Family doctors, get ready. When the blame for the Canadian Swine Flu fiasco stops rolling around, looking for a comfortable place to call home, I think it’s going to land smack in your laps. Please, please, all you good GPs, don’t say this isn’t true. From what I’ve witnessed these past few days, you already know. That’s why you’re working yourselves to exhaustion right now, trying to stay out of its way.
My epiphany came at a Nov. 10 press briefing. Nova Scotia’s chief medical officer, Dr. Robert Strang, refused to bite when reporters trolled “who’s to blame for this mess?” back and forth in front of him on almost every question. Lack of vaccine? Conflicting information? Strange distribution? Clinic nightmares in rural regions? Heck, these things just happen. No blame on Ottawa. Nor on Halifax. Now, if the Department of Health can just convince family physicians, the ones who could best handle it, to come on board, everything will gradually work itself out.
According to Strang, Nova Scotia has more vaccine than it has used but not as much as it needs. While regional public health organizations are trying their darndest to get people shot up to end this paradox, the push right now is to get the primary health care providers the public knows and trusts, the family doctors, involved in future distribution.
“The details of this have to be at the local level,” said Strang, “so public health services and the district health authorities are working with the primary care physician communities to figure out what’s going to work best in involving those communities in terms of involving physicians in immunization delivery.”
According to Strang, his people are “working through” the issues of getting vaccine into the hands of local physicians. Of course, the problem is that it makes no sense to divvy up the supply on hand so every doctor gets a tiny amount. Perhaps it will be dolled out to the bigger clinics. Maybe groups of doctors can band together where no major clinics exist.
How can doctors be expected to cooperate, one reporter asked, if this means some them are raking in big bucks for giving the shots while others are left with not a smell of this huge billings windfall?
“That’s the challenge we are putting in front of the physician community, how they can work together collaboratively, rather than competitively, to manage a limited supply of vaccine most effectively so Nova Scotians have good access to vaccinations. That ‘s their challenge to deal with,” Strang answered.
It certainly would take a load off the health authorities if local doctors were giving the shots, not to mention providing the public with faces to blame for things going wrong. My biggest question is this: can our physicians handle the tidal wave of paperwork that’s going to follow? A dozen or more federal and provincial agencies already have their fingers in the pie. Our doctors can expect to be inundated with forms and surveys as each agency tries to justify itself.
And here’s the part that worries me the most: I think it’s already going on, has been for some time, as all the players jockey for position at the starting gun. Last week, I needed some prescriptions filled. My doctor looked like, as my sainted mother used to put it, death warmed over. I learned he’s been coming in at 6 a.m. every day for the past few weeks for flu-related paper work. Later that day, I saw another doctor from the same clinic at a grocery store. She looked pale, worn out. That evening, my daughter saw her physician and reported the same dead, exhausted look.
If, as I suspect, these frontline troops are already being worked to exhaustion by the paperwork for the regular flu shots and preparation for the H1N1, what’s going to happen to them when the next wave of forms and surveys rolls over them? Not surprisingly, I have heard there are some doctors already saying they don’t want to handle H1N1 shots because of the anticipated paperwork.
Personally, I hope my fears are not justified. However, if physicians become the trench troops in this Swine Flu war, you know where the casualties are going to be, and who will bear the blame when things go wrong.