Thursday, January 31, 2013

Documentary: The Waiting Room

I saw The Waiting Room documentary film Sunday night at the Cinematheque Theater for a Journalism assignment. It was my first time to go there, and what better way to watch it than with CreComm classmates (who were watching it anyway)? So off we went.

Set in the waiting room in Highland Hospital, Oakland, California, the film portrayed the U.S. health care system. Even if it wasn't part of the assignment, I couldn't help but compare the Canadian health care system to the U.S. system while watching the documentary.

Patients at the emergency room had to wait for hours. There was one patient who waited for seven hours for a Tylenol. They had no appointments, so they had to wait the whole day because "there's just no place for everybody," (said by the nurse in the waiting room). They all had to wait. The patient who had a bullet in his leg. The young girl with tonsillitis. The patient who had a stroke.

I felt bad for those who had to wait. But then, it's the same case here in Canada too. I had to wait an average of three to four hours with my GP (that's why I rarely visit my doctor unless I'm really, really sick.)When I went to the emergency room summer last year, I waited for two hours (or maybe two and a half? I forget.). I was surprised that I only waited for less than three hours because I thought I had to wait long. It was Thursday afternoon, and there weren't many people in the waiting room. There was even a screen on the wall that indicated the number of patients in the room and the least and most wait times that day.

According to a report from the Canadian Institute for Health Information, 1 person in 10 waits for eight hours or more. While the "average length of stay is longer than four hours." The report was released November 29, 2012.(1) So I guess I was lucky that day...? (Even though I was unlucky because I was at the emergency room. Oh well.)

The Government of Canada have been improving this flaw in the system, when Health Canada established the "Patient Wait Times Guarantee" where there patients have access to a clinical or medical service with "a defined timeframe", and "access to alternate options of care (recourse) should that timeframe be exceeded."(2) However, this initiative doesn't apply to emergency rooms. 

But I guess it works? Bacchus Barua and Nadeem Esmail conducted a research study called "Waiting Your Turn: Wait Times for Health Care in Canada, 2012 Report", where medical or clinical treatment wait times have decreased between 2011-2012.(3) Their research reported "a total waiting time of 17.7 weeks between referral from a general practitioner and receipt of elective treatment." 

The biggest issue that stood out for me in the documentary was that most patients didn't have insurance to pay for their medical bills. Patients had to pay at the end of their treatment. The hospital staff mentioned that Highland Hospital has two options for patients who couldn't afford the bill: Charity Care Program and Patient Pay discount. If the patient qualifies for the Charity Care program, the hospital covers 60% of the payment and the patient pays the rest. The bill is split between hospital and patient for the Patient Pay Discount. Even though they have these programs, I don't think a person with very low (or no) income should pay for hospital fees.

I felt really bad that they had to pay for their hospital fees because when I went to the emergency room last year, I didn't pay at all (because the doctor just observed me and asked me questions. Hahaha). My dad didn't spend anything either when he had a foot surgery (except for medications and prescriptions, but they're covered by insurance at work anyway.).

I'm glad that people are treated equally and fairly in the Canadian health care system. It is the primary objective after all: It is hereby declared that the primary objective of Canadian health care policy is to protect, promote, and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.(4)

I understand that there are long wait times in the emergency room, but sometimes I think that I'm grateful that I don't have to pay for anything when I visit my doctor or when my friend had two complicated surgeries in her spinal cord and stomach. Because coming from the Philippines, surgeries cost a lot. And public health care there is terrible. Very unsanitary. Anyway, I'm just grateful with the Canadian health care system despite the flaws.

Now, despite the controversial and relevant topic, does the film work as a documentary?

The first 20 minutes was nice. The story began showing the patients waiting in the waiting room. It showed nurses and doctors assisting and talking to the patients. They were the narrators of the film. However, after 30 minutes of showing patients waiting, getting angry, and narrating, I've had enough. There was no story. I didn't understand what director Peter Nicks wanted to tell the audience.

(If I looked deeper into it, I think it's a metaphor--the Americans were waiting for someone (or something) to change their health care system.)

Anyway, the documentary only showed one side of the argument (i.e., the state of the U.S. health care system). For the Americans, the film offered nothing new because they already know how it is. Maybe it offered something new but little information to the non-Americans, but it wasn't controversial.

The setting was excellent; the audience got a glimpse of what it was like to be in the waiting room in a U.S. public hospital. I liked that most of the shots were close-ups because it made the people seem closer to the audience. The shaky camera showed the reality, instability, and vulnerability of the people. The rack focus was executed nicely in shots where two patients were talking and the camera would focus on one person, blur the other, and vice versa. For the editing to work, there had to be a story. And there was no story.

The background music was played three times (beginning, middle, and end) to show more sounds produced by the people to make it realistic. But sometimes were was too much talking, too much telling, and less showing (which brings me back to the editing and lack of story again).

The documentary let the people talk (but not too much) and let them narrate the story. If there was a story. If there was a story, it would've been a lot better. The patients would tell their story and show their story through their emotions (because emotions are more powerful than words). Then it's up to the production team to create an overall story through proper editing and sound.

The documentary had so much potential. It featured an interesting, controversial, and relevant topic, but it would've been so much better.

Sources (linked in post and here): 

(1) CIHI News Release. Nov. 29, 2012.
(2) Health Canada. Patient Wait Times Guarantees. Feb. 24, 2012.
(3) Barua, B., and Esmail, N. Waiting Your Turn: Wait Times for Health Care in Canada, 2012 Report. Dec. 4, 2012. Fraser Institute.
(4) Canada Health Act. Justice Laws. Jan. 30, 2013. 

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