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Taming of Queue conference tackles demographic issues

Providing appropriate care for seniors in a health care system lagging far behind the realities of the issues involved was the theme of the 12th annual Taming of the Queue conference held recently in Ottawa.

“The challenge of providing timely access to quality health care continues," said conference co-chair and former Manitoba politician and former Canadian senator Sharon Carstairs in introducing the meeting, which featured international and Canadian experts as well as patient representatives.

For the Canadian Medical Association (CMA), one of the conference sponsors, most of what was said at the two-day meeting was a vindication of the CMA’s decision to focus on seniors care as the critical issue facing the health care system.

In his remarks to the conference, CMA President Chris Simpson was critical of cuts in health care funding as an “unimaginative and mean way” of controlling costs. He advocated an emphasis on the delivery of quality, patient-centred care.

Simpson called on physicians to take the lead in making the necessary reforms, as he said the medical profession has the necessary tools to do so.

The CMA campaign for a national seniors strategy to co-ordinate the delivery of care was endorsed by Toronto geriatrics expert Dr. Samir Sinha in the final panel discussion at the conference. Sinha is one of several physicians serving on a CMAadvisory panel on seniors care.

“The world is changing but health care isn't changing with it - we are in the 19th century with respect to attitude and culture,” was how the issue was framed by keynote speaker Sir John Oldham, chair of the Independent Commission on Whole Person Care.

His perspective was mirrored by Dr. Ross Upshur, Canada Research Chair in Primary Care Research, who delivered a blistering critique of the failure of the current Canadian system to respond to the growing challenges of treating aging patients who have multiple chronic diseases.

Upshur was also critical of the emphasis placed on clinical practice guidelines to treat patients because such an approach has a single-disease focus not appropriate to those patients with multiple morbidities.

The growing population of frail elderly patients “needs coordinated, person-centred care rather than treatment as a collection of separate diseases,” said Dr. John Muscedere, scientific director of the Technology Evaluation in the Elderly Network and professor of medicine at Queen’s University, Kingston, Ont.

Many innovative programs already in place in Canada to help seniors maintain their independence in the community were featured at the meeting, but the project receiving most attention was the Northumberland (Ont.)-based Partners Advancing Transitions in Healthcare (PATH) project with its emphasis on involving seniors and their caregivers in their care.

“The best place is home,” is how Carstairs summarized what many speakers said about the need for co-ordinated community care.

While Taming of the Queue 2015 had a deliberate focus beyond strategies to improved wait times for medical procedures, the wait times problem was addressed in an overview by University of York, UK, economist Luigi Siciliani

Based on his review of strategies to reduce wait times in OECD countries over the past 13 years, Siciliani said it is now clear that setting some form of maximum wait time guarantee is effective.

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