![]() If you don’t think Canada is experiencing a critical healthcare crisis, just look at any emergency department (ER) across the country. As with the sickest patients in the ER, the situation with Canada’s healthcare system is medically complex. Bottom line, the Canadian healthcare system is broken. More than one simple break, the problem is akin to a car window that shatters into thousands of tiny pieces on impact. Many problems that require many steps to fix all of the breaks. It is going to take years to dig us out of this hole, and it will require policy changes across the spectrum. I liken it to a giant cross-country jigsaw puzzle that can only be completed in small steps. Below I outline both systemic and societal changes I believe will help our broken system. This list is by no means comprehensive; it’s simply a starting point to encourage discussion and change that’s within your power to enact. Systemic Shortages. We know that there exists:
Primary Care Fixes. Delivering the right care at the right time requires adaptations to both how care is delivered and who actually delivers that care. How care is delivered. Virtual care, as addressed in the Federal-Provincial-Territorial (FPT) Virtual Care Summit, is a critical component of how we deliver the right care at the right time. Allowing patients to access care in their homes—and home communities—saves time and money for both the patients and the healthcare system as whole. When it comes to older Canadians, the Canadian Medical Association (CMA) and the National Institute on Ageing reported that 96% of Canadians want to age in place. They want to stay in their own homes as long as possible and stay independent at the same time. Virtual care, combined with in-home care, will improve health outcomes for both seniors and non-seniors alike. It will also prevent the overuse of acute care settings—such as hospital emergency departments—for patients who can and should be seen in non-acute settings. Who delivers care. In some parts of Canada, primary care is evolving to a healthcare-team model, where nurse practitioners, nurses, physician assistants, mental health professionals, and allied health professionals such as social workers, exercise specialists, and dieticians are operating within primary health care clinics. For example, people want individualized exercise and diet advice, and we can't expect their doctors to be the experts on everything. But what we can expect is a referral (preferably within the same clinic to ease the burden on patients) to the right professional. In fact, I wrote about this topic a few years ago. The Ontario Kinesiology Association has been advocating for the inclusion of exercise-specific professionals to be included on all primary care teams in the province: "Exercise and physical activity are recognized unequivocally as among the most effective means to both prevent and manage chronic disease. Managing these illnesses is critical: Chronic conditions such as cancers, cardiovascular diseases, diabetes and chronic respiratory disease are the leading cause of death in Ontario. The cost of supporting individuals with chronic disease is estimated to be 55% of total direct and indirect health costs.” Building on the premise of delivering the right care at the right time, recent changes to the Canada Health Act will enable non-physician healthcare providers—such as nurse practitioners and pharmacists—to provide medically necessary care that will be covered by provincial/territorial health care plans. This will ease the burden on family doctors and ensure patients have more timely access to care in a non-acute setting. As a whole, systemic changes such as the ones I’ve outlined above are both cost-effective and user-friendly. Societal Changes: The Herd Immunity of Healthy Habits Herd immunity happens when enough people in a population are immune to a disease, either through vaccination or prior infection, making it harder for the disease to spread. This protects those who aren’t immune because the disease has fewer opportunities to infect others. While herd immunity is typically ascribed to the spread of infectious diseases, I would argue that a herd immunity of healthy habits could help ease the burden on our overtaxed healthcare system. Herd immunity helps communities already, because it lowers the healthcare burden of an infectious disease outbreak: Fewer cases mean less strain on hospitals and healthcare workers, allowing resources to be used for other medical needs. By reducing the overall presence of a disease, herd immunity creates a safer, healthier environment for everyone. If we all made a concerted effort to sit less, move more, and make healthier food choices, it would go a long way to prevent and manage chronic health conditions that are resulting in multiple capacity issues in both acute (hospitals) and chronic (primary care providers) care settings. I propose that demystifying physical activity and improving education on healthy eating are two healthy habits that need to be explored further. Consider them low-hanging fruit in getting Canadians healthier. Demystifying physical activity. Physical activity at any intensity helps prevent and manage chronic health conditions like heart disease, type 2 diabetes, and some forms of cancer. It also improves mental health, by curtailing symptoms of anxiety and depression, and improving overall well-being. Physical activity that is accumulated in sporadic bouts throughout the day still reduces the risk of early death. Indeed, the World Health Organization’s guidelines on physical activity state, “Regular physical activity is proven to help prevent and manage noncommunicable diseases (NCDs) such as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain healthy body weight and can improve mental health, quality of life and well-being.” Better education on healthy eating. In addition to adding dieticians to primary care teams, I would argue that we also need to be teaching children about the importance of healthy eating. This is an example of a societal change that will benefit our overtaxed healthcare system in the long term, because healthy children become healthy adults. In closing, let me leave you with the words of Hippocrates, widely considered the father of modern medicine. He was the first physician to prescribe exercise to his patients—approximately 2,400 years ago.
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July 2024
AuthorAmanda Sterczyk is an international author, Certified Personal Trainer (ACSM), an Exercise is Medicine Canada (EIMC) Fitness Professional, and a Certified Essentrics® Instructor. |