A lovely letter to the editor in this month’s Canadian Journal of Emergency Medicine (Petrie, Campbell and Ross) with respect to the often conflicting paradigms of predicting the emergency needs of a community and the issue of emergency physician compensation.
The authors point out that modeling for compensation is problematic as it pits doctors in the typical negotiation framework associated with professional medical bodies and government.
Far better that we frame the discusssion in terms of a community’s needs for emergency medical coverage. They state that “we know that prolonged emergency department waits are associated with mortality in a dose response” and “we know that inadequate emergency physician coverage prolongs wait times ina non-linear relationship” ie when things falls apart, they do so quickly
Discussing it in the context of a community’s needs makes it a public health issue not the typical fiduciary dogfight for increased physician compensation.
The authors conclude:
“Situating discourse and decision making in the realm of health care policy (rather than in the potentiallly adverse and opaque process of physician services negotiations) brings more evidence, transparency, public accountability, patient centredness and fiscal responsibility to dialectically working toward creating a safe and sustainable emergency health care system.”