NEWS

The Silver Tsunami: A Unique Perspective on Ageism in Health Care

On Tuesday June 8th, Strathroy Middlesex General Hospital Foundation held a special event featuring Dr. Brian Goldman at Trillium Village in Strathroy. His presentation to over 120 people examined how the health care system deals with aging patients, exploring the fine line between age appropriate care and ageism from the unique perspective of a practicing medical professional.

Dr. Goldman is a prominent Emergency Department physician at Mount Sinai Hospital in Toronto. He is well known as CBC Radio One’s “house doctor” and since 2007 has hosted the medical focused radio program White Coat, Black Art.

Starting with the ‘Silver Tsunami’, a term coined to refer to the baby-boomers - Canada’s fastest growing population demographic, and new technology that has helped to increase longevity, our aging population has many critical implications on the health care system with very specific challenges facing seniors. Older adults are frequently being blamed as the highest users of health services and for creating a financial burden on the system.

Consider the scenario of 2 patients entering an emergency department, both with heart attacks. Dr. Goldman asks if one patient is 50 and the other 85, does it make the question of who gets the procedure done first any easier. He offered that an answer of ‘yes’ to that question is considered age discrimination by the medical professionals responsible for their care.

“Orphan” patients, those who cannot currently find a family doctor, have created a disturbing phenomenon where some physicians “cherry pick” new patients in order to take on the low maintenance and less time consuming younger people, instead of the elderly who may require more complicated care. Dr. Goldman spoke about how these restrictive practices by physicians will make an already ‘stretched’ health system even worse for seniors in the future.

From the physician’s perspective, he talked about how doctors currently must see a minimum of 56 patients per week in order just to keep the office running smoothly with a high volume of patients to see, that’s about 5-6 patients per hour with 10 minutes for each person. To complicate the situation, it’s difficult when a patient comes in with a ‘list’ of concerns as there may only be enough time to discuss 1-2 concerns from the list before having to rebook for another appointment. It’s a challenge for doctors to balance between the way the OHIP pays them for the volume of patient visits, and having enough time during each visit to provide the highest quality of care.

Unique solutions to help

Three unique solutions to help alleviate these problems in the system, and ways that patients can shorten their wait times in doctor’s offices, were presented by Dr. Goldman.

Firstly, physicians who have hired a registered nurse to work in their office have found that they were able to better manage their patient load. He also encourages integration of Nurse Practitioners and Physician Assistants as these roles don’t replace the doctor’s role but augment the practice to alleviate the primary care physician’s workload.

As a second option, some physicians have run efficiency programs to help them find areas for improvement within their practice, helping to maximize patient appointments.

Thirdly, some physicians in Canada have begun trying shared group visits, seeing 10-17 patients with similar symptoms in a 90 minute group meeting. In this type of setting, patients can not only receive a diagnosis but there may be an increased benefit to hear and recognize other health concerns.

Overall, Dr. Goldman’s presentation offered an excellent public venue to encourage people to think about some of these growing issues and possible solutions in health care. In the future, the Ministry of Health and Long Term Care may need to review exactly how people are cared for, to help improve the system. For example, does a primary physician really need to take care of an eye infection or is that something another medical professional can handle so that doctors stay focused on the most urgent matters, making best use of their skill set.

Throughout the evening, Dr. Goldman offered comic relief while still maintaining a serious focus on some of the more delicate issues when it comes to health care, like preparing a living Will. By preparing a Will, your family members know exactly what your wishes are in case you were to end up in a hospital ER, unable to communicate your preference for resuscitation or other vital decisions. Openly discussing this type of situation with family members can help alleviate the unnecessary burden of leaving your family to struggle with a life or death decision - especially if you are unable to make these choices for yourself. This allows your family to focus on the most important thing - spending time with an injured or sick loved one.

This fall, SMGH Foundation will be launching a new Basic Free Will program, offering residents in the region the chance to have a Basic Will written FREE OF CHARGE. Interested participants can contact Sue McLean for more information by calling 519-245-5632.

SMGH Foundation would like to thank everyone who attended Dr. Goldman’s presentation on aging which provided a unique and thought provoking insight into some of the challenges our health care system continues to face.