Fear Now, Fear to Come

“When you’re dealing with a monopoly, and they believe that they can deliver any type of care, and there are no consequences, they’re going to continue to deliver bad service. And competition is one option… But the other is the fear of having it taken away. That is going to be a very powerful competitive incentive for the managers to say, ‘Oh my goodness, if we continue to deliver terrible care in Drayton Valley, then somebody else is going to be chosen for the operator.’” — Premier Danielle Smith

“With Premier Danielle Smith promising to bring “competition” and “fear” to Alberta Health Services workers in the future, we asked a few doctors — and then asked them again, because they are beyond busy — a simple question: What’s causing you fear right now?

Jessie Breton: “What causes me fear? The continuous expectation to do more with less despite knowing that patients are slipping through the cracks. Wait times and patient volumes are skyrocketing as people often have nowhere else to turn.”

Shazma Mithani: “My biggest fear in health care right now is not being able to provide timely care to Albertans. With the health-care system stretched beyond capacity, the ongoing concern is that when a patient needs the health-care system, either through an ambulance, cancer care, the ER or primary care, that system won’t be able to deliver what that patient needs and deserves.”

Marc Curial: “For me the primary fear I feel is that primary care will continue to collapse to a point that the only option for medical care is through a hospital.

“Independent family medical clinics should be the cornerstone of a well functioning health system. These clinics need to be present to provide chronic disease management, health promotion, screening and, hopefully, urgent care as well. We are seeing more and more community-based care kicked to the hospital through ERs since these clinics are not financially viable any more. I cannot tell you how many chronic back pains, knee arthritis, diabetes, and high blood pressure cases I have seen in the past month — it’s massive.

“Additionally, the number of ER-based first diagnosis of potentially treatable cancers in young patients recently has been heartbreaking. I should not be the first point of contact with health care for a 30-year-old with breast cancer… but I am. As the system falls apart the truly sick cases that the ER is designed for suffer, care costs increase, and no one wins.

“So, to summarize, I fear that government policy and outdated incentivization models will kill family medicine leaving walk-in clinics and the ER as the only available source for substandard health care.”