I was fascinated to read how Dr. Zitmer attempts to co-opt the words of
Tommy Douglas into support for his Primary Care Co-operatives scheme.
Canadians DO make significant contributions to the health care system (which
is, in fact, an illness care system...but that's another posting!), through
our taxes.  Dr. Zitmer uses this quote out of context, in my opinion.

I was also struck by Dr. Zitmer's characterization of nurses as
'professional assistants' to physicians, who allow physicians to 'specialize
in higher value activities'.  Dr. Zitmer may be surprised to learn that
nurses (along with other regulated health professionals in Canada) have an
established, self regulated scope of practice independent of medicine.  I'm
sure that many would question the 'higher value' of activities provided by
physicians.  The health of Canadians is promoted by the collaborative work
of many disciplines; with differing approaches, but certainly of equal
value.  I'm sure that many physicians would agree that an activity is not of
higher value simply because it is provided by a physician.  Perhaps access
to care would be improved if Nurse Practitioners and other regulated health
professionals could be fully reimbursed for their services by provincial
Health Programs.  Physicians currently monopolize this billing process, and
are rigidly opposed to opening this up to any other health profession.

I also wonder to whom these proposed monthly fees would be payable?
Physicians?  The nurses who provide the service?  I find it hard to believe
that anyone's health would be improved by renewing prescriptions by phone,
or getting lab results by email (most people would need to have such results
interpreted for them anyway).  People in Ontario already have access to
health information through a provincial telehealth phone line, staffed by
nurses.  Many Health Units also provide the same service.  Dr. Zitmer seems
to be proposing that people pay more for services that already exist.

I suggest that Health dollars would be more wisely spent by shifting focus
from 'illness care' to those approaches that can prevent visits to
physicians offices and hospitals in the first place.


Corrine Langill RN, BscN
Adolescent Health Specialist, Program Development
City Of Ottawa, Community Services Branch
495 Richmond Rd.
Ottawa, ON
K2A 4A4
(613) 724-4122 ext. 26258
fax: (613) 724-4148
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