Frontline Physicians' Concerns Absent in HHS Plan

By Ted Mitchell
Published January 21, 2008

(Published as a letter to the editor in the Hamilton Spectator on Jan 21, 2008.)

In his Jan. 16 column ("Will 'kids only' ER trouble the adults?") column, Andrew Dreschel drew attention to some but missed many negative consequences of the Hamilton Health Sciences' changes proposed for medical care in Hamilton.

Most significant is the absence of input from the community and front-line physicians. So far, local media have mostly accepted the spin supplied by administration without inquiring about potential setbacks in the delivery of medical care.

Patients seldom present with clear single-system pathology, hence the current emphasis on subspecialty care is inherently flawed. An integrated, multisystem approach to patient care in which generalists and specialists work together has always been regarded as more desirable and affordable than the model offered by HHS.

As more generalists are squeezed out of the hospital environment in favour of "centres of excellence," patients lose continuity of care and are treated less like people and more like consumers.

Any adult suffering from a life-threatening illness in West Hamilton, Dundas and Ancaster will be forced to drive past a functional ER and will not be served well by the proposal.

The last thing this city needs is more vehicle travel and ambulance trips ferrying patients from one specialized site to the other, as is necessary to meet the needs of multisystem ailments that are becoming the norm in an aging population.

With this proposal, McMaster health-care students lose a world-class adult teaching hospital on their doorstep, and well-considered links to clinical and basic science buildings will be severed.

Non-administrative members of McMaster's health-care team would probably have countless more concerns if they were asked, and anyone was listening.

Ted Mitchell is a Hamilton resident, emergency physician and sometimes agitator who recently completed a BEng at McMaster University. He is fascinated by aspects of our culture that are harmful, but avoid serious public discussion.


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By Medic (anonymous) | Posted January 21, 2008 at 08:49:49

Dr. Ted...puleeeeez. Climb down that high horse or you'll need nosebleed attention.

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By jason (registered) | Posted January 21, 2008 at 10:36:43

I too was wondering about this when I heard the news from HHS last week. All residents in Upper and Lower Hamilton west of the 403 and all thos in Dundas/Ancaster/Waterdown/Flamborough will need to come downtown to St Joes or the General for ER needs. Doesn't sound very practical, or safe, to me. I wonder if both uses could be housed at Mac?

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By Mark (registered) | Posted January 21, 2008 at 17:37:04

The problem with thinking locally in this case is that Hamilton is a regional referral centre for Niagara falls to brantford to halton. General hospitals are the norm in the periphery but the move toward specialized centres in major cities is a trend that goes far beyond HHS.

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By Al Rathbone (anonymous) | Posted January 21, 2008 at 18:04:06

Amen,I just had this conversation with a Doctor at the HHS last night.

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