Blog Post One
Introduction to: 9-1-1: Canada's Healthcare Crisis
My name is John Maddigan, and like many Canadians, I don't have a family doctor, I haven't had one for almost two years, and like many Canadians, I'm frustrated. So, I decided to investigate the Canadian Health Care System to determine what was happening. I found lots of information from many sources, but no one put it all together to answer my two burning questions. 'Why is Canada's health care system broken, and how can it be fixed?' I couldn't find the answer, so I thought about starting a blog to find out and let the rest of Canada know what I discovered.
In 1992 my wife and I left Canada to pursue an MBA in the USA. Every Canadian I knew had a family doctor back then and wait times for elective surgeries were short. When we returned in 2021, we thought the same situation would prevail. We chose to live in the East Kootenay region of B.C., 40 minutes north of Cranbrook. We picked that location, in part, because of its proximity to the regional hospital in Cranbrook that serviced the East Kootenay region.
But we soon found out, like many Canadians living in rural locations finding a family doctor was impossible. We've been trying to find a family doctor for two years without success. Luckily, I have few medical needs, but you would hope think that living close to a regional hospital would give me access to the one specialist I need, an ophthalmologist, so I could get my prescription approved.
You would be wrong.
Like many Canadians living in rural areas, I drove four hours to find an ophthalmologist to fill my prescription. The doctor was great, and I was lucky to wait only nine months for an appointment and drive four hours.
Many Canadians aren't so fortunate.
But the shortage of specialists and family doctors is not limited to rural areas in Canada. Friends of mine in Victoria also have been without a family doctor for over two years because their doctor retired. And the lack of family doctors is not limited to British Columbia.
Here’s the link to this article: Why Victoria is losing so many family doctors
This problem is Canada-wide and getting worse. Today, it is hard to say that Canada's healthcare is "universal' when it is not 'accessible."
Sadly, Canada's healthcare crisis goes beyond limited access to family doctors; it extends to long lines at emergency rooms if they are even opened on weekends due to staff shortages and long wait times for so-called "elective" surgeries. The backlog for surgeries have been well documented for years and still persist to this day.
Why I Started This Blog
As I mentioned, when I left Canada in 1992, I had a family doctor, and so did most people I knew, things seemed to be okay with Canada's healthcare system back then, but in the ensuing 29 years, the train seemed to have jumped the track. Today access to a family doctor is problematic for more than 6 million Canadians and almost impossible for those in rural and remote areas. Surgery waits are intolerably long, emergency rooms are overloaded, and many in remote areas are closed on weekends due to a lack of staff.
I thought this problem was limited to this remote corner of B.C. I quickly learned from watching the news that this problem was everywhere in Canada. So, I naively expected that the problem was well in hand and that our provincial governments would quickly handle this "acute" problem.
Wrong on both fronts.
Canada's healthcare problems have been ongoing for years, and our governments have been struggling for decades to fix the issues that all Canadians see as getting worse by the day.
I believed I would find a website dedicated to fixing Canada's healthcare crisis where everyone agreed on the problems and ways to improve them.
Wrong again!
So, I did the only thing I thought I could. I foolishly decided that I would start a website. I decided that I would begin to put Canada's healthcare crisis into focus by looking at how it started, what studies and reports were looking at the problems, and what all levels of government were doing to address those problems. The good news is that there are LOTS of studies, reports, and pilot projects to review; in fact, too many. The bad news is that most reports, studies, and pilot projects were left to collect dust with minimal action taken even though many were first-rate and potentially helpful.
Lots to Work on and Lots to Work with
Canada's healthcare system has many problems, but as I mentioned above, there have been countless studies and reports to try and address those problems. From extensive studies done by Canada's Senate for the last twenty years to Newfoundland's most recent very comprehensive Health Accord published in June 2022. One of the problems with so many studies and reports is that there are so many that even researchers likely have trouble aggregating and keeping track of them. So, I'm going to do it for them. I will compile as complete a list of all the studies, reports, and pilot projects across Canada as possible and do my best to summarize them so that healthcare professionals and ordinary Canadians can see what our governments are doing to improve healthcare in Canada. I'll also track developments and announcements by all the provincial governments to see what ACTIONS they are taking to fix our healthcare problems.
So Why Me?
I'm retired, love research, am thick-skinned, and have over twenty-seven years of experience running hospitals – veterinary hospitals with my wife. We've run some of the largest small animal hospitals in Oregon (one hospital had 17 veterinarians and 56 staff), and they were busy 7 days a week. But perhaps my most important virtue is that I am not involved with the healthcare industry or government. That's more important than you think because the problems with Canada's healthcare system are both complex and challenging and will require some unwelcomed and sometimes controversial decisions to be made.
I know what you're thinking – wouldn't a healthcare professional be better at making decisions about healthcare? Maybe, but maybe not, and here's why.
• No one wants to get it wrong, especially someone that is part of the healthcare system.
• No one in the industry wants to make bold changes and risk their good reputation if things don't work out.
• Making painful changes takes courage, and the risks to one's reputation are too high.
• Insiders would have too many other insiders influencing their decisions, particularly if those choices impacted those insiders negatively.
• Disruptive innovations never come from the incumbent players, always from outsiders, and I am that outsider.
Luckily, I'm not part of Canada's healthcare system, making it much easier to make bold suggestions and demand radical changes. And I've done this on a MUCH smaller scale with our 10 veterinary hospitals in Oregon. We ran low-cost, high-volume hospitals that provided top-notch care at affordable prices. We were the "Costco" of vet hospitals. We were affordable, accessible, and high quality – the same characteristics that Canada's healthcare system needs to be!
I will also take a different approach to problem-solving because I want to hear from both ordinary Canadians and healthcare professionals. I want your suggestions on how to make Canada's healthcare system better NOW, not 10 years from now. Canada's healthcare system will only be reformed if it is done from the bottom up and not the top down. And I genuinely believe this.
Immediately after I completed my MBA, I started working with Motorola in Austin, Texas, at their Final Test Facility. I was responsible for the High Performance Test operation, which had chronically underperformed for many years. I was tasked with increasing our daily throughput from roughly 9200 units per day to 25,000 units.
Upper management had decided to implement Statistical Process Control (SPS) principles in this operation and allowed me to control the program. Much to senior management's protests, I put the frontline operators in charge. They set up the control sheets, set the pass/fail perimeters, and the rollout of the program.
Long story cut short we succeeded. Six weeks later, we reached 25,000 units per day over a ten-day period. Everyone wondered how we did it, and my answer was simple:
"I put the people in charge of the work in charge of the process. They controlled their work environment for the first time EVER, and the results were stunning."
This is why I believe the only sustainable change in Canada's healthcare system must come from the bottom up. I've always wondered why the people doing the work – nurses and doctors – are not in charge of changing the work processes to improve them. Instead, administrators and MBAs like me are charged with "making it better" when we know little about the work.
I believe we can improve Canada's healthcare system because the SYSTEM of healthcare is broken and NOT the people delivering the care.
Did the same operators at Motorola that had "failed" repeatedly in the past suddenly "succeed" solely because Statistical Process Control was implemented? NO. They succeeded because they were finally in control of their work environment and knew precisely how to make it work. I claimed no credit for this success other than simply unleashing their talents. I left Motorola three months later because senior management credited me with this success and completely ignored the facts.
Why Should Canadians Read This Blog?
First and foremost, I want to improve Canada's healthcare system for all Canadians. I am not beholden to industry influences, and like millions of Canadians, I still need a family doctor – I can't use my sister. She deals with kids 50 years younger than me. In addition:
• We won't ask for your email address.
• We won't ask for donations or try to sell you stuff.
• We won't try to send you newsletters, you get too many already.
• But we will ask for your input, comments, stories, and suggestions, especially if you are a healthcare professional.
I want to improve Canada's healthcare system, and I'll need your help because all of us are smarter than anyone one of us.
And finally, if you're one of 10 million Canadians that doesn't have a family doctor or is experiencing unusually long wait times for elective surgery, you'll want to read this blog to see how to fix both problems.
Topics I’m Going to Cover
Our focus will be on identifying problems, providing some background, and providing solutions to those problems. These are the topics we'll cover:
We'll look at labour shortages and how to improve the retention rates of our most valuable resource, our nurses, and doctors.
· I'll start with the shortage of family doctors across Canada, how provincial governments initiated this unforeseen consequence in 1992, and why we should have seen this shortage coming. We'll also look at what some provinces are doing and propose our own suggestions.
· I'll move on to the ever-growing costs of providing health care and explain why money alone will not solve the problem.
· I'll also explain why we can't just stand by, and watch healthcare costs continue to increase without making drastic changes or at least demand improvements when more money is being spent.
· I'll explain why Canada's aging population and the explosion of chronic diseases will soon start to have the same impact on our healthcare system as Covid 19.
· Then I'll look at what ordinary Canadians can and must do if our healthcare system is to survive the next 30 years.
· I'll explain why doctors aren't the problem with rising healthcare costs and suggest how to spend less on bureaucracy and more on direct care.
· We'll look at labour shortages and how to improve the retention rates of our most valuable resource, our nurses, and doctors.
Lots to cover, and if it all works out, I'll start a podcast; I'll invite experts and ordinary Canadians to help us solve Canada's healthcare crisis - I know we can do it.
Transforming Canada’s Healthcare System one day at a time.
