Do the right thing
CMAJ 2000;162:1664
Charlotte Gray's report on Canada's hospital emergency department crisis [News and Analysis]1 showed that we must take off our blinkers. As Gray reported, this was done in major hospitals in Alberta and Saskatchewan, where staff anticipated the arrival of the annual flu season in order to avoid emergency department overcrowding. Far too often, planning like this is anathema to solo practitioners, both specialists and FPs, who act as if they are running a corner store.
Surely medicine is not only a business but also a public service. That, and the responsibility to care for individual patients, should lead to 24/7 service. Why is this not the universal standard? Why is it not a moral as well as a legal requirement of medical practice? The hospital emergency department is not a substitute for continuity of practice, and it is the next best thing to a cop-out to use emergency departments as an alternative to the doctor's office.
As a pathologist, I was part of a group that provided such service at night and on weekends. I am sure that evening and weekend coverage by a physician as part of a formal or informal group is the least the public can expect. Being on call once in 7 nights or weekends is all that would be required in most cases.
Communication systems can now be used to route calls to the person on call without redialing, to provide at least a triage consultation. Medical bodies, such as the provincial colleges, should consider making such coverage obligatory and subject to disciplinary action. Come on, colleagues. Let's do the right thing for our patients!
J.V. Frei
Pathologist (retired)
Toronto, Ont.
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Reference
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Gray C. Hospital crisis? What crisis? CMAJ 2000;162(7):1043.
© 2000 Canadian Medical Association or its licensors
