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‘We don’t have time for this’: Ontario doctors rail against red tape in long-term-care COVID fight

‘We don’t have time for this’: Ontario doctors rail against red tape in long-term-care COVID fight
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They can’t get into homes fast enough to help frail seniors because of excess paperwork and bureaucracy, representatives of the organization that represents Ontario’s 33,000 practising doctors told an online news conference Wednesday.

“This war is being fought in long-term-care centres and we need to simplify the process,” said Dr. Pamela Liao, chair of palliative medicine for the OMA.

She explained that provincial funding to help out homes is flowing through hospitals. But if a doctor does not have privileges at a hospital that is helping a particular home, it’s difficult for that doctor to hit the ground running.

“Right now, the challenge is that hospitals have to approve that,” Liao said, adding that physicians without privileges are wasting time hunting down hospital executives to get approvals.

“I’m hearing from colleagues in Etobicoke, North York (and) Scarborough. They’re scrambling. ‘Well, who is the chief of medicine? How do I reach them? Which home is where? Who’s getting the vaccine?’

“We don’t have time for this.”

Liao said it would be helpful if doctors had easy access to information showing what home is associated with what hospital and who the contact person is at each hospital.

“Unfortunately, there’s paperwork, bureaucracy and red tape that gets in the way of physicians being able to move in an agile way,” she said.

The OMA is also calling on the province to appoint “chief medical officers for long-term care” for different regions of the province. Doctors in these roles could co-ordinate efforts between hospital and long-term-care sectors, liaise with public health, and oversee physician coverage over multiple homes.

“The idea of a chief medical officer is to provide some guidance to all of our homes’ medical staff. Currently there is little direction,” said Rhonda Collins, vice-president of the Ontario Long Term Care Clinicians organization.

The lack of direction is what led to confusion during the first wave of the pandemic, when some physicians avoided going into long-term-care homes, explained Collins, who also serves as chief medical officer with Revera Inc., and co-chair of the province’s pandemic response table on long-term care and congregate care.

“They weren’t certain what guidance to follow, as the primary guidance was virtual care where possible to avoid contamination,” she said.

In total, the OMA has made five recommendations to the provincial government to improve the pandemic response in long-term care. The other three are:
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