Healthcare highways in your community

Howard Stuart
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Abstract

This abstract serves to introduce a 10 minute video in which I will discuss issues pertaining to the structure of the healthcare system in Quebec. At the same time I will review the concept of community within and around that system. The relationship and interplay between the two will be explored in the hope that the viewer might find resonance and meaning, and perhaps a springboard to further reflection and conversation. Many perceive a need for change in both the organizational systems as well as in the existing cultures within healthcare institutions, both in and outside of Quebec. Yet we often feel powerless to act. I will touch upon ideas on how we can make a difference using our individual influence to bring about the changes we seek. The concepts under discussion are abstract. In the hope of creating a greater degree of tangibility, I will offer a metaphor – namely the long-term detrimental effects brought about by the disruption, and in many cases destruction, of vibrant North American communities, caused by the building of highways straight through their hearts. I will suggest that though there may have been benefits to the society as a whole arising from the building of those highways, the adverse effects extended well beyond the individual communities involved. With this metaphor in mind, I will present the argument that the current structure of healthcare in Quebec, brought into effect in 2015, has resulted in over-bureaucratization and “decommunitization”, with a consequent diminution in the presence and role of culture, ultimately representing a loss for the community at large. Unintended deleterious societal effects arising from social system restructuring, are a phenomenon not unique to healthcare, nor to Quebec. It may take years for these consequences to become manifest, by which time they may prove difficult to reverse.
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你所在社区的医疗高速公路
这个摘要是为了介绍一个10分钟的视频,在这个视频中,我将讨论有关魁北克医疗保健系统结构的问题。与此同时,我将回顾该系统内部和周围的社区概念。这两者之间的关系和相互作用将被探索,希望观众能够找到共鸣和意义,也许是进一步思考和对话的跳板。许多人认为有必要在组织系统和现有文化内的医疗机构,无论是在魁北克内外的变化。然而,我们常常感到无力采取行动。我将谈到我们如何利用个人影响力来实现我们所寻求的改变。讨论中的概念是抽象的。为了创造更大程度的有形性,我将提供一个比喻——即由于修建高速公路直接穿过充满活力的北美社区的心脏而造成的破坏,在许多情况下是破坏,所带来的长期有害影响。我想说的是,虽然修建这些高速公路对整个社会可能有好处,但其不利影响远远超出了所涉及的个别社区。考虑到这个比喻,我将提出这样的论点,即魁北克目前的医疗保健结构于2015年生效,导致过度官僚化和“非军事化”,随之而来的是文化的存在和作用的减少,最终代表了整个社区的损失。由于社会制度重组而产生的意外有害的社会影响,不是医疗保健所独有的现象,也不是魁北克独有的现象。这些后果可能需要数年时间才能显现出来,到那时它们可能很难逆转。
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