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Let’s not have Groundhog Day in Alberta’s public health care By Don Dick and Linda Woodhouse

Let’s not have Groundhog Day in Alberta’s public health care By Don Dick and Linda Woodhouse

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Published by EvidenceNetwork.ca
Is it Groundhog Day in Alberta? We Albertans seem doomed to wake every day to the same thorny and emotional debate: public health care vs. private health care.

It’s a mug’s game but we appear as inexorably caught in it as the weatherman in the movie Groundhog Day, who realizes he is hopelessly condemned to spend the rest of his life in the same place, seeing the same people do the same thing day after day after day.
Is it Groundhog Day in Alberta? We Albertans seem doomed to wake every day to the same thorny and emotional debate: public health care vs. private health care.

It’s a mug’s game but we appear as inexorably caught in it as the weatherman in the movie Groundhog Day, who realizes he is hopelessly condemned to spend the rest of his life in the same place, seeing the same people do the same thing day after day after day.

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Published by: EvidenceNetwork.ca on Mar 06, 2014
Copyright:Attribution No Derivatives

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07/02/2014

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umanitoba.ca
http://umanitoba.ca/outreach/evidencenetwork/archives/16878
Let’s not have Groundhog Day in Alberta’s public health care
 A version of this commentary appeared in the Calgary Herald, the Huffington Post and the Edmonton Journal 
Is it
Groundhog 
 Day in Alberta? We Albertans seem doomed towake every day to the same thorny and emotional debate: publichealth care vs. private health care.It’s a mug’s game but we appear as inexorably caught in it as theweatherman in the movie Groundhog Day, who realizes he ishopelessly condemned to spend the rest of his life in the
same place
, seeing the
same people
 do the
same thing 
 day after dayafter day.Dr. Robert Hollinshead’s announcement before Christmas that hewill become the first surgeon in Alberta offering for-hire surgery ina private clinic outside of the public medical system has sparkedneeded discussion among physicians. Behind his decision are years of pent-up frustration with long waits for surgery.He proposes “a functioning private option” as a way of making more beds and operating rooms available, thusreducing waiting times.But we’re afraid it will be Groundhog Day again as discussion gets bogged down in a debate about public vs. privateservices.Maybe it’s easier to spill our emotions than it is to get down to the hard slogging required to fix what we have. But thepublic needs to know that, contrary to what is often stated, we can fix public health care, not with ever larger doses of taxpayer dollars, but with intelligent, innovative ideas founded on evidence and clinical experience.The first thing to understand is that our public medical system was built for an age when life-threatening acute illnessdominated the medical landscape. In response, we built large hospitals suitable for dealing with episodes of acuteillness.Today, our number one medical challenge is chronic disease
 diabetes, hypertension, osteoarthritis and even somecancers, to name a few. Chronic disease is long-term and requires care best delivered in the community by amultidisciplinary partnership, rather than a provider-to-provider handoff.Do we need to introduce a parallel private system to cope with this development? We have evidence this is notnecessary. And the evidence comes from one of the most demanding areas of orthopaedic care: osteoarthritisleading to hip or knee replacement.Over the past three years, we have succeeded in embedding an evidence-based model of care as the standardpractice for hip and knee replacements across Alberta. Patient referrals are centralized. Care is delivered bymultidisciplinary teams. A case manager navigates the patient through the system and coordinates services. At hipand knee clinics, referred patients are advised of their surgeon’s waiting time and offered the next available surgeon,thus moving patients from those with the longest wait lists to those with the shortest.In addition to these improvements in process and practice, Alberta has begun to make waiting time measurementparameters reflective of real-world circumstances. Where the wait for hip and knee replacements has routinely beenmeasured from the date the patient
decides
 to have surgery, it is now also being measured from the date the patient

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