White Coat, Black Art

Quebec family doctors have struck a tentative agreement with the province, but Dr. Marina Lagodich has made up her mind. When the CAQ government rushed through their healthcare overhaul, Bill 2, in late October, it was the last straw. December 17 will be her last day practicing as a Quebec doctor. Across the province, doctors have criticized the bill, saying it encourages “fast food medicine.” Health policy expert Steven Lewis says although the Quebec government’s means are extreme, it’s hard to argue with its aims: to solve the “disgraceful” primary care crisis.

Ottawa family physician Dr. Nili Kaplan-Myrth faced a long wait for surgery after post-menopausal bleeding, and has seen her patients endure the same. Dr. Nick Leyland, president-elect of the Society of Obstetricians and Gynecologists of Canada, explains that gynecologists have limited operating room access, fewer perform surgery, and ovaries are valued less than testicles in the surgery hierarchy. Also: what’s being done to improve care for women nationwide.

Miles Randell, an advanced care paramedic, is trying to do something different for frontline health-care workers who need a supportive work environment. He says years of working as a paramedic in Vancouver led to post-traumatic stress that left him unemployable. And that the help he needed wasn’t there. So he created TEAAM (Technical Evacuation Advanced Aero Medical), a non-profit that deploys helicopters to provide advanced life support in some of the most rugged locations in B.C.’s wilderness. But TEAAM is also a workplace where health-care workers are encouraged to regularly check in and talk about work stress after a call.

Dr. Paxton Bach has spent years trying to help people navigate a broken system. Inconsistent approaches to withdrawal management, long wait times for detox and recovery programs and a system that struggles to address the social determinants of health have caused too many of his patients to fall through the cracks. So he and a team at St. Paul’s Hospital in downtown Vancouver are trailblazing a new model of care that’s set to roll out across B.C. It’s called Road to Recovery, and it’s helping doctors like Bach answer the question: How can I keep you alive until tomorrow?

Like many of Canada’s rural and remote communities, Mackenzie, B.C.’s hospital struggles to staff the ER. But once a week, a doctor hundreds of kilometres away fills in virtually. Many provinces like B.C. are using virtual care in ERs in an attempt to keep the doors open. But critics are concerned about patient safety and the need to balance virtual with in-person care.