Emmanuelle Faubert is an economist at the MEI, a think tank with offices in Calgary, Ottawa, and Montreal.Anytime meaningful change to Canadian healthcare is proposed, we see the same special interest groups coming out of the woodwork to claim that any change is a slippery slope to an Americanized healthcare dystopia.The recent announcements in Alberta regarding dual practice were no exception.Some critics of the proposed measures to allow doctors to work simultaneously in both the public and private systems went so far as to claim that this would risk leaving public hospitals devoid of personnel.Unfortunately for the fearmongers — and fortunately for us — there is ample evidence from other health systems demonstrating how such a change is to the benefit of patients, and how it can increase access to care for all..HILL / THOMPSON: Here’s why Calgary City Hall should keep ‘blanket rezoning’.When it comes to access, Canada’s health system falls short, coming in seventh out of the 10 industrialized countries in the Commonwealth Fund’s latest ranking.The reason for this is that while our system is financially accessible, we face another barrier to access, which are long wait times. Just think of the last time you or one of your loved ones needed emergency care, and how long they spent waiting to be seen by a physician. It likely took the better part of the day (and/or night).When looking at the six countries that rank above us in terms of access, such as France, Germany, and the Netherlands, we quickly notice that they have a few things in common..First, they all have universal health systems, meaning that access is guaranteed to all, much like in Canada.Second, all but one of them allow physicians to work for both the public and the private systems at the same time. (The only one that doesn’t is the Netherlands, where all health establishments are operated by private non-profits. Since there is no public system for physicians to practice in, there is no need to legislate on dual practice.)The predominance of dual practice is no coincidence. That’s because when done right, it can increase the amount of time physicians are able to spend treating patients..BURTON: Ottawa, Alberta’s MOU hands BC a veto, Canada another missed opportunity.While the body of research on the topic is rather slim, one interesting study looked into how this sort of system played out with surgeons and anesthesiologists in Denmark.When it comes to time spent in the public system, the researchers found that physicians in dual practice spent, on average, similar amounts of time working in public hospitals compared to their counterparts in public-only practice. They were also about as likely to perform duties outside of their normal working hours as their public-only counterparts, even at short notice..Where the study’s authors found a difference was in the total time spent practicing, with physicians in dual practice spending an average of five extra hours per week treating patients in the private system. In essence, far from depriving the public system of valuable resources, dual practice physicians were adding treatment time and capacity by taking on additional work in their independent practice.This can be explained in part by the greater availability of operating room time in private surgery settings. This means that instead of playing another round of golf because they can’t get access to the facilities they need to treat patients in the public system, surgeons have an alternative way to increase the number of patients they treat in any given month..OLDCORN: ‘Singh Hortons’ has become a national disgrace, no longer ‘Canada’s coffee shop’.While there are those who would have you believe that this would play out differently in Alberta, their apocalyptic scenario has not come to pass in the other advanced health systems that allow dual practice. That should tell you about the likelihood of it happening here in Canada.In sum, as patients around the world know, dual practice works, no matter what the fearmongers say.Emmanuelle Faubert is an economist at the MEI, a think tank with offices in Calgary, Ottawa, and Montreal.
