WHITBYFREE PRESS, WEDNESDAY, AUGUST 3,,1988,PAGE 7 PAGE SEVEN HE OTHER SIDE By Doug'Anderson Y 1 THE DOCTORS' DILEMMA Three years ago Ontario's doctors went on strike for more money. The strike was designed to force the medical delivery system to a crisis that the government could only resolve by giving in to their demands. It failed. The system did not break down. Although they had some support, there was a much louder cry of disgust that doctors were prepared to use their patients as pawns. Against that backdrop the Ontario Medical Association is again negotiating a new fee schedule with the government and just like three years ago'they are a long way apart. Medical care in one form or another consumes about one third of the provincial revenues and it seems quite reasonable that the government would want to contain further expenses. In a province which has just passed pay equity legislation - it would be worthwhile to scrutinize the doctors' role vis-a-vis other health workers. A hundred years ago, the doctor was the only medical care available. His wife was his nurse, his carriage was the ambulance, his home was in all probability the hospital, he carried the pharmacy in his bag and any medical fees collected were his entirely. In large centres doctors built private hospitals where better care and facilities could be provided. Public hospitals were only for the indigent but inevitably, as costs rose, government subsidized hospitals became the norm for all except the very wealthy. Pharmacists took over much of the doctors' drug- dispensing functions when it became necessary to regulate the wholesale abuse (far worse than today) of heroin and cocaine derivatives at the turn of the century. With Florence Nightingale, nursing became a respectable profession and as qualifications and ability rose so did responsibilities. Today, many nurses are as well qualified as doctors and many emergency medical decisions are delegated to them as a matter of course. The invention of X-ray and its newer derivatives created a new branch of health care with its own cadre of technical experts to assist in diagnosis and treatment. Laboratory medicine, which a hundred years ago was limited to the colour and smell of urine, can now measure thousands of body chemicals on a routine basis. As with X-ray, a separate profession developed. Strains and sprains have been delegated to the physiotherapists. And with the incredible increase in information, even keeping medical records has become a separate and highly skilled occupation. This is the backdrop against which doctors are negotiating. They want to maintain the same relative standard of living they had before all these changes occurred. Put simply, doctors are now only one cog on the mighty wheel of the health care system. Granted they may be the quarterback but just like a football team, every position must play its best to defeat the opponent - in this case, disease. The issue is not how much a doctor is worth but how do you split the health care pie - what is the relative worth of each of tbe competing elements. Lt seems inevitable thatWHTYSRE FARP AD ON RCK ThE SUTUGS 1,13 doctors will bave to accept a smalller piece in order to provide for the other elements iri proportion to their contribution. AInte10sWtbbedasrtfiroteAgstiicHlaywkndwibpces doctor is not wortb three time as much as a nurse.gontote aadaLeinadRtrClbTefotinheoerudisro te Today's modern hospitals aeequipped with the ultimateOsaaoarClbHeinCipedClrntoeltadHpies. in sophisticated hardware and are staffed by highly trained professionals that keep it working. The doctors make tbeir 1 ER G rounds once or twice a day and base their treatments onfomteWdsayAust2198dionfth information provided by the nurses, physiotherapists, X-rayWHTYFE PRS and lab technologists. The support staff could usually make *Tocntuto okr eeeetoue tasomswrst tAhladCîon the decisions just as well - sometimes better. The role of the sres01Jl 7 physician is te co-ordinate and direct the treatment. *Grrd rwi h eiin ftePtrPryAada htysottnigctzno My own long experience with bospitals leads me to the*197 cocuinthat bealth care will be a great deal more efficient *JmHge fSabrubbsprhsdte10ya-l rohnfu ii and effective when doctors recognize, acknowledge, and Gîey accept their co-workers as partners rather than assistants. 2 ER G Part of that is a willingness te share the pie more equitably. fo h hrdy uut1 93eiino h Butiveg ore mpohentCantedrsponibigioenplaeddo Rtay Club.Y TheWotiS h oegon sfo h support staff have not kept pace with the level of their Negotiations are nearly complete forvelopment of a shopping mail at Dundas Street and training. In a study of lab technologists in the States, more Kendalwood Road. than half responded that they did not expect to be in the field Three Whitby hotels have applied for liquor licences. five years later. The most frequent reasons were lack of Most industrial plants in Whitby bave ciosed for summer vacation. direct responsibility to the patient and frustration with a Editor Carl Mantz says annexation negotiations between Wbitby Town and Township supporting role. I am a living example of one who left. As a should be based on the needs of the people. technologist, doctors were paid more for reading my results than I was for doing the work. 100YEARSAGO Nurses, physiotherapists, pharmacists and radiology tech- from the Friday, August 3, 1888 edition of the nologists are all fighting for a larger, more meaningful role. WHITBY CHRONICLE Staff turnover is expensive and inefficient and something * William Ware Tamblyn, head master of the Bowmanville Igh School, is the new principal we can't afford. In the interests of their patients, doctors of the Whitby Collegiate Institute. should accept a gradual decline in their relative income in * The town wants the Grand Trunk Railway te improve safety measures at the Corbett's order that the their co-workers can receive a more Point crossing. appropriate share. Without them, we would have to return to * Whitby Harbor is a god stopping place for yachters. the herse and buggy days. Can we afford that?