Social Systems & Institutions | The Rowanwood Chronicles

Within the Hitchhiker’s Guide to the Galaxy, a trilogy told in five parts, Douglas Adams postulates that a rapid increase in the number of high street shoe shops is a clear indicator of the impending collapse of a civilization. Today, I am suggesting that Adams got it wrong; and instead of shoe stores, it’s the never ending construction and use of indoor storage facilities that is the harbinger of our society’s inevitable doom.

Why are we so fixated upon storing possessions that will rarely see the light of day again? Boxes of paperwork, generations of photos, and great grandma’s old wooden chest are just some of the items our kids will be dealing with at the end of our days. Current monthly rentals run in the order of $200 to $500 for storing all our knickknacks, and the cubic capacity for conserving our personal histories continues to rise.

During the pandemic, an acquaintance actually bought a second house because his primary residence was full, and he had run out of room to store his constantly growing collection of furniture, art and books. Last year, I filled a large dumpster with a small part of my life’s detritus, and it was difficult to see the difference. This year, I gifted hundreds of books and DVDs to a local charity, and I finally felt some weight lifted from my shoulders. My closets are next, and the hardest part will be the kilts.

In Sweden, they have the gentle art of death cleaning, where seniors or those battling a terminal illness organize and declutter their homes so as to save their loved ones from the burden of this cumbersome chore while grieving their loss. A more sensible life activity I cannot name, and it is the anthesis of IKEA and its flat pack storage frenzy.

Paperwork can be digitised, meta-tagged and stored safely in the cloud. Photos likewise, and both collections can be searched and retrieved instantly, if and when needed; whereas great grandma’s chest should either be offered to the kids, or if they don’t want it, (and we all know they don’t want it) sold or gifted to someone who really has a use for it.

Adams describes civilisation’s collapse because, in the end, all that could be bought were shoes, and so eventually we took to the trees and evolved wings. Perhaps if we all just dealt with this overflow of physical possessions, communities could use these multi-storey repositories to provide housing and other amenities to help combat the current homelessness and lack of social housing infrastructure.

Let’s adopt Scandinavian ways, and modify the tradition, so that starting today, indoor storage buildings gain a more meaningful use while decluttering our lives, and lifting all that weight from our shoulders. In the meantime, I may have found a good home for my kilts within the next generation, and surprisingly, my business suits are being eyed too!

When writing my blog posts, I don’t normally take on a single person’s point of view, rather I do my research, and integrate it with my own thoughts, laying out a structured argument. In this case, I however I find myself significantly aligned with an experienced, medical academic, and politician.

Dr. Jane Philpott, Dean of Medicine at Queen’s University, and a former federal Minister of Health, has been an advocate for innovative solutions to improve healthcare accessibility and continuity. Her thinking aligns well with the concept of automatically assigning primary care providers, as she has highlighted the urgent need for systemic reforms to address Canada’s primary care shortages and patient access issues. Just as the system automatically assigns schools for our kids when we move, or as they age, we need to assign a primary care provider to each family member. Dr. Philpott has emphasized the critical role of primary care in managing population health and preventing unnecessary use of emergency services, noting that consistent access to primary healthcare can significantly reduce healthcare costs and improve outcomes across communities.

Philpott has been vocal about the necessity of rethinking how healthcare services are delivered and organized, especially given the increasing number of Ontarians without a primary care physician. She has stressed that to meet rising demands, Canada needs to adopt more accessible, team-based approaches and integrate technology more effectively to bridge gaps in care. An automatic assignment system could serve as an important structural change to support the patient-centred and accessible healthcare system she envisions. For instance, automatic assignment, combined with integrated electronic health records, could streamline access to primary care by matching patients with physicians who can access their medical histories immediately.

Philpott’s support for interprofessional healthcare teams also enhances the feasibility of an automatic assignment model. She has argued that Ontario should move away from the traditional, individual-doctor model towards team-based care where primary physicians work in collaboration with nurse practitioners, physician assistants, and mental health professionals. Such teams could accommodate the additional patient load an assignment system might create, ensuring new residents receive timely and comprehensive care.

Dr. Philpott’s insights underscore that for Ontario to effectively manage an automatic assignment system, the government would need to address physician shortages and create incentives for healthcare professionals to practice in underserved areas. This, paired with increased support for virtual healthcare, could mitigate the challenges posed by Ontario’s geographic diversity and high urban-rural patient disparity. Embracing such reforms, as Philpott suggests, would reflect a proactive step toward equitable healthcare access in Ontario and a sustainable solution to the primary care crisis.

Sources:
CBC News, (2023). “Canada’s Family Doctor Shortage: How Did We Get Here?”
Queen’s University, (2022). “Rethinking Primary Care: Team-Based Solutions for Canada’s Health System,” Philpott, Jane.
CMAJ, (2022). “The Role of Primary Care in Canada’s Health System,” Thorpe, Kevin.