To the editor,
The Algoma District has a primary care crisis. This isn’t news to anyone who can’t find a family doctor or waited a long time in the emergency room or a walk-in clinic. It certainly comes as no surprise to the 10,000 patients who found themselves without a primary care provider earlier this year.
The issue is well known, and we are fortunate to have dedicated individuals and organizations in our region working tirelessly to address it. This ranges from the work of the Northern Ontario School of Medicine and physician recruiters to the everyday actions of individuals, such as locals making visiting locum physicians feel welcomed in their communities or providers taking the time to teach a new generation of health-care workers. Algoma should be proud of the work done so far, but we must keep up the fight because we have a long way to go.
We talk about the available supply of doctors and health-care providers, but what about the other side of the equation? What’s driving the demand? I’ve been thinking about this long before I became a doctor, particularly in my first career as a paramedic. I began my work in Hornepayne and later served across the district —from Wawa to Richards Landing to Elliot Lake.
During this time, I responded to many medical emergencies and was always left with one question: Could this have been prevented? A highway collision I responded to could have been prevented by more provincial funding for road maintenance, a heart attack could have been prevented by better tobacco policies, and the list goes on.
This recurring theme of prevention became my calling. I enrolled in medical school and discovered there was an entire medical specialty devoted to this, Public Health and Preventive Medicine. It’s a complex specialty that requires the same length of training as any other specialty like surgery or cardiology. I applied for that specialty with no hesitation, but all new public health specialists receive a warning early on: You are facing an uphill battle. No one wants to fund prevention when they have immediate problems facing them here and now. The sick patient today will always supersede the prevention efforts of tomorrow.
With that said, we all know that an ounce of prevention is worth a pound of cure. This informs our work every day at Algoma Public Health. A simple example is immunization. Every dollar spent on routine vaccination saves up to $16 in health-care costs depending on the vaccine — an exceptional 1,600 per cent return on investment!
This is just one of the prevention activities we do in one domain of public health services. We also make sure food and water is safe, advocate for healthy policies that improve the health of residents, work with families and children to ensure they have a healthy start in life and respond to emergencies that threaten the health of the public. I have the privilege of working with highly trained public health professionals who make sure this all happens in the background of our lives.
When we do our job well, you don’t even know we’re here.
In that sense, our great successes in prevention become the biggest threat to our work. Our unseen benefit lacks the urgency of an acutely ill person in need of treatment. Funding then shifts away from prevention leading to more illness. More sick people leads to more health-care spending, which leads to less money for prevention, which leads to more sick people, and on and on.
We need to break this spiral to ensure we have a sustainable future for our health-care system. This is why investment in public health matters, because you don’t just deserve a doctor to care for you when you’re sick, but you also deserve prevention efforts to ensure you’re sick less often.
Dr. John Tuinema
Acting Medical Officer of Health
Algoma Public Health