Pressure to get people through the health care system is forcing hospitals to use cabs to send people home once they've been discharged, says the Canadian Association of Emergency Physicians.
"Thirty years ago we'd probably keep little old ladies in our emergency department and give them tea and cookies until the light of day and we could make sure that family came and get them," said Alan Drummond, chair of the CAEP.
"The pressure to resolve crowding, to keep the beds open … has sort of had the, I think, a bit of an impact in terms of that decision now to be able to discharge people come day or night."
Two Winnipeg men, aged 78 and 62, recently died in separate incidents after being sent home by taxi. Neither made it into their homes.
That has sparked debate about the responsibilities of cab drivers to wait until their passengers get through their front doors.
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On Friday, Manitoba Health Minister Erin Selby said the province is drafting a protocol that will require taxi drivers to ensure patients being driven home get inside their homes safely.
Families must take role
Drummond said families of patients need to step up and help them get home.
"We can't rely on ambulances because they're in the business of retrieving sick and injured to come, and they don't consider themselves to be a taxi service," he said.
"We should start to sort of insist, I think, that families probably take a greater role."
Drummond said nurses and doctors first assess the patient to see if they're physically able to leave the hospital.
Beyond that, responsibility has to fall to the patients and their families.
"Just as a patient can register to the emergency department at any time of the day or night to be treated, now, unfortunately, so can they be discharged at anytime of the day or night," Drummond said.
"It appears heartless sometimes. It isn't really that way but it's good to have somebody with you to make sure that things go smoothly."