Gabriola Sounder
The Editor,
Monday, November 6 2006
The Editor,
Monday, November 6 2006
Before the Health Centre locomotive - lobby gets up more steam, we should all try to agree where its going. As one of the Island doctors offering medical care, I venture also, to offer my thoughts on the choices of destinations and on the chances of arriving.
Would the lobby please define/refine their expectations of the Health Centre!
My sense is of an expectation that the facility will be staffed 24 hours/year round and have a friendly, competent person to listen and look, assess and treat. Great! Should it also have Xray, Lab and the techs to operate them - probably not!
Staffing appropriate to such a facility would require 4 to 6 nurses, working 12 hour shifts, say 4 days on, 3 days off and allowing for holidays. I am not at all sure that Government, in our case VIHA, is about to cross the line to fund 24/365 nurse staffing, where it presently does not exist, for an island, geographically, a ferry-ride-suburb ofNanaimo
Hornby Island Gabriola Island
However, in my opinion, THE critical limitation of manning the centre will be the availability of doctors willing to provide extended on-call coverage. Such a doctor will run an office in the day and will be available, on-island for on-call rota, one night in two, three or four, depending on how many wish to take call. This level of on-call is the norm for doctors working in under-serviced, isolated communities such asHornby Island or, as in my former practice in remote Northern BC
Present Health Ministry policy, currently spending 38% of the total BC Budget for 2006/07, is going to be reluctant to make the quantum step of commencing on-call stipends for a ferry-ride suburb ofNanaimo
What do I suggest? NURSE-PRACTITIONERS - government loves them - doctors have reservations. Dr. McPherson and I were invited byAthabasca University
Three to five nurse practitioners could offer constant staffing (or a lesser number for only after-hour call) in the setting in a small emergency room where they would assess and triage, usually with doctor consultation. Clearly, illness or injury beyond the Centre’s scope for instance, serious fractures, heart attack, acute abdomen e.g. appendix would be transferred to Nanaimo, as at present with the aid of our excellent Paramedics.
I do not see the need for doctors to transfer their day-time office to a purpose-built building: We should recognize the effort, time and money, present and past doctors have invested in their offices. Doctors would continue to bill fee-for-service and offer to be available as back-up for the out-of-hours nurse practitioners. My doctor colleagues may criticize my concentration on the dollars - sorry it HAS to come into the equation because it is important to ALL parties, Government and staff.
We should be aware that building, staffing and maintaining a facility will be in the millions of dollars.
Do we need a new building at a proposed site (with view) nearly a kilometer from the Village? Not really. The present Gabriola Professional Centre accommodates in 6,000 sq/ft of its nearly 10,000 sq/ft, a cohort of independent health professionals, namely Dentist, Doctors, Chiropractor, Massage Therapist, Acupuncture, MDS Metro Lab and soon, a replacement for the previous Physiotherapist. Presently, there is a nearly 2,000 sq/ft wing of the building potentially available which would make an adequate small emergency room and possibly even also a doctors office. It is ground floor, well lit, has adequate parking and is central. I think Government would be more amenable to rent such space than build and maintain a dedicated building.
Finally, my argument is, yes, let’s make our island less dependent onNanaimo General Hospital
Sincerely, Dr H.G. Harding
Would the lobby please define/refine their expectations of the Health Centre!
My sense is of an expectation that the facility will be staffed 24 hours/year round and have a friendly, competent person to listen and look, assess and treat. Great! Should it also have Xray, Lab and the techs to operate them - probably not!
Staffing appropriate to such a facility would require 4 to 6 nurses, working 12 hour shifts, say 4 days on, 3 days off and allowing for holidays. I am not at all sure that Government, in our case VIHA, is about to cross the line to fund 24/365 nurse staffing, where it presently does not exist, for an island, geographically, a ferry-ride-suburb of
However, in my opinion, THE critical limitation of manning the centre will be the availability of doctors willing to provide extended on-call coverage. Such a doctor will run an office in the day and will be available, on-island for on-call rota, one night in two, three or four, depending on how many wish to take call. This level of on-call is the norm for doctors working in under-serviced, isolated communities such as
Present Health Ministry policy, currently spending 38% of the total BC Budget for 2006/07, is going to be reluctant to make the quantum step of commencing on-call stipends for a ferry-ride suburb of
What do I suggest? NURSE-PRACTITIONERS - government loves them - doctors have reservations. Dr. McPherson and I were invited by
Three to five nurse practitioners could offer constant staffing (or a lesser number for only after-hour call) in the setting in a small emergency room where they would assess and triage, usually with doctor consultation. Clearly, illness or injury beyond the Centre’s scope for instance, serious fractures, heart attack, acute abdomen e.g. appendix would be transferred to Nanaimo, as at present with the aid of our excellent Paramedics.
I do not see the need for doctors to transfer their day-time office to a purpose-built building: We should recognize the effort, time and money, present and past doctors have invested in their offices. Doctors would continue to bill fee-for-service and offer to be available as back-up for the out-of-hours nurse practitioners. My doctor colleagues may criticize my concentration on the dollars - sorry it HAS to come into the equation because it is important to ALL parties, Government and staff.
We should be aware that building, staffing and maintaining a facility will be in the millions of dollars.
Do we need a new building at a proposed site (with view) nearly a kilometer from the Village? Not really. The present Gabriola Professional Centre accommodates in 6,000 sq/ft of its nearly 10,000 sq/ft, a cohort of independent health professionals, namely Dentist, Doctors, Chiropractor, Massage Therapist, Acupuncture, MDS Metro Lab and soon, a replacement for the previous Physiotherapist. Presently, there is a nearly 2,000 sq/ft wing of the building potentially available which would make an adequate small emergency room and possibly even also a doctors office. It is ground floor, well lit, has adequate parking and is central. I think Government would be more amenable to rent such space than build and maintain a dedicated building.
Finally, my argument is, yes, let’s make our island less dependent on
Sincerely, Dr H.G. Harding
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