A new report from the Canadian Institute for Health Information about access to primary care and emergency department use underscores the need for a more integrated, data-driven approach to health-care reforms, says a New Brunswick ER doctor. The report found nearly 15 per cent of visits to the emergency department in Canada in 2023-24 were for conditions that could have been managed by a family doctor or other primary care provider, such as a nurse practitioner or pediatrician. Even among people with a family doctor, about 13 per cent go to the ER to get basic primary care, according to the Canadian Institute for Health Information, or CIHI. And more than half of those visits could have been handled virtually, says the report, which was based on data from Prince Edward Island, Nova Scotia, Ontario, Saskatchewan, Alberta and Yukon. 1 in 7 ER visits in Canada are for conditions that could have been managed in primary care: report Although no New Brunswick data is included, Dr. Fraser Mackay, an emergency physician in Saint John and chair of the rural, remote and small urban section of the Canadian Association of Emergency Physicians (CAEP), said the findings align with what he sees on a daily basis. He believes the proportion of ER visits for conditions that could be handled elsewhere, such as ear infections and prescription refills, is closer to 25 per cent in New Brunswick, he said, citing the report's the findings for rural and remote communities and noting the rural nature of the province. Any problems in health-care access are "magnified" in rural communities, said Mackay. There are fewer doctors in rural areas, so fewer citizens have access to primary care, he said. Emergency departments often end up being "the clearinghouse for all-comers," which is "not best patient care." 'Slow-burning disaster' He described ERs as "a slow burning disaster." The most challenging part, he said, is dealing with patients who apologize for resorting to the emergency department out of frustration. But patients who don't have a family doctor and seek treatment for minor ailments aren't the ones driving ER overcrowding and long wait times, Mackay said. The bigger problem, he said, is ER patients who have been admitted but can't be moved to a hospital unit because too many beds are occupied by seniors and other patients waiting for a nursing home bed or other long-term care placement. "That fundamentally isn't actually an emergency medicine problem," said Mackay. "It's a health-care problem, and that is a government policy, big-scale problem." WATCH | 'There has to be overlapping accountability for this': Here’s what one Saint John doctor thinks of ER report findings 1 hour ago Duration 1:58 Dr. Fraser Mackay says a new report from the Canadian Institute for Health Information, about access to primary and emergency health care, lines up with what he's experiencing in N.B emergency rooms. He said what's needed is an integrated approach to planning and management that recognizes the overlap between primary care, emergency care, inpatient care and long-term care. As it stands, Mackay said there is "a series of different departments and programs, but there is no overarching system" in health care. He also called for more accountability for how health-care dollars are spent, including patient outcomes. Not all doom and gloom However, Mackay acknowledged there are "a lot of positive changes" underway in New Brunswick. He cited Premier Susan Holt's pledge to open "at least" 30 collaborative health-care clinics , including 10 in 2025. These clinics, which will bring together doctors, nurses, nurse practitioners, psychologists, physiotherapists, pharmacists and others to provide a "health-care home" for patients, have been shown to increase access, satisfaction and overall quality of care, said Mackay. The Liberals pledged during the election campaign this fall to open at least 30 collaborative health-care clinics before 2028. (Shutterstock) Virtual care models are "another piece of the puzzle," he said. Medical schools have also increased enrolment for students as well as residents. "I think there's a lot of things [that] are moving in the right direction," said Mackay, adding that "it's going to be slow and it's going to be hard for a while." 'Big' changes a decade away He estimates "big" changes are about 10 years away — the time it will take to train more doctors and nurses. There are, however, opportunities to increase efficiencies in the shorter term, according to Mackay. He said he's hopeful the new Holt government will engage with the various areas of health care through organizations, such as CAEP, the College of Family Physicians and the New Brunswick Medical Society, he said. Only 79% in N.B. have access to permanent primary-care provider, survey finds Data collection, analysis and dissemination is a "key building block," said MacKay, pointing to population projections and human resources planning as an example. But New Brunswick has been "subpar" in that regard to date, he said. "That's why things like the CIHI report are so critical." Province committed to improving access The Department of Health did not respond directly to any of Mackay's comments. But spokesperson David Kelly said the government is committed to increasing the percentage of New Brunswickers with access to a primary care provider, which will ease pressure on our hospital emergency departments. "Collaborative care teams are a key part of the solution," he said in an emailed statement. "To make that happen, recruitment and retention of health-care professionals, will be a top priority." The government is working to deliver retention payments to permanent full-time and part-time nurses , and is "committed to creating a multi-pronged plan to improve the working conditions of health-care workers and prioritize their wellness," said Kelly. It has also implemented short-term solutions such as NB Health Link, he said. People talk about ... the impending health-care system collapse. We're right in the middle of it. - Fraser Mackay, Saint John ER doctor That program, which provides New Brunswickers with access to a network of family doctors and nurse practitioners while they wait to be matched with a permanent provider, has more than 64,000 people eligible to receive services, said Kelly. An additional 38,000 people are waiting for more clinics to open or for existing clinics to expand, he said. More than 12,500 patients have been placed permanently with a primary care provider through NB Health Link. New Brunswickers can also use eVisitNB or Tele-Care 811, he said. Mackay said it will take "political courage because it's a very big, daunting task" to improve the system. But the situation is "urgent," he said, noting health-care professionals have been warning about the health-care crisis for about 15 years. "People talk about ... the impending health-care system collapse. We're right in the middle of it."Arlington's F.J. 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It’s here. American Thanksgiving. While most of our friends south of the border look at the late-November holiday and think NFL when it comes to sports, most Canadians view it through a different lens. They examine the NHL standings – hoping that their team is above the playoff line. Why? Since realignment occurred over a decade ago, 80% of the teams that are in playoff spots at Thanksgiving qualify for the post-season. For those that are mathematically challenged, that’s 13 out of 16 teams. That was the case last season as well as Edmonton, Nashville and the New York Islanders were the only teams to make the playoffs despite being on the outside looking in on Nov. 23, 2023. Last year on that date, the Vancouver Canucks had 27 points and only the Vegas Golden Knights — with 30 — had more. The Canucks performance in those first 20 games basically clinched a playoff spot. This season the Canucks haven’t been as fortunate. Not having the services of all-star goaltender Thatcher Demko since the start of the season due to a knee injury was the first issue that the hockey club had to deal with. Dakota Joshua also missed the first 14 games recovering from off-season cancer surgery. Brock Boeser suffered what appeared to be a concussion on Nov. 7 and missed seven games but was set to return to the lineup in Boston against the Bruins on Tuesday night. Then there’s J.T. Miller, who took a leave of absence on Nov. 19 for personal reasons. Add it all up and it’s a Canuck team that has been treading water without their three All-Stars from a year ago. After Monday’s games, Vancouver was below the playoff bar with 23 points, trailing both Colorado and Edmonton by one point for the two wildcard spots. The Canucks are also two points behind the Los Angeles Kings for third place in the Pacific Division. The good news with all of these scenarios is that the Canucks have played the least number of games — 19 — of any team in the National Hockey League entering Tuesday’s game versus Boston. They have three games in hand on Edmonton, Colorado and Los Angeles. However, the question remains: will the Canucks make the playoffs? Many assume once the team gets 100% healthy, they will find a way to get it done but you know what they say about people who assume. Let’s start with Demko, the 28-year-old who compiled a 2.45 goals-against-average and a .918 save percentage last season to go along with 35 wins in 51 games. Since March 10, he has played a grand total of four games; that’s four games in eight months. After such a lengthy layoff, the biggest concern for Demko will be timing and getting used to the intensity level of NHL games. As we often say when it comes to football, nothing duplicates game speed. For Demko, getting used to the speed and regular chaos of NHL games will be a challenge. Then there is Boeser, who had been out of the lineup for almost three weeks after taking a headshot from Tanner Jeannot in a game against the Kings in early November. Hopefully, there won’t be any lingering symptoms from that injury and Boeser can regain the pace that saw him score 40 goals last year and which he was duplicating this season with six goals in 12 games. As for Miller, when he does return, what player will the Canucks be getting? His play had dipped to the point where he was benched for the last 14:40 of the third period in his final game versus Nashville on Nov. 17. Miller’s production had waned with only six goals and ten assists in 17 games – well off the levels from a year ago when he tallied 37 goals and 66 assists. Then there are other issues that are of concern as well. The second defensive pair of Tyler Myers and Carson Soucy has struggled this season to the point where the organization is checking in with other teams as they look to get help for their blue line corps. What has compounded the problem is that Tocchet has emphasized since training camp that he wants his defencemen to be more involved in the offense and generating more chances. That doesn’t exactly fit into the skill set of either Myers or Soucy so it’s been noted that the Canucks are talking to other teams with Pittsburgh’s Marcus Pettersson being a player of interest. Although Pettersson is a solid defender, he’s not exactly the answer to the Canucks problems when it comes to offence from the back-end. While we are on the topic of Petterssons, the enigma known as Elias Pettersson will need to regain the form that saw him be a dynamic play-driver who scored 30-plus goals the last three seasons. Tocchet and the organization wanted to see more of an investment from Pettersson and the Swede has shown signs of improvement with four goals and six assists in his last seven games. There are other positive signs as well. Quinn Hughes continues to play at a Norris Trophy-calibre level while Kevin Lankinen has provided consistent goaltending during Demko’s absence. Conor Garland continues to play like Conor Garland and Pius Sutter and Teddy Blueger continue to provide good depth while new additions Kiefer Sherwood and Erik Brannstrom have exceeded expectations. Given what we know about the U.S Thanksgiving Day playoff trend, it’s not a slam dunk that the Canucks will make the post-season but it’s not a slam dunk they won’t either. Unlike last year when the team had enough of a cushion in the standings to play games pressure-free for the most part in the second half, it appears they won’t have that luxury this season. As Tocchet always likes to say, things are going to just keep ‘getting tougher’ and the Canucks are going to have to ‘embrace the hard’ as they deal with the grind of an NHL season. Their playoff hopes will depend on it.Same glitz and glamour for the Las Vegas Grand Prix, and perhaps another Verstappen championship
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Black Friday ‘bargain’ warning over fake AI reviews that could lead shoppers to dangerous products – how to spot themWorld News Live: Welcome to our World News live blog, your go-to source for instant updates on major events across the globe. Whether it's political shifts, economic trends, environmental crises, or international conflicts, we deliver real-time reports to keep you informed and engaged with the latest global developments. Disclaimer: This is an AI-generated live blog and has not been edited by Hindustan Times staff. ...Read More World News Live : Benjamin Netanyahu undergoes successful prostate surgery
Israeli hospital says Netanyahu has undergone successful prostate surgery TEL AVIV, Israel (AP) — Israeli Prime Minister Benjamin Netanyahu underwent successful surgery Sunday to have his prostate removed, hospital officials said, a procedure that came as he manages multiple crises including the war in Gaza and his trial f Tia Goldenberg, The Associated Press Dec 29, 2024 12:41 PM Share by Email Share on Facebook Share on X Share on LinkedIn Print Share via Text Message FILE - Israeli Prime Minister Benjamin Netanyahu speaks during a press conference in Jerusalem, Dec. 9, 2024. (AP Photo/Maya Alleruzzo, Pool, File) TEL AVIV, Israel (AP) — Israeli Prime Minister Benjamin Netanyahu underwent successful surgery Sunday to have his prostate removed, hospital officials said, a procedure that came as he manages multiple crises including the war in Gaza and his trial for alleged corruption . Netanyahu, who has had a series of health issues in recent years, has gone to great lengths to bolster a public image of himself as a healthy, energetic leader. During his trial this month, he boasted about working 18-hour days, accompanied by a cigar. But as Israel's longest-serving leader, such a grueling workload over a total of 17 years in power could take a toll on his well-being. Netanyahu, 75, is among older world leaders including U.S. President Joe Biden, 82 , President-elect Donald Trump, 78 , Brazil's President Luiz Inácio Lula da Silva , 79, and Pope Francis , 88, who have come under scrutiny for their age and health issues. Netanyahu's latest condition is common in older men, but the procedure has had some fallout. The judges overseeing his trial accepted a request from his lawyer on Sunday to call off three days of testimony scheduled this week. The lawyer, Amit Hadad, had argued that Netanyahu would be fully sedated for the procedure and hospitalized for “a number of days.” Jerusalem's Hadassah Medical Center announced late Sunday that the procedure had been “completed successfully.” Justice Minister Yariv Levin, a close ally, served as acting prime minister during the operation. Netanyahu is expected to remain hospitalized for several days. With so much at stake, Netanyahu’s health in wartime is a concern for both Israelis and the wider world. A turbulent time in the region As Israel’s leader, Netanyahu is at the center of major global events that are shifting the Middle East . With the dizzying pace of the past 14 months, being incapacitated for even a few hours can be risky. Netanyahu will be in the hospital at a time when international mediators are pushing Israel and Hamas to reach a ceasefire in Gaza and as fighting between Israel and Yemen’s Iran-backed Houthi rebels intensifies . Prostate issues are common and in many cases easily treatable. Still, the procedure puts a dent in Netanyahu’s image of vigor at a time when he would want to project strength more than ever, both to an Israeli audience navigating constant threats as well as to Israel’s enemies looking to expose its weaknesses. Previous health issues, including a heart condition Netanyahu insists he is in excellent health. His office releases footage of him touring war zones in full protective gear flanked by military officers, or meeting with defense officials on windswept hilltops in youthful dark shades and puffer jackets. But that image was shattered last year when Netanyahu’s doctors revealed that he had a heart condition , a problem that he had apparently long known about but concealed from the public. A week after a fainting spell, Netanyahu was fitted with a pacemaker to control his heartbeat. Only then did staff at the Sheba Medical Center reveal that Netanyahu has for years experienced a condition that can cause irregular heartbeats. The revelation came as Netanyahu was dealing with massive anti-government protests. The news about a chronic heart problem stoked further anger and distrust during extreme political polarization in Israel. Last year, Netanyahu was rushed to the hospital for what doctors said likely was dehydration . He stayed overnight, prompting his weekly Cabinet meeting to be delayed. Earlier this year, Netanyahu underwent hernia surgery , during which he was under full anesthesia and unconscious. Levin served as acting prime minister during the operation. Recovery can be quick According to Netanyahu’s office, the Israeli leader was diagnosed with a urinary tract infection on Wednesday stemming from a benign enlargement of his prostate. The infection was treated successfully with antibiotics, but doctors said the surgery was needed in any case. Complications from prostate enlargement are common in men in their 70s and 80s, Dr. Shay Golan, head of the oncology urology service at Israel’s Rabin Medical Center, told Israeli Army Radio. Golan spoke in general terms and was not involved in Netanyahu’s care or treatment. He said an enlarged prostate can block proper emptying of the bladder, leading to a build-up of urine that can lead to an infection or other complications. After medicinal treatment, doctors can recommend a procedure to remove the prostate to prevent future blockages, Golan said. In Netanyahu’s case, because the prostate is not cancerous, Golan said doctors were likely performing an endoscopic surgery, carried out by inserting small instruments into a body cavity, rather than making surgical cuts in the abdomen to reach the prostate. The procedure lasts about an hour, Golan said, and recovery is quick. He said that aside from catheter use for one to three days after the procedure, patients can return to normal activity without significant limitations. ___ AP correspondent Isaac Scharf contributed reporting. Tia Goldenberg, The Associated Press See a typo/mistake? Have a story/tip? This has been shared 0 times 0 Shares Share by Email Share on Facebook Share on X Share on LinkedIn Print Share via Text Message More World News Jetliner skids off runway and bursts into flames while landing in South Korea, killing 179 Dec 29, 2024 1:02 PM Syria's de facto leader says it could take up to 4 years to hold elections Dec 29, 2024 11:57 AM What we know about the deadly passenger jet crash in South Korea Dec 29, 2024 8:36 AM Featured FlyerNone