Tyler Johnston

Emergency Medicine Doc | Global Health | Health & Social Policy | Dadx2

[alan drummond @alandrummond2]

Emergency Medicine again in the news this morning.
Been lying dying on the road now for some months (years) - glad somebody finally noticed the slight flicker of our tail feathers.
The Dead Canary Chronicles;

[Ken Milne MD @TheSGEM]

@NightShiftMD I suspect we will lose more healthcare workers this winter when the totally anticipated wave of respiratory illnesses hit a system running short staffed & over capacity with no plan to effectively manage the yearly surge :(
@alandrummond2 @raghu_venugopal @davidcarr333

[Raghu Venugopal MD @raghu_venugopal]

Every Canadian will need the ER. That's why this matters. ER doctor's difficulties reflect the difficulties of patients. The solution is improving ERs - not yoga, meditation, cookies or pizza. 👇👇👇

ERs nationally face overcrowding and no beds. ERs are full because hospitals are full. When there's no space to operate, it degrades patient dignity and the ability to see patients.

ER doctors are punched in the face, spit on, face the same homeless polysubstance drugs users who are racist and violent, night after night. ER doctor's patients die prematurely because medical orders couldn't be carried out. Hospitals don't act like they care what ER doctors say. Governments act like they don't care what ER doctors say. Their patients with real emergencies are stuck in chairs. ER doctors face vexatious complaints and get push-back from other doctors who we ask for consultation/help. Patients are mad at ER doctors. Other doctors are mad at ER doctors. ER doctors are the target of blame, and so they check out and move on. ER doctors don't have hope the system will change, so they check out.

The irony of the situation is ER doctors love their jobs. When ER docs do "wellness surveys" they're told they are at higher risk of suicide but have out-of-the-world job satisfaction. Why?

ER doctors truly help people. We make untold numbers of patients feel better. We save lives. We correctly diagnose patient's problems. We connect patients to a sprawling healthcare system. We get incredible thank you's from grateful families and patients. That's why we stay.

For at least 25 years - as long as I have been there - the ER has been a tough place to work. That tough place to work pushes good doctors away.

The reason we don't want good doctors pushed away is simple. You want an ER doctor when you have an emergency. ERs have scheduling gaps and close when there aren't enough ER doctors. That's how it affects the population. Lost ER doctors represents a loss of a publicly-funded resource. Lost ER doctors is a loss of institutional knowledge of how to get the job done.

The reason this matters is because every Canadian is going to need an ER doctor at some point.

@OntarioHealthC @OntariosDoctors @NightShiftMD @LaurenPelley @CAEP_Docs

https://t.co/rY7iy3Yi69

[Tyler Johnston @TylerJohnston33]

Great article on ED overcrowding … https://t.co/h9XbuJFcTp

[Tyler Johnston @TylerJohnston33]

@BlueJays Thanks for an amazing season. You played the game the right way for each other and for 🇨🇦. We are so proud of you!

[alan drummond @alandrummond2]

And in other news....
After being a physician for 47 years and being a Family Physician in Perth for 42, I have decided to finally retire.

[CAEP @CAEP_Docs]

A REMINDER 🧵👇
The challenges faced by the emergency care system and in primary care are two distinct crises, with distinct solutions.

[Andrew Petrosoniak @petrosoniak]

Very true.

[Sam Ghali, M.D. @EM_RESUS]

“What’s the craziest thing you’ve seen in the ER?”

The daily consequences of a completely broken healthcare system.

[Tyler Johnston @TylerJohnston33]

This CEO embraces the night shift https://t.co/L7sMxOHVmN

[Howard Ovens @HowardOvens]

Patients are ‘routinely’ being diagnosed with cancer in busy Canadian emergency rooms, doctors warn @kee_gre @SREMI_MSH @CMAJ https://t.co/URTJRaImWD via @torontostar

[Raghu Venugopal MD @raghu_venugopal]

Primary care is not the sole or even a major cause of ER overcrowding. Solving one doesn't solve the other. Patients define emergencies (not nurses, MDs or policymakers). A sore throat can sometimes even be life-threatening. I strongly support the @CAEP_Docs statement below.

[Raghu Venugopal MD @raghu_venugopal]

The ER problem is hospital beds, beds, beds. Team-based primary care is important, but family medicine is not the ER problem compared to beds, beds, beds. Reporting by @naomibargh - @CAEP_Docs @CMA_Docs @DrKathleenRoss1 @TrevorJain

https://t.co/l6PRc79sxV

[Raghu Venugopal MD @raghu_venugopal]

What we are witnessing is the collapse of the emergency medical system across Canada. @markhollandlib @CAEP_Docs

Across Quebec, ERs at 147% overcapacity (some at 200%). Total average wait time to see an ER doc was >5 hours. The nation is in meltdown.

https://t.co/Rr4hYC56pT

[George Mastoras, MD, FRCPC (@yiatre.bsky.social) @georgemastoras]

EDs are designed for Anyone, Anything, Anytime
NOT Everyone, Everything, Everytime

[Tyler Johnston @TylerJohnston33]

ERs across Canada likely to face rolling closures, long wait times, doctors, nurses warn | iPolitics https://t.co/keRirtpiEe

[Paul Atkinson @PaulAtkinsonEM]

My 4 take home points from @CAEP_Docs @CAEPConference

[Rosemary Wyber @RosemaryWyber]

11/11 On the cusp of thesis submission, I still believe that RHD elimination is possible. It will take much, much more than we are doing now. It will not happen in the health system alone. Without political commitment & resources it will not happen at all.

[Rosemary Wyber @RosemaryWyber]

8/11 The numbers are real people. Some of whom I’ve known as a remote GP. Medicine asks so much from people with RHD – years of painful monthly injections, travel Down South for open heart surgery, scans, medications & measurements. We are offering so little action in return.

[Rosemary Wyber @RosemaryWyber]

6/11 Research and new technologies may also accelerate the decline of RHD – via a Strep A vaccine, new diagnostics for ARF, a better long-acting preventative antibiotic or new treatments. Good science is an important adjunct to the other work.