– Bacchus Barua is a senior economist in the Fraser Institute’s Centre for Health Policy Studies.
CANADA – If you leave a medical condition untreated for too long, it can turn into a debilitating chronic condition. Most Canadians know these circumstances all too well, and it’s time the rest got on board.
For too long, we have failed to address the fundamental causes of wait times for medical treatment in Canada, and they are now our health-care system’s defining characteristic.
In 1993, when governments and policymakers were still questioning whether wait times existed in Canada, the Fraser Institute published the results of the first national estimate of wait times: 9.3 weeks between referral from a general practitioner to receipt of medically-necessary treatment. This year, the estimated wait was 20 weeks – the longest in the history of the survey.
Most provincial governments understand this is a serious issue.
And it’s widely accepted that the Fraser Institute’s survey is the only comprehensive, nationally comparable estimate of wait times that can track changes over almost 25 years.
However, a last few defenders of the status quo are still unwilling to work toward improving measurement and proposing solutions. Instead, they attack the survey.
For example, a recent article published on the CBC’s website by reporter Kelly Crowe questions the survey’s methodology and its motives.
In general, the article questions whether the results of the survey count since “only around one in five doctors participate.” It also casts doubt on the results because physicians have a chance to win $2,000 by taking part in the survey.
First, it’s remarkable that anyone would choose to ignore the voices of one in five physicians who (on average) say there’s a serious problem with the time it takes for patients to receive treatment.
Second, a 20 per cent response rate is well in line with other population-based surveys of medical professionals in Canada. Population-based surveys are different from those based on a sample of the population. The latter, for instance, could have a 100 per cent response rate but only question 100 physicians. Instead, the Fraser Institute’s survey is sent to almost every specialist in Canada (practising in 12 medical specialties) on the Canadian Medical Association (CMA) membership rolls. So achieving a 20 per cent voluntary response rate is no mean feat.
For example, the National Physician Survey (NPS) – a collaboration of the CMA, the College of Family Physicians Canada (CFPC), the Royal College, the Canadian Institute for Health Information (CIHI) and Health Canada – reported a 16 per cent response rate in 2014. However, both the Fraser Institute and NPS surveys should be taken seriously because of the large number of responses – 2,357 specialists and 10,191 physicians (including family doctors and other specialists) respectively. Similarly, the NPS also offered a $1,000 prize draw for respondents, a standard courtesy for voluntary surveys like ours.
Steven Lewis, a health policy consultant based in Saskatoon, calls the Fraser Institute survey “preposterous” and the methodology an “abomination.” Lewis asks, “Why not use a thermometer rather than asking people for their opinion about the weather?”
Because the thermometers available use different temperature scales and only measure certain ranges. And, most importantly, people are already screaming about the fact that they’re freezing in the cold!
More directly, government websites measure wait times for procedures in different ways, and often ignore the wait to see a specialist (usually only measuring the wait from hospital booking to treatment). Importantly, when asked, 2,357 doctors said the average wait time was 20 weeks – longer than what they consider clinically reasonable. It would be remarkably arrogant to ignore their voices.
Finally, the article ends with Karen Palmer, a health policy analyst and adjunct professor at Simon Fraser University, blaming “miscommunication” in the medical sector for the long waits that patients often endure.
While it’s certainly possible that marginal improvements can be made by streamlining the triaging process (as Palmer recommends), to suggest that long wait times in Canada are primarily the result of physicians not communicating well with patients (or because “[s]ometimes patients forgot to book appointments”) is blatant oversimplification.
It’s time for everyone to come together on this crucial issue that affects the lives of patients. Instead of challenging those who are providing information, it would be more productive to provide new and better measures. Instead of questioning the motives behind such measurement, offer concrete solutions.
We must remember that long wait times affect real people – Canadian patients and their families – and to disregard their hardship is heartless. We’ve waited long enough for a wait time solution.
© 2016 Distributed by Troy Media
