The Politics of Healthcare: Quinte’s family doctor shortage means patchwork healthcare for many of our region’s infants

* The following article was researched and written as part of a Freelance Writing course I took while completing my Certificate in Professional Communication at UBC. While it speaks to our regional need for family doctors, I believe the same article could be written for many communities province-wide. 

When Courtney Good moved to Quinte Region while pregnant with her first baby, she never imagined she’d be the one piecing together her daughter Cora’s healthcare for the first eight months of her life.

As a first-time mom and someone who values the security of having access to primary care, Good knew that she would need to find a family doctor for her unborn baby once settled in the region. However, coming from Toronto, a city with plenty of primary care providers (PCPs), Good didn’t realize how difficult it would be to get one here.

As her due date approached, she began to panic. “I thought you could just go to a doctor that said, ‘accepting new patients’ but that’s not how it is,” Good recalls, adding that Health Care Connect (HCC), Ontario’s registration system for linking unattached patients with PCPs, posed an additional challenge. She explains that she couldn’t use her doctor in Toronto as a back-up for Cora because to register with the system patients can’t be rostered with a PCP.

Despite registering with HCC while pregnant, Good was told that the waitlist was long, and it could be months before her daughter was connected to a PCP. Sadly, Good’s story is not unique in our region.

Catherine Walker, director at Quinte Health Care (QHC), reports that for the last three years an average of 11% of babies born at QHC have been discharged home without a PCP. That means that in our region, approximately 150 families each year are left to navigate a complex health care system for their infants on their own. While staggering, this number did not come as a surprise to Dr. Shalea Piteau, Chief of Pediatrics at QHC.

Piteau explains that while they ensure all critical newborn exams are done in the hospital prior to discharge, the hurdles for parents begin immediately as babies need to be seen within the first few days of life. Without access to a PCP, hospital staff advise parents to take their babies to Public Health, walk-in clinics or the emergency department for that first check-up, and beyond. Piteau says that those options are “less than ideal.”

Indeed, Good’s experience using Public Health as a primary care substitute was less than ideal. She recalls the frustration felt during an appointment for her daughter’s 4-month vaccines, “I had a series of questions and I was hoping that they would weigh her and do very basic things. But they couldn’t do any of that and they couldn’t really answer my questions,” she adds, “if anything had happened to Cora, if she was ill, if she had anything that was sort of irregular, then she would have really fell through the cracks.”

Paul Huras, CEO of the South East Local Health Integration Network (SE LHIN) agrees that it seems this population of patients has fallen through the cracks in our region. He admits that our community tends to dwell on the fact that we have the largest proportion of people over the age of 65 in the province. “The problem with this, is we do miss other populations that are in need,” Huras says, adding that provincially we are not responding as well as we should be to the many realities of family doctor shortages.

Good’s reality, like many other families in Quinte, was a year long attempt to string together a patchwork of healthcare for her daughter. “The scariest part of not having a family doctor for your baby is that you end up relying on the internet to be your doctor, and that’s not a good thing,” warns Good.

Special Thanks to Courtney Good, Paul Huras, Shalea Piteau and Catherine Walker for contributing to this piece as Interviewees. 

 

Why we chose the rough school at the end of the street

* The following essay was written a little over a year ago as part of a Freelance Writing course I took while completing my Certificate in Professional Communications from UBC. I'm sharing it today as it remains just as relevant as I prepare to enroll my second born in Kindergarten this fall!

My bowtie clad four-year-old stands happily with his Star Wars backpack pressed up against the faded brick of a tired looking century school. The semi-formal attire he insisted on this morning stands in amusing contrast to the school’s worn-out façade. The weary school bell echoes feebly off the faded play structure and beckons the teachers to gather the lively students. As I watch the muddled line of backpacks disappear behind the rasping metal doors, the cold clang of the latch dismisses me and the other parents from the school yard and announces the start of another day at the rough school at the end of our street.

As I begin the 3-minute walk home, I’m transported back to a little over a year ago, to the first time we visited our house with the realtor. I had remarked at how close the school was located to our front door only to have him emphatically declare that he “would never send his kids to that school, it’s a rough school.” Having just moved from a large urban centre I immediately feared the worst. That moment of fear still amuses me, as I’m not sure what exactly I believed the “worst” to be in a Junior elementary school. Kindergarten gangs running crime rings and drugs? Nevertheless, I pressed for what qualified the school as a rough one. He matter-of-factly stated, “a lot of kids come to school with no lunches and some come without shoes.” I smiled as I followed him into the front hall relieved that our definitions of “rough” differed greatly and excited at the prospect of living near a school with a bit of diversity in an otherwise white-washed city.

The gentrification of our city’s downtown core would suggest that we are not the only yuppies with kids to have fallen in love with its charming century homes and tree lined streets. However, the predominantly negative reaction to our endorsement of our neighbourhood school suggests a general lack of confidence in an institution whose outwards appearance has fallen victim to an unrelenting lack of resources. Ironically, the once stately but now crumbling school is not unlike the homes we have bought and renovated.

From the moment we decided to put an offer in on our home, we have been pressured by people in our social and professional circles to bypass our neighbourhood school. Colleagues have endorsed the local private school. Friends have encouraged us to enroll our son in the Catholic school system via the French Immersion program. Others have urged us to inquire about wait lists at other more affluent public schools in the city. While their solutions have differed, they have all agreed that the somewhat run-down school at the end of our street is a problem that must be circumvented. While we know these people are well-intentioned, we chose to enroll our son at our neighbourhood school not only because we can leave the house three minutes before the bell rings, but because despite crumbling stone, chipping paint, and resident pigeons it stands as any school does, a neighbourhood pillar, a beacon of hope and dreams.

We send our son to that beacon each morning full of love, excitement and more often than not, instant oatmeal; and he returns to us each afternoon armed with new ideas, challenging questions and amazing artwork, sometimes as exotic as 35 vertical lines drawn on a single piece of paper. We’ve watched in awe as, in only a matter of months, our naturally reserved 4-year-old has transformed into a boisterous student persistent in his pursuit of learning. The overlooked school at the end of the street continues to foster his dreams while encouraging his potential. When asked what he wants to be when he grows up, no longer does he just say police robot but police robot engineer. The simple addition of a word onto an otherwise outlandish response has transformed his make-believe aspiration into a real world one and is testament to the education he is receiving within those dated walls.

While it’s no secret that our son shares a school with many children who come from challenging situations, what has become more evident is the positive effect that this diversity is having on him. There have been certain situations that have prompted targeted discussions, like the morning announcement about breakfast club that generated a conversation about how it was a resource for his classmates who don’t have breakfast food at home, not a club dedicated to his favourite meal; or the time he asked about why he couldn’t live with his grandparents like some of his friends. But more importantly, attending our neighbourhood school has allowed our son to meet and befriend children from all walks of life.

The school at the end of our street may look a little rough but those faded brick walls remain warm and welcoming. The feeble school bell still elicits the same soldierly respect from students and parents alike and the sun-bleached playground continues to harbour the excited laughter and happy cries of students at recess.

We chose to enroll our son at our local school because despite the effects of 10 decades of Canadian weather on it’s exterior and the years of dwindling resources on it’s interior it continues to do what it has done for over 100 years. It continues to provide education and opportunities for friendship to the children of our neighbourhood regardless of their circumstances.

As I make my way up my driveway I hear a familiar but sarcastic voice behind me, “that’s quite the commute you have.” Absorbed in reflection for the entire walk home, I didn’t notice Lisa, or Lylah’s mom as I affectionately like to call her, pull up behind me on her way to work. She laughs and gives a friendly wave as she drives off down the road. I smile, thankful for my friendship with Lisa, the perfectly cooled cup of coffee waiting for me on the counter and the rough school at the end of the street that made them both possible.