ENCORE: Virtual doctors for real ERs

Dr. Paxton Bach has spent years trying to help people navigate a broken system. Inconsistent approaches to withdrawal management, long wait times for detox and recovery programs and a system that struggles to address the social determinants of health have caused too many of his patients to fall through the cracks. So he and a team at St. Paul’s Hospital in downtown Vancouver are trailblazing a new model of care that’s set to roll out across B.C. It’s called Road to Recovery, and it’s helping doctors like Bach answer the question: How can I keep you alive until tomorrow? 

Like many of Canada’s rural and remote communities, Mackenzie, B.C.’s hospital struggles to staff the ER. But once a week, a doctor hundreds of kilometres away fills in virtually. Many provinces like B.C. are using virtual care in ERs in an attempt to keep the doors open. But critics are concerned about patient safety and the need to balance virtual with in-person care.

When care at a hospital or clinic falls short for you or a loved one, how do you raise concerns that get results? We asked listeners for stories about making complaints in health care and were flooded with them. Dr. Rob Robson, an ER physician, patient safety expert, and health-care mediator, helps us unpack what works and what doesn’t when you want your voice to be heard.

Until recently, Jeremy Auger’s diabetes was unstable. Then he met endocrinologist Dr. David Campbell and the team with the diabetes mobile clinic in Calgary. The roving clinic brings care directly to people who are homeless or have low incomes. For patients like Jeremy, it’s a lifeline that helps prevent devastating complications.

Obesity has more than tripled in Canada since 1981. In their new book “Food Intelligence,” Canadian co-authors Julia Belluz and Kevin Hall - an award-winning health and science journalist, and a prominent researcher on metabolism in the U.S. - argue that it’s not because of a collective loss of willpower. Instead, they say the foods we buy and eat have become more calorie-dense, delicious and addictive over the last 40 years. 

More with Kevin Hall! Until recently, Hall was the U.S. National Institutes of Health’s key researcher on the connection between ultra-processed foods and obesity. He took an early retirement due to increasing censorship of his work. He talks about his groundbreaking study with former “The Biggest Loser” contestants, the link between Big Tobacco and Big Food, and why Canadian scientist expats like him may soon be looking to return home. 

When his wife died of endometrial cancer, Charles Kinch refused to accept that the care she received was the best she could get. His complaint, at first dismissed, has now sparked major changes in how cancer patients in British Columbia are treated and supported.

Like many Canadian small towns, Carberry, MB had become a healthcare desert. In 2023, the small ER closed and the last doctor left. Carberry embarked on the fight of its life to get healthcare back. Just days before the first of two new MDs starts work, Dr. Brian Goldman visits Carberry to learn about the Herculean efforts it takes for one town to reinstate healthcare, and make sure they don't lose it again. 

For three decades, Dr. Brian Day has been at the centre of the debate around private health care in Canada. Despite losing his court battle to bring it to B.C., Day still wants to see more private, for-profit clinics. The orthopedic surgeon and owner of Vancouver's Cambie Surgery Centre says competition from the private sector could push the public system to deliver faster and better care.

Ottawa’s Montfort hospital sees twice the number of patients for mental health emergencies as the Ontario average. And as this number increased in recent years, the everyday environment of the ER waiting room – chaotic, loud and overstimulating – became an ever larger trigger, causing distressed patients to flee or harm themselves or others. In the new Mental Health Emergency Zone right off the main ER, everything has been designed for de-escalation, and staff and patients are seeing dramatic results.