In order to make hospitals in B.C. more efficient, physicians need to have a bigger say in how they operate. according to B.C. Medical Association president Dr. William Cunningham.
During a visit to Prince George on Thursday, Cunningham raved about the success the province has had in modernizing the way family practice is done and he wants to see doctors get the same opportunity to provide input on how hospitals should be managed.
"The health authorities run [the hospitals] with very siloed budgets and very little innovative thinking," he said. "And it's the innovative thinking that we've seen through the [divisions of family practice] and the collaboration with other healthcare professionals that has led to outstanding results in the cost effectiveness and sustainability of primary care."
Developments in primary care have included finding ways to attach more patients to doctors, with the Blue Pine Clinic in Prince George serving as one shining example. Cunningham also cited the emphasis that's been put on disease prevention and the management of chronic conditions which both help patients and the healthcare system.
With those changes in place, the medical association wants to shift the conversation to the hospitals. Cunningham said the precise issues vary from facility to facility across the province, but some of the common themes are a lack of engagement from family doctors, patients staying in hospitals longer than they need to be due to lack of home care options and inefficient operating rooms, which sometimes sit idle during the day.
Better management of operating room time will reduce wait lists for patients, according to Cunningham, but he said infrastructure improvements will also help clear up the backlog. New surgical techniques using scopes have created procedures that no longer need a full operating room to complete, yet many of those procedures have yet to be moved to outpatient facilities.
"I'm always very disappointed to hear operations being done in the main operating rooms that really should be done in procedural facilities," he said.
As an emergency room physician, Cunningham has a unique vantage point on how hospitals function. He described ER doctors as the canaries in the coal mine because they see first hand what's working and what's not in a community healthcare setting.
If there are a lack of family doctors, ERs see more patients who would be better served going to a primary care physician. If there's a lack of mental health services in a particular place, then ERs often see those cases.
Cunningham said his association is currently negotiating with the provincial government to find a way for physicians to have a larger voice in the hospital environment and he hopes to have a deal in place before his term ends in June.
"The ministry has seen the great successes in primary care and I think that can be translated into very large successes in the facilities as well," he said.
Cunningham was in Prince George as part of the annual medical association's president's tour. He was in Valemount and McBride earlier in the week and he visited UHNBC on Thursday morning then met with groups of physicians in the afternoon and evening.