france health care wait times

Document the clinical assessment and any attempts to arrange an earlier appointment. Monitor the impact of wait times on patient safety and be prepared to adjust accordingly. In such a circumstance, physicians risk being faced with the need to deliver care to patients without having timely access to the resources necessary to meet their treatment obligations. Introduction. Such decisions are often made by health-care authorities and institutions who manage physicians', and consequently patients', access to resources. The inconsistencies in both wait times and the approaches being pursued to reduce these times undermine confidence in the health-care system. Waiting Your Turn: Wait Times for Health Care in Canada, 2019 finds that the median wait time for medically necessary treatment in Canada this year was 20.9 weeks. In many ways, this is the worst possible situation in which a number of complicating, and possibly extenuating, circumstances converge to disadvantage the patient. The medical profession should seek to leverage the patient safety benefits inherent in any wait-times reduction initiative, while actively working to minimize the potential negative implications. Some important participants in the discussion, in particular the College of Family Physicians of Canada, have expressed the view that the determination of wait times should also take into account the time between the patient's first visit with his or her family physician and when required, subsequent visits with consultants, as well as the time it takes for a patient who does not have a family physician to find one.1 Regardless of the definition chosen, the CMPA is of the view that a common, clearly communicated definition is required and such a definition should form the basis for all measurement activities. Notify the referring physician of the scheduled appointment dates. The CMPA is concerned that, in many instances, workable procedures do not exist. While the need to address high-priority procedures as a starting point is widely acknowledged as being a sound approach, it has inevitably led to concerns about resource allocations. The concepts of accountability and liability are fundamental both to reducing wait times and to addressing issues that result from an inability to achieve benchmarks and/or care guarantees. In a world in which timely access to care is not a problem, managing the queue of patients waiting for care would be a straightforward issue. Depict wait times as benchmarks or targets, not as guarantees. Hardly a week goes by where we don’t see a story on the world’s ever-lengthening patient queues (and trust us, … For example, there are indications in Ontario that, although the time a patient waits for surgery after being put on a waiting list may actually be getting shorter, the total waiting time may not be getting any better due to increased waits to see specialists following referral by a family doctor. Any legal action would be further complicated if a patient's condition deteriorated when a wait time exceeded the performance goal. This duty of care is guided by the following considerations: Within their particular scope of practice, physicians have a responsibility to direct their patients' care. This approach places some patients whose treatment requirements fall outside one of the five priority clinical areas in a difficult position as they see their wait time remain overly long and potentially being extended. A situation in which everyone is accountable often means, in reality, no one is. The wait-times situation has come to be one of the most dominant elements of health-care discussions. A number of stakeholders have important roles to play in putting in place mechanisms to address the accountability and medical liability issues associated with health-care wait times. While Canadians appear to be generally satisfied with the quality of care provided, they are increasingly expressing concerns about the timely access to care. Establishing wait-time benchmarks for all diagnostic, therapeutic and surgical services; Developing and implementing wait list management tools; A duty of care arises if there is a doctor-patient relationship. Issues relating to a physician's obligations in relation to the overall management of the waiting list are relatively new territory. In terms of implications for physicians, from past experience, it can be expected that the courts will likely, based on the individual facts of the case, examine what a physician did, what alternatives were considered, and what efforts were made to obtain the necessary care for his or her own individual patient. The danger of applying the same weight to wait-time guidelines as is accorded to clinical standards is real and it could potentially result in a number of unintended legal consequences. It is safe to predict there will always be a gap between the demand for health-care services and the resources available to provide them. Patients expect their physicians, not the "system," to provide access to care and, when required, to serve as their advocate to gain such access. It is foreseeable that efforts to reduce treatment wait times and to create the most efficient system possible will generate concerns about patient safety. It is a universal service providing health care for every citizen, irrespective of wealth, age or social status. Many stakeholders have advocated two measures to incorporate government accountability for wait times — the establishment of wait-times guarantees and the withholding of funds when such guarantees are not met. DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. Communicate patients' needs to the careproviding institutions, consulting physicians and others as required. To date, the courts have not yet fully addressed the extent to which physicians, regional health authorities and governments may be held liable for injuries suffered by a patient who does not receive treatment within the wait-time benchmark. Communicate to the consulting physician any significant changes in the clinical condition of the patient. While representing only the first step in what must be a concerted and sustained campaign, recent efforts to reduce wait times are encouraging and should be fully supported. The challenge facing Canada and many other countries is one of balancing the demand with the finite amount of available resources. In the opinion of some, this has occured to the detriment of other equally important issues facing the health-care system. Notwithstanding efforts to develop that trust, there is much work that needs to be done in the domain of benchmarks. While Canadians appear to be generally satisfied with the quality of care provided, they are increasingly expressing concerns about the timely access to care. Wait-times guarantees involve a commitment, on the part of governments, to deliver treatment within a publicly declared wait-time period. 1. Conflicting measurement methodologies within and among provinces/territories are confusing and result in Canadians trying to compare apples to oranges. However, until these questions are adequately addressed, the CMPA remains concerned physicians and their patients are at risk. Individuals should therefore be held accountable if they have not followed procedures prescribed to govern their profession or to access the resources necessary to enable them to deliver upon their accountabilities. Document all actions taken in each of the above circumstances. Should the clinical condition of your patient necessitate an earlier appointment or should the scheduled appointment exceed the wait-time benchmark, attempt to negotiate an earlier appointment. As government focus has rapidly shifted from benchmarks to targets to care guarantees, the identification of wait times has taken on a new urgency. The scope of the duty of care is unique to each circumstance and depends on the extent of the physician's contact with the patient. This section identifies key steps that can and should be taken to mitigate these issues. Governments, health-care authorities, hospitals and health-care providers all have some accountability for providing health-care services, but this accountability needs to be defined in a way that is practical for all involved. This individual responsibility to one's patient is a foundation of medical practice and it is clearly spelled out and well understood by physicians and, within their own scopes of practice, by other health-care professionals. When viewed individually, the majority of these recommendations are generally very sound and, if implemented, would make a useful contribution to reducing wait times. Assist physicians in assigning patients to the queue and in ensuring flexibility to adapt the queue to changing clinical conditions. Wait Time Alliance for Timely Access to Care. If, at the time of the referral, the wait time exceeds the benchmarks, consider: - Declining the new consultation and recommending referral elsewhere, and. In turn, it is not surprising regional and local health authorities and institutions appear to be attempting to use access to facilities as a means through which to hold physicians accountable for ensuring that collective targets are met. For example, particular care should be taken to ensure targets are realistic and in stating that wait-time benchmarks should not be interpreted as de facto standards. The use of CMPA learning resources is subject to the foregoing as well as the, Public policy, submissions, and responses, Wait Times — a medical liability perspective. Avoid the cannibalization effect wherein wait-time targets for one clinical procedure jeopardize access to others. The emphasis here is on the words "reliable reporting" that engenders trust in the health-care system. Reported wait times generally factor in neither waits for consultation nor the time taken to access family physicians. It will take a coordinated effort from all parties involved if the fundamental questions are to be addressed. This requires an ongoing monitoring of patients to ensure their clinical needs remain paramount. In view of the multi-faceted nature of any solution to reducing wait times, quick progress on this issue is, while highly desirable, unlikely. In this regard, the CMPA recognizes compromises may well be required if the competing dynamics of system efficiency, patient safety, professional accountability, individual liability and patient expectations are to be met. The primary goal should be to ensure every Canadian has timely access to high-quality health care. There are likely to be both positive and negative patient safety implications from efforts to reduce wait times. Communicate these accountabilities to all involved, including patients. If one accepts that the effective management of health-care wait times will be a permanent requirement, then the need to address accountability and liability issues takes on a strong degree of urgency. Average Wait Time to See a Doctor in France Pediatrician or radiologist – three weeks Dentist – one month (average 17 days) Gynecologist – six weeks (average 32 days) Cardiologist – 50 days Dermatologist – two months Ophthalmologist – 80 days

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