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Wait times are often seen as one of the
biggest problems facing our health care system. Even though they get
a lot of attention, and even though there has been some progress, we
still do not manage medical wait times as effectively as we should
in this province.
Wait times can occur in any service
area, from shopping to providing MRIs. The reason they occur is that
the capacity to supply a service does not meet the immediate demand
for that service. If there is only one lane open at your local
supermarket which can only serve two people a minute, and more than
two people come every minute, you will have to wait to pay for your
groceries. It is the same thing with an MRI. Too many people want
the service at the same time to serve everyone immediately and a
queue forms.
The optimal arrangement is when demand
equals supply so that neither patients nor providers have to wait.
Yet there are a number of reasons why achieving this optimal
arrangement is nearly impossible for health care. The pattern of
morbidity is not constant. It is hard to quickly change either the
supply or the demand for most medical services over the short term.
Long-term planning for medical services is no easy feat, especially
when we consider the uncertain impact of new technologies.
Furthermore, the demand for medical services often increases when
the supply of those services increase.
There are advantages to having excess
demand, at least from the point of view of the health care system as
a whole. Queues make the system more efficient. If specialists had
to wait around most of the day for patients to show up, this would
be a problem. We should not worry that there are wait times. Rather
what we need to worry about is when waits become excessive, in the
sense that they adversely affect a patient’s likelihood of recovery
or leaves them in discomfort for a long period of time.
In order to ensure waits are not
excessive, we need a coordinated wait management policy. An
effective wait management policy must focus on improving patient
outcomes, using the system efficiently, allocating services fairly,
being transparent, communicating effectively with the public and
providing better customer service to patients. It should also be
sensitive to the fact that there is a big difference between how
long of a wait is acceptable from a medical perspective and how long
of a wait is acceptable when it is a person’s family member. This is
no easy task. There is, however, hope for better management of wait
times. There are a number of programs across the country, e.g.,
Saskatchewan Surgical Care Network, which have given some order to
wait time management.
Excessive wait times result in poorer
care for patients and are a public relations nightmare for our
public health system. Managing them on a system-wide basis is key to
the sustainability of a health care system that provides high
quality and timely care to Newfoundlanders and Labradoreans.
Roger Chafe is a graduate student in
health policy in the Atlantic Regional Training Centre program at
Memorial University’s Faculty of Medicine. |
