Dr. Brian Goldman

The book gave me an opportunity to give a state of the nation on emergency medicine at a time of crisis when we still have an opportunity to do something about it, when I wanted to call attention to it to Canadians.

so that they could complain about it, so they could give voice to the stories and maybe do something about it before it's too late.

The emergency room is the nexus point for a lot of patients.

It was originally designed to be the place where you brought people who are having flat-out emergencies, heart attacks, strokes, people who are bleeding to death, people who are dying of sepsis, and it has morphed into something larger.

It's the place...

to go when you have no other appropriate place to go.

So it's become the place where the 6 million Canadians who don't have primary care, don't have a family doctor, don't have a nurse practitioner will go when their choice is either the emergency department or an urgent care center.

And if you've ever been to an urgent care center, you don't go at two in the afternoon.

You phone

at seven in the morning and on speed dial and keep dialing and dialing and hoping that you can get a slot because by eight o'clock in the morning, all the slots in urgent care centers are full.

And so your only other option at that point is to go to the emergency department or wait another day.

And it's not just the six million Canadians who don't have primary care.

Many millions more can't get a timely appointment.

So by the time it takes to get an appointment, their condition is much worse.

And where do they go?

They go to the emergency department.

It is the place where people who have severe mental health challenges go, people who have substance use, the unhoused.

And my friend and colleague, Dr. Al Drummond, who I profile, I do a whole chapter on the emergency department that he helped to build in Perth, Ontario.

It punches way above its weight.

It was one of those smaller emergencies that closed down for three weeks, broke his heart when that happened.