Thread by @alandrummond2

@picardonhealth recent column is a must read for every politician, regional health authority and hospital CEO and manager.

As always he nails it.

"Could we please, in the name of all that is good and holy, stop telling people to avoid the ER during the holidays?

Better yet, let’s make it our New Year’s resolution to stop blaming patients for the structural flaws and managerial failures of the health system."

"Let’s dispense, once and for all, with the patronizing reflex of telling sick people to put off their sickness care until it’s a little more convenient for “the system.”

"The most grating example of this is telling people to avoid the emergency department, as so many hospitals and health regions are wont to do as soon as the holidays roll around."

"The reason the coughing, wheezing, limping, chest-clutching hordes are lined up a mile deep in hospital waiting rooms is precisely because there are no alternatives."

"The vast majority of primary-care practices close or reduce their hours. Specialized clinics generally shut down during the holidays. Hospitals go to great lengths to send as many people home as possible so they can close beds.

So what’s left? The emergency room."

"We have built a system – or, more precisely, a disjointed non-system – that has no front door. So by default, people head to the ER. And because so many other doors are shut around the holidays, the stampede to the ER becomes even more pronounced."

"Bigger ERs alone are never going to solve ER woes – just as more highways are not going to resolve traffic congestion."

Let me repeat that: Bigger ERs are never going to solve ER woes"

"Studies, time and time again, have shown the three overarching reasons why people use the ER. One is a lack of access to primary care. Millions of Canadians don’t have a family doctor, and very few have a practitioner who provides same-day or after-hours care."

"The second is perceived urgency; there might be a few people who head to the ER with a hangnail, but most people are worried that they have something serious. "

"The third is confidence; all the resources and facilities a patient needs are in the ER. If you need an X-ray or a blood test, what’s the point of going to a doctor?"

" And why call the Telehealth line when, 110 per cent of the time, they will tell you to go to the ER?"

"These are completely rational and sensible reasons.

People trust the care in ERs, and we should be bolstering that trust – not undermining it"

I know @picardonhealth has a kazillion honorary degrees but could somebody please give him the Order of Canada?