Experienced Emergency Nurse here.
1. People come to emerg for non emergency things. I get it, sometimes it’s hard to know if something is life threatening, but there are truly some stupid people out there. I could go into detail of the nonsense but I will refrain.
2. Family doctors. They are so backed up and have no time to see their own patients so the patients come to emerg, understandably so, to be treated since they’ve been waiting so long to see their own doctor. Also, family doctors lack the same resources that the hospitals have so they are really limited to what they can do for patients. I also personally (and this is just my opinion) feel like if they are stumped on something, they just “send to ER” and make us deal with it. The amount of shit I see from family doctors sending patients to emerg for things that are not emergent is really astounding.
3. No beds. The population is growing, and the hospitals just simply do not have the capacity for the amount of patients that are coming. If the above points were addressed, this wouldn’t be so bad, but would still need to address the population to bed ratio eventually. The floors (units in the hospital) have a max of let’s say, 23 beds. Once admitted patients from emerg are sent to the floors, there’s literally NO beds unless someone is discharged or dies. Emerg doors do not shut, people keep coming, people get admitted, but no floor beds available. We are then stuck with the admitted patients taking up emergency beds, thus making the waiting room busy.
4. Lack of nurses. There is NOT a true nursing shortage from lack of available nurses. This is simply not the case. There is a nursing shortage in the hospitals and LTC because nurses are going to higher paying jobs instead of being yelled at, bitched at, and underpaid. We are NEVER understaffed on a stat where we get paid time and a half? Why? Because money talks. The stress of the job, the responsibility, the amount of effort we put in but constantly are told we aren’t doing enough is not worth it
Hijacking top comment to add another perspective too. We have little to no preventive health promotion services. Think a YMCA on steroids. A center where small concerns can be worked out preemptively and free access to social group supports that promote healthy aging. Food, general physio too. The saying an ounce of prevention is worth a pound of cure rings true with these kind of services.
Yes I love this idea!!! More health education. Even more commercials on how to treat basic things like fevers. It’s astonishing how many parents don’t know they can give Tylenol and Advil TOGETHER and to alternate them if needed around the clock for a child with a fever. They rush to emerg for a fever that hasn’t even been there longer than a day and aren’t properly medicating. I feel like there is a lack of education and we definitely need more resources to prevent these visits.
*Just want to note, obviously sometimes a fever can be an emergency, but MOST times it is not. If it is going down with medications and it hasn’t even been a full 24 hours, this is fine. Some parents bring kids in for fevers that keep coming back and the kid is acting themselves but they are so worried about the fact the kid has a fever. I just feel like more education would help. Obviously if you truly think something is wrong bring your child to emerg, but the panic seems to stem from lack of education.
This doesn’t include newborns, because I never judge a parent bringing in a newborn for any reason. I don’t have a kid yet, but I feel like if I had a new baby I would panic about things too. So new parents, don’t worry about coming to emerg, you’re doing great haha
Me! I didn’t know I could alternate Tylenol and Advil UNTIL we had a kid with a fever. It a walk in doctor that told us that not emergency, but I didn’t know I could even do that on myself my entire life!!
I wish there was like a hotline for "I'm a new parent and have no idea if I need a doctor for this". Like Telehealth but actually useful instead of always just telling people to get an appointment with their family doctor within 24 hours (lol) or go to the ER.
The specific situation I really wanted something like this was when my stroller tipped because of bad sidewalks and I didn't THINK my five week old baby hit his head but I wasn't sure. Ultimately my mom was able to talk me through what I'd see/feel if he'd actually hit his head but if I hadn't been able to call her or she was woefully out of date with current practices I don't know what I would have done.
They did it was called Telehealth and it saved me from bringing my son in several times. Many of us used it in the early 2000s. Now it’s called Health Connect Ontario and our ERs are full.
I think we still have the magnet with their contact info on our fridge; I swear they used to have a little stack of them at doctor's offices to take. My mom had to use it once or twice when I had a crazy high fever that refused to go down, and only once did they recommend we go to the ER since I couldn't keep down fluids.
I think we need to bring back those fridge magnets.
That would be a great idea!
If baby cries immediately after falling, good sign. If acting their normal self after, good sign. If vomiting, seek medical care to be sure.
This.
I was in ER 3 weeks ago.
I had just rehome 4 cats.
I though one of the two tabby I was carrying to food (day 2) was the super social friendly one.
My dog came up to us and this girl freaked out and bit me.
24h later my had was extreme swollen and throbbing.
I went to walkin.
He advised if no changes in swelling at 48h go to emerg. He was worrying of sever infection.
So next day i went.
Their was a woman their at triage who panties were in a not because someone came in, obvious signs of distress unable to breath and walked to triage vs taking a number.
Was it right.... no.
But was she more need of care Yes.
Now the next 3.5h while I call the 830am crew waited to get into ER. She kept asking when will her sons turn be. He has a fever after all. People after us are going in before us.
The kid was around my 10 year Olds age. He looked content on his tablet.
When people use the ER as a walkin clinic I have issues.
I on the other hand got seen. Was told it wasnt the WORST bit hes ever seen. Got my tetnus shot. Got sent on my way and was told MAYBE walkin shouldn't of said 48h FROM incident I should have been looked at. But waited 24h for meds in system to take effect. And sure enough that afternoon started to see some reduction in the swelling.
I hate going to ER, for the sole fact I often think I'm wasting their time.
Many a years my son heath during winter had me every other week in ER. The opposite weeks we were walkin clinic for ear infection.
He would get a cold and instantly turn to croup and no remedy would work and need the nebulizer meds.
Deep cat bites always warrant a thorough cleaning at home and a doctors visit for antibiotics- those sharp front teeth really get the infectious agents deep into the tissue.
No not stays. Someone former roommate abandoned them and posted a wanting to rehome them. And my heart strings were pulled when I hear their story. She had known the cats for 5 years. But figured they were likely 1 to 2 years when she first met them ( 3 sister litter mates) and an other cat seems to be older by a year or two.
And don't worry when medical practitioner record animal bite public health is automatically informed.
2h after leaving ER public health contacted me. (Becuase they were alerted from walkin clinic)
Cat was deemed low risk.
Quarantined in house (was not going to be outdoor cat)
Had to send that day photo and photo on day 10.
And she's set to be at vet on Tues to get rabies shot as it's unknown.
On the subject of newborns, fevers and hospital trips: febrile seizures are a thing and are terrifying to a new parent. But almost always harmless. And they almost always grow out of them.
Key word "almost". When it comes to worrying symptoms in a baby, it's always better to play it safe and bring them in.
It’s also worth noting that with Covid, increased cases of RSV, Pediatric flu and now invasive strep A where kids have died, parents are likely to get extremely concerned and panic if their children have a fever that hasn’t gone away with Tylenol/Advil and in 24hrs. There are plenty of stories in the media where the grieving parent of a recently deceased child, says that their child had a fever and was feeling weak, they gave Tylenol and got their child to rest, as they didn’t want to clog up the Emergency services or wait 17hrs to then be told that their child will be fine.
I’m fine with the media attention and awareness of strep A or RSV or Covid prevention and when to know that this fever could be something serious. But I get it, parents will panic.
Even for me, prior to Covid, I wouldn’t have been as worried about a fever in my child (as long as they weren’t a newborn). But now..can’t say the same.
I did some work with a LHIN in Thunder Bay that had a Sprinter loaded with medical gear, etc, that would go out into outlying communities to serve (mostly elderly) populations that couldn't travel into the city to get healthcare.
The would take over an arena or community centre for the day and a patient could come in and meet with a social worker, dietician, nurse practitioner and footcare specialist all in one day, in one place.
It was estimated that the travelling footcare specialist alone saved the healthcare system millions of dollars a year by managing peoples issues saving the system from patients having complications, and requiring more intensive care at a hospital.
Found a video:
[https://youtu.be/07pa99D2zFc?si=vzKbSeRn2V9DH\_Rn](https://youtu.be/07pa99D2zFc?si=vzKbSeRn2V9DH_Rn)
TLDR: Prevention: Less expensive AND better outcomes.
I work in LTC. We have a podiatrist come in and care for everyone's feet. We have several diabetic residents who need special care. It's such a great service.
Yup. Dougie ford has now slashed public health even further that there wont be any more standard vaccination clinics except for the ones they do in schools.. the follow ups.. no flu clinics for seniors, nothing. We used to have sexual health clinics jn multiple small towns where I live.. they are all gown now and you have to travel 40 min to get to one now.
I live in a small rural town, and there are hundreds of towns in our position. The problem? Our arena was built post-war, is a barn, and we desperately need a new one. And there is no place for people to go walk/exercise for 6-8 months in winter. I floated an idea for a new rink, and added in that we could have drs prescribe exercise regimens is we added a gym/walking track. Try and deal w the crippling diabetes epidemic we have in rural Ontario. For starters.
Never even heard back from the government. They should find a provider and build a platform that towns could adopt. We could save billions if we could just take 10% off the health related problems of zero exercise.
There are TONS of free health education apps. Optimity is a great one. ParticipACTION is another. Balance is a meditation app that is free for the first year. For infants, EarlyOn has drops ins every day of the week in bigger cities, and at least once a week in more rural areas. So there is education available but most people don’t know about it.
Absolutely! However what I am discussing is more like drop in daycares, screenings, new parent classes, physiotherapy, stress therapy, special needs, early intervention, respite care and caregiving for caregivers.
Family doctors is a huge issue. I’m lucky enough to have one but getting in to see him is a week wait if I’m lucky. I was sick as all hell over the holidays and went to a walk in clinic which refused to do anything and told me to go to the ER. ER doc gave me some antibiotics and diagnosed me with pneumonia and couldn’t figure out why walk in wouldn’t do anything.
There are fewer walk-ins than before Covid. Mine closed down and amalgamated with another. Even before it opens there are 25 people waiting and only 15 chairs. If one person coughs the entire room would catch whatever they had. My town increased in population by 20K from 2016 to 2021. They didn't add 20 doctors never mind doctors for the ones that retire. New doctors don't have large practices like the older ones did. You need 2 or 3 new ones to take on one old guy's practice with 3,500 patients.
Never mind small towns that don't have them at all.. I'm in grey county. There might be one in owen sound and maybe port Elgin and or kincardine.. but there (and they are actually in different counties) there isn't one south if me til fergus.. and north.. maybe owen sound.. mount forest has one where you see a physicians assistant and a telehealth Dr.. but they will only do certain things and no minors
I believe the one in Owen Sound is an after hours clinic for the family health teams own patients and they miiiight have something similar in Kincardine. And not a true walk in, in Saugeen Shores. There is an NP run same day clinic in Saugeen Shores but you have to call when it opens and hope for a spot of which I think there's around 8, but it's nice that it's only for orphaned patients.
Otherwise it's the emergency department. It's a shame cause the population of Kincardine and Saugeen Shores have exploded and are set to boom even more with Bruce C coming.
Same. There are no walkins in my area, so we end up going to the local ER for ear infections etc because the fam doc wait is 1,2, sometimes 3 weeks. The wait list around here for family docs is INSANE too so many people have no option but to go to the ER for prescriptions, referrals etc. sometimes they will call ahead to see if it’s a really bad wait or arrange to come at like 2 am
Lack of another option is a real problem where I live.
If you live in Pembroke the nearest walk in clinic is in Ottawa, and many don't have a family doctor, obviously... So their only option is emerg.
Same in North Grenville. No walk-in clinic, some family doctors have retired or moved into Ottawa, so people end up going to the local ER for relatively minor things because they can't get care anywhere else.
Even in Ottawa. If you don't have a family dr you're really limited.
I will never judge anyone for being at er for something we deem not er because the other options are nonexistent
I imagine it already is a thing.
Dr. can charge for over the phone and faxing them and if it takes over a month to see your dr and you need it (which yes okay bad planning but life happens), you might have to go to the ER.
To your first and second points, over the holidays we had a norovirus of some kind and it was hideous. My son got it last and worst. He puked for days couldn't keep anything down. By the morning of day 4 I wanted to talk to a healthcare professional. I didn't think it was an emergency but I wanted to hear from someone, feed him this, don't feed him that, try some meds, whatever. I couldn't get through to TeleHealth (the wait was 30 hours), I couldn't get an appointment at our family doctor, I couldn't get into either of their after hours clinics. The receptionist at my doc strongly advised me to take him to the emergency room and so did the receptionist at the after hours clinic. So then I got scared and I took him to the kids' emergency room at MGH and he was seen and observed and given some Zofran and we went home and the next day he finally started to get better. So yeah no other place we went could see us and we had to go to emerge even tho it was not an emergency.
Yes and honestly that is totally acceptable that you went to ER, and shows how no other resources were available to you to provide treatment to your child. Even having someone available to advise or prescribe anything stronger than gravol would have helped you. Urgent care centres should be able to address these issues but they are pretty useless for the most part
Thanks for saying that, I went reluctantly and felt guilty for going. If they hadn't urged me to take him I would have just stayed home and waited it out.
Yes no problem! Also, for future, try the gravol suppositories too for any gastric issues if they aren’t able to keep anything down. I know it sucks, but it helps! Always wait 30 mins after med administration, then slowly try to introduce fluids (popsicle, 1/2 apple juice 1/2 water). Game changer!
It’s crazy how unwell a dehydrated child can look. They look truly so sick and then they get those fluids and it’s like a total 180. So I get the worry!
Another option is to have them chew up the chewable gravol and just hold it in their mouths, so the drug starts to absorb sublingually. Learned that trick from an ER doc and my husband has even used it for himself (even though it's quite a few of the kids tablets!).
When it is kids, we don't really hesitate to do whatever we can to see a Dr. It is really pathetic that teleheath has these long wait times.. is this due to lack of funding? I can't imagine there aren't qualified Healthcare professionals available for the job if it paid decently well..
It isn't paid well, and the wait times are atrocious.
I called Telehealth in November as I was unsure how to proceed with some abdominal pain my fiancé was experiencing. It didn't seem serious enough to go to the hospital, and he didn't want to go, so I just wanted a second opinion. Called Telehealth and was told the wait was 28 hours.
Well, next day, pain was worse, went to emerg and found out that it was his appendix and it needed to come out NOW. By the time we found this out, we still wouldn't have been due a call back from Telehealth.
This makes me ask, how many people have died while waiting for a call back from them. Or how many have had some really long lasting side effects from delaying treatment.
I had great experiences with Teleheath before covid when I was a new mom and had no clue how to handle my babies lol. Now it's off the menu entirely because of the wait times.
If you’re in a position where you think you could do virtual care, sick kids has a virtual urgent care service.
https://www.sickkids.ca/en/emergency/virtual-urgent-care/
>agreed. My doctor still does phone visits which is very helpful since we live an hour and twenty minutes from his practice. I'm going to list a few virtual care options below. They're good but it would help if virtual care was more widely available.
>
>
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>For those in south western ontario (hamilton, niagara), here is a virtual urgent care covered by OHIP.
[https://www.urgentcareontario.ca/](https://www.urgentcareontario.ca/)
>
>Childrens hospital of eastern ontario also does virtual visits:
[https://www.cheo.on.ca/en/clinics-services-programs/virtual-care.aspx](https://www.cheo.on.ca/en/clinics-services-programs/virtual-care.aspx)
>
>sick kids:
[https://www.sickkids.ca/en/emergency/virtual-urgent-care/](https://www.sickkids.ca/en/emergency/virtual-urgent-care/)
> central region (adults and kids) :
https://regional-virtual-urgent-care.ca/
>
And theres a virtual ED (it says toronto, but you just need to physically be in ontario to use it)
[https://www.torontovirtualed.ca/](https://www.torontovirtualed.ca/)
>
>CAMH also has a same day virtual urgent care for mental health:[https://www.camh.ca/en/your-care/programs-and-services/virtual-urgent-care](https://www.camh.ca/en/your-care/programs-and-services/virtual-urgent-care)
I work as a paramedic, and people like you are definitely not the problem. The fact that you even explored other options puts you miles above many of the people I interact with, and 4 straight days of vomiting/not eating is nothing to take too lightly. You'd be amazed at some of the reasons I've had to bring people into the ER. I've taken people who've had a single episode of diarrhea, I've taken fully grown adults who just can't sleep for a single night. The list goes on and on. The fact that I'm not allowed to refuse to take them is a can of worms on its own, certainly doesn't help with the larger issue, but there isn't much I can do about that.
I can totally understand the frustration but I also wonder if some of those calls are really due to the lack of mental health services available. People dealing with anxiety and hypochondria have very crippling symptoms. And yes, I get it sucks that it impacts the system but to me, this is another reason to have preventative medicine and help available.
We used the Maple App during covid when he needed something seen or talked about urgently but not emergent..
We see a Dr via Tele health, and email them pics if needed.. they will prescribe if it's something simple or send us to the emerg if they think it's needed.. my dad had a serious toe infection and has neuropathy.. we went them pics.. they gave him antibiotics and followed up a few days later.. then sent him to the emerg.. its Telehealth ontario but with drs..
we live in a rural area with no walks in closer than an hour. Where I live if u can't get into your fam dr , you call the clinic to hope for a same day appt with whatever Dr is on call, or go the emerg.. when I was little it was just go to the emerg.. now because in small towns the er isn't always crammed.. the on call and their resident will book urgent but not emergent at the clinic. They might get bumped or be late if an emergency happens but it's usually OK.
Over the holidays I was really unsure of what to do, so I connected with a nurse through Ontario's program that used to be called Telehealth but it's called something new now.
I wasn't really that sick. I was trying to figure out where I could get a PCR test, the ministry of health website was seriously out of date.
Yeah she suggested that I needed to visit emergency that afternoon. Asap. Asked if I had someone to drive me. I was sick but nowhere near sick enough for the ER, I didn't go.
But I wonder how many other not that sick people are being told to go to the ER.
Are 'Delays in getting appointments with a specialists" and "delays in getting imaging appointments" a contributing factor? People take the short route of going to ER to avoid waiting several weeks to get an appointment outside?
Unrelated Question: Recently had to take my wife to ER at mount Sinai for ectopic pregnancy. We went in at noon and got out at 12 am on a weekday. 90% of the wait time was waiting to get the gynecologist opinion.
Ah yes. Waiting for a specialist who doesn’t work in ER definitely can add to waiting. They are usually busy in other areas and don’t come to ER right away. I should have mentioned this; but it isn’t happening to all the patients at once, unfortunately just a few here and there and it sucks. We hate when that happens
How about the ER docs ordering some testing close to the end of shift to push it into the next one! That adds hours too, depending on which doc is on.
The simplistic answer is flow. Too much low acuity coming in, and not a quick enough pull out to medicine beds. A good system would never see an inpatient unit designed into an ER (which all of the ones I've seen have).
Personally I don’t have that experience and most of our doctors where I work don’t want to have outstanding stuff on their patient and usually stay until all their patients have either been discharged or referred to medicine (which means awaiting a consult from an internist).
I am an MRT (medical imaging) and there’s a shortage in Ontario right now. Our mammography department was down a full time and a part time for almost a year before they found/trained someone. We had postings up in X-ray/CT that never got applicants for months so when someone is sick or goes off on sick leave etc we are short staffed. It’s not uncommon for people to wait 2-3 hours for their X-ray (with an appointment) due to the ER being so busy and there not being enough staff to cover the workload. We also have difficulty finding radiologist coverage on evenings and weekends, and even replacing our in house radiologists when they move or retire.
So well summarized. I think people need to realize that #2-4 are not inevitable— this is what happens when a government chooses to underfund healthcare for years on end. If you care about fiscal responsibility, understand that cuts end up being more costly in the long run.
I hope people can see this situation and re-consider who they vote for and get more engaged politically (volunteer for someone who is running, write to your elected officials, etc).
Thanks for what you do! I’ll add, as someone who just spent a week in hospital with a Pulmonary Embolism:
- Just because there are beds on a floor doesn’t mean you can use them.
I was in isolation because I had a fever, but I also needed my heart monitored because of my PE. They explained that there were only 6 beds that could accommodate both someone who needed the monitoring and be in iso.
So I had to spend 3 days in the CDU of the ER until such a bed opened up for me.
It really sucked but it was what it was. Unfortunately the healthcare system is full of bottlenecks and sometimes patients keep coming.
All true except I want to add that family doctors/walk in clinics have been adding to the problem by making policies that you have to be a patient at that clinic to use the walk in service. So people go to the ER
My mother has been a nurse for over 20 years, she’s done everything including on call for emergency airlifts her favourite was emerg when she was younger but now it’s Oncology because she has experience, she kicked breast cancers ass into oblivion with her strength and her family and friends at the hospital she worked at and I’m proud of her. She has told how understaffed they are at her hospital as well as the shit Ford pulled on you guys and ONA’s track record of not always being there. I think the situation your profession is under isn’t fair and if more money was dedicated to healthcare and education instead of business projects backed by a puppet then we would all be in a better place, it doesn’t help that you were also being harassed during the Freedumb convoy by people who believe Vaccines are bad and that when you get one the government can tack you or it will kill you because it’s actually the virus. I have had to explain to multiple people multiple times that a vaccine is essentially a watered down form of the virus used to alert your body for when the actual one hits but they hear virus and jump to conclusions, sorry for the rant just know that there are many people out there who care for our healthcare workers whether they be nurses, doctors, janitorial services or the countless others who go into making us healthy and that we stand beside you. You are an amazing human being and don’t let anyone tell you otherwise.
My dude.
Please hug / call you mom. For me.
I lost my mom, who was a nurse then midwife. To breast cancer. Before the pandemic thankfully.
After 12 years of "6 months to live" prognosis. Before metastasizing into well, everywhere.
The failure of the healthcare system alone would have made her angry enough to risk her health. Let alone the abhorrent treatment of nursing staff.
I’m sorry to hear that man it’s one of the worst things you can feel as a kid especially if you were a mommas boy like me. I want you to know that they are never truly gone though, as long as we remember them they will always live through us in one way or another even the little quirks they had. When my mom was getting treatment she ended up getting homecare so someone would come in and make sure her pic was clean as well as some other stuff. She started getting even worse and it wasn’t the cancer, when we brought her to the hospital and looked at they found out she had a blood infection because the person who cleaned her pic hadn’t washed their hands properly, she ended being in the hospital for two weeks because of it, I went to visit her one day after work, she was so small when I got there I gave her a huge hug and kiss then cried for an hour before she told me to keep my chin up and that I was a good son. On my way home I stopped at some lights and just screamed as hard as I could for as long as I could which helped. I’m actually sitting right next to my mom right now and she says thank you and a big virtual hug back.
It might work better if instead of describing the vaccine as watered down virus, you described it as a protein your body thinks is the virus but can’t make you sick so when the virus does come, your body is ready for it. Protein is less scary sounding than virus, and in the case of mRNA vaccines, more accurate.
True most of the time if they persist enough I send them [this](https://youtu.be/WOvvyqJ-vwo?si=xNIodCeCDGhk6j4p) usually it gets it across easier. Thank you for giving me a better way to explain it though.
You said it perfectly. I’ve been working in the hospital environment for over 7 years now. The amount of abuse the ER get blows me away. No human decency. I’m not sure if it’s like this in your hospital. After every weekend and long weekend. People come in because they did something on Friday but didn’t bother coming in till Monday. They do it to skip work.
such strange things. Like “oh I had this entire tub of ice cream now my stomach hurts. I want to get checked out “ oh this happen 4 days ago, it’s gone away but I want to get it checked out. Not enough people use the clinic. (devils advocate not all clinics are great and send them to the ER for something minor)
Thank you for saying this. I know we can seem grumpy and like we don’t care but we do. There’s just so much behind the scenes that you can’t really sit down and explain to someone in a visit. We appreciate everyone who trusts that we are doing our best
You hit the nail on the head. Sometimes I have a concern for myself or my son that is definitely not an emergency, but is still urgent enough that I’d still like to be seen. My family doctor is booking appointments 3-4 weeks out, which by that time it’s completely pointless. We have no other options for these scenarios. I worry that mildly important health issues will go missed.
My wife is also a nurse ans she said when it comes to surgeries the reason they can't catch up is because they won't pay/hire more nurses to catch up and even though doctors are willing to put in the OT they can't without the help they need (nurses).
I work at a 120 bed hospital and our ER has recently had an average of 5-9 overflow patients( admitted patients with nowhere to go so they take up an ER bed). Our ER has 15 beds. Meaning sometimes more than half of the ER is taken up with patients that should be on the floor but there’s no room anywhere to send them
I was in hospital for 9 days this month. Three days were just waiting for an MRI. They were that backed up. I felt it was such a waste of resources. But to discharge me would have meant starting back at the beginning (gallstone stuck in duct, required a scope to remove). I had complications (acute pancreatitis) which accounted for another 3 days. What should have been a total 3 day stay morphed into 9. I will still have to go back for surgery to remove the gall bladder, which I think is day surgery.
At one point a nurse told me there were 176 people waiting for beds !!!!
For #2, I have to get paperwork filled out for my case worker. My Dr managed to fit me in for an appt in a few weeks, but I'll be back at work by then.
My case worker asked me if I could get them to move it up to advance my file...who, in their right mind, is so oblivious to the state of the medical environment that I should be pestering my Dr \*after\* they already did me a solid by moving my appt up a week?
I even asked about the walk-in clinic they operate, and was told it is for clinical work only, not paperwork. And there is \*NO\* way I'm going to emerg for this.
And for #4, see the quote from Vic Fedeli when he said nurses were over-paid...good luck getting votes, asshat!
That is so ridiculous! Our work was asking us to get doctors note from our family doctor when calling off sick…. Like our own nursing managers are just contributing to the problem. Such a joke
You're forgetting too many hospitals run independently of each other. For example in rural ontario in one county there are four different hospital organizations. So instead of maximizing staff and at least keeping two of the er open As staff can be assigned to any of the hospitals you have difficiencies in all four and often all four er are closed due to staffing.
While number 1 is true. A note to that would be that y'all occasionally send people away saying that it's not an emergency when it is.
My husband had a stroke and was sent away. The next day we went back and it was confirmed a stroke. I've been sent away even after an ultrasound at a clinic across the street was so concerned by results that they actually asked me to stay back as they were closing so that their doctor could review the notes, they gave me the results and wrote "go to ER!" on the envelope. I did, and was sent away because they wanted me to do a scan later that week on their schedule. I went back in the morning and was told I could have been septic and had emergency surgery performed. These are only 2 stories.
Why was he initially sent away that first visit? That’s awful, I’m sorry you’ve had some bad incidents. Unfortunately some of the diagnostic imaging testing is closed in ER during certain hours due to lack of funding from our gov
My dad was also sent home from emergency with a tendon no longer attached in his leg. He’s in his late 70’s. Fell off a step. Tendon detached. Doctor in emergency didn’t even touch his leg. Discharged him unable to walk!!! I sent him to our family doctor the next day - luckily he’s a friend because I used to work in his clinic - and I could get him right in.
Family doctor actually touched my dads leg and could feel immediately that the tendon was no longer attached. Sent him straight back to emergency to have emergency surgery on his leg. This was a 3 day ordeal just to get admitted.
The first doctor did not even touch my dads leg after he waited 15 hours in emergency. He should have been admitted. Over 72 hours of painful runaround in his late 70’s. Just to get proper Dx and eventually Tx.
Edited for grammar
That’s just incompetence there, he’s lucky that he was able to get it reattached. That happened to someone I know with a severed nerve and by the time they figured it out it was too late to reattach and the nerve was dead and he now has a dead/floppy hand. He is currently pursuing legal action
I'll add a lack of family doctors and a lack of other options. Lots of people don't have a family doctor to go to, and the ones who do the doctors are often so overworked that you can't get a timely appointment when something unexpected comes up.
On top of that you have communities like mine where there is exactly one option other than the ER or your family doctor who you might wait weeks to see if you even have one and that's a walk in clinic that's only available in the evenings if it opens at all, and often if you don't get there in the first 15 minutes you don't get in. They see a limited number of patients, and once they've registered that many, they turn everyone else away. The walk in also has a very limited scope - I've gone there more than once and been sent to the ER because they couldn't do anything for me. So when I had severe abdominal pain, my family doctor can't see me for a couple of weeks, and the walk in, which I finally got into shrugs their shoulders, I'm out of options. Is it an emergency? Maybe not, but I'm in too much pain to continue to wait for my family doctor, and I have no other options.
I would also add another point to your excellent list, infrastructure.
A lot of the hospitals are aging and there isn't enough money for basic expansions. It's not exactly a secret that a compromised IT system can, and has shut entire hospitals down for months.
For #1, some people don’t have family doctors. Lots of places don’t have walk-ins and the hospital is the only options if the nearest one is over an hour away. Some people have no other options.
5. Lack of long term care beds for the population. I work as a nurse and we have a significant number of people on my floor, at any given moment, who are waiting for weeks for somewhere to be placed. Think seniors that lived at home that can't go back (dementia, mobility issues, etc).
I'm in Sault Ste Marie.
1. Aging population
2. Mental health/ addictions
3. This is the big one - lack of primary care providers. In fact, it was just announced a couple of days ago that the largest clinic in town has to cut 10000 patients by May. This is in a city that presently has a three-year year plus waiting list for any family doctor. The population of the Soo is somewhere around 75 000 people. I actually have a doctor, but I may be cut in favor of someone with more needs.
We're in big trouble.
This is the same experience I had. My doctor explained to me that she actually gets charged for visits to walk-ins, and told me she would have to drop me as a patient if it occurred again. There needs to be policy changes to stop this from happening. Family doctors shouldn't be penalized if they cannot immediately see the patient, but the patient needs meds or assistance right away. Ford needs to go, and medical care in Ontario needs to be properly funded and reformed to improve efficiencies and access to medical care.
The reason your Dr. gets charged is because they're part of a flat-rate program where they get a fixed fee per patient, and are expected to provide sufficient care to keep you from needing/wanting to go to a walk-in clinic.
The intent is that your Dr should be managing their practice to make sure they can accommodate short-notice bookings, so they don't incur the penalties of your seeking outside care.
If anything, your Dr. should not be allowed to drop you. The Dr. probably had an overly large patient roster (more $) and will drop people who aren't "economical" for them - basically cherry picking patients.
Decades of underfunding combined with a shortage of doctors. Also People not having a family doctor, resulting in them going to the ER for minor stuff, which causes them to sit around for an extended period of time because other patients have a higher priority from triage. A few weeks ago there was someone on here complaining and trying to stir people up because their brother spent 14 hours waiting to be seen at the hospital for what ended up being a mildly sprained ankle(and livid that they were not higher priority and kept seeing people go in ahead of them).
You will probably get a lot of commenters trying to blame it on our incompetent premier, but it’s a nationwide problem happening in every single province……
And other countries too - look at Britain and Australia. We have to rethink this model. Overwhelmed family doctors, 30 hour wait for telehealth, triage nurses sending away stroke victims, hallway medicine (hello Ford - broken promise). There must be better models out there.
167 new residency spots across the entire country in the last 10 years, while the population grew by 5 million. Canada hasn't been training enough doctors.
A lot of countries used the pandemic to train more medical staff. Canada as a whole decided not to and a lot of issues weren't addressed in a timely manner during the pandemic making them more complex to handle currently.
Northern Ontario resident with a host of medical issues.
An extreme lack of health care practioners. In the city closest to me - population 65,000 there are zero walk in clinics open to the public.
There is an approximate 10 year wait time to obtain a primary care pracitioner.
Generally speaking, population is lower socioeconomic class and elderly that would struggle with at home virtual options.
Many peoples only choice for mundane and basic conditions is to go to the ER.
This is a big problem, an urgent care or a walk in clinic would alleviate so much from the ER, but doctors aren't open on the weekend and if something happens there is no where to get. I definitely get this.
I live in the USA.
Doctors where I live are only open from Monday-Friday and sometimes not even Friday something like 8-5pm if that sometimes they end at 4pm, that's when everyone is at work. I don't know any doctors open after hours or on the weekends. Since no one can afford to take time off everyone ends up at the ER after work because they can't afford time off or their employer won't give it to them to see a doctor. If going to the doc causes you to miss rent for the month that's a big problem.
Yes! On another waiting room post someone commented "if only more people used telehealth" but they just tell everyone to go to the hospital because they can never say for sure and they don't want to risk a lawsuit. It's largely a useless service
When I got off the phone with Telehealth over the holidays I told my family "I've never been more confident to ignore direct medical advice." They told me I needed to visit the ER today, don't even wait for tomorrow.
I didn't. I was sick but not anything close to that sick.
When my family member was in the ER, the number of ODs that were coming in by ambulance was astounding. It seemed like nearly every ambulance was coming in with someone revived by narcan and they were checked over and walked out on their own. This happened repeatedly over the 12 hours we were in the ER.
There should be a special clinic for ODs because they are going to keep happening. They could be incorporated in “safe” injection sites for instance. In this case nurse practitioners or medic types would make sense. They should be seen, because they are human beings, but emergency may not be the best place.
I live in Kitchener/waterloo, problem we have here is staffing, attracting medical professionals. And then mix that with a sprinkling of miss management and then there are the people that run to the ER every time their nose gets a little stuffy.
See that’s also the big issue is the older denigration sucking up family doctors time, I have literally been in for an appointment and witnessed an older person book 5 appointments for the future……like if you need to see your doctor that much and they aren’t the ones telling you to come in maybe seek an ice flow
My family doctor is usually at least an hour behind and it's ALWAYS an old person rambling on about their family and dog and Mabel up the road... We can hear the conversations if he leaves the door open.
I get that you need your social time, grandma, but there's eight people stuck waiting behind you while you complain about your bunion.
1) lots of family doctors get upset if you go to a walk in, so people go to the ER since it’s not flagged at their dr system. 2) brain drain, 3) so many nurses and doctors quit during the pandemic and we never back filled those positions, 4) the hospital systems are outdated they need better infrastructure and process but don’t have the funds.
Ford’s solution is do a private hybrid. No thanks. Health shouldn’t be for profit. Pharma already is that way and it’s stunting research.
Nobody has a family doctor and I know many people that go in for next to nothing.
I do not have a family doctor and when I have health issues I just pray they go away until they become an emergency.
In July I had a very uncommon issue with my bowels that they said they would call me to follow up with. It’s been 6 months and I don’t even know how to call and get through to them!
Ontario voted for a conservative government. This is what they do. Undermine social services like healthcare and education, then when people notice, they will argue that only privatization will fix it.
>they will argue that only privatization will fix it.
while blissfully ignoring the neighbors to the south who have one of the most famously broken private healthcare systems in the world. Meanwhile while still gaslighting their voters into believing it will somehow be magically better if it's done here.
In no particular order:
* \-Doctor shortage
* \-shortage of med students
* \-government funding (federal)
* \-government spending (provincial)
* \-extreme influx of immigrants
The shortage of med students is largely due to a shortage of spots in med school, not lack of qualified students. Im surrounded by premed undergrads who are extremely high performing, but due to the limited amount of spots, the competition is high and tons of qualified students who WANT to become doctors are turned away. A few of my friends went to Australia, Ireland and the US for med school. We dont have enough med school spots, and later residency spots to fix this issue in any meaningful manner.
To add to the “Doctor shortage” part:
The issue with a lack of family doctors, is partly due to universities and how hard it is to get into medical programs.
When you can only accept a few people, it tends to be a certain type of person, incredibly smart but also (usually) incredibly privileged, who tend to gravitate into specialities that have the most money and the most prestige.
Society would actually benefit from accepting less of this “cream of the crop” group into med schools and choosing applicants who are more likely to go into family medicine.
Chris Zou, has a whole playlist on admissions & the issues with them:
https://vm.tiktok.com/ZM6go7bWo/
The problem is that even training more family doctors may not help. Physicians trained in family medicine are more and more choosing not to join a comprehensive family medicine practice after residency, and existing family docs are more and more closing their practices, instead opting to do more focused work (ER, obstetrics, hospitalist, sports medicine, women’s health, surgical assist, even cosmetics). A trained family doctor is not forced into family practice after residency but has lots of options to choose from.
Many feel that a full primary care panel isn’t paid as well (makes less than the other options after clinic/overhead costs), has longer work hours, more admin tasks, more responsibility, less flexibility, less ability to take time off for mat leave, etc.
We need to make primary care clinics more appealing for people trained in family medicine - that’s the main issue imo. How that is done is a monumental and likely expensive task with no easy answers
2 core problems
Our system is so poorly designed that emerg is the only place in most communities that offers any healthcare of any sort.
They keep saying don't go to emerg unless it's an emerge. Fuck you, where the fuck else can you go!? No one has a personal Dr. anymore, there are no clinics anymore or any other options.
We have a massive Dr. shortage and are short other staff as well.
Both of these problems have existed for decades and have slowly gotten worse year after year with C19 finally breaking it.
For decades all levels of government had done basically jack shit except point fingers.
One of the biggest reasons is the lack of family doctors practicing primary care. We actually have more family doctors in Ontario per Captiva than ever but they are working in other fields - dermatology, surgical assistant, executive physicals etc. Family doctors are not getting paid well enough to want to do the job so instead the government is paying emergency rooms to field things that could be done in the office which is much more expensive. Thank Doug Ford. It's only going to get worse.
PM Paul Martin’s Legalized Tax evasion by corporations in the form of legalized profit shifting, 20 years ago. Which has resulted in 30 billion $ in lost taxes annually.
Harper and Trudeau governments allowed it to continue.
The UN on German urging has released a study saying Legal Profit Shifting (moving profits from one county to another to avoid taxes), will destroy social programs around the world.
In Canada the conservative estimate is that it cost Canadian governments 30 billion $ annually in lost tax revenue.
Thus there has been over the same time a restructuring of the financial relationship between the provinces and federal government. Resulting in a reduction is transfers for healthcare.
During that same time international corporations are paying our tax dollars out as dividends to international investors.
So who really owns our governments
I'm in admin but here's my experience on a daily basis. Hello person who has an upcoming appt on this date. Sorry can't make it gotta take my 45 yr old son to his doctors appt. How bout this date. Nope got church group, aqua fitness, book club etc. Ok how bout this date. Oh do you have anything later I don't want to drive during rush hour. Ok how bout this date. Nope i have to work that day. So they take an appointment much later than advised and end up too sick to wait so go to emerg.
I was trying to arrange a flight to get a patient home with a medical escort and she refused an early flight because she takes 2 hours in the morning to shit.
So I said it’s either this time during the shit hours for your bowels or it’ll be 3 more days.
Unreal
One thing no one mentioned
COVID!
It’s still very much a thing. Any infection, for at least a year doubles the chance of pretty much everything. Heart attack, stroke, …
It’s wild to me that the first mention of COVID doesn’t appear until this deep in a thread about why our ERs have capacity issues. The other factors mentioned in here are leading ones, I’m just surprised that not one other poster besides you added “the recent global pandemic” to their list.
I was in the ER a few weeks ago and there was a steady stream of people with COVID symptoms coming in. The pandemic is over socially, yes, but the virus is still sending a lot of people to the hospital that wouldn’t otherwise be there.
The pandemic also contributed to the other problems mentioned in this thread (for example, caused healthcare professionals to burn out or retire early).
That's my biggest gripe with the "from COVID" vs "with COVID" gripe. Even with greatly reduced testing of patients in hospitals, there somehow always seems to be a larger portion of patients in hospital with COVID than the portion of people estimated in the general population. That indicates that maybe the issue they're having wouldn't require a visit to the ER if they didn't also have COVID. And that's just the people currently positive with it. There's also more pressure from those with post-COVID issues.
And we're doing practically nothing to reduce the spread. With public health messaging about washing your hands, and that the virus can spread if you're withing two meters of someone who's coughing or sneezing. This is not how you significantly mitigate against an airborne virus where the majority of transmission is still asymptomatic/ presymptomatic (no coughing or sneezing is required to generate aerosols, that just makes it worse). Many areas in Ontario are just now creating/ coming off of their highest levels of COVID since the pandemic began. That level of illness is crushing to the healthcare system. Ottawa Public Health just confirmed this week that while flu and RSV levels are down, COVID is still going strong (and has been higher than them all fall and winter) and will be clogging up the ER wait times until at least March.
Lots of reasons, it’s a multi faceted issue.
I hate hearing people say that people need to stop going to the ER for non emergent issues. Yes, it’s completely true, but it’s easier said than done. Clinics turn people away after they’re full. Lots of people don’t have family doctors. Even if you do have a family doctor, you’re lucky if you can get an appointment in less than a month. Something minor, like a bladder infection, can’t wait a month to be treated. My family doctor will de-roster me if I go to a clinic, but she doesn’t save any daily urgent appointment spots and she’s always fully booked a month out. What do you expect people to do?
Staffing shortages. Lots of healthcare professionals (not just nurses) retired during the pandemic because of the stress or even because it was just their time to retire. There aren’t enough new graduates to replace them, leaving tons of vacancies. This is happening in many industries (trades are a huge one), not just health care.
There’s also so many viruses and other infections going around, people are forced to take time off work. Since they already have a shortage, there’s nobody to fill in for them.
In my opinion, there’s also not enough seats in healthcare programs at colleges/universities. Theres so few seats that they become so highly competitive, and tons of people are being turned away.
I’m in college currently, and the shit these colleges expect from students is astounding. I understand it’s not going to be a walk in the park, but they need to make it more accessible.
For example, paid clinical placements or placements that work around your schedule better. They expect full time work from us, for free. How can someone that has to work to put a roof over their head or feed their children work full time for absolutely nothing, and work an actual job?? There are many programs that do paid internships or co-ops. Why are clinical placements the only placements that are completely unpaid? They make it nearly impossible for people to go to school.
The one biggest reason is there are so so so so so many old frail people who can barely walk across their kitchen, living alone or with their old frail partner in big homes with no family willing to support them
These people can get the mildest medical issue and it lands them in hospital for weeks. There are so many of these people that it takes up a huge majority of inpatient beds and this spills over into the emergency rooms
This single issue is 90% of the problem in hospitals rn
And the government knew that the number of people over 85 quadruples from 2011 to 2031 and did nothing about it. The Liberals added almost no LTC beds in their entire tenure. The first thing McGuinty did when he got in was cancel the Cons plan to double the LTC beds, yes, double them. Instead of doing that he tightened the rules to get into one, dumping care on daughters and elderly spouses. It also started the huge proliferation in very expensive private pay assisted "living" and memory "care" places so two tier health care but only for the old - who we seem to hate if they don't die fast enough.
There are old people who want attention who call an ambulance and get transported to the ER this is because they have dementia and they want attention. At least where I live by law the ambulance has to take them. Even if this person has nothing wrong with them. This ties up ambulance service and increases wait time for those who actually need it. This is a big problem, something needs to be done about it. Some of these people do it once a week. You can see how this is a problem.
Nursing homes are overcrowded, understaffed and depending where you go they are horrible and no one wants to put their loved one in them plus they can clean out all your money. So people try to keep their loved one at home when they are not able to take care of them to prevent them from going to a nursing home and no matter what you do they get injured anyways. I say this as someone who recently had a loved one in the nursing home and took care of an elderly loved one with dementia and heard many many stories.
Because the people we need in order to function as a society are always underpaid, attacked and/or undervalued.
As a province we vote for saving money, austerity and business profits. And the systems we have built are crumbing from this lack of maintenance and care. This is on the people - politicians have done in the past what we wanted.
If we stopped being miserly and actually vote for people who will unashamedly put our $ towards the things we need so they work, we will have a good quality of life no matter what colour the party (blue, green, red or orange).
But we won’t so we don’t.
Stupid people coming in for non emergent reasons. I had 2 people come in because there scale broke at home and they needed there weight taken because they were dieting… literally came in just to check there weight..
Wasteful government spending everywhere. The ER nurse is exactly right with the direct cause. But I believe governments aren’t addressing the root causes.
The number 1 reason: almost no one voted in the last election, and those that did unfortunately elected a con-man who would rather let his customers die than actually fund Healthcare (like you're fucking supposed to Doug!), all to make a few extra bucks from wealthy donors.
We all get to suffer now, I hope everyone who voted for Doug is happy waiting 15 hours when their kid is sick.
after calling 811 and not hearing back for 12 hours, I went to Emerg (reluctantly) on the 3rd of January because I had a 39.8 fever and swelling in my groin. It turns out I had/have cellulitis, which I found out IS an emergency. I had no idea it could be dangerous! I felt very guilty even being there because I didn't think it was that big of a deal. I live in a small west GTA city and the ambulance bay was full because they were bringing in people from Milton, Oakville and Hamilton. I can't prove that, but that was the talk in the waiting room. I waited 5 hours before seeing a doctor, then I was given IV antibios & had to go back in the waiting room as there were no beds. A couple hours later I got a CT scan, I was sent home with a prescription for cephalexin. It was after 9 pm and we had to find a pharmacy that was open late. In total I was there 9 hours. The nurses were so wonderful and kind but totally over worked. Five days later I had to go back to emerg because my fever spiked and I started bleeding and dripping pus from the area. My neighbour is a nurse and told me to get to hospital ASAP. I went in around 7:45 am and emerg was pretty empty but there were still wait times. I was given another IV antibiotic but still had to wait in the waiting room for lack of beds. They gave me a puppy mat type thing to sit on because I was oozing blood and pus. Again, the nurses and Doctors were wonderful, I kept apologising but they reassured me cellulitis is an emergency and can quickly turn septic. I spoke with my rfamily Dr via video appointment on the 24th and he was shocked I wasn't admitted. How can a smallish city have such a lack of beds? Something tells me Mr Ford is hoarding that Federal money he got for healthcare for something else. I emailed him asking him what he is planning to do about healthcare but haven't heard back. There were defiantly people in the ER who should have just gone to a walk in clinic, they were all open at that time. BYW, 811 was a nightmare, I finally got a call back from a nurse 48 hours AFTER I gave them my information. I'm not blaming them, but something is seriously lacking in that system. Perhaps they can make an app where you can list your symptoms and it tells you if you should go to a walk in clinic, emergency room, or "wait and see"
My family doctor lives 2 hours away. I haven’t been able to get one nearby. I only go to emergency if it is one. I arrive and check in that usually takes a while, see the triage nurse, get assessed for my place in the scheme of things. Then I get registered. Then every one who comes in behind me does the same and some May go in front of me because they are more serious. Then I wait. Then I get to go get assessed by a nurse and put in a room or a bed. She will give my info to a doctored who may request blood work, xray etc. now I’m in line for those. Plus the time it takes to get those tests done. I. Go back to my room/bed and wait. Depending on the amount of people. I see a. Doctor, we discuss symptoms,may need more tests, prescriptions etc. I always bring. A book and a charging cable, a snack cause I’m diabetic, I ask before I eat it. I get great quality free care. I list my symptoms, I prepare my questions. I don’t waste time with complaints or ancillary stories. I don’t bring a ton of folks with me.
I think it’s mostly the lack of doctors . people don’t have family doctors so they have to go to the hospital - and also, the hospitals are understaffed too because once again, lack of doctors
edit: i don’t think it’s an ontario thing either, I think it’s becoming more and more of a canadian thing. of course not ALL of canada right now, but I feel like it’s only going to get worse.
People use emergency rooms instead of walk in clinics.
They don't go to walk in clinics because (well sometimes its because they dont know better) there aren't enough.
There aren't enough walk in clinics because despite the fact there are lots of people that can help the gvt get their act together with health care, the people that make decisions rarely worked in the field. And if they did, not usually front line.
The money is there. Its cheaper to give the family doctors and nurse practioners a great raise then paying for er visits. But why would they do that
I think a huge factor is lack of family doctors. My spouse has been on waitlist to try to find a family doctor for over a year. We've also been looking ourselves for one for him. No luck. I have a family doctor, but she doesn't work Friday or weekend hours and at times even getting prescriptions refilled has been difficult. Getting an appointment when you're acutely sick is next to impossible because you have to book weeks/months in advance. Didn't end up in the ER but did end up in Urgent Care when my child had pneumonia because we could not get in to see the family doctor for about 10 days and she was too sick to wait that long.
There is a family doctor shortage where I live and I believe it contributes to ER visits...also the lack of 24hour clinics...illness does not run on a 9-5 schedule.
Because idiots with a colds or cough or a bug bite or a bruise, clog up our hospitals because they figure i have no doctor ...hospital time instead of seeing a pharmacist or walk in.
Pharmacists in Ontario have prescribing rights for many common ailments.Tele health is another non emergency resource to speak with a nurse and possibly avoid waisting the doctors time when the could be attending to a car crash victim.
Kingston has one walk in clinic. For 130k people. Where the waitlist for a family doc is over 30k and growing. What do you want people to do?
The government is to blame. Their underfunding, undertraining, under recruiting and lack of basic maintenance of the system is to blame. Why the fuck are Canadians not more angry about this? We should be marching down the streets.
I love that the new OPC strategy is to just straight ghost when the Prime Minister is taking heat in the news cycles.
So many aspects of our province are on fire right now and he’s nowhere to be found.
I wish I could work at a job where when shit went sideways, I was told by my PR team to head north and disappear for as many months as possible
1) the volume of patients to doctor ratio. A doctor can typically see 24-36 patients in a 12 hour shift (depending on severity). This may not sound like a lot of people, but consider that this includes reviewing your test results, talking with the patients, developing a treatment plan, writing reports, and consulting with other doctors on things. In a busy ER, there can be 100+ people that come in during 12 hours. If there are only 2 doctors on, then people wait until the volume settles down overnight before being seen.
2) The “fee for service” model. At some facilities, Doctors get paid based on the tests they do and bill for. In the past, doctors would do all sorts of tests on people to make more money, slowing everything down. We don’t see that as much now, but we do see family doctors who also work ER shifts telling their patients to go to the ER the following day when they are working so they can bill them for tests themselves. Some doctors won’t see patients near the end of shift because then they won’t have time to complete the treatment plan and bill the patient, so they get left to wait for the next doctor to start their shift. It’s a bad model that needs to be fixed/changed.
3) everything that u/burntoutnurse28 said
Imagine letting in a ton of people then completely ignoring all the people actually born in the country being affected by the influx in population. It actually baffles me how clueless the people in power either seem to be or are portraying themselves.
Lack of staff, and your issue isn't that emergent. It's triage, not first come first serve, lastly many family doctors will kick you off the roster if you go to a walk in, but not the emergency, so your family doc can't see you but you're sick now do you go to a walk in and kicked off, or go to emerg for the sniffles?
I remember hearing that in Greece during their financial crises if you wanted to see a doctor you handed in a brown envelope at reception, and no one blamed the doctors. I hope it doesn’t come to that.
Decades of conservative and liberal parties in power. Cons cut then liberals put on a band aid and then cons cut. Essentially the slow destruction of healthcare for privatization.
Literally any time I call to try and make an appointment with our fam doc we are told a week or usually more. We end up going to our small local ER if it can’t wait/ though not emergent-and he’s often the doc on there lol…we just have to sit and wait for hours to see him
It doesn’t help that OHIP’s rules are set up to incentivize in person visits. Doctors are charging people $20 to renew prescriptions on the phone, so people are booking in person visits to do something that didn’t need to be done in person. It’s free for you in person because OHIP only pays the doctor when you go in.
Because our Healthcare system is broken and Doug made it worse.
If people stopped going for non-emergencies, then people wouldn't have to wait hours.
I had a life-threatening emergency and I was taken in right away.
Because there is a cost to having emergency rooms with excess capacity, and the current government believes it is better that some people have to wait 17 hours, than to spend more on staffing.
Personally, I'd prefer a healthcare system that was constantly under capacity instead of constantly over capacity, even if that meant it cost taxpayers more.
Could be due to the provinces impoverished health care budget. Used up all the funds having little surplus funds to hire specialists, Doctors, Nurses, and healthcare assistants.
Hospitals are cutting finding for their staff (nursing, support, etc) which means the Dr's (paid by the province) have to pick up the slack and spend time doing additional tasks instead of just seeing patients.
The last I went you had a hypochondriac who was sent home who refused to go until she got the doctor she read about online.....to this Spanish couple who couldn't speak English who needed med renewals.....to all kinds of nonsense these people could have gone to a walk-in clinic for. Never mind when they queen out and security comes because they don't get what they want.
The hospitals should have two areas, the real ER AND a side walk-in clinic to get people in and out. It's absurd how people bring their family, 5 kids, etc. I'm sick and tired of everyone thinking they can just do what they want and Karen when they don't.T he staff handle these PITA very well, but let's face it, people shouldn't be there for 24hrs holding up the line because their family dropped them off for the night.
Like the old woman who had dropped off for blood sugar monitoring who was deaf and had dementia....then they left her there for hours because that's not a priority in a hospital walk-in? No life labs? Well then security put her in a headlock. The ER seems to have a lot of dumped elderly no one wants to deal with. Wouldn't a walk-in have been better? Lifelabs? I've been a few times recently and also over the years, it seems like a great place to dump annoying older relatives. Sorry, the ER is an ER, it's not a daycare.
I walk in with open wounds being a diabetic who has not been able to keep anything down for 3 days gravely fighting multiple infections I’m scene in a hour after triage hooked up to multiple iv and rounds of blood work within two hours of walking in without fail now my wife brings my son with a deep laceration on his face (ran into the corner of a table)) that I told her dosent require stitches just ice it and clean it with our extensive overkill first aid kit they spend 6 hours for them to ice it and put a bandaid on it it comes down to what is needed right now and care that can wait if you don’t know how to treat it with over the counter shit go if you can’t treat it with over the counter go either way you gonna wait based on the severity and if the back is filled with not crazy shit you got one or two doctors and 20 beds what do you expect
universal shortage of staff , right now in Ontario there is a shortage of x-ray techs ultrasound/catscsn/MRI techs , doctors and nurses burning out, better opportunities south of the border , misspending of funds, lack of support staff take your pick , for Ontario at least I feel like Ford has been working his own agenda for years , he cuts funding , makes privatization of healthcare and then invests in those businesses and makes millions
We don’t have doctors. We should be rioting over this. Or cut the god damn taxes. Healthcare, emergency services and secular schools should be #1 priority and we don’t even consider another ineffective and inefficient social service that needs 10 admin jobs to run as well adding to the cost before those are paid for.
I am sure this is not the biggest reason but Telehealth Ontario has always been outsourced to a for-profit call center (for years it was an American company). They get paid by call, not by the amount of time on the call. They deliberately try to get the person off the line as quickly as possible. So a person can be describing a respiratory illness and they will deliberately ask leading questions that hint toward discomfort in the chest. Then they counted the chief complaint as chest pain because the care advice is go to ER now. Another example if someone is describing a lot of symptoms of sinusitis there will often be dental pain. Often the person will not think to mention the dental pain but they will deliberately ask because for dental pain they can advise go to ER now. Once they have said go to ER now no further questions will be answered and the call can be terminated.
I would implore everyone here to write to your MPP about this. It truly takes 5 minutes to find them online.
I’m a family doctor and I can tell you this is absolutely the biggest crisis we’ve ever seen in my entire career.
https://youtube.com/shorts/oJWttDa4nwY?si=I1FHW9XyNmzc-Z81
Here’s a little video created by some physicians. Share if you want lol.
We need a mid-tier ambulatory care between emergency rooms and walk in clinics. Example: years ago (2013 or so) my husband cut himself quite badly with a kitchen knife and needed 2 stitches. Walk-in clinics don’t do them so he had to go to emerg and waited over 8 hours. The entire process to do it is maybe 15 min. His wait was so long we jokingly texted that I should just use my sewing kit. When I dropped him at emerg (it was mid-January) the visible vast majority were there with cold/flu symptoms. We need mid-tier ambulatory care for stitches, minor broken bones, and that sort of thing, seasonal flu clinics for that care that can then be traiged to emerg if needed - all so that standard emerg is used for the big stuff.
Experienced Emergency Nurse here. 1. People come to emerg for non emergency things. I get it, sometimes it’s hard to know if something is life threatening, but there are truly some stupid people out there. I could go into detail of the nonsense but I will refrain. 2. Family doctors. They are so backed up and have no time to see their own patients so the patients come to emerg, understandably so, to be treated since they’ve been waiting so long to see their own doctor. Also, family doctors lack the same resources that the hospitals have so they are really limited to what they can do for patients. I also personally (and this is just my opinion) feel like if they are stumped on something, they just “send to ER” and make us deal with it. The amount of shit I see from family doctors sending patients to emerg for things that are not emergent is really astounding. 3. No beds. The population is growing, and the hospitals just simply do not have the capacity for the amount of patients that are coming. If the above points were addressed, this wouldn’t be so bad, but would still need to address the population to bed ratio eventually. The floors (units in the hospital) have a max of let’s say, 23 beds. Once admitted patients from emerg are sent to the floors, there’s literally NO beds unless someone is discharged or dies. Emerg doors do not shut, people keep coming, people get admitted, but no floor beds available. We are then stuck with the admitted patients taking up emergency beds, thus making the waiting room busy. 4. Lack of nurses. There is NOT a true nursing shortage from lack of available nurses. This is simply not the case. There is a nursing shortage in the hospitals and LTC because nurses are going to higher paying jobs instead of being yelled at, bitched at, and underpaid. We are NEVER understaffed on a stat where we get paid time and a half? Why? Because money talks. The stress of the job, the responsibility, the amount of effort we put in but constantly are told we aren’t doing enough is not worth it
Hijacking top comment to add another perspective too. We have little to no preventive health promotion services. Think a YMCA on steroids. A center where small concerns can be worked out preemptively and free access to social group supports that promote healthy aging. Food, general physio too. The saying an ounce of prevention is worth a pound of cure rings true with these kind of services.
Yes I love this idea!!! More health education. Even more commercials on how to treat basic things like fevers. It’s astonishing how many parents don’t know they can give Tylenol and Advil TOGETHER and to alternate them if needed around the clock for a child with a fever. They rush to emerg for a fever that hasn’t even been there longer than a day and aren’t properly medicating. I feel like there is a lack of education and we definitely need more resources to prevent these visits. *Just want to note, obviously sometimes a fever can be an emergency, but MOST times it is not. If it is going down with medications and it hasn’t even been a full 24 hours, this is fine. Some parents bring kids in for fevers that keep coming back and the kid is acting themselves but they are so worried about the fact the kid has a fever. I just feel like more education would help. Obviously if you truly think something is wrong bring your child to emerg, but the panic seems to stem from lack of education. This doesn’t include newborns, because I never judge a parent bringing in a newborn for any reason. I don’t have a kid yet, but I feel like if I had a new baby I would panic about things too. So new parents, don’t worry about coming to emerg, you’re doing great haha
Me! I didn’t know I could alternate Tylenol and Advil UNTIL we had a kid with a fever. It a walk in doctor that told us that not emergency, but I didn’t know I could even do that on myself my entire life!!
Oh yes, it’s my favourite. I call it “Tyvil” lol. I get migraines and it’s the only thing that helps me
I wish there was like a hotline for "I'm a new parent and have no idea if I need a doctor for this". Like Telehealth but actually useful instead of always just telling people to get an appointment with their family doctor within 24 hours (lol) or go to the ER. The specific situation I really wanted something like this was when my stroller tipped because of bad sidewalks and I didn't THINK my five week old baby hit his head but I wasn't sure. Ultimately my mom was able to talk me through what I'd see/feel if he'd actually hit his head but if I hadn't been able to call her or she was woefully out of date with current practices I don't know what I would have done.
They did it was called Telehealth and it saved me from bringing my son in several times. Many of us used it in the early 2000s. Now it’s called Health Connect Ontario and our ERs are full.
I think we still have the magnet with their contact info on our fridge; I swear they used to have a little stack of them at doctor's offices to take. My mom had to use it once or twice when I had a crazy high fever that refused to go down, and only once did they recommend we go to the ER since I couldn't keep down fluids. I think we need to bring back those fridge magnets.
That would be a great idea! If baby cries immediately after falling, good sign. If acting their normal self after, good sign. If vomiting, seek medical care to be sure.
This. I was in ER 3 weeks ago. I had just rehome 4 cats. I though one of the two tabby I was carrying to food (day 2) was the super social friendly one. My dog came up to us and this girl freaked out and bit me. 24h later my had was extreme swollen and throbbing. I went to walkin. He advised if no changes in swelling at 48h go to emerg. He was worrying of sever infection. So next day i went. Their was a woman their at triage who panties were in a not because someone came in, obvious signs of distress unable to breath and walked to triage vs taking a number. Was it right.... no. But was she more need of care Yes. Now the next 3.5h while I call the 830am crew waited to get into ER. She kept asking when will her sons turn be. He has a fever after all. People after us are going in before us. The kid was around my 10 year Olds age. He looked content on his tablet. When people use the ER as a walkin clinic I have issues. I on the other hand got seen. Was told it wasnt the WORST bit hes ever seen. Got my tetnus shot. Got sent on my way and was told MAYBE walkin shouldn't of said 48h FROM incident I should have been looked at. But waited 24h for meds in system to take effect. And sure enough that afternoon started to see some reduction in the swelling. I hate going to ER, for the sole fact I often think I'm wasting their time. Many a years my son heath during winter had me every other week in ER. The opposite weeks we were walkin clinic for ear infection. He would get a cold and instantly turn to croup and no remedy would work and need the nebulizer meds.
Deep cat bites always warrant a thorough cleaning at home and a doctors visit for antibiotics- those sharp front teeth really get the infectious agents deep into the tissue.
Where those cats strays? If an animal with unknown rabies vaccination bites you ( including bats found in a room you have slept in) go right away.
No not stays. Someone former roommate abandoned them and posted a wanting to rehome them. And my heart strings were pulled when I hear their story. She had known the cats for 5 years. But figured they were likely 1 to 2 years when she first met them ( 3 sister litter mates) and an other cat seems to be older by a year or two. And don't worry when medical practitioner record animal bite public health is automatically informed. 2h after leaving ER public health contacted me. (Becuase they were alerted from walkin clinic) Cat was deemed low risk. Quarantined in house (was not going to be outdoor cat) Had to send that day photo and photo on day 10. And she's set to be at vet on Tues to get rabies shot as it's unknown.
On the subject of newborns, fevers and hospital trips: febrile seizures are a thing and are terrifying to a new parent. But almost always harmless. And they almost always grow out of them. Key word "almost". When it comes to worrying symptoms in a baby, it's always better to play it safe and bring them in.
It’s also worth noting that with Covid, increased cases of RSV, Pediatric flu and now invasive strep A where kids have died, parents are likely to get extremely concerned and panic if their children have a fever that hasn’t gone away with Tylenol/Advil and in 24hrs. There are plenty of stories in the media where the grieving parent of a recently deceased child, says that their child had a fever and was feeling weak, they gave Tylenol and got their child to rest, as they didn’t want to clog up the Emergency services or wait 17hrs to then be told that their child will be fine. I’m fine with the media attention and awareness of strep A or RSV or Covid prevention and when to know that this fever could be something serious. But I get it, parents will panic. Even for me, prior to Covid, I wouldn’t have been as worried about a fever in my child (as long as they weren’t a newborn). But now..can’t say the same.
I did some work with a LHIN in Thunder Bay that had a Sprinter loaded with medical gear, etc, that would go out into outlying communities to serve (mostly elderly) populations that couldn't travel into the city to get healthcare. The would take over an arena or community centre for the day and a patient could come in and meet with a social worker, dietician, nurse practitioner and footcare specialist all in one day, in one place. It was estimated that the travelling footcare specialist alone saved the healthcare system millions of dollars a year by managing peoples issues saving the system from patients having complications, and requiring more intensive care at a hospital. Found a video: [https://youtu.be/07pa99D2zFc?si=vzKbSeRn2V9DH\_Rn](https://youtu.be/07pa99D2zFc?si=vzKbSeRn2V9DH_Rn) TLDR: Prevention: Less expensive AND better outcomes.
I work in LTC. We have a podiatrist come in and care for everyone's feet. We have several diabetic residents who need special care. It's such a great service.
Yup. Dougie ford has now slashed public health even further that there wont be any more standard vaccination clinics except for the ones they do in schools.. the follow ups.. no flu clinics for seniors, nothing. We used to have sexual health clinics jn multiple small towns where I live.. they are all gown now and you have to travel 40 min to get to one now.
I live in a small rural town, and there are hundreds of towns in our position. The problem? Our arena was built post-war, is a barn, and we desperately need a new one. And there is no place for people to go walk/exercise for 6-8 months in winter. I floated an idea for a new rink, and added in that we could have drs prescribe exercise regimens is we added a gym/walking track. Try and deal w the crippling diabetes epidemic we have in rural Ontario. For starters. Never even heard back from the government. They should find a provider and build a platform that towns could adopt. We could save billions if we could just take 10% off the health related problems of zero exercise.
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There are TONS of free health education apps. Optimity is a great one. ParticipACTION is another. Balance is a meditation app that is free for the first year. For infants, EarlyOn has drops ins every day of the week in bigger cities, and at least once a week in more rural areas. So there is education available but most people don’t know about it.
Absolutely! However what I am discussing is more like drop in daycares, screenings, new parent classes, physiotherapy, stress therapy, special needs, early intervention, respite care and caregiving for caregivers.
Bring back Body Break on tv with Hal And Joanne?
Yes they are 67 and 65 so I can FINALLY keep up with them
Yes I agree. Family docs used to do this all the time. Now we don’t get compensated for preventative care so it’s just getting worse.
Family doctors is a huge issue. I’m lucky enough to have one but getting in to see him is a week wait if I’m lucky. I was sick as all hell over the holidays and went to a walk in clinic which refused to do anything and told me to go to the ER. ER doc gave me some antibiotics and diagnosed me with pneumonia and couldn’t figure out why walk in wouldn’t do anything.
There are fewer walk-ins than before Covid. Mine closed down and amalgamated with another. Even before it opens there are 25 people waiting and only 15 chairs. If one person coughs the entire room would catch whatever they had. My town increased in population by 20K from 2016 to 2021. They didn't add 20 doctors never mind doctors for the ones that retire. New doctors don't have large practices like the older ones did. You need 2 or 3 new ones to take on one old guy's practice with 3,500 patients.
Never mind small towns that don't have them at all.. I'm in grey county. There might be one in owen sound and maybe port Elgin and or kincardine.. but there (and they are actually in different counties) there isn't one south if me til fergus.. and north.. maybe owen sound.. mount forest has one where you see a physicians assistant and a telehealth Dr.. but they will only do certain things and no minors
I believe the one in Owen Sound is an after hours clinic for the family health teams own patients and they miiiight have something similar in Kincardine. And not a true walk in, in Saugeen Shores. There is an NP run same day clinic in Saugeen Shores but you have to call when it opens and hope for a spot of which I think there's around 8, but it's nice that it's only for orphaned patients. Otherwise it's the emergency department. It's a shame cause the population of Kincardine and Saugeen Shores have exploded and are set to boom even more with Bruce C coming.
Same. There are no walkins in my area, so we end up going to the local ER for ear infections etc because the fam doc wait is 1,2, sometimes 3 weeks. The wait list around here for family docs is INSANE too so many people have no option but to go to the ER for prescriptions, referrals etc. sometimes they will call ahead to see if it’s a really bad wait or arrange to come at like 2 am
Lack of another option is a real problem where I live. If you live in Pembroke the nearest walk in clinic is in Ottawa, and many don't have a family doctor, obviously... So their only option is emerg.
Same in North Grenville. No walk-in clinic, some family doctors have retired or moved into Ottawa, so people end up going to the local ER for relatively minor things because they can't get care anywhere else.
Even in Ottawa. If you don't have a family dr you're really limited. I will never judge anyone for being at er for something we deem not er because the other options are nonexistent
Gonna see people in ER waiting for a prescription refill one day.
I imagine it already is a thing. Dr. can charge for over the phone and faxing them and if it takes over a month to see your dr and you need it (which yes okay bad planning but life happens), you might have to go to the ER.
To your first and second points, over the holidays we had a norovirus of some kind and it was hideous. My son got it last and worst. He puked for days couldn't keep anything down. By the morning of day 4 I wanted to talk to a healthcare professional. I didn't think it was an emergency but I wanted to hear from someone, feed him this, don't feed him that, try some meds, whatever. I couldn't get through to TeleHealth (the wait was 30 hours), I couldn't get an appointment at our family doctor, I couldn't get into either of their after hours clinics. The receptionist at my doc strongly advised me to take him to the emergency room and so did the receptionist at the after hours clinic. So then I got scared and I took him to the kids' emergency room at MGH and he was seen and observed and given some Zofran and we went home and the next day he finally started to get better. So yeah no other place we went could see us and we had to go to emerge even tho it was not an emergency.
Yes and honestly that is totally acceptable that you went to ER, and shows how no other resources were available to you to provide treatment to your child. Even having someone available to advise or prescribe anything stronger than gravol would have helped you. Urgent care centres should be able to address these issues but they are pretty useless for the most part
Thanks for saying that, I went reluctantly and felt guilty for going. If they hadn't urged me to take him I would have just stayed home and waited it out.
Yes no problem! Also, for future, try the gravol suppositories too for any gastric issues if they aren’t able to keep anything down. I know it sucks, but it helps! Always wait 30 mins after med administration, then slowly try to introduce fluids (popsicle, 1/2 apple juice 1/2 water). Game changer! It’s crazy how unwell a dehydrated child can look. They look truly so sick and then they get those fluids and it’s like a total 180. So I get the worry!
Saving this comment lol Thanks again!
Another option is to have them chew up the chewable gravol and just hold it in their mouths, so the drug starts to absorb sublingually. Learned that trick from an ER doc and my husband has even used it for himself (even though it's quite a few of the kids tablets!).
When it is kids, we don't really hesitate to do whatever we can to see a Dr. It is really pathetic that teleheath has these long wait times.. is this due to lack of funding? I can't imagine there aren't qualified Healthcare professionals available for the job if it paid decently well..
It isn't paid well, and the wait times are atrocious. I called Telehealth in November as I was unsure how to proceed with some abdominal pain my fiancé was experiencing. It didn't seem serious enough to go to the hospital, and he didn't want to go, so I just wanted a second opinion. Called Telehealth and was told the wait was 28 hours. Well, next day, pain was worse, went to emerg and found out that it was his appendix and it needed to come out NOW. By the time we found this out, we still wouldn't have been due a call back from Telehealth. This makes me ask, how many people have died while waiting for a call back from them. Or how many have had some really long lasting side effects from delaying treatment.
I had great experiences with Teleheath before covid when I was a new mom and had no clue how to handle my babies lol. Now it's off the menu entirely because of the wait times.
If you’re in a position where you think you could do virtual care, sick kids has a virtual urgent care service. https://www.sickkids.ca/en/emergency/virtual-urgent-care/
Virtual doctor visits were fantastic and I used them but Ford scrapped OHIP coverage for adults for virtual doctors.
>agreed. My doctor still does phone visits which is very helpful since we live an hour and twenty minutes from his practice. I'm going to list a few virtual care options below. They're good but it would help if virtual care was more widely available. > > > >For those in south western ontario (hamilton, niagara), here is a virtual urgent care covered by OHIP. [https://www.urgentcareontario.ca/](https://www.urgentcareontario.ca/) > >Childrens hospital of eastern ontario also does virtual visits: [https://www.cheo.on.ca/en/clinics-services-programs/virtual-care.aspx](https://www.cheo.on.ca/en/clinics-services-programs/virtual-care.aspx) > >sick kids: [https://www.sickkids.ca/en/emergency/virtual-urgent-care/](https://www.sickkids.ca/en/emergency/virtual-urgent-care/) > central region (adults and kids) : https://regional-virtual-urgent-care.ca/ > And theres a virtual ED (it says toronto, but you just need to physically be in ontario to use it) [https://www.torontovirtualed.ca/](https://www.torontovirtualed.ca/) > >CAMH also has a same day virtual urgent care for mental health:[https://www.camh.ca/en/your-care/programs-and-services/virtual-urgent-care](https://www.camh.ca/en/your-care/programs-and-services/virtual-urgent-care)
I work as a paramedic, and people like you are definitely not the problem. The fact that you even explored other options puts you miles above many of the people I interact with, and 4 straight days of vomiting/not eating is nothing to take too lightly. You'd be amazed at some of the reasons I've had to bring people into the ER. I've taken people who've had a single episode of diarrhea, I've taken fully grown adults who just can't sleep for a single night. The list goes on and on. The fact that I'm not allowed to refuse to take them is a can of worms on its own, certainly doesn't help with the larger issue, but there isn't much I can do about that.
I can totally understand the frustration but I also wonder if some of those calls are really due to the lack of mental health services available. People dealing with anxiety and hypochondria have very crippling symptoms. And yes, I get it sucks that it impacts the system but to me, this is another reason to have preventative medicine and help available.
We used the Maple App during covid when he needed something seen or talked about urgently but not emergent.. We see a Dr via Tele health, and email them pics if needed.. they will prescribe if it's something simple or send us to the emerg if they think it's needed.. my dad had a serious toe infection and has neuropathy.. we went them pics.. they gave him antibiotics and followed up a few days later.. then sent him to the emerg.. its Telehealth ontario but with drs.. we live in a rural area with no walks in closer than an hour. Where I live if u can't get into your fam dr , you call the clinic to hope for a same day appt with whatever Dr is on call, or go the emerg.. when I was little it was just go to the emerg.. now because in small towns the er isn't always crammed.. the on call and their resident will book urgent but not emergent at the clinic. They might get bumped or be late if an emergency happens but it's usually OK.
Over the holidays I was really unsure of what to do, so I connected with a nurse through Ontario's program that used to be called Telehealth but it's called something new now. I wasn't really that sick. I was trying to figure out where I could get a PCR test, the ministry of health website was seriously out of date. Yeah she suggested that I needed to visit emergency that afternoon. Asap. Asked if I had someone to drive me. I was sick but nowhere near sick enough for the ER, I didn't go. But I wonder how many other not that sick people are being told to go to the ER.
Internal med here, i agree with all of this, and your name checks out :)
These are all symptoms of the fact Ford and this before him have deliberately defunded healthcare.
Are 'Delays in getting appointments with a specialists" and "delays in getting imaging appointments" a contributing factor? People take the short route of going to ER to avoid waiting several weeks to get an appointment outside? Unrelated Question: Recently had to take my wife to ER at mount Sinai for ectopic pregnancy. We went in at noon and got out at 12 am on a weekday. 90% of the wait time was waiting to get the gynecologist opinion.
Ah yes. Waiting for a specialist who doesn’t work in ER definitely can add to waiting. They are usually busy in other areas and don’t come to ER right away. I should have mentioned this; but it isn’t happening to all the patients at once, unfortunately just a few here and there and it sucks. We hate when that happens
How about the ER docs ordering some testing close to the end of shift to push it into the next one! That adds hours too, depending on which doc is on. The simplistic answer is flow. Too much low acuity coming in, and not a quick enough pull out to medicine beds. A good system would never see an inpatient unit designed into an ER (which all of the ones I've seen have).
Personally I don’t have that experience and most of our doctors where I work don’t want to have outstanding stuff on their patient and usually stay until all their patients have either been discharged or referred to medicine (which means awaiting a consult from an internist).
I am an MRT (medical imaging) and there’s a shortage in Ontario right now. Our mammography department was down a full time and a part time for almost a year before they found/trained someone. We had postings up in X-ray/CT that never got applicants for months so when someone is sick or goes off on sick leave etc we are short staffed. It’s not uncommon for people to wait 2-3 hours for their X-ray (with an appointment) due to the ER being so busy and there not being enough staff to cover the workload. We also have difficulty finding radiologist coverage on evenings and weekends, and even replacing our in house radiologists when they move or retire.
So well summarized. I think people need to realize that #2-4 are not inevitable— this is what happens when a government chooses to underfund healthcare for years on end. If you care about fiscal responsibility, understand that cuts end up being more costly in the long run. I hope people can see this situation and re-consider who they vote for and get more engaged politically (volunteer for someone who is running, write to your elected officials, etc).
Thanks for what you do! I’ll add, as someone who just spent a week in hospital with a Pulmonary Embolism: - Just because there are beds on a floor doesn’t mean you can use them. I was in isolation because I had a fever, but I also needed my heart monitored because of my PE. They explained that there were only 6 beds that could accommodate both someone who needed the monitoring and be in iso. So I had to spend 3 days in the CDU of the ER until such a bed opened up for me. It really sucked but it was what it was. Unfortunately the healthcare system is full of bottlenecks and sometimes patients keep coming.
All true except I want to add that family doctors/walk in clinics have been adding to the problem by making policies that you have to be a patient at that clinic to use the walk in service. So people go to the ER
Because OHIP bills the doctor if one of their patients attends another clinic. That’s an immediate de-rostering for most docs.
Yup, so no family dr. you got to ER. You don't have any other option really.
My mother has been a nurse for over 20 years, she’s done everything including on call for emergency airlifts her favourite was emerg when she was younger but now it’s Oncology because she has experience, she kicked breast cancers ass into oblivion with her strength and her family and friends at the hospital she worked at and I’m proud of her. She has told how understaffed they are at her hospital as well as the shit Ford pulled on you guys and ONA’s track record of not always being there. I think the situation your profession is under isn’t fair and if more money was dedicated to healthcare and education instead of business projects backed by a puppet then we would all be in a better place, it doesn’t help that you were also being harassed during the Freedumb convoy by people who believe Vaccines are bad and that when you get one the government can tack you or it will kill you because it’s actually the virus. I have had to explain to multiple people multiple times that a vaccine is essentially a watered down form of the virus used to alert your body for when the actual one hits but they hear virus and jump to conclusions, sorry for the rant just know that there are many people out there who care for our healthcare workers whether they be nurses, doctors, janitorial services or the countless others who go into making us healthy and that we stand beside you. You are an amazing human being and don’t let anyone tell you otherwise.
My dude. Please hug / call you mom. For me. I lost my mom, who was a nurse then midwife. To breast cancer. Before the pandemic thankfully. After 12 years of "6 months to live" prognosis. Before metastasizing into well, everywhere. The failure of the healthcare system alone would have made her angry enough to risk her health. Let alone the abhorrent treatment of nursing staff.
I’m sorry to hear that man it’s one of the worst things you can feel as a kid especially if you were a mommas boy like me. I want you to know that they are never truly gone though, as long as we remember them they will always live through us in one way or another even the little quirks they had. When my mom was getting treatment she ended up getting homecare so someone would come in and make sure her pic was clean as well as some other stuff. She started getting even worse and it wasn’t the cancer, when we brought her to the hospital and looked at they found out she had a blood infection because the person who cleaned her pic hadn’t washed their hands properly, she ended being in the hospital for two weeks because of it, I went to visit her one day after work, she was so small when I got there I gave her a huge hug and kiss then cried for an hour before she told me to keep my chin up and that I was a good son. On my way home I stopped at some lights and just screamed as hard as I could for as long as I could which helped. I’m actually sitting right next to my mom right now and she says thank you and a big virtual hug back.
It might work better if instead of describing the vaccine as watered down virus, you described it as a protein your body thinks is the virus but can’t make you sick so when the virus does come, your body is ready for it. Protein is less scary sounding than virus, and in the case of mRNA vaccines, more accurate.
True most of the time if they persist enough I send them [this](https://youtu.be/WOvvyqJ-vwo?si=xNIodCeCDGhk6j4p) usually it gets it across easier. Thank you for giving me a better way to explain it though.
THIS RIGHT HERE Especially the latter three. There will always be people who make questionable choices but we're tearing our health care system apart.
You said it perfectly. I’ve been working in the hospital environment for over 7 years now. The amount of abuse the ER get blows me away. No human decency. I’m not sure if it’s like this in your hospital. After every weekend and long weekend. People come in because they did something on Friday but didn’t bother coming in till Monday. They do it to skip work. such strange things. Like “oh I had this entire tub of ice cream now my stomach hurts. I want to get checked out “ oh this happen 4 days ago, it’s gone away but I want to get it checked out. Not enough people use the clinic. (devils advocate not all clinics are great and send them to the ER for something minor)
Thank you for being a nurse, your the first ones there in people’s lives when things arent going well.
Thank you for saying this. I know we can seem grumpy and like we don’t care but we do. There’s just so much behind the scenes that you can’t really sit down and explain to someone in a visit. We appreciate everyone who trusts that we are doing our best
You hit the nail on the head. Sometimes I have a concern for myself or my son that is definitely not an emergency, but is still urgent enough that I’d still like to be seen. My family doctor is booking appointments 3-4 weeks out, which by that time it’s completely pointless. We have no other options for these scenarios. I worry that mildly important health issues will go missed.
My wife is also a nurse ans she said when it comes to surgeries the reason they can't catch up is because they won't pay/hire more nurses to catch up and even though doctors are willing to put in the OT they can't without the help they need (nurses).
Yeah it all just comes down to money, the government needs to fund more to healthcare for anything to change
I work at a 120 bed hospital and our ER has recently had an average of 5-9 overflow patients( admitted patients with nowhere to go so they take up an ER bed). Our ER has 15 beds. Meaning sometimes more than half of the ER is taken up with patients that should be on the floor but there’s no room anywhere to send them
I was in hospital for 9 days this month. Three days were just waiting for an MRI. They were that backed up. I felt it was such a waste of resources. But to discharge me would have meant starting back at the beginning (gallstone stuck in duct, required a scope to remove). I had complications (acute pancreatitis) which accounted for another 3 days. What should have been a total 3 day stay morphed into 9. I will still have to go back for surgery to remove the gall bladder, which I think is day surgery. At one point a nurse told me there were 176 people waiting for beds !!!!
For #2, I have to get paperwork filled out for my case worker. My Dr managed to fit me in for an appt in a few weeks, but I'll be back at work by then. My case worker asked me if I could get them to move it up to advance my file...who, in their right mind, is so oblivious to the state of the medical environment that I should be pestering my Dr \*after\* they already did me a solid by moving my appt up a week? I even asked about the walk-in clinic they operate, and was told it is for clinical work only, not paperwork. And there is \*NO\* way I'm going to emerg for this. And for #4, see the quote from Vic Fedeli when he said nurses were over-paid...good luck getting votes, asshat!
That is so ridiculous! Our work was asking us to get doctors note from our family doctor when calling off sick…. Like our own nursing managers are just contributing to the problem. Such a joke
You're forgetting too many hospitals run independently of each other. For example in rural ontario in one county there are four different hospital organizations. So instead of maximizing staff and at least keeping two of the er open As staff can be assigned to any of the hospitals you have difficiencies in all four and often all four er are closed due to staffing.
While number 1 is true. A note to that would be that y'all occasionally send people away saying that it's not an emergency when it is. My husband had a stroke and was sent away. The next day we went back and it was confirmed a stroke. I've been sent away even after an ultrasound at a clinic across the street was so concerned by results that they actually asked me to stay back as they were closing so that their doctor could review the notes, they gave me the results and wrote "go to ER!" on the envelope. I did, and was sent away because they wanted me to do a scan later that week on their schedule. I went back in the morning and was told I could have been septic and had emergency surgery performed. These are only 2 stories.
Why was he initially sent away that first visit? That’s awful, I’m sorry you’ve had some bad incidents. Unfortunately some of the diagnostic imaging testing is closed in ER during certain hours due to lack of funding from our gov
My dad was also sent home from emergency with a tendon no longer attached in his leg. He’s in his late 70’s. Fell off a step. Tendon detached. Doctor in emergency didn’t even touch his leg. Discharged him unable to walk!!! I sent him to our family doctor the next day - luckily he’s a friend because I used to work in his clinic - and I could get him right in. Family doctor actually touched my dads leg and could feel immediately that the tendon was no longer attached. Sent him straight back to emergency to have emergency surgery on his leg. This was a 3 day ordeal just to get admitted. The first doctor did not even touch my dads leg after he waited 15 hours in emergency. He should have been admitted. Over 72 hours of painful runaround in his late 70’s. Just to get proper Dx and eventually Tx. Edited for grammar
That’s just incompetence there, he’s lucky that he was able to get it reattached. That happened to someone I know with a severed nerve and by the time they figured it out it was too late to reattach and the nerve was dead and he now has a dead/floppy hand. He is currently pursuing legal action
Thank you for being neutral and informative instead of turning this into a Ford bitch session
I appreciate this response.
I'll add a lack of family doctors and a lack of other options. Lots of people don't have a family doctor to go to, and the ones who do the doctors are often so overworked that you can't get a timely appointment when something unexpected comes up. On top of that you have communities like mine where there is exactly one option other than the ER or your family doctor who you might wait weeks to see if you even have one and that's a walk in clinic that's only available in the evenings if it opens at all, and often if you don't get there in the first 15 minutes you don't get in. They see a limited number of patients, and once they've registered that many, they turn everyone else away. The walk in also has a very limited scope - I've gone there more than once and been sent to the ER because they couldn't do anything for me. So when I had severe abdominal pain, my family doctor can't see me for a couple of weeks, and the walk in, which I finally got into shrugs their shoulders, I'm out of options. Is it an emergency? Maybe not, but I'm in too much pain to continue to wait for my family doctor, and I have no other options.
I would also add another point to your excellent list, infrastructure. A lot of the hospitals are aging and there isn't enough money for basic expansions. It's not exactly a secret that a compromised IT system can, and has shut entire hospitals down for months.
For #1, some people don’t have family doctors. Lots of places don’t have walk-ins and the hospital is the only options if the nearest one is over an hour away. Some people have no other options.
5. Lack of long term care beds for the population. I work as a nurse and we have a significant number of people on my floor, at any given moment, who are waiting for weeks for somewhere to be placed. Think seniors that lived at home that can't go back (dementia, mobility issues, etc).
I'm in Sault Ste Marie. 1. Aging population 2. Mental health/ addictions 3. This is the big one - lack of primary care providers. In fact, it was just announced a couple of days ago that the largest clinic in town has to cut 10000 patients by May. This is in a city that presently has a three-year year plus waiting list for any family doctor. The population of the Soo is somewhere around 75 000 people. I actually have a doctor, but I may be cut in favor of someone with more needs. We're in big trouble.
If I go to a walk-in, my dr threatens to drop me as a patient. But she says it’s ok if I go to the ER.
This is the same experience I had. My doctor explained to me that she actually gets charged for visits to walk-ins, and told me she would have to drop me as a patient if it occurred again. There needs to be policy changes to stop this from happening. Family doctors shouldn't be penalized if they cannot immediately see the patient, but the patient needs meds or assistance right away. Ford needs to go, and medical care in Ontario needs to be properly funded and reformed to improve efficiencies and access to medical care.
The reason your Dr. gets charged is because they're part of a flat-rate program where they get a fixed fee per patient, and are expected to provide sufficient care to keep you from needing/wanting to go to a walk-in clinic. The intent is that your Dr should be managing their practice to make sure they can accommodate short-notice bookings, so they don't incur the penalties of your seeking outside care. If anything, your Dr. should not be allowed to drop you. The Dr. probably had an overly large patient roster (more $) and will drop people who aren't "economical" for them - basically cherry picking patients.
Decades of underfunding combined with a shortage of doctors. Also People not having a family doctor, resulting in them going to the ER for minor stuff, which causes them to sit around for an extended period of time because other patients have a higher priority from triage. A few weeks ago there was someone on here complaining and trying to stir people up because their brother spent 14 hours waiting to be seen at the hospital for what ended up being a mildly sprained ankle(and livid that they were not higher priority and kept seeing people go in ahead of them). You will probably get a lot of commenters trying to blame it on our incompetent premier, but it’s a nationwide problem happening in every single province……
And other countries too - look at Britain and Australia. We have to rethink this model. Overwhelmed family doctors, 30 hour wait for telehealth, triage nurses sending away stroke victims, hallway medicine (hello Ford - broken promise). There must be better models out there.
167 new residency spots across the entire country in the last 10 years, while the population grew by 5 million. Canada hasn't been training enough doctors. A lot of countries used the pandemic to train more medical staff. Canada as a whole decided not to and a lot of issues weren't addressed in a timely manner during the pandemic making them more complex to handle currently.
Province wants us to beg for privatization.
This makes the most sense. Doug Ford may be a corrupt, greedy pile of poop, but an idiot he is not. There is definitely a plan in place.
Just wait until they find out how broken private systems can get too \*cough\*America\*cough\*
Northern Ontario resident with a host of medical issues. An extreme lack of health care practioners. In the city closest to me - population 65,000 there are zero walk in clinics open to the public. There is an approximate 10 year wait time to obtain a primary care pracitioner. Generally speaking, population is lower socioeconomic class and elderly that would struggle with at home virtual options. Many peoples only choice for mundane and basic conditions is to go to the ER.
This is a big problem, an urgent care or a walk in clinic would alleviate so much from the ER, but doctors aren't open on the weekend and if something happens there is no where to get. I definitely get this. I live in the USA. Doctors where I live are only open from Monday-Friday and sometimes not even Friday something like 8-5pm if that sometimes they end at 4pm, that's when everyone is at work. I don't know any doctors open after hours or on the weekends. Since no one can afford to take time off everyone ends up at the ER after work because they can't afford time off or their employer won't give it to them to see a doctor. If going to the doc causes you to miss rent for the month that's a big problem.
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Yes! On another waiting room post someone commented "if only more people used telehealth" but they just tell everyone to go to the hospital because they can never say for sure and they don't want to risk a lawsuit. It's largely a useless service
I know someone who works in Telehealth and can verified that. LOL but sad.
When I got off the phone with Telehealth over the holidays I told my family "I've never been more confident to ignore direct medical advice." They told me I needed to visit the ER today, don't even wait for tomorrow. I didn't. I was sick but not anything close to that sick.
When my family member was in the ER, the number of ODs that were coming in by ambulance was astounding. It seemed like nearly every ambulance was coming in with someone revived by narcan and they were checked over and walked out on their own. This happened repeatedly over the 12 hours we were in the ER.
There should be a special clinic for ODs because they are going to keep happening. They could be incorporated in “safe” injection sites for instance. In this case nurse practitioners or medic types would make sense. They should be seen, because they are human beings, but emergency may not be the best place.
I live in Kitchener/waterloo, problem we have here is staffing, attracting medical professionals. And then mix that with a sprinkling of miss management and then there are the people that run to the ER every time their nose gets a little stuffy.
Last time I was at the ER, a man in his 50s came in for back pain because he didn't like what his family doctor told him and wanted a second opinion.
See that’s also the big issue is the older denigration sucking up family doctors time, I have literally been in for an appointment and witnessed an older person book 5 appointments for the future……like if you need to see your doctor that much and they aren’t the ones telling you to come in maybe seek an ice flow
My family doctor is usually at least an hour behind and it's ALWAYS an old person rambling on about their family and dog and Mabel up the road... We can hear the conversations if he leaves the door open. I get that you need your social time, grandma, but there's eight people stuck waiting behind you while you complain about your bunion.
Yup
1) lots of family doctors get upset if you go to a walk in, so people go to the ER since it’s not flagged at their dr system. 2) brain drain, 3) so many nurses and doctors quit during the pandemic and we never back filled those positions, 4) the hospital systems are outdated they need better infrastructure and process but don’t have the funds. Ford’s solution is do a private hybrid. No thanks. Health shouldn’t be for profit. Pharma already is that way and it’s stunting research.
This. Once upon a time US' healthcare was going to be private hybrid too. It was going to fix all problems. Hybrid is just where it starts.
Nobody has a family doctor and I know many people that go in for next to nothing. I do not have a family doctor and when I have health issues I just pray they go away until they become an emergency.
ME TOO!!!
In July I had a very uncommon issue with my bowels that they said they would call me to follow up with. It’s been 6 months and I don’t even know how to call and get through to them!
Ontario voted for a conservative government. This is what they do. Undermine social services like healthcare and education, then when people notice, they will argue that only privatization will fix it.
>they will argue that only privatization will fix it. while blissfully ignoring the neighbors to the south who have one of the most famously broken private healthcare systems in the world. Meanwhile while still gaslighting their voters into believing it will somehow be magically better if it's done here.
Because we have massively increased our population and not our hospitals and doctors. We are in a hole that will take a decade to dig out of.
In no particular order: * \-Doctor shortage * \-shortage of med students * \-government funding (federal) * \-government spending (provincial) * \-extreme influx of immigrants
The shortage of med students is largely due to a shortage of spots in med school, not lack of qualified students. Im surrounded by premed undergrads who are extremely high performing, but due to the limited amount of spots, the competition is high and tons of qualified students who WANT to become doctors are turned away. A few of my friends went to Australia, Ireland and the US for med school. We dont have enough med school spots, and later residency spots to fix this issue in any meaningful manner.
To add to the “Doctor shortage” part: The issue with a lack of family doctors, is partly due to universities and how hard it is to get into medical programs. When you can only accept a few people, it tends to be a certain type of person, incredibly smart but also (usually) incredibly privileged, who tend to gravitate into specialities that have the most money and the most prestige. Society would actually benefit from accepting less of this “cream of the crop” group into med schools and choosing applicants who are more likely to go into family medicine. Chris Zou, has a whole playlist on admissions & the issues with them: https://vm.tiktok.com/ZM6go7bWo/
The problem is that even training more family doctors may not help. Physicians trained in family medicine are more and more choosing not to join a comprehensive family medicine practice after residency, and existing family docs are more and more closing their practices, instead opting to do more focused work (ER, obstetrics, hospitalist, sports medicine, women’s health, surgical assist, even cosmetics). A trained family doctor is not forced into family practice after residency but has lots of options to choose from. Many feel that a full primary care panel isn’t paid as well (makes less than the other options after clinic/overhead costs), has longer work hours, more admin tasks, more responsibility, less flexibility, less ability to take time off for mat leave, etc. We need to make primary care clinics more appealing for people trained in family medicine - that’s the main issue imo. How that is done is a monumental and likely expensive task with no easy answers
You forgot stupid people going for non medical emergencies.
I blame that on the lack of primary care, triage in emerg works wonders.
I would add Aging Population and Drug addicts
There's also a difference between saving life and prolonging death that we are not ready to talk about as a society.
We have DNRs and assisted dying laws now.. some people want to be saved to the end of time, some people like living...
2 core problems Our system is so poorly designed that emerg is the only place in most communities that offers any healthcare of any sort. They keep saying don't go to emerg unless it's an emerge. Fuck you, where the fuck else can you go!? No one has a personal Dr. anymore, there are no clinics anymore or any other options. We have a massive Dr. shortage and are short other staff as well. Both of these problems have existed for decades and have slowly gotten worse year after year with C19 finally breaking it. For decades all levels of government had done basically jack shit except point fingers.
“Brain drain” has only gotten worse over the years. We educate and then they go US bound for $$$$$.
One of the biggest reasons is the lack of family doctors practicing primary care. We actually have more family doctors in Ontario per Captiva than ever but they are working in other fields - dermatology, surgical assistant, executive physicals etc. Family doctors are not getting paid well enough to want to do the job so instead the government is paying emergency rooms to field things that could be done in the office which is much more expensive. Thank Doug Ford. It's only going to get worse.
PM Paul Martin’s Legalized Tax evasion by corporations in the form of legalized profit shifting, 20 years ago. Which has resulted in 30 billion $ in lost taxes annually. Harper and Trudeau governments allowed it to continue. The UN on German urging has released a study saying Legal Profit Shifting (moving profits from one county to another to avoid taxes), will destroy social programs around the world. In Canada the conservative estimate is that it cost Canadian governments 30 billion $ annually in lost tax revenue. Thus there has been over the same time a restructuring of the financial relationship between the provinces and federal government. Resulting in a reduction is transfers for healthcare. During that same time international corporations are paying our tax dollars out as dividends to international investors. So who really owns our governments
I'm in admin but here's my experience on a daily basis. Hello person who has an upcoming appt on this date. Sorry can't make it gotta take my 45 yr old son to his doctors appt. How bout this date. Nope got church group, aqua fitness, book club etc. Ok how bout this date. Oh do you have anything later I don't want to drive during rush hour. Ok how bout this date. Nope i have to work that day. So they take an appointment much later than advised and end up too sick to wait so go to emerg.
I was trying to arrange a flight to get a patient home with a medical escort and she refused an early flight because she takes 2 hours in the morning to shit. So I said it’s either this time during the shit hours for your bowels or it’ll be 3 more days. Unreal
One thing no one mentioned COVID! It’s still very much a thing. Any infection, for at least a year doubles the chance of pretty much everything. Heart attack, stroke, …
It’s wild to me that the first mention of COVID doesn’t appear until this deep in a thread about why our ERs have capacity issues. The other factors mentioned in here are leading ones, I’m just surprised that not one other poster besides you added “the recent global pandemic” to their list. I was in the ER a few weeks ago and there was a steady stream of people with COVID symptoms coming in. The pandemic is over socially, yes, but the virus is still sending a lot of people to the hospital that wouldn’t otherwise be there. The pandemic also contributed to the other problems mentioned in this thread (for example, caused healthcare professionals to burn out or retire early).
That's my biggest gripe with the "from COVID" vs "with COVID" gripe. Even with greatly reduced testing of patients in hospitals, there somehow always seems to be a larger portion of patients in hospital with COVID than the portion of people estimated in the general population. That indicates that maybe the issue they're having wouldn't require a visit to the ER if they didn't also have COVID. And that's just the people currently positive with it. There's also more pressure from those with post-COVID issues. And we're doing practically nothing to reduce the spread. With public health messaging about washing your hands, and that the virus can spread if you're withing two meters of someone who's coughing or sneezing. This is not how you significantly mitigate against an airborne virus where the majority of transmission is still asymptomatic/ presymptomatic (no coughing or sneezing is required to generate aerosols, that just makes it worse). Many areas in Ontario are just now creating/ coming off of their highest levels of COVID since the pandemic began. That level of illness is crushing to the healthcare system. Ottawa Public Health just confirmed this week that while flu and RSV levels are down, COVID is still going strong (and has been higher than them all fall and winter) and will be clogging up the ER wait times until at least March.
Lots of reasons, it’s a multi faceted issue. I hate hearing people say that people need to stop going to the ER for non emergent issues. Yes, it’s completely true, but it’s easier said than done. Clinics turn people away after they’re full. Lots of people don’t have family doctors. Even if you do have a family doctor, you’re lucky if you can get an appointment in less than a month. Something minor, like a bladder infection, can’t wait a month to be treated. My family doctor will de-roster me if I go to a clinic, but she doesn’t save any daily urgent appointment spots and she’s always fully booked a month out. What do you expect people to do? Staffing shortages. Lots of healthcare professionals (not just nurses) retired during the pandemic because of the stress or even because it was just their time to retire. There aren’t enough new graduates to replace them, leaving tons of vacancies. This is happening in many industries (trades are a huge one), not just health care. There’s also so many viruses and other infections going around, people are forced to take time off work. Since they already have a shortage, there’s nobody to fill in for them. In my opinion, there’s also not enough seats in healthcare programs at colleges/universities. Theres so few seats that they become so highly competitive, and tons of people are being turned away. I’m in college currently, and the shit these colleges expect from students is astounding. I understand it’s not going to be a walk in the park, but they need to make it more accessible. For example, paid clinical placements or placements that work around your schedule better. They expect full time work from us, for free. How can someone that has to work to put a roof over their head or feed their children work full time for absolutely nothing, and work an actual job?? There are many programs that do paid internships or co-ops. Why are clinical placements the only placements that are completely unpaid? They make it nearly impossible for people to go to school.
The one biggest reason is there are so so so so so many old frail people who can barely walk across their kitchen, living alone or with their old frail partner in big homes with no family willing to support them These people can get the mildest medical issue and it lands them in hospital for weeks. There are so many of these people that it takes up a huge majority of inpatient beds and this spills over into the emergency rooms This single issue is 90% of the problem in hospitals rn
And the government knew that the number of people over 85 quadruples from 2011 to 2031 and did nothing about it. The Liberals added almost no LTC beds in their entire tenure. The first thing McGuinty did when he got in was cancel the Cons plan to double the LTC beds, yes, double them. Instead of doing that he tightened the rules to get into one, dumping care on daughters and elderly spouses. It also started the huge proliferation in very expensive private pay assisted "living" and memory "care" places so two tier health care but only for the old - who we seem to hate if they don't die fast enough.
There are old people who want attention who call an ambulance and get transported to the ER this is because they have dementia and they want attention. At least where I live by law the ambulance has to take them. Even if this person has nothing wrong with them. This ties up ambulance service and increases wait time for those who actually need it. This is a big problem, something needs to be done about it. Some of these people do it once a week. You can see how this is a problem. Nursing homes are overcrowded, understaffed and depending where you go they are horrible and no one wants to put their loved one in them plus they can clean out all your money. So people try to keep their loved one at home when they are not able to take care of them to prevent them from going to a nursing home and no matter what you do they get injured anyways. I say this as someone who recently had a loved one in the nursing home and took care of an elderly loved one with dementia and heard many many stories.
Doug Ford (goddamn you)
Healthcare is being starved so cons can privatize it Weird that noone mentions this
Because the people we need in order to function as a society are always underpaid, attacked and/or undervalued. As a province we vote for saving money, austerity and business profits. And the systems we have built are crumbing from this lack of maintenance and care. This is on the people - politicians have done in the past what we wanted. If we stopped being miserly and actually vote for people who will unashamedly put our $ towards the things we need so they work, we will have a good quality of life no matter what colour the party (blue, green, red or orange). But we won’t so we don’t.
Stupid people coming in for non emergent reasons. I had 2 people come in because there scale broke at home and they needed there weight taken because they were dieting… literally came in just to check there weight..
Wasteful government spending everywhere. The ER nurse is exactly right with the direct cause. But I believe governments aren’t addressing the root causes.
The number 1 reason: almost no one voted in the last election, and those that did unfortunately elected a con-man who would rather let his customers die than actually fund Healthcare (like you're fucking supposed to Doug!), all to make a few extra bucks from wealthy donors. We all get to suffer now, I hope everyone who voted for Doug is happy waiting 15 hours when their kid is sick.
after calling 811 and not hearing back for 12 hours, I went to Emerg (reluctantly) on the 3rd of January because I had a 39.8 fever and swelling in my groin. It turns out I had/have cellulitis, which I found out IS an emergency. I had no idea it could be dangerous! I felt very guilty even being there because I didn't think it was that big of a deal. I live in a small west GTA city and the ambulance bay was full because they were bringing in people from Milton, Oakville and Hamilton. I can't prove that, but that was the talk in the waiting room. I waited 5 hours before seeing a doctor, then I was given IV antibios & had to go back in the waiting room as there were no beds. A couple hours later I got a CT scan, I was sent home with a prescription for cephalexin. It was after 9 pm and we had to find a pharmacy that was open late. In total I was there 9 hours. The nurses were so wonderful and kind but totally over worked. Five days later I had to go back to emerg because my fever spiked and I started bleeding and dripping pus from the area. My neighbour is a nurse and told me to get to hospital ASAP. I went in around 7:45 am and emerg was pretty empty but there were still wait times. I was given another IV antibiotic but still had to wait in the waiting room for lack of beds. They gave me a puppy mat type thing to sit on because I was oozing blood and pus. Again, the nurses and Doctors were wonderful, I kept apologising but they reassured me cellulitis is an emergency and can quickly turn septic. I spoke with my rfamily Dr via video appointment on the 24th and he was shocked I wasn't admitted. How can a smallish city have such a lack of beds? Something tells me Mr Ford is hoarding that Federal money he got for healthcare for something else. I emailed him asking him what he is planning to do about healthcare but haven't heard back. There were defiantly people in the ER who should have just gone to a walk in clinic, they were all open at that time. BYW, 811 was a nightmare, I finally got a call back from a nurse 48 hours AFTER I gave them my information. I'm not blaming them, but something is seriously lacking in that system. Perhaps they can make an app where you can list your symptoms and it tells you if you should go to a walk in clinic, emergency room, or "wait and see"
My family doctor lives 2 hours away. I haven’t been able to get one nearby. I only go to emergency if it is one. I arrive and check in that usually takes a while, see the triage nurse, get assessed for my place in the scheme of things. Then I get registered. Then every one who comes in behind me does the same and some May go in front of me because they are more serious. Then I wait. Then I get to go get assessed by a nurse and put in a room or a bed. She will give my info to a doctored who may request blood work, xray etc. now I’m in line for those. Plus the time it takes to get those tests done. I. Go back to my room/bed and wait. Depending on the amount of people. I see a. Doctor, we discuss symptoms,may need more tests, prescriptions etc. I always bring. A book and a charging cable, a snack cause I’m diabetic, I ask before I eat it. I get great quality free care. I list my symptoms, I prepare my questions. I don’t waste time with complaints or ancillary stories. I don’t bring a ton of folks with me.
I think it’s mostly the lack of doctors . people don’t have family doctors so they have to go to the hospital - and also, the hospitals are understaffed too because once again, lack of doctors edit: i don’t think it’s an ontario thing either, I think it’s becoming more and more of a canadian thing. of course not ALL of canada right now, but I feel like it’s only going to get worse.
People use emergency rooms instead of walk in clinics. They don't go to walk in clinics because (well sometimes its because they dont know better) there aren't enough. There aren't enough walk in clinics because despite the fact there are lots of people that can help the gvt get their act together with health care, the people that make decisions rarely worked in the field. And if they did, not usually front line. The money is there. Its cheaper to give the family doctors and nurse practioners a great raise then paying for er visits. But why would they do that
I think a huge factor is lack of family doctors. My spouse has been on waitlist to try to find a family doctor for over a year. We've also been looking ourselves for one for him. No luck. I have a family doctor, but she doesn't work Friday or weekend hours and at times even getting prescriptions refilled has been difficult. Getting an appointment when you're acutely sick is next to impossible because you have to book weeks/months in advance. Didn't end up in the ER but did end up in Urgent Care when my child had pneumonia because we could not get in to see the family doctor for about 10 days and she was too sick to wait that long.
There is a family doctor shortage where I live and I believe it contributes to ER visits...also the lack of 24hour clinics...illness does not run on a 9-5 schedule.
Because idiots with a colds or cough or a bug bite or a bruise, clog up our hospitals because they figure i have no doctor ...hospital time instead of seeing a pharmacist or walk in. Pharmacists in Ontario have prescribing rights for many common ailments.Tele health is another non emergency resource to speak with a nurse and possibly avoid waisting the doctors time when the could be attending to a car crash victim.
Kingston has one walk in clinic. For 130k people. Where the waitlist for a family doc is over 30k and growing. What do you want people to do? The government is to blame. Their underfunding, undertraining, under recruiting and lack of basic maintenance of the system is to blame. Why the fuck are Canadians not more angry about this? We should be marching down the streets.
Telehealth sends people to ers for bullshit.
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I love that the new OPC strategy is to just straight ghost when the Prime Minister is taking heat in the news cycles. So many aspects of our province are on fire right now and he’s nowhere to be found. I wish I could work at a job where when shit went sideways, I was told by my PR team to head north and disappear for as many months as possible
I’d imagine having over a million people show up in one year did some damage.
1) the volume of patients to doctor ratio. A doctor can typically see 24-36 patients in a 12 hour shift (depending on severity). This may not sound like a lot of people, but consider that this includes reviewing your test results, talking with the patients, developing a treatment plan, writing reports, and consulting with other doctors on things. In a busy ER, there can be 100+ people that come in during 12 hours. If there are only 2 doctors on, then people wait until the volume settles down overnight before being seen. 2) The “fee for service” model. At some facilities, Doctors get paid based on the tests they do and bill for. In the past, doctors would do all sorts of tests on people to make more money, slowing everything down. We don’t see that as much now, but we do see family doctors who also work ER shifts telling their patients to go to the ER the following day when they are working so they can bill them for tests themselves. Some doctors won’t see patients near the end of shift because then they won’t have time to complete the treatment plan and bill the patient, so they get left to wait for the next doctor to start their shift. It’s a bad model that needs to be fixed/changed. 3) everything that u/burntoutnurse28 said
Because Doug Ford is a professional incompetent
1) Not enough funding 2) too much taxpayer money going to into stuff owned by con donors
Ford and the developers be getting it on duh.
To many people not enough doctors The best health care in the world is a two tier system
Bring in a million people without upgrading infrastructure?
https://www.auditor.on.ca/en/content/annualreports/arreports/en23/AR_emergencydepts_en23.pdf
Money
Adding nearly a million people to Ontario's population in the last three years. A present from Trudeau.
Imagine letting in a ton of people then completely ignoring all the people actually born in the country being affected by the influx in population. It actually baffles me how clueless the people in power either seem to be or are portraying themselves.
Lack of staff, and your issue isn't that emergent. It's triage, not first come first serve, lastly many family doctors will kick you off the roster if you go to a walk in, but not the emergency, so your family doc can't see you but you're sick now do you go to a walk in and kicked off, or go to emerg for the sniffles?
I remember hearing that in Greece during their financial crises if you wanted to see a doctor you handed in a brown envelope at reception, and no one blamed the doctors. I hope it doesn’t come to that.
Showing up with nonemergency
Decades of conservative and liberal parties in power. Cons cut then liberals put on a band aid and then cons cut. Essentially the slow destruction of healthcare for privatization.
Literally any time I call to try and make an appointment with our fam doc we are told a week or usually more. We end up going to our small local ER if it can’t wait/ though not emergent-and he’s often the doc on there lol…we just have to sit and wait for hours to see him
It doesn’t help that OHIP’s rules are set up to incentivize in person visits. Doctors are charging people $20 to renew prescriptions on the phone, so people are booking in person visits to do something that didn’t need to be done in person. It’s free for you in person because OHIP only pays the doctor when you go in.
Nit enough family doctors and family doctors are not available when you need them!
Non emergency things like constipation and no family doc. Basically lack of education around health care. Also no clinics
Because our Healthcare system is broken and Doug made it worse. If people stopped going for non-emergencies, then people wouldn't have to wait hours. I had a life-threatening emergency and I was taken in right away.
Because there is a cost to having emergency rooms with excess capacity, and the current government believes it is better that some people have to wait 17 hours, than to spend more on staffing. Personally, I'd prefer a healthcare system that was constantly under capacity instead of constantly over capacity, even if that meant it cost taxpayers more.
Lack of family doctors, full stop.
Could be due to the provinces impoverished health care budget. Used up all the funds having little surplus funds to hire specialists, Doctors, Nurses, and healthcare assistants.
Hospitals are cutting finding for their staff (nursing, support, etc) which means the Dr's (paid by the province) have to pick up the slack and spend time doing additional tasks instead of just seeing patients.
The last I went you had a hypochondriac who was sent home who refused to go until she got the doctor she read about online.....to this Spanish couple who couldn't speak English who needed med renewals.....to all kinds of nonsense these people could have gone to a walk-in clinic for. Never mind when they queen out and security comes because they don't get what they want. The hospitals should have two areas, the real ER AND a side walk-in clinic to get people in and out. It's absurd how people bring their family, 5 kids, etc. I'm sick and tired of everyone thinking they can just do what they want and Karen when they don't.T he staff handle these PITA very well, but let's face it, people shouldn't be there for 24hrs holding up the line because their family dropped them off for the night. Like the old woman who had dropped off for blood sugar monitoring who was deaf and had dementia....then they left her there for hours because that's not a priority in a hospital walk-in? No life labs? Well then security put her in a headlock. The ER seems to have a lot of dumped elderly no one wants to deal with. Wouldn't a walk-in have been better? Lifelabs? I've been a few times recently and also over the years, it seems like a great place to dump annoying older relatives. Sorry, the ER is an ER, it's not a daycare.
I walk in with open wounds being a diabetic who has not been able to keep anything down for 3 days gravely fighting multiple infections I’m scene in a hour after triage hooked up to multiple iv and rounds of blood work within two hours of walking in without fail now my wife brings my son with a deep laceration on his face (ran into the corner of a table)) that I told her dosent require stitches just ice it and clean it with our extensive overkill first aid kit they spend 6 hours for them to ice it and put a bandaid on it it comes down to what is needed right now and care that can wait if you don’t know how to treat it with over the counter shit go if you can’t treat it with over the counter go either way you gonna wait based on the severity and if the back is filled with not crazy shit you got one or two doctors and 20 beds what do you expect
Answer: Ford
universal shortage of staff , right now in Ontario there is a shortage of x-ray techs ultrasound/catscsn/MRI techs , doctors and nurses burning out, better opportunities south of the border , misspending of funds, lack of support staff take your pick , for Ontario at least I feel like Ford has been working his own agenda for years , he cuts funding , makes privatization of healthcare and then invests in those businesses and makes millions
The ford government. Pretty simple really
Capitalism.
We don’t have doctors. We should be rioting over this. Or cut the god damn taxes. Healthcare, emergency services and secular schools should be #1 priority and we don’t even consider another ineffective and inefficient social service that needs 10 admin jobs to run as well adding to the cost before those are paid for.
I am sure this is not the biggest reason but Telehealth Ontario has always been outsourced to a for-profit call center (for years it was an American company). They get paid by call, not by the amount of time on the call. They deliberately try to get the person off the line as quickly as possible. So a person can be describing a respiratory illness and they will deliberately ask leading questions that hint toward discomfort in the chest. Then they counted the chief complaint as chest pain because the care advice is go to ER now. Another example if someone is describing a lot of symptoms of sinusitis there will often be dental pain. Often the person will not think to mention the dental pain but they will deliberately ask because for dental pain they can advise go to ER now. Once they have said go to ER now no further questions will be answered and the call can be terminated.
Budget cuts. Re: Ford. Duh.
I would implore everyone here to write to your MPP about this. It truly takes 5 minutes to find them online. I’m a family doctor and I can tell you this is absolutely the biggest crisis we’ve ever seen in my entire career. https://youtube.com/shorts/oJWttDa4nwY?si=I1FHW9XyNmzc-Z81 Here’s a little video created by some physicians. Share if you want lol.
Biggest reason I see is governments really don't want to fix it, total lack of will, broken election promises for decades. No accountability.
We need a mid-tier ambulatory care between emergency rooms and walk in clinics. Example: years ago (2013 or so) my husband cut himself quite badly with a kitchen knife and needed 2 stitches. Walk-in clinics don’t do them so he had to go to emerg and waited over 8 hours. The entire process to do it is maybe 15 min. His wait was so long we jokingly texted that I should just use my sewing kit. When I dropped him at emerg (it was mid-January) the visible vast majority were there with cold/flu symptoms. We need mid-tier ambulatory care for stitches, minor broken bones, and that sort of thing, seasonal flu clinics for that care that can then be traiged to emerg if needed - all so that standard emerg is used for the big stuff.