Corinne and Lynne, great ideas!!!

Can you suggest a way that governments across the country can adopt large
scale sponsorship of such programs? and in a way that doesn't take resources
from existing programs that influence population health?

In the meantime what do you suggest for people  who don't have access to the
multidisciplinary teams that seem so important? How would you suggest
practioners (nurses and doctors) who support such an arrangement go about
developing it in the face of resistance (or at least lack of funding) from
health departments?
best wishes
David Z.

>===== Original Message From Social Determinants of Health <[log in to unmask]>
=====
>Thank you Corrine for your clarity and support of a fully publicly
>funded system with salaried clinicians working in multidisciplinary
>environments (virtual or otherwise) and each one operating within their
>scope of practice. Nurses, Nurse Practitioners, Social Workers,
>Chiropodists, Doctors and alternative health practitioners working in
>partnership for patients/clients, employing health promotion, illness
>prevention and treatment. And even more importantly understanding how
>the social determinants impact health.
>
>This is the Community Health Centre Model...and it works.
>
>Lynne Raskin
>
>-----Original Message-----
>From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
>Langill, Corrine
>Sent: Friday, April 30, 2004 4:09 PM
>To: [log in to unmask]
>Subject: [SDOH] FW: primary care cooperatives
>
>
>> HI everyone,
>> I'll respond just this last time, and will try to be brief.  First,
>> David, my apologies for misspelling your last name.  I'll address your
>
>> questions. I feel that you used Tommy Douglas's comments out of
>> context, whatever the understanding.  By quoting him as you expound
>> your proposal for Primary care cooperatives, you imply that he would
>> approve, when that is certainly not clear.
>>
>> You requested suggestions for ways of working with other primary care
>> professionals.  Some ideas:
>> *     Stop characterizing nurses as assistants, as you did in your
>initial
>> message.  Nurses must be able exercise their full scope of practice.
>> Currently in Ontario, nurses who are employed in physician's offices
>> are underpaid, and frequently end up doing clerical work.
>> Alternatively, in the Sexual Health Centre (part of our Public Health
>> Department) here in Ottawa, nurses complete client assessments,
>> determine what tests are required, do all teaching about medications
>> and contraceptive methods.  In smaller, satellite clinics, Public
>> Health Nurses complete pelvic exams, pap tests and STI screening, and
>> provide oral contraceptives, depo provera and emergency contraception
>> under standing orders from our Medical Director.  I'm certain there
>> are many other examples other nurses and health professionals could
>share.
>> *     All immunizations could be provided by Public Health Units, at a
>> great cost saving.  It is much more expensive to have immunizations
>> provided by family physicians.
>> *     Physicians should be salaried, and Community Health Centres
>(with
>> the broad range of services they provide) be more widely available.  I
>
>> believe this would allow physicians to spend the time they would like
>> to spend with their clients, and likely clients would experience
>> improved outcomes.  The current funding formula is not working for
>> anyone, and physicians are burning out.
>> *     a shift in health funding (less on hospitals and 'downstream'
>care,
>> and more on public and community health).  I strongly support
>> increased funds funding for housing, education, employment and social
>> assistance. It is understood that such a shift would be gradual.  Even
>
>> a small change would make an enormous difference.  I once heard Dennis
>
>> speak at a network meeting I attended, and he reminded us that the
>> wealthiest Canadians currently owe millions of dollars (perhaps
>> hundreds of millions?) in unpaid taxes.  Certainly this money could be
>
>> put to good use.
>>
>> Thanks everyone, for your indulgence.  Florence Nightingale's birthday
>
>> is May 12th, and nurses throughout Canada (and likely around the
>> world) celebrate Nurses Week in her honour May 10-14.  I say, buy a
>> nurse a drink! Cheers,
>> Corrine
>>
>>
>>
>> Corrine Langill RN, BscN
>> Family Health Specialist
>> Family and Community Health
>> City Of Ottawa, Public Health Services
>> 495 Richmond Rd.
>> Ottawa, ON
>> K2A 4A4
>> (613) 724-4122 ext. 26258
>> fax: (613) 724-4148
>> [log in to unmask]
>>
>>
>>
>
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David Zitner, M.A., M.D., C.C.F.P., F.C.F.P.
Director, Medical Informatics
Dalhousie University Faculty of Medicine
902-494-3802

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