Ford Fools Physicians on Arbitration?

Premier Ford fooled me.

People have asked what I think about this week’s arbitration fiasco.

For the first time, a Canadian government walked away from arbitration.

The Arbitration Act of 1991 defines the law that parties must follow, when they agree to a third party process to resolve disputes.

It is bad when a government overturns an arbitration ruling. It is unheard of to walk away during the middle of arbitration. It is like walking out of a court case. No one does that.

Ford has found ways to do what no one else thought he could. He kicked out Hydro One directors, cancelled Solar and Wind contracts, and did not hesitate to whip out the notwithstanding clause.

Pundits rolled their eyes at first. Not anymore.

Regular voters want action. Most do not read political philosophy. One quarter of American adults have not even read a single book of any kind in the last 12 months. Why would voters know or care about all the ways Ford Nation tramples good government?

What Flavour is Ford?

Premier Ford campaigned as a Progressive Conservative. But is he even progressive or conservative?

There are Birkenstocked Burkeans, paleo-cons, social-cons, neo-cons, theo-cons, crunchy-cons (my favourite), baby-cons, and a hundred other flavours.

What flavour is Ford? Continue reading “Ford Fools Physicians on Arbitration?”

How to Change Doctors’ Behaviour

Parents and politicians share the same struggle: How do we make people behave?

The new Ontario government talks about accountability almost as much as it does about debt.

No money means no carrots, which leaves only sticks. Is leadership only carrots and sticks?

Leadership is influence. Influence comes from relationship. Successful leaders influence others toward positive ends. As a parent/leader, how do you make your son clean his room?

You could:

Give a pep talk.

Lay down the law.

Nag.

Bribe.

Give up. He’s a boy.

Change Doctors’ Behaviour

Governments repackage these tactics to change doctors’ behaviour. Politicians often:

Give a pep talk from a famous leader on the privilege of caring.

Tighten accountabilities (Lay down the law).

Increase oversight and add behavioural prompts (Nag).

Incentivize behaviour and offer bonuses (Bribe).

Give up. Impose global cuts and offer sub-inflationary fee increases.

System leaders repackage the same rules for everything: after-hours care requirements, surgical outcomes, in-patient lengths of stay, etc. But better rules do not guarantee better patient care. Better rules make doctors focus on rules, not patients.

Rules change behaviour the way speed limits change driving habits. People perform to the limit of what goes unpunished. This Faustian deal works for speed limits. It does not work for patients. Continue reading “How to Change Doctors’ Behaviour”

Do Colleges Cause Physician Suicide? A New Book

Surgeons should not remove normal breasts or amputate healthy legs. Some things should never happen.

In the late 1990s, surgeons confronted wrong site surgery. They said it should be a ‘never event’ and have changed process to make it so.

We can directly relate at least 6 physician suicides to doctors being under investigation by Colleges of Physicians and Surgeons across Canada. Have the Colleges confronted this and changed they way they work?

Blog posts about medical regulation remain popular topics for doctors, for example, Is Self-Regulation Dead? and Concentration of Power – Are Medical Regulators Autocratic?

Dr. Albert Benhaim just published a medical best seller in Quebec: The Execution: A doctor’s battle against moral and institutional harassment. Continue reading “Do Colleges Cause Physician Suicide? A New Book”