Beedie hears Dr. Danielle Martin’s three big ideas to transform healthcare

Dec 01, 2014

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The Canadian healthcare system is one that Canada can rightly be proud of – but that is not to say that there is not work needed. Specific improvements relating to equality, cost, and access would address the challenges faced by the system, for the benefit of all Canadians.

Dr. Danielle Martin, Vice-President, Medical Affairs and Health System Solutions at Women’s College Hospital, presented three ideas on these areas to improve Canadian healthcare at a special SFU Public Square event.

The event, held at the Beedie School of Business’ Segal Graduate School on November 27, was delivered in partnership with SFU’s Faculty of Science, the SFU School of Public Policy, the City of Vancouver, and the Canadian College of Health Leaders.

It was attended by a diverse cross section of attendees, including guests from a variety of health authorities, Beedie School of Business students, faculty, and alumni, and physicians from the Beedie Executive Education GPSC Leadership and Management Development Program.

Martin noted that from coast to coast Canadians see their system as the highest expression of Canadians caring for one another. It was built on a dual promise of delivering accessible, high quality service in an equitable way, and giving the nation something of which to be proud.

The question now, is how do you make a social program worthy of iconic status? To tackle the problems faced by the system, Martin identified three ideas – cost, equality and access – to drive change for the better.

“Our system does a terrific job of delivering when someone is seriously ill, but the reality is there are places we need to improve,” said Martin. “In the areas of cost, equality, and access, we have much to be proud of, and we have a lot of work to do.”

Her first idea – relating to cost – acknowledges the issue that the healthcare system has evolved significantly since its inception in the 1950s, when the bulk of healthcare was delivered by doctors in hospitals.

Nowadays, one of the mainstays of treating chronic disease is prescription medicine – yet as one of the only healthcare systems in the world where patients are charged for prescription medicines, one in ten Canadians does not take their medication as described because of concerns about cost.

Acknowledging that moving prescription care under Medicare would not be immediately possible, Martin suggests moving the top 20 most common prescriptions under public coverage, arguing that the change would result in public savings.

“In Canada we pay much higher prices for drugs than other systems do,” she said. “In BC, 10 milligrams of a popular cholesterol lowering pill goes for 37 cents – the exact same pill sells for less than a penny in New Zealand. If we bargain more effectively across the country, the prices would go down.”

Secondly, she proposed doing more with less – improving access to healthcare for Canadians that need it most by reorganizing the way it is delivered.

“We need to take the resources available to us and use them more efficiently,” she said. “If wait times are long, don’t immediately hire more surgeons – instead ask two questions: would everyone on the wait list benefit from this procedure; and could the bottle neck causing the wait list be alleviated?”

To accomplish this, Martin suggested eliminating inappropriate treatments, such as MRI and CT scans. This could be achieved by having other types of medical professionals evaluate whether the patient required the treatment.

She also proposed implementing applied queuing – a single common queue where patients are served at the next available opening – nationwide, after a successful trial in part of Ontario had reduced wait times from 19 months to seven months for certain treatments.

Her third idea differed in its approach, in that it focused on the root cause of the strongest predictor of health – income. With studies showing that low income Canadians are more likely to die at a younger age than those with higher incomes, Martin proposed bringing all Canadians up to a standard of living.

As well as improving health, income security would provide peace of mind for families, secure in the knowledge that illness would not automatically result in them falling on hard times.

Following her presentation, Martin participated in a spirited Q&A session, touching on subjects such as how physicians can help to reduce the number of treatments prescribed to patients; the barriers in pushing forward pharmacare; the idea of a centralized intake; and how to implement her three big ideas in a political landscape that is based on short term cycles.

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