Emergency physician Alain Vadeboncoeur says he wrote the book To take care to “stimulate this desire for change which should inspire us if we wish to revive” our health system.
Posted at 4:00 p.m.
By reading it, we say to ourselves that this book could have been called Letter to the next Minister of Health.
Because this instructive test is intended as a manual for solving the many failures of our network. Problems which, as the author wisely points out, “were already, and for a long time, the object of reflection”.
This is part of the strength of this book (which is an extension of a previous essay on health, Deprived of care, published in 2012). Alain Vadeboncoeur has had three decades to assess the problems of our system.
When I first interviewed him in 2001, while covering health, he was the emergency coordinator at the Montreal Heart Institute. He had also joined the committee of experts of the National Emergency Coordination Center.
He was already looking for solutions.
The other great quality of the book is that it is accessible. Never technical, this little essay is intended for a wide audience.
To take care is composed of about twenty chapters, each of which represents a failure of the system, generally told by means of an anecdote featuring a patient in the flesh.
An example: Patricia, an elder who receives home care. She ends up in the emergency room when her condition deteriorates “due to a lack of home staff”. And a few weeks later, we have to place her in a CHSLD.
In this regard, the poor coordination of care and services offered to frail elderly people still at home is pointed out by Alain Vadeboncoeur, as is hospital-centrism and its perverse effects.
Another example: Pierre, who meets with the author to assess his heart problems, but whose examination must be postponed because the medical notes from other health establishments are not yet available. “We are still waiting for the fax”, writes the doctor, who tells this story by deploring the absence of a single medical file to disseminate patient information throughout the network.
In 2022, it is a situation as scandalous as it is incomprehensible. And in health, it is far from being the only one…
Moreover, no taboo is set aside by the author, who even speaks of medical errors, overmedication and the salary of doctors (he would like to see it drop to hire more, as in Europe).
You will have understood that we are not swimming in abstract theories here. We are on solid ground. Alain Vadeboncoeur also recalls the extent to which it is “essential to listen to the people in the field” in order to solve problems.
A committed doctor, he approaches his subject with a humanist nuance and unfailing optimism. This is also what makes the strength of his work.
“No company is supported by so many dedicated people who identify with such a mission imbued with humanity, namely that of providing care,” he writes, speaking of the health system. He suggests mobilizing them, drawing inspiration from them and giving them the means to transform their environment.
Our decision-makers, who are wondering about the remedies to be administered to this system, would be wrong to lose sight of this. And wrong, too, to miss this book.
Extract
“I wouldn’t change jobs for anything in the world, but I’m not naïve: even if I am convinced that the majority of what is done in the health system includes a lot more positives than negatives, I see the problems as everybody. I experience them as caregivers or accompanying sick relatives, I understand those who criticize the system and I am disappointed to see that we often move away, for a host of complex reasons, from approaches that allow for the best care — this, despite the willingness of caregivers. »
Caring – At the bedside of the health system
Alain Vadeboncoeur
Lux editions
141 pages
Who is Alain Vadeboncoeur?
Emergency physician, former head of the emergency medicine department of the Montreal Heart Institute and full professor at the University of Montreal, he is also a columnist for the magazine Newsas well as the author of several essays.