Jocelyn Lehman

@ABDanielleSmith, purposely conflating evidence-based cancer screening best practices w/ what she describes as "peace of mind" testing in her presser today, is unhelpful & inaccurate. She is fanning anxieties to increase demand for clinically low-value but hig-profit testing.

😷 BREAKING🚨 Canada launches a new National Advisory Committee on Preventive Health Services. It will be chaired by Dr. David Keegan, a leading advocate for masks in healthcare and on airplanes who filed human rights litigation on both fronts.

Sooner or later, almost every colleague, expert, institution, and idol disappoints us on this issue. They almost have to. Because accepting that COVID still poses meaningful risks would force a painful audit of years of assumptions, interpretations, and decisions. It would require changing behavior. It might require admitting mistakes. It might require changing identity. That’s a heavy lift. Denial is lighter. And that’s why it’s so popular.

Activity Based Funding Alone Will Not Fix Alberta's Healthcare Crisis: Alberta is moving forward with Activity Based Funding (ABF), where hospitals and surgical facilities are paid according to the number and complexity of procedures they perform. Let's start with an important point: this is not inherently a bad idea. When properly designed, Activity Based Funding can improve efficiency, increase transparency, reward productivity, and reduce wait times for procedures such as cataracts, hip replacements, knee replacements, and day surgery. High performing healthcare systems in Australia and Scandinavia have successfully incorporated versions of ABF into their funding models. But those same jurisdictions teach us an important lesson. They do not rely on Activity Based Funding in isolation. They pair it with robust investments in primary care, prevention, home care, rehabilitation, assisted living, long term care, community-based services, and significantly greater acute care capacity. These countries maintain approximately 3.8 to 4.2 acute care beds per 1,000 population. Alberta has approximately 1.76 beds/1000, less than half. This capacity gap, combined with blocked patient flow, is Alberta's fundamental healthcare challenge. After 35 years in the front lines, I can say with confidence that once Albertans gain access to care, they generally receive world-class care. Access is the problem. Every day, sick Albertans sit in crowded emergency department waiting rooms wondering why the system is failing them. Many assume the problem starts in the emergency department. It does not. The emergency department is where the failure becomes visible. For decades, Alberta's population has grown faster than its healthcare capacity. Our population is aging, chronic disease is increasing, and medical care is becoming more complex. At the same time, hundreds of patients who no longer require acute hospital care remain in hospital beds because they are waiting for home care, rehabilitation, transition units, assisted living, or long-term care. Hospitals are designed to treat acute illness, not to house patients waiting for the next level of care. Healthcare is fundamentally a flow system and we have a major flow problem, especially in the Edmonton zone. Patients enter through primary care, emergency departments, and ambulance services. They move through hospitals and, when ready, back into the community through home care, rehabilitation, assisted living, and long-term care. When any part of that flow becomes blocked, the entire system slows down. That is exactly what Albertans are experiencing today. Hospitals function best at approximately 85% occupancy. Above that level, delays increase, flexibility disappears, and patient flow slows. When hospitals routinely operate at 100-110% capacity, they do not become more efficient, they become less safe. The consequences are predictable and preventable. Emergency departments back up. EMS crews wait to transfer patients into care. Admitted patients board on stretchers waiting for inpatient beds. Surgeries are delayed or cancelled. Patients may be discharged earlier than ideal because of bed pressures, increasing the risk of complications and readmissions. Most concerning, the risk of medical errors rises when healthcare professionals are forced to work in overcrowded, high-pressure environments for prolonged periods. Chronic overcrowding contributes to burnout, moral distress, absenteeism, staff turnover and less efficiency. Asking healthcare workers to function indefinitely in crisis mode is neither sustainable nor safe. Public hospitals managing complex admissions, emergencies, and Alternate Level of Care patients cannot fairly compete in a pure activity-based funding model against facilities focused primarily on lower-complexity elective procedures. Changing the funding formula will not solve these structural issues. If Alberta is serious about improving access and reducing wait times, our priorities should be clear: 1. Retain, recruit, and support healthcare workers. 2. Expand acute care capacity, particularly in Edmonton, which serves a vast and underserved northern region. 3. Move Alternate Level of Care patients to the appropriate level of care within 24-48 hours whenever possible. 4. Expand home care, rehabilitation, transition units, assisted living, and long-term care. 5. Strengthen primary care, prevention, and community-based services. The single most important performance measure in healthcare is not the number of procedures performed. It is how quickly patients receive the right care, in the right place, at the right time. A patient who requires admission should move from the emergency department to an inpatient bed within six to eight hours, 90% of the time. Even in the middle of summer, many Edmonton patients are waiting four to six hours simply to be assessed by a physician. Another respiratory virus season is only months away. Activity Based Funding may improve surgical efficiency and deserves a fair evaluation. But Albertans should not mistake a funding reform for a healthcare solution. Until we fix the bottlenecks at both the entry and exit doors of our hospitals, our emergency departments and inpatient wards will remain overcrowded and inefficient regardless of how hospitals are funded. The biggest bottleneck in Alberta healthcare is not the operating room…It's patient flow…It's the hospital entry and exit door. @ABDanielleSmith @nenshi @PfParks @JMeddings @raghu_venugopal @TheSGEM @TheBreakdownAB @RealTalkRJ @cspotweet @BradenMannsYYC @UCPCaucus @abndpcaucus

I’ll break it down: 1. Lukaszuk checked the POLICY box 2. He did not check the referendum box. 3. That’s the legal mechanism under the Citizen Initiative Act 4. He knew the UCP would violate the law 5. He added a caveat to protect Albertans 6. The UCP twisted his caveat.