Saturday, September 3, 2011

Integrated care, house calls

What is the key to improving healthcare?
I do find that individual doctors are more than reluctant to provide care for failing seniors. Many are doing a fine job. But there are those, particularly attached to an institution, either long-term care (LTC) or a retirement facility, who pop in, do not see the resident for more than a few minutes, refrain from truly listening to the patient, and write a prescription.
In some facilities nurses are acting as Nurse Practitioners (NPs), and the physician has little in the way of hands-on treatment of residents. I understand that house calls are demanding, travelling time eats up much time better spent with patients, but to see residents in a facility is a good use of time. Physicians appear to pop in, do as the nurse bids, and leave.
I could be wrong. But the clients with whom I have worked, in retirement homes, and several LTC where I have volunteered, are getting the least amount  of intervention possible.
Imagine a 92-year-old, in a retirement home, with sciatica. Painful, painful issue (I know), that remains unresolved. Surely physiotherapy, and some pain relief is required. Whether one is 92 or 32.
Transportation remains one of the biggest barriers to good medical care in rural seniors, or those unable to use mass transportation systems in cities. If one is ill, is it hard getting up the energy to visit an office.

Ontario Liberals promise doctor house calls

Posted: Aug 28, 2011 4:54 PM ET 

Ontario's Liberals are promising to bring back medical house calls if re-elected, in a bid to court voters prior to the Oct. 6 election.

Ontario's Liberals are promising to bring back medical house calls for some Ontario residents if re-elected. Minister of Health and Long-Term Care Deb Matthews said Sunday the program, for those with mobility issues or severe illnesses, would cost the province about $60 million a year.

And in another article:

Ontario health care needs more integration: report

Almost 16 per cent of patients in Ontario hospitals should be at home or in an alternate and more appropriate level of care in the community, according to the report.

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