Mao area, central command issues orders and nothing is to be deviated from. The care aids are quite clear, they deviate, they’ll be in trouble. All of these people work for the government. Its a mess. its a disaster. After 3 months all the fighting with VIHA resulted in me having symptoms of PTSD come back to visit.

    Will another government do better. No because we had the B.C. Lieberals for 16 years and that is what got us into this mess. Not all the problems can be resolved in 2 or 3 years. But as this population ages, the government is going to have to do a huge over haul on home care. If you don’t get home care you wind up in a care home wbich is much more expansive–private care homes encouraged by all sorts of provincial governments., including the former government of the B.C. Lieberals. Being in those when COVID hit, resulted in a lot of deaths. Being at home is safer and cleaner if you have help. One friend in Alberta took her 90 yr old parental unit out of their care home and is looking after them there. its cleaner, its safer and incredibly hard on my friend. We saw the problems with COVID and care homes in Quebec and Ontario. Its time for the federal government to get their act together and include care in the home in the National Health Act. That would at least force some provinces to meet specific standards, I hope. Yes, it will be expensive but so are all these private care homes in the country and people die miserable deaths there. Me, I’d rather take the Trudeau exit than go into one of those places. At least its fast and clean. If I ever break a leg again, I’m checking into a resort with room service.

    (Response: I suspect you’re right: another government wouldn’t likely do much better ..if at all. This is the reality facing many of our citizens now …especially the elderly with mobility problems. Yet I’m sure every one of us could think of a dozen programs/spending announcements all levels of government have spent hundreds of millions of dollars on programs we would view as less worthy or less critical. The squeaking wheel gets the grease …and the old, the chronically ill are just not organized or represented as a group … unlike those you see demanding programs and money in the news so often. h.o)

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