General health care problems got worse in the pandemic but Ontario doctors are working to correct the problems

·5 min read

There are gaps in the Ontario health-care system that have grown wider from the pandemic -- things such as cancer screenings, surgeries and mental health issues -- but the Ontario Medical Association (OMA) said that work is underway to correct the problems. Members of the public were also advised to do their part by reaching out now to their physicians for help and advice.

The issues were defined during a one-hour Zoom teleconference held Wednesday and hosted by OMA president Dr. Adam Kassam. The event was held to identify "cracks" in the system and discuss ways of improving health care.

Kassam said although the pandemic has demonstrated the strengths of Ontario's health care and the dedication of the front line health care workers, it has also exposed what he called the gaps in the system, gaps that have grown wider because of COVID-19.

"As we emerge from the most challenging public health crisis of our time, and start our pandemic recovery, we have a unique opportunity to rebuild our healthcare system, fix the cracks and make it even better," said Kassam.

Also participating in the discussion was Dr. Samir Sinha, Director of Geriatrics at Sinai Health in Toronto, who said the pandemic has been "quite devastating" for older people in Ontario.

In a global sense, Sinha said looking at the numbers of people who have died from COVID-19, roughly 95 per cent of those have been people aged 60 and older. Across Canada, Sinha said 58 per cent of the COVID deaths have been people who were living in long-term care homes.

"So we know this is a pandemic that has disproportionately affected older adults," he said.

One of the side issues of this he said is that a lot of older Canadians chose to shelter in place in the past 16 months and not seek any medical care for any issues because of their fear of the coronavirus.

"This means there's a lot more deferred care happening and a lot more other challenges," he said.

He said many patients chose virtual care, by telephone, but Sinha said it didn't work for all patients.

He said surveys done in Ontario, and other parts of Canada, have shown that many seniors are not happy with long-term care right now.

"What we've seen is that 70 per cent of people in Ontario now say they'd rather receive their long-term care services at home; not in a long-term care home," said Sinha.

He added that most Canadians are now reconsidering whether they would ever accept a long-term care home for themselves or a loved one. Sinha made references to "the challenges in our system, the gross underfunding, the lack of staffing" and how that all translates to poor outcomes.

"So we have a real clear agenda ahead of us, especially when right now in Ontario where there are nine times as many pediatricians as we do geriatricians," he said.

There was also discussion on mental health issues with comments from Dr. Renata Villela, president of the Ontario Psychiatric Association, who also has an independent clinical practice in Thornhill, Ontario. She said the pandemic had produced a feeling of high anxiety for psychiatric patients unable to access normal channels of care.

She remarked on the issue of domestic abuse during the pandemic, saying it was not being talked about enough. She said part of the issue is about a culture of shame, violence and fear.

"Which makes it really difficult in terms of trying to connect people with the resources that would be of benefit to them."

She said the pandemic forced people to be isolated in their homes. She said this was a barrier for people who had plans to leave the harmful home environment and seek respite.

Villela said psychiatric care in Ontario will need to respond to the people who need help and give people the feeling of hope that there is a lifeline for them.

Also joining the conference call was Dr. Simron Singh, a medical oncologist at the Sunnybrook Health Sciences Centre and associate professor at the University of Toronto. He said there were similar themes in the world of cancer care, as were experienced by the other health care providers, in that all normal avenues of care were suddenly blocked when the pandemic occurred back in March of 2020.

"We didn't know a lot about COVID at that time and cancer isn't something we could really put a pause on," said Singh.

"There was a scramble to try to understand the virus and what the impact of the virus would be," he added.

He said it was especially worrisome for those caring for cancer patients whose health and immunity was truly compromised.

"A lot of backup plans were being made for surgeries, for radiation, for systemic therapy, for chemotherapy to try to ensure we could continue to offer care during the pandemic," said Singh.

"You can imagine for a patient how scary it must be to have cancer during this time of upheaval in our healthcare system," he added.

The doctors also spoke about one of the chief concerns in the medical community these days, which is burnout. Kassam commented that it has become such an issue that the OMA has its own in-house task force to address it.

"I can tell you as a physician working on the front line myself and have been working flat out for the past 16 months side by side with my colleagues, people are tired. People are burned out," said Kassam.

"And the fact that we now have an increasing challenge with working through backlogs of care that will require health human resources and expertise, we know that this is a problem," he added.

Kassam said discussions are underway to find solutions so that healthcare professionals can carry on in the best way possible.

The video recorded version of the OMA teleconference can be found online.

Len Gillis is a Local Journalism Initiative reporter at Sudbury.com. He covers health care in Northern Ontario.

Len Gillis, Local Journalism Initiative Reporter, Sudbury.com

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