Diagnosing what ails the health care system


By: Kate Jackman-Atkinson


Last week, the Health Council of Canada released a report titled “How do Canadian primary care physicians rate the health system?”.  The report was based on survey results from the 2012 Commonwealth Fund International Health Policy Survey of Primary Care Doctors and examines physicians’ perspectives on the performance of their country’s health care system.

The survey was last done six years ago and the questions related to access to care, coordination of care, use of technology and practice improvement as well as incentives. The responses allow a comparison between the health care systems of different countries. Compared to other countries surveyed, Canada had the top score in only one category, reporting the highest percentage of physicians who receive extra financial support for providing enhanced preventative care.

Looking at the results for Manitoba, the province outperforms most of the other provinces in only one category; only 25 per cent of Manitoba physicians say that their patients often experience difficulty getting specialized diagnostic tests. While this is the second best Canadian score, it’s well below Switzerland’s three per cent. In the 11 other major categories reported, Manitoba rates at or below the Canadian average.

In Manitoba’s 2012 budget, Health and Healthy Living accounted for by far the largest expenditure. Of $14 billion in total expenditures budgeted for 2012, Health accounted for $5.5 billion or 38 per cent.
When Manitoba Liberal leader Dr. Jon Gerrard, who practiced pediatric hematology-oncology before his political career, was in Neepawa last week, he spoke to a couple of issues raised by the study.

In a phone interview, Gerrard expressed major concern over how Manitoba fared when it comes to co-ordination of care. He explained, “It’s outright terrible that [only] 10 per cent of family physicians get information 48 hours after a patient leaves the hospital.” Because it leads to delays, extra physician visits and additional tests, he added, “Poor coordination has a big cost… It’s a really bad mark on Manitoba.”

The lack of communication doesn’t just apply to emergency room or hospital visits, only 31 per cent of Manitoba physicians say that they “always receive a report back from specialists with all relevant health information”. When family physicians are sending patients to specialists, they often are getting the results of that specialized treatment or testing.

When it comes to keeping family physicians informed about their patients’ interactions with the health care system, Gerrard said response rates should be closer to 80 per cent. Many physicians can’t put together a list of their patients’ previous care or medications.

The other area of concern for Gerrard is preventative medicine. Manitoba falls well below the Canadian average for physicians receiving extra financial support for managing patients with chronic disease or complex needs, physicians receiving extra support for providing enhanced preventative care and physicians who receive extra financial support for making home visits. Looking at these responses, especially those relating to preventative medicine, Gerrard said, “Other provinces do it much better. [Manitoba is at 18 per cent] It should be 90 per cent, it should be 100 per cent… Preventative medicine is not appropriately dealt with.”

Looking at the results, Gerrard said, “Manitoba has a problem and a lack of focus.”