I think it’s great that we’re putting more money and supports into the community, and I think it’s awesome that we want to send people home first. My ward has always had the philosophy that home is best, and we need to respect the patient’s wish to live at home, even if it is at risk. However, we have a multi-disciplinary care team for a reason, and it’s not to sit with our thumbs up our asses.  If our entire team assesses and feels that this patient cannot live at home, even at risk, perhaps you should listen to them. We know what the community supports are, and we know what our patient needs.  To stand there and say that we have (HAVE) to send the patient home with the max supports “just to see” is insulting. You are implying that we are not doing our assessments properly.  You are implying that we, their health care providers, do not know our patient as well as you do. You, some figurehead that came to one meeting, think you know the patient better.  And our hands are tied, because we have no choice, we must send every patient home first. Full Stop.  We have to let them fail at home first, and then come back to us in much worse condition. This is what healthcare is now, black and white, no grey areas for people to be in.
And then when they get re-admitted, we have to look at we what WE did wrong. How we failed. Perhaps it's not us, perhaps it's a system failure? Maybe there's a problem with the community?  Maybe you should have listened to us and not sent the patient home in the first place. 
They keep touting the successes of their program, despite the fact it hasn't even been around long enough to get significant data. And, as my stats teacher would say "Correlation does not equal causation."  You can make anything correlate in your favour. 
But, as people keep reminding me, healthcare is a business. f it is a business, this is a terrible way to run it. No other business would send something out knowing it would fail. Cities don’t build bridges know that they are going to collapse, just so they can build the right one next time. Companies don’t send out parts that they know are going to fail, only to re-do it right the next time.  Its insanity, it makes no sense and it ends up costing millions of dollars. Although I accept that healthcare is a business, I will not accept putting my patients at risk. I will always stand up for my patients, no matter how many people I am standing against.  

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