At a recent symposium, we had the pleasant opportunity to meet with the doctors, nurses, and administrators of the local hospital, chatting about the new technologies and services available now and soon to come, at our regional health centre.
I did a little reading research so I would have a small amount of knowledge about what our health professionals might be discussing with us. You know, so I could ask intelligent questions. But the one thing I really wanted to know was why, in heavens name, in this age of high-tech, did doctors still use fax machines?
Facsimile technology has been around for almost 160 years according to Dr Google. Originally it was transmitted over copper wires using dots and dashes (improved to zeros and ones, off and on, later) and printed on paper when we figured out how to do that. But now, the copper wires are mostly gone the way to the dodo, replaced by wireless transmission of – you got it – ones and zeros, on and off, at the speed of light. Okay, electrons.
Professor Google also informed me that there are two professions that still use the Fax technology: the medical and legal professions. Almost everyone will acknowledge that these professionals are well-educated, have innate smarts about their profession, and are informed on modern technology and the ways of the world. Some have accumulated modest wealth, the material things of life, and are generally acknowledged as a credit to their community.
The doctors know about nuclear medicine - isotopes and radioactive injections – how to read x-rays and scans, diagnose and inject curatives. The lawyers know how to talk. And so, one wonders, why are they still using the old technology of fax transmission? Could it be that they do not trust the digital world or is it a matter of economics? Who better to ask than the administrator of the finances and computer technology?
Using the old math of the lowest common denominator, the one thing all the medicos in the area, in the district, in the province, had in common was the fax machine. Because they worked with the doctors, pharmacies also used the fax. Yes, the profession was slowly going digital, but there were so many different pieces of hardware and software that they were unable to decide on a common denominator. While they are trying to get this sorted, and because of liabilities and the capital gains tax, enter the law profession – fortunately also using facsimile technology.
Were these professionals wary of being hacked? They do have sensitive information that should be kept confidential, so hacking is a concern. Back in the day, a person could ‘tap’ into a telephone line and listen to conversations, but the beeping of the fax transmission was unintelligible to the human ear. (Computers were not that common back then). As another safeguard, faxes often contained hand-written sections. It is common knowledge that the handwriting of doctors is a carefully crafted skill that can only be interpreted by calligraphy specialists in the pharmacy. 99% of the time.
Oh, and I should mention that we were told that the fall-back position in case the Health Centre was hacked, was to go to paper. Write everything down and sort it later. Rule number 2 was to print because the new generation of workers could not read cursive writing. Or is that cursed writing?
Happy to change subjects, the medicos talked of the new technology that was coming online. A new technology in mammograms will be the ability for the patient to adjust the pressure the machine applies to the breast while doing the scan. Also, the electron-type scan can better define any mass in the breast – good news for those who have dense or fibrous breasts. And, with new isotope tracing, in-situ treatment, and arthroscopic surgery, the less-invasive treatments will minimize recovery time.
If you are a little squeamish, skip this paragraph.
What is new and exciting (well the presenter, a urologist, thought so) was a device for men who dribble. There will be a clamp-like device that surrounds the urethra that will open and close the duct on demand. One will just need to push a little button to pee or not to pee. The button will be installed inside the scrotum. What about us – the women at the table asked. They are working on it, the doctor replied. Finding a place for the button was the issue.
Asked what their number one wish was, the obvious answer would be more money – from the Ontario government. Doug’s people are still trying to catch up from the pandemic and redressing that attempted Bill 124 wage limitation. The local Foundation fundraising is going well – that is where we raise money for new capital equipment. I posed the idea of moving to complete Federal funding. Health is a provincial responsibility - like housing – and the Feds stepped in there. Okay, the BNA and all that, but we need to get this health care under control.
Aside from more money, what was their second wish? More nurse practitioners. Really? This was coming from people who ran the ER. They explained the reasoning behind their wish, accompanying it with the news that they had opened up some short-term beds for ER patients and that their response times, despite staff shortages, were within the best in the north. Despite the anecdotal stories we hear about ER wait times, we are not unique. Much of the problems come from a general lack of GPs in the community.
Do not think we are unique in this. A recent study in the US pointed out the same issues: GPs retiring; GPs leaving the practice to specialize; stress taking its toll; med students not opting for General Practitioner roles. The average wait time for an appointment with your GP in major US cities was 26 days. Wait times in ERs were similar to ours, with about 10% of people simply giving up and leaving the waiting area before seeing a doctor (or nurse practitioner).
We are focused on the economy, jobs, and housing, but if you are sick you cannot work, you cannot afford that house, and life can become a misery. Let’s keep our eye on the ball (stick on the ice season is almost over). Oh, and just asking for a friend, where does he fax his application for that dribble button?
