(Published as a letter to the editor in the Hamilton Spectator on Jan 21, 2008.)
In his Jan. 16 column ("Will 'kids only' ER trouble the adults?") column, Andrew Dreschel drew attention to some but missed many negative consequences of the Hamilton Health Sciences' changes proposed for medical care in Hamilton.
Most significant is the absence of input from the community and front-line physicians. So far, local media have mostly accepted the spin supplied by administration without inquiring about potential setbacks in the delivery of medical care.
Patients seldom present with clear single-system pathology, hence the current emphasis on subspecialty care is inherently flawed. An integrated, multisystem approach to patient care in which generalists and specialists work together has always been regarded as more desirable and affordable than the model offered by HHS.
As more generalists are squeezed out of the hospital environment in favour of "centres of excellence," patients lose continuity of care and are treated less like people and more like consumers.
Any adult suffering from a life-threatening illness in West Hamilton, Dundas and Ancaster will be forced to drive past a functional ER and will not be served well by the proposal.
The last thing this city needs is more vehicle travel and ambulance trips ferrying patients from one specialized site to the other, as is necessary to meet the needs of multisystem ailments that are becoming the norm in an aging population.
With this proposal, McMaster health-care students lose a world-class adult teaching hospital on their doorstep, and well-considered links to clinical and basic science buildings will be severed.
Non-administrative members of McMaster's health-care team would probably have countless more concerns if they were asked, and anyone was listening.
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