Nature of Medicine Ignored – Why Programs Fail

david suzukiDavid Suzuki made millions telling Canadians about The Nature of Things, starting with his show by the same name.

He mixed science with story-telling to promote everything from the environment to globalism.

His descriptions became prescriptive. He told us what is, and we inferred what ought to be. Regardless of what you think of Suzuki’s politics, his methods work.

Medicine needs its own Nature of Things. Continue reading “Nature of Medicine Ignored – Why Programs Fail”

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Healthcare System vs Patients – Stewardship Part II

fork_in_the_road_-_geograph-org-uk_-_1355424Canadian healthcare stands paralyzed in a Robert Frost poem:

Two roads diverged in a yellow wood,

And sorry I could not travel both

And be one traveller, long I stood

And looked down one as far as I could

To where it bent in the undergrowth; 

– The Road Not Taken

Wooly-minded people pretend binary choices do not exist. They think we can choose both roads. Or they think one road will always be clearly wrong, as long as we use logic, facts and good will in choosing.

Doctors face two roads every day:

Do we do what’s best for the patient and prescribe an expensive treatment, or do we do what’s best for society and save the money for something else?

Until recently, doctors just prescribed what patients needed. Continue reading “Healthcare System vs Patients – Stewardship Part II”

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Relationship vs. Stewardship – Patients vs. System

screen-shot-2016-10-01-at-8-25-09-amFriends can speak without using words. Marketers used people sharing private looks to create a brilliant ad for Lexus. It sells cars using relationship.

Medicine starts and ends with the doctor-patient relationship.

Patients want their doctors to care most about them, not about society, or the greater good. Patients want to feel they have an exclusive relationship with their doctor; one that sees them as a unique and important.

This creates a problem:

How can doctors have exclusive, therapeutic relationships with patients and, at the same time, be stewards for the greater good?

With unlimited money, doctors can pretend to put their patient’s interests first and try to please society at the same time.

But at some point, doctors must choose: Do they do what’s best for the patient in front of them, or do they do what’s best for the community as a whole?

Medicine became loved and respected for choosing individuals. Medicine works on relationships, exclusivity and individuality. Continue reading “Relationship vs. Stewardship – Patients vs. System”

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Not About the Money

Hand holding fanned out Canadian money.The Canadian Press Images-Mario Beauregard
The Canadian Press Images-Mario Beauregar

Almost 50% of couples divorce, but 90% never fight about money, according to a new study.

Government has fought with doctors for almost 50 years now, and it looks like all they do is argue over money. This assumption is reasonable, and wrong.

Money is a Distraction

Most grownups pay attention to their accounts. They limit debt and make payments on time. They know that money runs out.

Government takes a different approach. In part, government does not need to worry; it can always raise taxes. But voters will not tolerate anything. Taxes run out, too.

When doctors and government fight about money, observers often miss an important point: Government does not really need to worry about the money it spends on doctors. Continue reading “Not About the Money”

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Distract Doctors, Gain Control

distracted-parentSmart kids learn to distract and stay out of trouble. They know Mom won’t bother about overdue homework, as long as she stays stressed about something else.

Politicians do the same. They distract voters with new handouts, or even better, stoke anxiety about Zika, Global Warming or some other ominous event.

Just do not let voters ask about things that government can impact, like patient wait times.

How to Gain Control

If government wants to shape society, instead of just serving it, politicians need the power to tell people what to do. Continue reading “Distract Doctors, Gain Control”

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Unspoken Debates – 1st Step to Recovery

kids-ask-questionsDysfunctional families sit down for dinner and dance around old feuds. They trip over unspoken debates and pray the kids don’t ask awkward questions.

The same thing happens in healthcare. Doctors sit down with patients and try not to think about why healthcare works the way it does.  Hopefully no one asks an awkward question.

How to Create a Mess – 101

In theory, healthcare works like this: Doctors care for patients and leave funding to the government. If patients need specific care that no one offers, some doctors retrain so that they can open clinics to provide the needed service.

Doctors fill needs and niches. They form an organic network of medical services and referral patterns around patient care.

Everything would work fine, if government could just let it happen and step in only when doctors and patients asked for help, for problems they cannot solve themselves.

Instead, government jumps in with its own ideas, even when no one asks. Continue reading “Unspoken Debates – 1st Step to Recovery”

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Our Medical System Needs Choice to Survive – National Post

private_health_20160901national-post-logo This must read, 700 word editorial from the National Post sums up the issues with Canadian healthcare and the BC Supreme Court case.

Read the original article here, or in the full text below.

Our Medical System Needs Choice to Survive

National Post, Sept 7, 2016

Defenders of public health care in Canada should welcome Dr. Brian Day’s constitutional challenge to Canada’s health-care system, which has finally reached British Columbia’s Supreme Court. The system needs choice to survive.

Day’s critics clearly don’t see it that way. Predictably, they warn that a victory for the former Canadian Medical Association president will sentence Canadians to “U.S.-style health care” and an inevitable decline in standards or access. The claim suggests a curious myopia. First, there is no reason to assume the only alternative to our current system is 100 per cent private medicine Continue reading “Our Medical System Needs Choice to Survive – National Post”

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Doctors Need a Common Enemy

common-enemyMy son’s hockey team kept losing, even though they had one outstanding player. They got an early win when their superstar was away. The team started passing, worked together and won.

Team unity beats divided talent every time.

The OMA presented a contract to the doctors of Ontario in July. Even at first glance, people could see that it would divide doctors.

We should not fear dangerous ideas. But ideas must come out at the right time, in the right place.

Tackling divisive issues in a tentative contract is like starting a team brawl in the locker room, just before a game. You will lose.

Divide and Conquer works well. Politicians know that.

Government is Not the Enemy

Doctors need government. Teams cannot play without goal posts and referees. Doctors cannot provide care without government to enforce contracts and maintain order.

As much as many of us hate to admit it, we need a little government bureaucracy.

But sometimes, government is the enemy.  Continue reading “Doctors Need a Common Enemy”

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Identity Crisis – Whose Side are We On?

luke skywalkerWhether in war or the Super Bowl, anyone who tries to cheer for two opponents gets called a traitor by both.

Serious opponents wrestle over fundamental differences.  Dreamy relativists dismiss debate and sing, “Why can’t we be friends.”

Although peace costs less than war, sometimes you must pick a side and fight. Peace-brokers risk becoming irrelevant to both sides, after the war ends. Those too eager for peace could incite civil war in their own ranks.

That’s not to say we should never call a truce. Calling a truce means, by definition, that there are two sides. You cannot deny differences and hope to win favour with both opponents.

Identity Crisis

Doctors are not on the same team as government. Politicians are on their own team. As soon as their interests do not align with ours, doctors often lose. Continue reading “Identity Crisis – Whose Side are We On?”

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Dreams of Co-Management

Blond Boy CryingWe start life ruled by passion. We clench our fists, howling at hunger pains and wet diapers. We swing from elation to rage, driven by desire.

Eventually, we grow up. We learn to control emotion. But passion continues to fuel our dreams throughout life. Life absent passion is death.

Dreams of Co-Management

Doctors have audacious dreams. They want a say in how patients receive medical care. They want an equal voice in decisions about medicine.

Some call these dreams arrogance. Continue reading “Dreams of Co-Management”

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