The cow, the health system and the future

The cow In a small, impoverished village, residents used to make their livelihood by milking a cow. One fateful day, the cow accidentally got her head stuck inside a clay jar while drinking water and couldn’t free herself. The villagers were bewildered and sought the counsel of their wise elder to resolve the situation as they wanted to save the cow and keep the jar, as both were crucial in their lives. After careful contemplation, the wise elder assessed the predicament and came to a decision: “Cut off the cow’s head.” They followed his advice and then remarked, “Wise elder, the cow’s head is still inside the jar.” He smiled and replied, “Break the jar.” They did as he suggested and liberated the cow’s severed head. The wise elder stepped aside, lit his pipe, and gazed at the sky. The villagers reassured him, saying, “Do not be disheartened, wise elder. We sacrificed the cow and the jar for your sake.” He looked at their faces with a smile and stated, “I am not saddened by the cow or the jar, my dear villagers. I am concerned for you, for how you will manage your affairs without me.” Read: Dr. Jabir Jassam: CPSO: Thank you The health system The healthcare system is in crisis, with doctors abandoning their practices, shifting specialties and avoiding long-term patient care. Many patients are left without a healthcare provider, resorting to walk-in clinics, emergency rooms or online services. Amidst growing demands, policy-makers addressed the issue and the financial struggles of doctors and the declining number of healthcare professionals so they decided to expand the role of nurse practitioners. Several years later, the situation hadn’t improved, so they decided to broaden the scope of pharmacists which, of course, did not yield positive results, with the healthcare system continuing to deteriorate. They thought that was not enough so they decided to expand the pharmacist roles even further. But again, this didn’t prevent doctors from leaving their practices, family doctors closing their doors and emergency rooms becoming overwhelmed. The future For a possible better solution, policy-makers decided to take this issue to a different level and consulted the college of family medicine looking for a practical quick solution, and they decided to extend family doctors’ training by another year though almost all family physicians were opposed to the solution, and more doctors are leaving their profession, and medical students are turning away from family medicine. (This extra year was cancelled.) Things are worse; more and more Canadians are without doctors. To solve the issue, they decided to expand the scope of midwives. Fast forward a few years, and after several meetings and decisions, the situation has escalated and almost everyone—massage therapists, chiropractors, physiotherapists and paramedics—are granted the privilege of prescribing medications. The country is full of prescribers but no actual doctor, the referrals to other specialists are skyrocketing as every patient gets a referral to somewhere, specialists are overwhelmed. The shortage of family doctors persists, and clinics remain closed, more patients go without doctors and the death of the health system is pronounced. I am not sure if the policy-makers like to say: “What would Canadians do without us?” Dr. Jabir Jassam is a family physician in Ottawa.

The cow, the health system and the future

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