Unfiltered and emotional social media postings are emerging as a potent tool for critics of Canada’s health system, though some observers are dubious they’ll prompt lasting changes.
In Nova Scotia, the latest example came recently when a team of three emergency physicians posted a GoFundMe campaign to raise money for long-term care beds – a campaign rapidly expanded through Twitter.
Soon, online commentators suggested this would be the health system’s equivalent of food banks – charity supplementing what should be a basic public service.
“This is an initiative to get the conversation going,” said Dr. Rob Miller, one of the three doctors involved, adding that fundraising is secondary to the advocacy.
The doctors say the underlying problem is that elderly patients awaiting nursing home care are occupying beds at the Valley Regional Hospital in Kentville, N.S., creating a logjam in admissions and cascading into long waits in the emergency unit.
Their posting came on the heels of a viral video – viewed 2.6 million times on Facebook – made by Inez Rudderham, a frustrated young Nova Scotia mother who says she waited two years for her cancer diagnosis. She has said she was without a family doctor and had to repeatedly visit an ER before being referred to a specialist.
Meanwhile, in Newfoundland and Labrador, the mother of a 10-year-old child who spent two weeks in Janeway Hospital in St. John’s posted Friday that she observed four cases of 24-hour shifts pulled by nurses in the unit.
Howard Ramos, a Dalhousie University sociologist who studies social media, says the initial power of the posts depend on whether they touch a chord online.
In the case of Rudderham’s story, “it hit a nerve that many people feel they’re experiencing … It shows many people across Canada are having trouble accessing health care,” he said.
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At the Nova Scotia Health Authority, the flow of negative postings draws a mixed reaction.
Dr. Mark Taylor, the interim co-vice president of medicine at the agency, says in the case of Rudderham, it has led to an internal review.
“The good news is that it brings to the public problems that are real in our system and encourages us to find solutions to these problems,” he said in an interview.
“The unfortunate thing is that what is put forward on social media may not be entirely accurate and only one side of the story is brought forward.”
The young mother said in her video she had to seek care in emergency departments and was only diagnosed after three trips to the ER. She also says she won’t be able to get the mental health services she needs to deal with the stress brought on by her ordeal until July.
Taylor said he can’t comment on details of the case due to privacy concerns, adding his staff were still attempting to reach her on Tuesday.
Meanwhile, he says the doctors in the Kentville ER have a valid point about hospital crowding leading to backups in the emergency room.
“We need a greater emphasis on discharging patients, including improved home care services, improved capacity of patients to be managed in alternative locations,” he said.
However, he also said, “I personally wonder if GoFundMe campaigns will achieve funding for long-term care beds. I’m not sure how that will work.”
Rod Drover, a spokesman for Eastern Health, the largest health authority in Newfoundland and Labrador, said legislation prevents him from discussing details of the cases such as the one posted Friday in St. John’s.
“There have been no changes to nursing staffing arrangements at the Janeway intensive care unit for years, as the existing staffing ratio is based on national standards of best practice for ensuring quality of care,” he wrote.
The agency accepts the reality of social media, “as a communications tool,” but – like Taylor – Drover says there’s a risk of inaccurate information spreading.
Katherine Fierlbeck, a political science professor at Dalhousie University, said in cases like Rudderham’s video, a posting can highlight “underlying structural problems” in a powerful way.
For example, it suggests there’s a massive difference between simple access to some kind of primary care – such as walk-in clinics and ERs – and access to the regular and consistent care of a skilled family doctor.
Still, some health care problems, such as the public outcry over a lack of access to family doctors, are complex.
Nova Scotia’s ratio of 257 doctors per 100,000 people is the highest in the country. And yet there were 51,119 people on a waiting list for a family physician in the province as of March 1.
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Fierlbeck notes that these statistics don’t reflect key details, such as data suggesting physicians in the province may have to spend more time on patients who are older and sicker than in other provinces.
Meanwhile, the political scientist says when political parties – such as Nova Scotia’s Liberals – have tied their core electoral promises to budget control, they don’t easily shift to growing the health budget.
“You’re going to have to commit a certain amount of money and the more you commit, the less positive the fiscal management part of your portfolio looks.”