The kitchen sink…

Sink 2

On Christmas Day, two hours before the biggest, messiest, most dish-dirtying dinner of the year, our kitchen sink suddenly stopped draining.   We are aways careful about not putting grease down the drain, and it seemed to have been flowing well the day before, so it presented a bit of a puzzle.   We filled the sink with hot water and tried plunging it to no avail.   I took the trap apart and found nothing but a small amount of debris and a plastic straw.   Even the hand-powered snake I keep for special occasions failed to resolve the issue.

Our work-around solution was to cart dishes in a bin around the corner and down the stairs to the laundry room, where they could be washed up in the large set-tub.  Cumbersome, but it got the job done.

I contacted a plumber friend who mercifully agreed to come by on Boxing Day.   Ninety minutes later we were back in business.

Note to general contractors.    Horizontal or reverse-grade drainpipes will not win you any design awards.

You never really appreciate things like plumbing or electrical wiring until it stops working.   These seemingly mundane inventions have vastly improved our lives.  In Canada, it really would not be much of a stretch to say we depend on them for our lives.

This led me to think about how technology and socialized medicine have improved health care in this country.  Years ago I read George Orwell’s essay “How the Poor Die.”  In this gut wrenching depiction of a large hospital in France in the 1920’s he describes in literally agonizing detail, the sad and painful deaths of those who could not afford private medical services.   Read it some time.   It’s an eye opener.   It might be particularly useful for those Frederictonians who have a penchant for writing letters to the paper or generating reports complaining about things like a soiled towel on the floor, or a stain on a curtain.   You folks really need to count your blessings because, if you take the time to read Orwell, you will realize that things could be worse.   A lot worse.  And within the span of a single human lifetime, they were.

http://www.orwell.ru/library/articles/Poor_Die/english/e_pdie

Ramble on, you may say.  What’s this got to do with EMRs?

EMRs, like plumbing and electricity, can improve our lives if used as they are intended.   As things stand in New Brunswick, there are forces at play which prevent all but a select few doctors from utilizing their EMRs to full potential.   It again comes back to the need for EMRs to “talk” to the Ministry of Health computers.   To date, this has been blocked by an exclusivity agreement between the New Brunswick Medical Society and the Department of Health.

This agreement sits there like a big, greasy, rancid clog in the pipe.  Until we get rid of it, things are never going to work as well as they should.

The current government-sanctioned monopoly EMR system in New Brunswick is a bad design.   It’s like a horizontal drainpipe.   Cheap to install, works so-so for a while, but down the road, disaster looms.     A properly designed EMR system would accommodate multiple software vendors.   Doctors could pick the vendor that meets their particular needs.   This was the original intent for New Brunswick, but the plan has been derailed for reasons that are not at all clear and which deserve an explanation.

There are people in this city who are actively limiting what my EMR is capable of doing.  This in turn is limiting the quality and quantity of care I can deliver to my patients.   It is, in effect, inefficiency by design.   And I’m not the only one affected.   There are dozens of New Brunswick doctors who find themselves in the same predicament.

The Honourable Ted Flemming and the President of the New Brunswick Medical Society Dr. Lynn Hansen need to step up and fix this inequity.   In the name of my 3000+ patients, and in the name of the tens of thousands of patients cared for by other early adopters of EMR technology, I implore you, help us do our jobs.

It’s the right thing to do.

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