An Untold Fact About The GP Shortage

General practice is in a bad state in Vancouver, and probably most of Canada, because of the well known shortage in general practitioners. Many people can't find a GP and those that have one hesitate to visit their doctor because they know that they're doctors are overbooked and appointments need to be made far in advance. Somewhat nonsensical because most of us can't predict that we will be sick two weeks ahead of time. This leads to obvious problems because if patients don't see their doctors regularly, their doctors cannot catch their illnesses early and control their disease before it becomes more harmful to the patient and more expensive for the system.

Doctors, educators, and public health officials often discuss these issues when they publicly debate the GP shortage. However, an aspect of the problem that is not discussed as often are the unnecessary mistakes made by physicians who are overwhelmed with an unrealistic schedule. Doctors know that there is a GP shortage, so they often find it difficult to turn away a new patient who has nowhere else to go; thus GPs tend to have too many patients.

Next, consider the fact that these GPs develop very close relationships with their patients and feel obligated to see them as soon as possible when they become ill.

Having a large patient population and wanting to ensure no patient is turned away means that GPs will have many patients to see each day.

Then realize that these doctors have lives, families waiting at home, and that they can't stay in the office all day. They would stop time for you if they could, but they can't, really.

Many patients + wanting to see all of them + time is finite = 10 minute visit

The 10 minute visit is an attempt to maximize efficiency while minimizing any potential harm to patient care. However, any time you speed up ANY process, you risk making silly mistakes. These errors are often easily correctable, but sometimes they aren't. Compromising patient care is something no doctor ever wants to do, but it is something that will happen. Even in a perfect system, doctors will make mistakes (sorry, they're human too), but in an imperfect system, doctors will make more.

There are two ways to resolve this problem:

1) We can improve the system. This would mean improving general practice and luring more med students into the field so that there will be fewer patients per general practitioner and then each doctor can spend more time with their patients.

2) We can make perfect doctors. That means they would have to be robots. Getting a DRE sucks now. It'll probably be a lot worse if it's done by a robot.

Malpractice: Don't Rush The Surgery

Take a look at your palm. Now make a fist as tight as you can. Chances are you can now see two seperate tendons running over the middle of your wrist. One of these tendons is the tendon of palmaris longus. 10% of the population will NOT see this tendon when they make a fist because they were born without it. It's not a big deal, the tendon is pretty useless functionally. Thus, when a patient tears an elbow ligament, surgeons often scavenge the palmaris longus tendon and reattach it to the elbow in place of the torn ligament.

We were told an unfortunate story about a surgeon who rushed a surgery and cut into a patient's wrist, hoping to scavenge the palmaris longus tendon. Turns out that this patient was in the 10%, he did not have the tendon. Guess what is usually underneath the tendon? The median nerve. This surgeon cut clean through the nerve controlling the muscles of the patient's thumb, index, and middle finger. These fingers are now non-functional for this patient. A really tragic case and a reminder to all physicians not to rush their surgeries.

Reminder: Wrist Bone Pneumonic

So Long To Pinky Here Comes The Thumb

Scaphoid, Lunate, Triquetrum, Pisiform. (Proximal)
Hamate, Capitate, Trapezoid, Trapezium. (Distal)