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On the eve of New Year’s Eve, Quebec’s Ministry of Health issued a press release urging the public to “respect good practices” and avoid going to hospital emergency rooms if their health problem was “non-urgent.”

This kind of idiocy is rampant in Canada right now. Telling people to avoid hospitals is not a solution to ER overcrowding. It’s a recipe for disaster.

It’s also a grievous failure to do what actually needs to be done: Fix the underlying problems that are causing ER backlogs and closures around the country.

The vast majority of people who go to emergency rooms feel their health problem is urgent. Stop blaming them for the failures of a health system that is supposed to serve them.

The patient declares their own emergency. Not a health ministry bureaucrat, or a health minister.

Of course, Canadians have to take some personal responsibility and not go to the hospital for the sniffles. But who is actually doing so?

The notion that people are going to ERs for hangnails and head colds is nonsense. Nobody spends four, eight, or 12 hours waiting in an uncomfortable plastic chair for fun.

They do it because they’re scared. Because they have weird heart palpitations, trouble breathing, violent gastric problems, a piece of their finger chopped off, or whatever they feel needs urgent medical care.

Members of the public should not be expected to do complex triage and differential diagnoses. That’s the job of nurses and doctors.

Not to mention that there are few, if any alternatives.

Where are people supposed to go for medical care if they don’t have a family doctor? And 6.5 million Canadians don’t, while many of those who do can’t get an appointment for days or weeks.

The challenge is even greater during the holidays when doctors’ offices and clinics are closed. There are walk-in clinics and telehealth lines like 811, but they invariably steer people to ERs too. Only a couple of provinces have urgent care centres – a halfway point between the ER and the family doc.

We shouldn’t forget that people with minor ailments are not causing the backlog in ERs. That’s a misconception. Minor cases can generally be dealt with summarily – if people don’t mind waiting.

The real problems in ERs lies elsewhere – primarily, the lack of beds available to admit new patients.

Those poor souls lying on stretchers in the ER for 12, 24, or 48 hours? They are being kept in the hospital hallways because they need to be admitted, not because they should have stayed home.

Their experience is no picnic; it’s humiliating, unacceptable, and all too common.

There are no beds available for these seriously ill new patients because many beds are tied up with long-time hospital patients who, in turn, should be in long-term care homes or rehab facilities. But they lack available beds too.

It’s like a traffic jam and the worst bottleneck always occurs at the entry point – the emergency department. But it’s about patient flow more than it is about patient volume.

All this, of course, is exacerbated by labour shortages. That’s why the ER closures and diversions that have become routine in rural areas are now moving to larger centres like Saskatoon.

The crush of respiratory viruses sending people to hospitals in larger numbers is being blamed for the current ER crisis. Yet, the “unexpected” surge is entirely predictable. This is the busiest time of year in hospitals, as it is every year, but made worse because of the extra burden of COVID-19.

The health system is allergic to planning, so we have built no surge capacity into our ERs and hospitals.

We know the underlying causes of ER overcrowding all too well. The Canadian Association of Emergency Physicians has outlined these in detail. So, too, has the Canadian Agency for Drugs and Technology in Health (CADTH).

One of the key problems is Canadians’ lack of access to primary care. Another is insufficient inpatient bed capacity in hospitals and care homes. Throw in some excessive bureaucracy that affects patient flow. And, of course, a larger neglectful omission, not adapting the system to the needs of the aging population.

ERs are overflowing because of bad planning and misplaced priorities. So we need to focus our efforts on restructuring the system to meet the needs of the population.

Simply telling people that the ER is busy so they should stay away is not a public service, it’s a failure of public policy.

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