This article originally appeared in the Fall 2021 issue of the Ontario Medical Review magazine.
Provincewide consultation one of the most comprehensive in association’s history
Dr. Saara Rawn began practicing in Sault Ste. Marie, Ont. two years ago, one of two full-time rheumatologists in the city. She quickly found herself not only managing her own patients but consulting with doctors all over northern Ontario.
The OMA’s new health-care recommendations are informed by months of consultations with members, stakeholders, community leaders and the public and align with research findings. The result: powerful policy options that reflect Ontarians’ concerns.
The recommendations in the Ontario Medical Association’s new Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care, offer solutions to the most pressing problems in Ontario’s health-care system today. The OMA’s objective is to encourage all parties to incorporate some, and ideally all, of the recommendations into the health-care platforms they will be launching before the June 2022 provincial election.
“We believe this plan, based on the input of doctors, nurses and other health-care workers, patients and community leaders, provides a very clear path forward.” —Dr. Adam Kassam, OMA President
Over a six-month period, more than 1,600 members shared their views through regional member roundtables, one-on-one meetings with section heads and physician leaders, a member survey and a member prioritization session. More than 150 health-care stakeholders and community leaders participated in virtual roundtable discussions. And close to 8,000 Ontarians from more than 600 communities have completed a public survey.
The feedback from all those consulted is consistent, with five key priorities emerging: addressing wait times and the backlog created by the pandemic, putting more resources into addressing mental health and addictions, especially the opioid crisis, taking better care of our elderly and offering increased and improved care options, pandemic preparedness, and access to integrated care including fixing the doctor shortage.
“We heard loud and clear from our members and health-care partners — we need a plan that reflects the needs of those working together to make health care better for all,” said OMA President Dr. Adam Kassam. “And we need a plan that encourages even greater collaboration and partnership. We believe this plan, based on the input of doctors, nurses and other health-care workers, patients and community leaders, provides a very clear path forward.”
Human stories are embedded in every data point: a patient in need of knee surgery waiting for the backlog to clear; a teen struggling with addiction who can’t find help; a grandparent nervously eyeing each passing birthday, wondering what care will be available when they need it.
People across the province wonder how we will get through this pandemic, and whether we’ll be ready for the next. Many Ontarians just want to know that when they need a family doctor or a specialist, the right people will be available to help them. Stories like these reinforced what the OMA’s members already knew.
With its partners, the OMA engaged thousands of patients, physicians, and other health-care workers, industry leaders, and others across the province in in-depth surveys, interviews, and group consultations, covering an exceptionally broad spectrum of open-ended and guided questions.
“Even before the pandemic, physicians were the most trusted to provide advice on health-system transformation,” Dr. Kassam explains. “I, together with local physicians and OMA Health-Care Advocates are working closely with the government and political parties to encourage them to adopt these recommendations.”
Stephen Piazza appreciates the lengths the OMA went to in its efforts to find that broad consensus. Piazza, a senior manager at the Canadian Cancer Society, was one of the myriad of stakeholders the association consulted with.
“This process gave us the opportunity to really bring the patient perspective together with the physician perspective. For instance, our own research has shown that caregivers’ anxiety was higher even than that of cancer patients themselves during the pandemic. That was really insightful because it quantified what so many people understand instinctively: the foundational importance of caregivers to quality of care.”
Along with issues around caregiver access, Piazza and others at the society served as a conduit of insight on issues important to patients and caregivers, including backlogs, inequities and other long-standing problems that have only heightened through the pandemic.
“They did a great job of bringing diverse organizations and perspectives to the table, including from those working within health care,” he said. “This consultation was certainly a great way to move that process forward.”
“This process gave us the opportunity to really bring the patient perspective together with the physician perspective. For instance, our own research has shown that caregivers’ anxiety was higher even than that of cancer patients themselves during the pandemic.” —Stephen Piazza, Canadian Cancer Society
Deep research and broad consensus enabled the OMA’s plan to reflect the needs of everyday Ontarians, and the priorities of medical professionals tasked with delivering Ontario’s health care. Dr. Kassam is optimistic that the recommendations will become platform planks in next year’s election.
“We believe political parties should adopt these recommendations because they provide solutions to the most pressing problems, they reflect the input of the broader health-care network, they address the concerns of community leaders and the public, who are ultimately our patients. Our prescription for better health care reflects an emerging consensus of what needs to be done to strengthen our system and make people’s lives better,” Dr. Kassam said.
In the worst public health crisis of our generation, Ontario’s doctors have been at the front line of this pandemic. Their experiences treating patients has given physicians a clear line of sight of the health-care system’s weaknesses and illustrates the negative and long-lasting impact neglect and underfunding is having on Ontarians. These are their stories:
“Ontario’s large geographical and cultural nature presents a challenge for health-care leadership. Nowhere more is the challenge greater than in northern Ontario. Fortunately, Ontario has the right people and resources to meet the challenge of building a world-leading health-care system that is equitable, effective and accessible. Though progress has been made, Ontario still has much left to do, especially in northern Ontario.”
“A frantic mother brought her teen daughter to emergency on a busy Saturday. Sadly, in a desperate cry for help, the girl had cut herself and now required multiple stitches. Together, they had waited six long hours to see me and it was clear her mental health needs far outweighed this repairable wound. All I could offer was a piece of paper with a referral phone number to call on Monday. It was obvious, our health-care system was failing her. I felt helpless.”
“Being able to offer virtual psychotherapy during the pandemic has expanded psychiatrists’ ability to better meet the needs of marginalized populations by offering consistent treatment without some of the barriers that would have previously prevented people from accessing care. With virtual care here to stay, we can continue to enhance options to relieve suffering.”
“I had the honour of caring for a very lovely gentleman. As his dementia worsened, I cautioned his wife that he would soon need placement as she could no longer manage his care needs. After a few months she agreed to apply for long-term care for him. His case was escalated to crisis. Again, we heard nothing. Eventually, his behaviours escalated, and he actually attacked her. He was transferred to hospital and still waits for a long-term care bed. It has been almost a year. He is languishing in our system. This is not an under resourced place. This the heart of the city of Toronto. When will there be more accountability?”
Patchen Barss is a Toronto-based freelance writer.