Letter: Golden physicians discuss possible changes to Lab Services

Changes have been proposed to Lab Services in our town. Based on past experience and the current climate, change usually means cut backs.

Golden Star readers were recently made aware of changes being proposed to Laboratory Services in our town. Based on past experience and the current climate, change usually means cut backs.

Possible changes include: replacing some tests with more rapid, cheaper and less accurate devices at the bedside known as Point of Care tests, sending more samples to be tested in Kelowna, and a reduction in laboratory personnel. The physicians in Golden are unanimous in our opposition to any change that would result in a reduction of services.

Point of Care testing means for example, that if you come the Emergency department, a nurse would take blood samples and run tests right away on a small machine. If you need more tests, samples would be sent away, creating a delay in results. If you need more frequent tests, we may have to send you to another hospital because we wouldn’t be able to get results fast enough. Also, tests done on a less accurate machine may have to be repeated later to be verified.

Our primary concern is to treat members of our community according to the highest possible standard of care. To do so, we must rely on timely and accurate test results. Being able to deal with any and all possible emergencies requires a broad range of readily available tests. Furthermore, we are all well aware of the transportation challenges we face, particularly in the winter months from road closures to grounded helicopters or planes due to poor weather. A large degree of self-sufficiency is essential to safely provide emergency care as well as to keep patients stable while we await transport.

Reliable laboratory services are also essential to the obstetrical and surgical programs currently offered in Golden. Any erosion to our already thin complement of local tests will likely jeopardize these programs.

This would mean that even more of our residents would be required to travel elsewhere for routine childbirth and surgical procedures. If we cannot monitor patients who require frequent reliable testing, more of them will need to be sent to Cranbrook or Kelowna. We feel that putting more patients on the road is inappropriate.

Implementation of Point of Care testing raises many other concerns such as increasing workload of nurses, recruitment and retention of personnel, potential loss of samples, and accuracy of testing to name just a few.  We are skeptical that transporting more samples to a centralized lab or caring for more patients outside of their community will bring any meaningful cost savings.

Daily we see our patients struggle to access the help they need and deserve in a timely manner. We know the disadvantages of being ill in a rural community compared to a larger centre. Any decrease in laboratory services would only widen this gap. The question becomes, what is the minimal standard of care deemed acceptable to a rural community such as ours?

While we look forward to the consultation process announced, we are leery of a predetermined political decision and feel that community engagement is essential. In that spirit, we encourage you to share your thoughts on this issue with the BC health minister, the Honourable Terry Lake (email hlth.minister@gov.bc.ca). Additionally, if you are interested in getting involved to advocate for local medical services, please contact Karen Wilson (goldenkaren@eastlink.ca or see her “Keep Medical Services Local” Facebook page). If you have stories of challenges accessing care to share with the minister, please contact Mickey Balas (email mickeybalas22@outlook.com).

 

Signed,

 

The physicians of the Golden Medical clinic:  Dr. Jessica Chiles, Dr. Trina Larsen Soles, Dr. Jean Gaston Descoteaux, Dr. Bruce Starke, Dr. Virginia Clark, Dr. Kirk McCarroll, Dr. Kate McCarroll, Dr. Jennifer Woolsey, Dr. Bruce McKnight, Dr. Adam Watchorn, Dr. Saskia Acton, Dr. Nicholas Tan, Dr. Robert Drysdale, Dr. Meghan Guy, Dr. Jill Cunes, Dr. Allison Clare