Beyond Mediocrity: What Canadians Should Expect From Their Healthcare System

... And Why They're Not Getting It
Thought provoking and honest.

Public Presentation by Steven Lewis, U of Calgary/SFU
Dalhousie University School of Health Administration
Halifax, N.S.
Audio/slide presentation
Link

'What Would You Think If...
Your dry cleaner made you wait 3 weeks for your clothes
7% of the meals you ate in restaurants gave you food poisoning"

Part of a series - http://schoolofhealthadministration.dal.ca/Excellence%20in%20Health%20Series/

"Excellence in Health Series
Tomorrow’s Thinking ~ Today’s Care

In 2008 the School of Health Administration established a public-education program entitled, Excellence in Health Series. The Excellence in Health Series is designed to provide an open forum, equally accessible to the public and professional community. The lectures provide a ‘large-canvas’, upon which cutting-edge topics are discussed, from healthcare planning and management, healthcare funding and delivery, healthcare law and legislation, to healthcare policy. All members of the public are welcomed, as are healthcare professionals, from healthcare practitioner, policy analyst, lawyer, to healthcare administrator. To maximally engage the public, the series is held in the evenings, off campus, at a local Hotel, and no admission fee is charged.

The Excellence in Health Series will feature national and internationally lecturers, each respected for their leadership on the topic of discussion. To ensure maximum learning opportunity to the public and professional communities throughout the region, nationally and internationally, the Excellence in Health Series is digitally recorded and made available through the School of Health Administration website.

Beyond Mediocrity: What Canadians Should Expect from their Healthcare System and Why they're not Getting it.
By: Steven Lewis

Medicare and the Law: Playing with a Full(er) Deck
By: William Lahey

How to Reduce Your Risk of Experiencing a Medication Error
By: Dr. Neil MacKinnon

A Weight On Our Minds: Obesity in Nova Scotia
By: Dr. Sara Kirk

Population Aging and Health Care
By: Dr. Kenneth Rockwood

"To get the best care, you have to go out and get it"

he desire to be seen as a person is a common complaint among cancer patients caught in a system that seems overwhelmed by waiting lists and swamped by test results, where phone calls tunnel through to voice mail and a busy doctor may have mere minutes to explain the most complicated, heart-stopping medical information.

Lynda Coghill recalls how her doctor barely spared a few seconds to deliver a curt death sentence. The Newmarket, Ont., school teacher was diagnosed with ovarian cancer at 39. At an appointment after surgery and radiation, she told her oncologist she was still bleeding. He did a quick exam, announced she had a new tumour, and said bluntly: “Your chances are slim to none.” He told her to wait a few weeks for the results of a biopsy, then left to treat a patient down the hall.

“I looked at the nurse in sheer disbelief,” Ms. Coghill says. “The doctor had proceeded to tell me, in less than 30 seconds, that I was going to die. He didn't seem to care that I had three small children.”

She cried for days, unable to eat or sleep. She and her husband planned her funeral. At last, she contacted the sympathetic nurse from the doctor's office and persuaded her to call for an “unofficial” biopsy report. The tumour was benign. Eight years later, Ms. Coghill remains angry about having been treated “like a numbered object on an assembly line.”

To get the best care, patient advocates say, it's not enough to wait passively in an appointment room. You have to go out and get it.'

From The Globe and Mail - Link

This article does not, we think, apply just to cancer patients...and it is telling that physicians dread falling ill, because then they would be cast in the role of... patients.

From the drama/film WIT with Emma Thompson. This patient was too good, and paid the ultimate price.
It's good to be patient - but not too patient...

Illuminations from THE RUNAWAY BUNNY by Margaret Wise Brown.

Signs of the Times

Osler computer wallpaper, with neither the great doctor nor a patient anywhere in sight...
These days it seems doctors want to be like "Doogie Howser MD" - a sort of precocious Peter Pan physician.
HOUSE MD, another popular medical television show, features a disabled hero who is friendless and addicted to drugs. Neither character is a proper role model for healers.



When you hear physicians talking together in your hospital, are they discussing health or holidays, medicine or mortgages? If perks and a big salary represent your physician's most precious goals, maybe it's time to hand him a golf ball and tell him to Tee Off.

Physical Diagnosis: A Lost Art?

Image: Sir Willam Osler at a patient's bedside

"The history and physical examination remain the backbone of medical evaluation and assessment. However, the many advances in both laboratory and imaging technology and the pace of modern medicine have resulted in the physical examination being abbreviated and undervalued, and viewed (subconsciously, perhaps) as redundant.

Although few studies examine physical diagnosis skills over successive generations of physicians, skill and familiarity with certain bedside maneuvers and confidence in eliciting physical signs appear to have declined, with increased dependence on the aid of a radiologist or first-tier laboratory data. The new student on the wards soon finds that skills at the computer in getting data back and arranging for tests to be done are valued as much or more than learning to percuss well or hear a pericardial friction rub. At times, it almost seems as if the patient in the bed is an icon for the real patient who exists in the computer, and 'rounds' (a word that in this context connotes motion) are conducted with the participants immobile and seated in a room and with the patient represented either on an index card or a PDA (personal digital assistant) screen."

Link


If your doctor is paying more attention to his gadgets and to test results than to you and what you tell him, maybe it's time to worry...

Myxedema

Thyroid patients restored to health - Before and After.




http://en.wikipedia.org/wiki/Myxedema

http://www.thefreedictionary.com/Myxedema+madness

Merck on Thyroid disorders



Hands and feet may swell in hypothyroid conditions. Doctors should not confuse this with acromegaly.
http://tinyurl.com/hypothyroid-hands-and-feet

Hypothyroid presenting as psychosis - PDF

Health care's missing care

"Part of the mistrust of doctors is the growing sense that they seem uninterested in caregiving."

http://www.theglobeandmail.com/news/opinions/health-cares-missing-care/article1214800/

This was once a problem that seemed confined to the USA, but now hard attitudes have come to Canada too. Tommy Douglas would be rolling in his grave.

Steven Crowder takes on the Canadian health care system here:
http://www.youtube.com/user/StevenCrowder

Osler on Caring Carefully

http://www.baylorhealth.edu/proceedings/12_4/12_4_bryan.html