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HomeMy WebLinkAboutThe Citizen, 1999-12-01, Page 11THE CITIZEN, WEDNESDAY, DECEMBER 1,1999. PAGE 11. Approaching the Millennium Medicine - yesterday, today and tomorrow By Janice Becker Citizen staff As we approach the new millenni­ um, the medical profession, medi­ cine and the way the public per­ ceives its rights to medical care have changed substantially over the last 100 years. A discussion of the change in medical practices over the last cen­ tury is one which would fill pages and elicit as many varied perspec­ tives. Living in a rural community the" life and well-being of residents in the past relied heavily on the avail­ ability of a doctor, the skills he brought to the table and the resources available to him. However, 100 years later, the people of Huron County are once again faced with traveling great distances for medical care and worrying that emergency situations may not get immediate attention because of a lack of trained personnel. Though every sector of medicine is affected, from a shortage of gener­ al practitioners for routine health maintenance needs to critical servic­ es such as surgery, one of the most natural events of a human’s life can­ not be fully supported in rural areas as the year 2000 nears. As provincial financial support for hospitals is continually cutback and physicians lack the required physi­ cal and mechanical backup to pro­ vide a level of comfort, women giv­ ing births are faced with often daunt­ ing decisions. With fewer GPs willing or able to provide the required late-term pre­ natal care for expectant mothers, the women are forced to go out of their home communities by their seventh month to find a physician in either London or Stratford. Once a doc­ tor’s services are procured and a relationship hastily built over the short two to three-month period, the patient is not assured that will be the doctor at the delivery. There is no continuity of service, no opportunity to build trust or attain a comfort level for the birth. It is partially due to these factors that mid­ wife Susan Wilts of the Blyth area feels that more and more women are turning to alterna­ tives now offered and because midwifery is being supported by local hospitals. Though midwifery was the prevalent method for delivery early in the century for most rural women, Wilts says the profession has “really come around in the last five years.” “It was ‘pioneering’ then,” she says, “but now it is established.” That “pioneering” aspect is a result of years of decline in mid­ wife usage and a trend towards hospital deliv­ eries after mid-century. Not only has the budget problem for local hospitals and the lack of needed physicians helped create the open­ ing as midwifery is very cost effective, says Wilts, it is also an alter­ native women are looking for. “Women are choosing to get back to basics, to be comfortable in their surroundings and be near family.” With the majority of hospital births taking place in London or Stratford facilities, the women are forced out of their communities and away from families. Midwives also provide the conti­ nuity of service women are seeking. There is care from the early days of the pregnancy to six weeks after the birth for follow-up checks for both the mother and child. It gives the woman an opportunity to develop a trusting relationship with the two midwives usually involved in her care, says Wilts. This intimate level of care was available in a different form, in the years after the war as some physicians such as the late Dr. Charles Myers of Brussels, set up maternity boarding houses in their homes. Dr. Myers and his family lived and worked in the house, providing a family surrounding for the women yet husbands were not involved in the event as they often are today. From 1946 to 1956, Dr. Myers served the needs of his patients while his wife nursed them and the children entertained. The cost for a delivery was $35 and the stay was $5 per day which usually lasted at least a week. “Dad probably didn’t know what we used to do,” says his daughter, Rene Richmond of Brussels, “but we used to go sit on the patients’ beds.” She and her siblings were involved in the care, helping carry trays to do what was needed. Richmond remembers one occa­ sion when she was only about 10 when her aid was needed for the transport of a premature baby to Wingham hospital. “I got to hold it for the whole trip.” Dealing with the medical practice was just part of life, she says. Maternity house Dr. Charles Myers ran a maternity house in Brussels from 1946 to 1956. It was a one-stop facility in those days as the dispen­ sary was in the house and patients just dropped by when they needed care. Richmond remembers many occasions when the waiting room over­ flowed and the staircase served as seating. Aside from the birthing facilities, Dr. Myers rendered other medical serv­ ices until 1961. Teeth were pulled and tonsils extract­ ed in the office. Always decked out in a suit and tie, Dr. Myers was on- call 24 hours a day, she says. “It’s not that Dad was never at supper with us, but it was not unusual for him not to be there.” Dr.John Conners,a Listowel physi- cian, who.along with his father Earl, served south Huron and north Perth County patients for many years, acknowledges the long hours and house calls which were an inte­ gral part of the profession in the early part of the century. Dr. Earl Conners graduated from medical school in 1935 and after spending time at a lumber camp up north, settled in Atwood for nine years, where he was the only physi­ cian, before moving to Listowel. There was no government-spon­ sored health care in those days, says his son. “Patients looked after their owns bills and they appreciated the care they received.” Richmond and Conners both recount the novel methods of pay­ ment used in the early days. Particularly in rural communities where money was often scarce and produce was not, payment would come in the form of vegetables, fruit, chickens or a pig. “There was not a lot of money in those days,” says Richmond. “Dad did it to help out his patients.” Conners sees doctors today as government employees and people believe that medical care is an “in-born” right”. Earlier doctors didn’t have to worry about being sued, but now it is a big concern, says Conners. “The fees (for medical care) have gone up astronomically, but so have the (patient’s) expectations.” Conners sees part of those astronomical costs coming with the increased technology which is available for patients needs. “It has grown tremendously, but it is all extremely expen­ sive. A crunch time is Caring for mother and child As a midwife, Susan Wilts is the primary caregiver for an expectant moth­ er from the early stage through to the six weeks after the birth as well as looking after the well-being of the baby. coming when we really can’t afford it.” Conners expresses a concern over the increased use of emergency rooms, for more minor ailments. There were fewer trips to emergency rooms years ago, he says, though this may be due in part to physicians having evening office hours. “The government has taken all the responsibility away from patients as they have no OHIP payments.” Having entered the medical pro­ fession in the early 1960s, Conners believes he started at a good time as new medicines and procedures were becoming available. While Conners says he is serving clients from a broader area due to transportation, his father made a practice of house calls. His son fol­ lowed this tradition for several years, saying that it was often the time spent in the patient’s home which was needed as much as med­ ical care. This is rarely a considera­ tion today. The evolution away from house calls came as better equipment became pan of doctor’s offices and local hospitals. The patients could get better care by going to the office, but it was not always as convenient for them, he says. Conners also sees a great differ­ ence in how doctors are trained today, though there have been efforts in recent years to encourage more well-rounded knowledge. In his father’s day, the GP did everything. Though most surgeries took place in the hospital, even his father did a few on the kitchen table with just ether. “It was scary, but sat­ isfying,” he says. “People appreciat­ ed what you did.” His father’s education included a rotating internship at a large hospital where he worked in many different departments. “Today. doctors receive two years of family medi­ cine,” says Conners, “but they prob­ ably get very little surgery, orthope­ dics or anesthesia. However, psychi­ atry is a big thing now.” Though Richmond sees a lot of differences with the lifestyles of doctors today she agrees it is better in many ways. “It appears they don’t work the same type of hours, without evening office hours and family life is more a consideration. Doctors are able to take a holiday now. If Dad took a holiday we had to really get away, like to the east coast.” As we enter the new millennium, Conners foresees a continued explo­ sion of knowledge, diagnostic and therapeutic techniques. Computers will change practices as knowledge is more retrievable, more quickly, both for doctor and patient. Patients are becoming more knowledgeable about diseases, are finding information on the internet and are able to come to their physi­ cian with relevant questions. This allows for better decision-making by the patient for the care they prefer. “Sixty years ago, when a doctor said, ‘That’s the way it is', people accepted that,” says Conners. “Today, they are looking at many sources for health answers.” Rural practices may continue to be centralized as recruitment is difficult and there is not the equipment or personnel available for backup. However. Conners sees hope if young doctors get out and see what rural areas are like. “It is more satis­ fying to have a varied practice,” he says, “rather then just checking someone and sending them to a spe­ cialist.” Returning to a traditional practice, Wilts says good relationships are being built with doctors, support staff and hospitals. Partnerships are forming for the betterment of patients to serve their needs and wishes. While in some ways, society has come full circle in medicine, resum­ ing methods of another era, the tech­ nology continues to result in increased knowledge, skills to treat and prevent diseases and afford the opportunity of a more fulfilled life for those coping with the many chal­ lenges of life.