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You know, for years, Canada has listed health care or Canadians as their top concern or one of their top concerns consistently. Unfortunately, that concern hasn't turned to action as we watch. And this is my opinion, my words, that the disintegration of the system, whether we're talking about
waiting lists, whether we're talking about the absence of family doctors. And the list is a long one. That's why I'm so pleased to welcome to the show Dr. Anna Silvestrovich, who's with me. Anna, first of all, Dr. Anna, so much appreciated that you're finding time. And I appreciate that when doctors, in your case, you've got, what, 30 years, you know, in this profession.
speak out let us know what's going on so i know this is a too broad a question but if you can give us just a quick nutshell what's your impression of the healthcare system now and i know that's it's a big big question just you can single out anything you want but what's your impression on the front lines my impression is that the system is beyond repair and there is no will or incentive to repair it
Everybody is talking the talk, but nobody is making hard decisions. And doctors and nurses are muzzled because of the Health Professions Act called C-36. So if they speak up or they say anything that goes against the mantra of their health authority, they will be fired.
you know, I'm just trying to think of the public has such a myriad of concerns and unfortunately the public becomes aware of this. As you say, we don't have a lot of people speaking out, but the public becomes aware of it because they're on the receiving end. You know,
They find out we don't have family doctors or they find out the wait list for something. And unfortunately, we've had a news recently, a story about a patient who died, cancer patient who wasn't seen, didn't see a specialist within anything close to the required times and then passes away. Well, that family certainly understands there's problems in the system. Absolutely. So two people close to me, Alison Dulcozo and Torva Logan have spoken up about this.
about their cancer care that they received in the US and the consequences for the people involved. One of the doctors that recommended Alison go to the US to get the care, there was, I believe, some disciplinary action. And so we have to be very careful. Our scope of practice as medical doctors has become narrower and narrower, and we are constantly looked at by doctors
You know, the college, our regulatory body, and yet the scope of practice of people that are not as qualified is getting broader and broader, which may be a good thing. But on the other hand, some of the things that they're doing, they are not qualified to do.
Well, I want to go further with that because now this is me. I remember, and I'm not going to do names, but it was 2017. Somebody gets appointed to head up one of the, you know, health authority boards. And I'm thinking that person's background has nothing to do with health. Like really, literally, I'm not stretching it, nothing to do with health. They may have been a hell of a plumber, for example, but that's not health care. And I see that repeated in the situations I understand.
Was that the Allied Workers Union United Fishermen scenario? That one? Yeah. So the same type of thing happens at my health authority if you go through the board. There's always an honorary MD up there, but they hardly have any time to breathe, never mind attend meetings. So decisions are made by these board chairs. And right down to when our federal health minister resigned,
The political appointment was a person who had no healthcare background whatsoever. And this person was dictating what was going to happen with the Quarantine Act and pandemic policy in Canada.
There are serious concerns and I never paid any attention to this as a physician. All I wanted to make sure was that my nanny shows up on time so I make it to the operating room on time. Never really looked at the big picture of what was going on. And, you know, the health care system has been deteriorating now for a good 20 years. Brian's been fighting this for a very long time and not really getting anywhere. And it seems like now they've really decided they're going to stick to the Canada Health Act.
They're not going to change anything. Bureaucracy keeps growing and doctors are just frontline workers, doctors, everybody is just collapsing. It's an astounding statement. I'm aware of the one you just made with federal politicians saying we're not going to change anything. We're going to stick to the Canada Health Act. And I'm looking at the results. I mean, come on, we rank...
close last or close to last for wait times if you go to an emergency room. And if people, again, have experienced it, they know what I'm talking about. I hope someone doesn't have to. But, you know, all of these measures, the international measures by the Commonwealth Health Index, et cetera. And, you know, SecondStreet.org has talked to us about 17,000 plus people dying waiting for diagnostic scans or treatment in 2022, 23.
That's not enough to get someone to say we need a radical shift here? We're sticking to an ideology. We're sticking to this ideology that our system is universal and it's accessible and it's there for everybody and it's free. Well, it's none of those things. And even our own health minister is a type 1 diabetic and has absolutely no insight into the frustrations of type 1 diabetics in this province. We give free needles to the drug addicts. We...
We give them free drugs, safe supply, unlimited methadone, unlimited Narcan and type one diabetics who this is not a condition that they can avoid. And, you know, they have to pay for their needles and their insulin and their continuous blood glucose monitors, everything. So the system has never been universal and it's never been equal because we
There's been two-tiered medicine forever with politicians have their own set of rules and there's WCB and the military and
It's always been like that. So if you want to incentivize an anesthetist to stay after hours, you make sure you put a DND case at the end of the day so they can make more money than they did for the rest of the day at the very end. Well, it's an important part. We had the pleasure of talking to Dr. Kevin McLeod, who was talking about some of the financial challenges. And I've talked to family doctors about that. I'm not going to go too long in it, but the
comes back to my worry is the number of doctors and professionals leaving the system. Some are going to the US, some are retiring. I can tell you firsthand the capital gains exemption change, which changed doctors' pensions who had organized through corporations. Now the first dollar's taxed. Well, I knew someone firsthand who was 61 years old who said, well, that's the last straw for me. I'm out of here. And I do worry about that. We need, you know, in certain sides of it, it's not so simple, but, you know, some specialists, etc. But
surely chasing people out of the system isn't an answer to the problems. Well, I think that the big plan is, and this is from a colleague of mine who's very much still within the system practicing anesthesia,
the big plan is to just get doctors under control because they're just too demanding and replace them with you know nurse practitioners and nurse anesthetists and and that's the big plan put everybody on salary but you know it's not that easy to just pick up and leave and go to the states my very first job was at um lucille salters children's hospital in stanford and i never took that job because i ended up anyway life happened and but you know
but you know i talk to people in america that work in the american system and it also has its challenges yes they're in the private system you make an awful lot more money it's not that easy you still have to do a lot of board exams licensing exams you may not end up in the state that you want to be working in so um let's look at ways of what we can do to to fix it to fix what we have and
Sadly, the way things are run by the people that are in charge, I'm not sure there's a lot of fixing of anything because if we speak up about the issues, we're dismissed and we're silenced and we're threatened. And I went from being a really good anesthesiologist with not a single complaint letter ever in 30 years to a danger to the public. So how does that happen? Mm-hmm.
Well, and it's incredibly disconcerting. I mean, you're not going to get a change to the system. We've watched the erosion, and it's measurable. And yet, if they don't have the attitude of that's a problem, if they don't even start with, hey, that's a problem when that many people die waiting for treatment, or that's a problem when they sit in an emergency room for eight hours. It doesn't affect them. It will only affect them if it happens to their family member. But for some reason, like I mentioned, if our health minister is a type 1 diabetic and has no idea of the issues affecting type 1 diabetics in this province...
Let me ask you about, and again, it's ridiculous to try and sum up these major issues in just moments, but give me the two or three things that jump out at you if I said, what's your biggest concern? I mean, is it the exodus of professionals? Is it the use of drugs? My goodness gracious. You know, that kind of thing. I think my biggest concern is when a system falls apart, there are parasites and opportunists waiting to...
to prey on people. And so if money is mismanaged and misallocated, and one of the forensic psychiatrists tells me, you know, we spend an awful lot on homelessness, drug addiction, and poverty, and we're really very concerned about saving lives and vulnerable people. And yet our cancer patients who have paid taxes, taxes their whole life cannot get cancer care and are offered plan Z, which is medical assistance in dying. We have a problem. And so we,
the drug companies look at that and say, "Oh, you know, well, we'll just come in there and we will help out." If you enroll so many patients in these studies and here you go, here's this much money and we'll run some clinical trials. And that's what I discovered. And that's why I just can't stay quiet because
Every time you almost every medical school, you have to take the Hippocratic oath and the Hippocratic oath is first to do no harm. So if there is a drug that caseworkers are getting paid for in order to inject into people for profit without their informed consent, I see this as a just an enormous issue. And again, an example of another one that's not in the public domain that's not being discussed. I mean, I,
until it impacts people individually. Like we're finally having a discussion a little bit about family doctors, for example, when people notice they don't have one and can't get one, you know, and, and I'm afraid that we're going to see this deterioration until it bumps everybody, you know, until everybody gets involved. At some point we all access the medical system. You know, if you're lucky enough, you're doing it at a hundred years old, but you may have accessed it much earlier. So the way our medical system works is that we need people,
access to a family doctor in order to get access to a specialist, right? The problem is we have all these family doctors, but they just don't want to work in the systems that are constructed for us. So the numbers seem like we have enough of them. I looked at those numbers. I believe we have... So seven... We're supposed to have...
708 doctors for a population of 885,000 people for the island. That's one doctor for every 1250 patients. And we have 954 family doctors. So we have enough numbers. They just don't want to work in some of these UPCCs. So in 2018, the first UPCC was opened up on the West Shore in Victoria. Now we have 30 of these urgent primary care centers. They're costing...
the amount of money that they predicted, which was $90 million. But each patient visit is much more expensive and the overhead is much higher than predicted. And they're only seeing about half the number of people that they thought they would be seeing. And there is no continuity of care. So we now have the infrastructure. We have these clinics, but they're not working well because there is no business leadership. It's like running this little clinic has given me an idea
a bird's eye view of what it's like to run a business or to run a clinic and to have people. And, you know, one of my, because of the unions as well, one of my family doctor friends that works at one of these clinics says to me, you know, I have three nurses assisting me with a pap smear.
Well, it used to be she did the pap smear herself, filled out all the paperwork, ran it all off. Now we have three people assisting. There's coffee breaks. The inefficiency is insane. And so it's also even back when we were doing the vaccine clinics, you know, doctors could have done an awful lot more of the vaccines. But I think the policy was that the nurses can only do four an hour. So it's
The efficiency has gone down because people don't maybe understand just how hard some doctors work in order to make those big bucks. It's not 40 hours. That's a part-time job. 40 hours is part-time. If I could get you to, or I could wave a magic wand, I mean, time's too short here, but the last thing is, if you could make one change, what would it be?
Somebody very bold in nursing needs to address how we train and retain nurses in this province. Nurses are the backbone of healthcare.
And so, you know, the doctors, they operate, they go home. Doctors in a hospital, right? The nurses keep everything going. And so some of the most exceptional nurses in cardiac and other areas, other surgical areas, ICU, they don't have a Bachelor of Science nursing. They were trained in-house. We need to go back to mentorship programs and training that way.
So we need to bring nursing students into the hospital and pay them, I don't know, $18, $20 to help with patient care because the nurses that are currently on the floors simply cannot do it. We can't have patients coming into the operating room covered in feces for a hip operation because they haven't got the care they need. So...
We need to look at bodies. We need manpower. And so we need to support our nurses, but we also need to bring in way more nurses and train them in-house. I would start there.
Well, there's so much more to say, but let me just say we really appreciate you stepping out. You know, it comes at, I'll say this, you don't have to, but some professional risk, you know, they're not welcoming change, they're not welcoming criticism, they're not welcoming the bright light being shone on it. So when doctors like yourselves take the time, speak out, I think it does a tremendous public service and great for our audience. Thanks very much for taking the time. You're welcome, Mike. Thank you.