Why Aren’t More Doctors Speaking Out Against A Deteriorating Hospital System In Niagara? Why Aren’t They?

By Dr. William Hogg

Why Is It, Doctor?

Dr. William Hogg, speaking at hearing earlier this year on cuts to hospitals in Niagara Health System.

I recently got into a conversation with the alien resident inside my head. It was more like a question and answer session. The first question was not unexpected.

Why is it, doctor, that so few of your colleagues are speaking out about what is happening to our badly deteriorating health care system?

Well, it’s not that they are apathetic or indifferent. Many doctors feel sorry for the people who are being cheated by their government which is wrecking its own health care delivery system. Some of the old time doctors knew from the very outset that Medicare was being set up wrongly, incorrectly – and are amazed it has lasted so long as it has. And the fact is that most of the younger doctors figure they’ll have work whichever way it goes.

Each of those answers needs elaboration. As an old-timer yourself, what went wrong at the beginning?

We tried to warn government that a medical delivery system cannot work on a strict balanced budget in a typical business supply and demand bottom line format.

How’s that?

When a government promises everything, universal care, consumer demand for new services based on new discoveries will always be outrunning supply. There will always be a deficit. You can count on it. And you’d better be prepared for it, budget for it.

But didn’t government have real business consultants to guide them, not just amateur doctors?

Yes, but that was one of the first mistakes made. Businessmen do not know medical business and gave the wrong advice. They didn’t calculate into their bottom line the moral aspects of medical practice, and by that I mean the Hippocratic Oath.

Well that’s a new twist on things…

No, it’s very old – over two thousand years old.

Well, we’re drifting a bit afield, doctor, let’s get back to the rest of my first question. What did you say about the younger doctors?

They figure that they’ll always have work no matter what messes government and lay administrators create. But that doesn’t necessarily apply to the young family doctor or general practitioner.

Why?

They are well enough educated to know that they’re not. And by the time they finish medical school, they know that they’ll have to study for the rest of their lives to keep abreast of new knowledge. But, and here’s the big but – by the end of internship they are not thoroughly trained anymore. They do not have the necessary skills to practice in a Third World country.

Now that’s a mouthful. Please clarify.

They no longer know how to deliver babies. Or do basic surgery. Or treat babies and small children. Or maintain life support in emergencies. Or have enough psychiatry at their fingertips to do some on-the-hoof counselling with couples and families. All of these are basic skills that have to be trained in, similar to how a mechanic goes through an apprenticeship.

But why are all these things necessary, doctor?  Don’t GP’s just make referrals to specialists?

Unfortunately, the way our government and its business minions are messing things up, the new young doctors, will be going to the equivalent of a Third World country if they opt to practice in any outlying area in Canada. They wont be able to get by, by paper-pushing and making referrals.

Then, you’re essentially saying that nurse practitioners will replace them?

Not at all. Those wonderful new ladies cannot do those things either! The young doctors will have to be trained as real doctors, in the old way, all over again, to survive in the strange new medical wastelands government is creating.

That sounds bad.

Not entirely. Canadian medicine, through research in the universities, will maintain its high eminence, but Canadian Medicare, now called Health Care delivery, will become a total laughingstock.

You’re painting an ugly picture, doctor.

Yes. It distresses me. Let’s take a break.

May we continue another time?

Yes, if you want.

(Dr. William Hogg is a retired medical doctor in Fort Erie, Ontario, and a past teacher of medicine with expertise in emergency and other hospital services.)

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