Six Sigma and Medical Care

Does your hospital utilize Six Sigma in its planning and methodology?
Six Sigma Catapults Hospitals to Next Level of Quality
If not, the consequences can be very costly to you...and to the hospital.

"Lawsuit could set precedent about end-of-life decisions

Robert Cribb
Toronto Star
Staff Reporter
September 04, 2010

As her father lay struggling for breath in a Toronto hospital bed, Joy Wawrzyniak pleaded with doctors to intervene and save his life.

Medical staff instead stood back and allowed the World War II veteran to die, against his wishes and to the shock of his daughter, Wawrzyniak claims in a stunning $1 million lawsuit filed this week against Sunnybrook Health Sciences Centre and two doctors responsible for her father’s care.

While Wawrzyniak and her father, Douglas (Dude) DeGuerre, had repeatedly requested he receive life-saving treatment in case of a medical emergency, doctors unilaterally overruled those wishes without consent or consultation, the lawsuit claims...."
Lawsuit could set precedent about end-of-life decisions

Do you trust your doctor?

Do you trust your doctor? Increasingly, many (Canadians) do not.
It may be wise to ask questions. Today, university medical education is often funded by Pharma (grants to chairs and departments, for research, dictating what shall be taught) and continued in the doctor's office during visits by drug company reps with high school educations and doctor prescribing info and personality profiles on their Bl*ckberries.

From an article at Maclean's

...horror stories have made Canadians wary, says Mario Canseco of Angus Reid Public Opinion, who oversaw the Maclean’s poll. “Not only do they worry that there will be mistakes, but they assume so,” he says. “Even if you’re happy with your GP, you see what’s happened to those around you. You think it may be your time next.”

For doctors, this is an unaccustomed, and not especially pleasant, spot to be in. For generations, physicians have enjoyed greater public respect and appreciation than practically any professionals—a reflection, perhaps, of their status in many communities as the most educated people in town. That’s changing, however, as post-secondary education becomes the norm and Canadians in general grow less deferential. “There used to be a very paternalistic relationship between doctors and their patients,” says Dr. Rocco Gerace, registrar of the College of Physicians and Surgeons of Ontario. “It worked both ways. Patients would essentially give doctors the decision-making ability, as opposed to considering options and then consenting. It’s changed dramatically, and I think for the better.”

That shift has been accelerated by the Internet, which puts not only diagnostic information but reviews of individual physicians at the fingertips of patients. RateMDs.com, a California-based site that went online in 2004, has doubled its traffic every year since, with Canadians as its most enthusiastic constituency. The site now has user-submitted ratings for over 85 per cent of Canadian doctors, and a surprising 45 per cent of its 1.2 million monthly visits originate in this country. The phenomenon speaks not only to patients’ doubts, but an appetite for frank criticism that Hugh MacLeod, chief executive of the Edmonton-based Canadian Patient Safety Institute, says will only grow. “For those in the system who think things are getting wild now,” he says, “put on your seat belts.”

All this crowd-sourcing raises an obvious question: are medical mistakes becoming more common? Or are they merely being amplified by proliferating media, both social and mainstream? Geoff Norman, a McMaster University psychologist who studies how doctors make errors, believes recent scandals played out in the media have simply caused patients to demand reviews and investigations, the coverage of which has fed impressions that things are going awry. Doctors are more willing to own up to mistakes, he argues, and he points to the publication in 2000 of “To Err Is Human,” a report by the Washington-based Institute of Medicine, as a watershed moment in encouraging practitioners to acknowledge their fallibility. “Now,” he says, “there’s almost like a legislative review process when something goes wrong.”

http://www2.macleans.ca/2010/08/16/do-you-trust-your-doctor/
Print version
http://www2.macleans.ca/2010/08/16/do-you-trust-your-doctor/print/

"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.