Hugh Mackenzie
Huntsville Doppler
Now Here is an Idea.
Last week I received a late night email from Mayor Scott Aitchison, just hours before he underwent extensive heart surgery, which he has subsequently come through with flying colours. In spite of his condition and not one to sit around feeling sorry for himself, he was still thinking about Huntsville, particularly about our hospital situation. I smiled when I read his email, not only because he was spot on, but also because it reminded me of a commercial for an insurance company I see often, whose punch line is: “We know a thing or two, because we’ve seen a thing or two.” Well Scott Aitchison has seen a thing or two. Here is what he wrote:
“I have been thinking while down here at Southlake (Newmarket Hospital), and I have been chatting with doctors and nurses about the speciality programs they run here. They are specialists in cardiac surgery, catheterization and rehabilitation. They have a cancer care program as well. RVH (Royal Victoria Hospital) in Barrie has the cancer care program and they are now working to establish a cardiac catheterization program. Many people here seem to think that what RVH is doing is a good thing because they cannot keep up with the demand here.
“All of that is to say that I think our approach on the whole hospital discussion in Huntsville needs to be about convincing the Ministry of Health that we need some kind of ‘in-demand’ speciality in Muskoka that will bring business in – bring in enough business to create the critical mass required to support the ER and ancillary services that both communities need.”
What a breath of fresh air and clear thinking that is amongst the myriad of committees and bureaucrats struggling to decide how to deliver effective acute care services in Muskoka. It is a relatively simple proposition and it has been proven to work.
The Town of Parry Sound is a good example. Although its population is little more than a third of Huntsville, it has a large, modern hospital campus that provides both acute and long term care to people in the District of Parry Sound. It has been able to accomplish this because it also established itself as an ‘in demand’ speciality centre for orthopaedics. They have orthopaedic surgeons there with national reputations and consequently attract patients needing this service from across Canada. Revenue from this source contributes significantly to the viability of the Parry Sound hospital, allowing them to provide a general level of care to their community that might otherwise not be available.
The great debate about the provision of hospital services in Muskoka has been going on for too long. There is too much squabbling, too much positioning and too little money. It has created uncertainty and suspicion and there is little trust in the process. There have been consequences for this, not the least of which is a sharp decrease in financial support for the two hospital foundations in Muskoka, as potential donors worry about the future of acute care services.
Perhaps the way to stop all that is to take a step back and focus on a single process: developing a business model, based on the provision of ‘in demand’ speciality health care services that will provide sufficient revenue to support acute care in Muskoka and East Parry Sound. If it can be done elsewhere, it can happen here. We live in a unique location to attract the best in the business when it comes to health care. We can create a market for speciality services that will bring patients from well beyond our borders. And we have people in our community with the background and knowledge to bring it all about.
What more can we ask for? Scott Aitchison has the right idea. It has the potential of breaking down barriers and getting the job done. We would be foolish not to pursue it.
Hugh Mackenzie
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I like this idea and feel that any monies involved in the construction of yet another hospital to be a waste of scarce financial resources. Let each hospital develop into a centre of excellence for one (or even two) specialties. Train the northern students in whichever specialty equates to whichever town. Start working together instead of wasting time and money in futile territorial disputes.
Kudos to the Mayor and to Mr.Mackenzie for recognizing the value of an outside-the-box idea (for us anyway).
I live in Burks Falls and travel to Gravenhurst for regular visits to the ophthalmologist there, as do most patients with macular degeneration, cataracts, etc. in Muskoka and East Parry Sound. He has two technicians going full time assessing sight and preparing patients for procedures and no doubt spent a fortune for precision optical equipment to set up his offices. They are overflowing with patients every time I visit and the turn around time for an appointment is never less than two hours.The wait time for cataract surgery is over a year. That is appalling and unacceptable but the Ministry of Health has limited the number of surgeries that they will pay for each year regardless of need or wait time.
Try having to accept being blind for over a year because you cannot get a simple out-patient operation any sooner. I suggest that you might consider how to expand the outpatient day surgery services for opthmology at Huntsville Hospital and get it accepted as a centre for excellence for this specialty. Try adding a training component in cooperation with NOSUM so clinical experience can be acquired by students in this specialty. I am quite sure patients waiting for cataract surgery would flock to your facility if you could make it possible. Only the Ministry of Health stands in the way.
I usually don’t want to weigh in on these open mic sessions but when it is really something I know about I must. The medical practitioner community and the Hospital Corporation have both been aware of the potential to attract specialty medical services to our community. Unfortunately all too often it is based on an individual and not a program. As a gastroenterologist I am a subspecialist in Internal Medicine. The Hospital did have to buy some special equipment for me to practice here. Having said that, I can also work with our group of Internists to run a call schedule and at the same time add value to the Medical Specialty services at our hospital. The surgeons and I share some skills and thus we can cross cover each other as well. We did have a Obs/Gyne specialist for a number of years, but when he retired we could not replace him. This was primarily because of a lack of specialists tripping over each other to take any job anywhere, but in addition other Obs/Gyne experts do not want to work in a solo environment. 24/7 call does not work. Some of you may remember Dr. Bell, the solo ENT surgeon. He is gone and so is the service. Yes, we have been using some of our unused OR time to have some ENT and Gyne surgery performed in one or both of our sites, but this is not truly a local specialty service. I do believe that you are over calling the orthopedic service in Parry Sound. Again it is a sole practitioner doing a limited number of orthopedic procedures. He uses OR time that would have gone unused and offers a service that would otherwise require travel, but it is not a Centre of Excellence. Often we use the term Tertiaryness. This means doing things that are not usually seen in primary or secondary level locations. Examples would include the NOSM training of 3rd years students and Residents. Our running of the Skills Enhancement Courses in Colonoscopy as one of only 4 locations in Ontario in another example. We did for a brief period of time have some plastic surgery performed here. Unfortunately the volume was not there. Some of the writers have rightly stated that you have to build it before they will come. That usually means buying and maintaining equipment not bricks and mortar. The investment in a set of specialty instruments for any subspecialty of surgery is big dollars. The hospital depends on volume under the present payment scheme to offset the cost of investment. The per-procedure payments are usually at a level under the average cost for the procedure in Ontario so only those places with large volumes can break even.
Now, Parry Sound. How convenient to be the only Hospital in your LHIN. Of course it is a necessary facility. In addition it was the parting gift of long time MPP Ernie Eves. Some might say the Huntsville Hospital’s present campus was a similar gift of Frank Miller. One would argue that these constructions were not likely done without a lot of political influence over the necessary planning.
I wonder what our present Mayor thinks about when he thinks about the need for local acute care medical services today?
I applaud ideas to improve our tertiaryness but there are several realities unknown to those who do not do these jobs as professionals. Keep the ideas coming, but bounce them off someone in the know.
I agree, we need a new, technologically advanced facility with at least one specialty, which would then result in resources for other necessary services. The only sticking point is the location…and I think the Ministry of Health should make the decision on the basis of the distance between North Bay and Orillia, placing this new hospital equidistant between the two.
This may be a new thought by our Mayor but certainly not a new thought by our Medical Proffessionals or our Hospital Administrators. Just as you wouldn’t attract a new Tesla plant to town, if all you have to house it in is a stable. You won’t attract a specialized surgeon or any other specialized medical practitioner to either of the antiquated hospital facilities Muskoka has to offer. Parry Sound built a state of the art building with Northern Ontario Provincial and Federal help. They attracted a specialist by doing so. If we stop the incessant mine, mine chatter between the two towns and focus on building one state of the art hospital replete with energy efficient and waste efficient new technology, they will come here also. Let all politicians at all levels work together to make it so.
St. Mary’s hospital in Kitchener was facing its own demise when the idea of specialization in coronary care/cardiac surgery was introduced. It is now held in high esteem, and has expanded in trying to keep up with the needs.
A superb idea. Just this summer our cottage neighbors have had to travel to Newmarket, Barrie, Sudbury and Owen Sound to get the specialized care they needed. One speciality in each of the hospitals might greatly reduce the travel needs of our residents.