Deepa Soni

mother. wife. emergency physician. spiritual seeker. design junkie. opinions my own views. RT for discussion. advocating for a safe health care system

[Dr. Sohail Gandhi, MD @drmsgandhi]

My guest blogger felt their story about @ONThealth and @OntarioHealthOH and their utter failure in #homecare was so controversial- they requested anonymity. Read on to see what the fuss was about. #onhealth #onpoli https://t.co/FKGMWsF5QI

[Deepa Soni @drdeepasoni]

Disturbing reports of corporate pressures on pharmacists for profit: https://t.co/kr5iRuprA0

When diagnosis (dx) leads to Rx which leads to profit for corporation, unlikely for pharmacist to be allowed to dx viral illness and no Rx sold. Dx and Rx sale shouldn't be in same hands

[Deepa Soni @drdeepasoni]

Another example: sore throat isn't always strep throat needing antibiotics. Without an examination and a thorough history, how will the pharmacist know whether this is peritonsillar abscess, mononucleosis, or life-threatening conditions like epiglottitis?

[Kimberly Moran (she/her) @kmoranONT]

As a voice for @OntariosDoctors, we must emphasize doctors are irreplaceable in providing comprehensive, high-quality care. 🧵
https://t.co/zkrnWmIMPi

[Deepa Soni @drdeepasoni]

@LeachKathleen @OCPInfo @OntPharmacists @OntariosDoctors I'm not a pharmacist. Every time a patient asks me a detailed question about a drug interaction, I will do my best to look up the information, but I always direct them to pharmacists who are the experts in this field. Why are pharmacists not able to understand this distinction?

[Deepa Soni @drdeepasoni]

@LeachKathleen @OCPInfo @OntPharmacists @OntariosDoctors Please look up Dunning Kruger effect. What is about to be embarked on is a dangerous experiment. People with little/no training in diagnosis being given license to come up with a diagnosis that results in rx. Your clinical records cannot be those of MD because you're not an MD

[Deepa Soni @drdeepasoni]

@LeachKathleen @OCPInfo @OntPharmacists @OntariosDoctors I wasn't aware that pharmacist do a thorough history and physical? When did they start getting training and differential diagnoses for the conditions that they are about to be prescribing for? How many hours were they trained to recognize epiglottitis versus strep throat?

[Deepa Soni @drdeepasoni]

so much rhetoric about private care and that patient shouldn't have to pay to receive primary care. No one addressing the fact that big corps like shoppers drug mart are making $$$ profit from the selling of medications that pharmacist playing doctor Rx'd -- conflict of interest

[Deepa Soni @drdeepasoni]

The answer is they can't. They haven't had the training to diagnose. And in the name of convenience care, the antibiotic will be prescribed to make the patient happy. We already have a worldwide antibiotic resistance problem, which will spiral completely out of control.

[Deepa Soni @drdeepasoni]

Substituting other professionals for convenience care is not the answer.
Eg: woman treated 3 times by pharmacist for "yeast infection" eventually comes to ED -- diagnosed with diabetes --blood sugar of 30 (reason for yeast infection)
Pharmacists have a role, but not as doctors

[Kimberly Moran (she/her) @kmoranONT]

As a voice for @OntariosDoctors, we must emphasize doctors are irreplaceable in providing comprehensive, high-quality care. 🧵
https://t.co/zkrnWmIMPi

[Deepa Soni @drdeepasoni]

An excellent piece about the need for comprehensive family medicine for our system to work properly written by somebody in the trenches. Well worth a read https://t.co/U07NcPm1kz

[Deepa Soni @drdeepasoni]

I feel tremendous privilege to work in the emergency department. But I feel equally tremendous frustration that for 2 decades, this problem has been swept under the rug with the annual "flu surge" explanation for why patients wait for care. Let's tell the truth and fix this.

[Deepa Soni @drdeepasoni]

The only way this will stop is when patients start sharing their experience like this mother did. Only voters can make federal and provincial govt change.

Doctors & nurses have been raising alarm bells for years. We have one of the lowest number of beds of OECD countries. 1/

[Julia Malott @AlottaMalotta]

Please share this widely! I couldn't be more terrified of our country's healthcare crisis and @ONThealth can do better!

Ontario healthcare is broken and we've long known it. It's been like this my entire lifetime, and I'm not exactly young.

This is my daughter's IV line, which she's been connected to since 2:00am this morning. She's been awake for well over 24 hours, as have I, as we await care at @StMarysGenHosp in Kitchener, Ontario.

We arrived shortly after 10:00pm yesterday evening after my daughter complained of excruciating abdominal pain. As usual, care took hours to arrive. She was given a bed where she squirmed and sobbed until finally, shortly after 2:00am, the doctor paid her a visit and ordered pain meds to make things bearable.

It was evident by 4:00am that we were almost certainly looking at appendicitis, as the pain was centralizing in the lower right quadrant. We all suspected this, but we couldn't confirm until 8:00am because... apparently we don't have ultrasound technicians during the evening. No one has medical emergencies in the middle of the night, I suppose?

For those who haven't had the pleasure of an inflamed appendix, appendicitis often leads to a ruptured appendix after a period of increasing pain, and that rupture can be fatal. Fortunately for us that hasn't happened yet, but time matters. There's nothing this hospital can do for us as 'we need to confirm it's appendicitis'. We wait until 8:00am

By 5:00am we are told that my daughter needs to give up her emergency room bed. Someone else needs it. She is still in pain, but will now make due sitting in the waiting room, putting pressure on her abdomen in the process. There's no negotiation—there are no beds available.

We wait until 8:00am. We wait until 9:00am. Some guy walks in with a Tim Horton's cup during our tenure and gets the first ultrasound slot. I'm sure his condition was just as severe.

By 10:00am the doctor confirmed what had been evident for hours—we've got a case of appendicitis on our hands and we need to move forward with emergency surgery.

...Except... they can't do that in this particular hospital and @grhospitalkw doesn't have any beds available either. No one knows when they will have a bed for my daughter who is both sleep deprived and in critical medical condition.

I inquire. An hour? A bed by noon? Will we even get one today?

No one has an answer. No one wants to have the conversation. I can tell I am a burden to the overworked staff.

We return to the waiting room and my daughter keeps sitting. She's been awake now since yesterday morning. Her pain flares up every few hours and—after being brought almost to tears the edge is subdued with another dose of pain suppressants.

She's refused a bed because there are no beds available, and I can't take her home to her bed because she needs surgery—though there's none of that available either.

She hasn't eaten in more than 18 hours and she's been told that she's not allowed one bite because she might have surgery any moment... Or perhaps never... so we sit and wait—watching her IV machine go into upstream occlusion every 5 minutes. The nurses don't have time to do anything about it.

This is a simple problem to fix. Fund our healthcare system! @SylviaJonesMPP, @fordnation, our citizens deserve better.

Fix it!

[Deepa Soni @drdeepasoni]

It's going to require recognizing the backbone of our healthcare system is primary care. Family doctors are overwhelmed by administrative burden, trying to run their offices and taking care of large practises in the community without adequate resources. 16/

[Deepa Soni @drdeepasoni]

It's time we stop labelling the state of our health care system with euphemisms like "flu surge". It's time we recognized that our system lacks, adequate beds and resources and that the solutions lie in properly allocating tax dollars to long-term solutions, and not Band-Aids.

[Deepa Soni @drdeepasoni]

The emergency department is a reflection of a system that is strained beyond capacity. Throwing Band-Aids at it is like trying to mop up the floor under an overflowing sink, instead of trying to figure out how to turn off the tap 13/

[Deepa Soni @drdeepasoni]

Stories like this are happening every day in ON and 🇨🇦. Most patients/family are too busy dealing with the acute heath problem. When people take the time to bring these stories to the light, they can't keep being ignored by government. 14/

[Deepa Soni @drdeepasoni]

It will require a system that has a national Pharmacare program. Interprovincial licensing of doctors and nurses. Improvements in the pay and working conditions of hospital nurses in order to recruit and retain adequate numbers to care for both admitted and Emergency patients 12/

[Deepa Soni @drdeepasoni]

When the vast majority of the emergency department beds are being used to take care of hospital patients, that means that patients that are waiting in the emergency department waiting room, will wait for hours for care, much like this story is describing 5/

[Deepa Soni @drdeepasoni]

It's going to require adequate long-term care beds. It will require dementia care. We need better funding of, and beds for hospice and palliative care so patients with cancer can Have their last days, be spent pain-free, and surrounded by their loved ones. 12/

[Deepa Soni @drdeepasoni]

It's going to require investments in homecare... paying homecare nurses well and creating proper infrastructure for the home care system to function well enough for patients to receive treatments in the community. Right now, this system is starved of resources 11/

[Deepa Soni @drdeepasoni]

Media needs to scratch beyond the surface and hold government to account. Real solutions are going to require thinking beyond the four-year election cycle to what will our system look like in 20 years? and planning for that. 10/