Is Self-Regulation Dead?

I believe the term ‘self-regulation’ is well on its way to the dustbin of history.”

With this, the registrar of the College of Physicians and Surgeons of Ontario (CPSO) wrapped up his final note in From the Registrar’s Desk.

He went on,

In the future, College work will no longer be described as ‘the privilege of self-regulation,’ but instead ‘the responsibility of medical regulation.’

Candor comes easy when people leave office.

Is Self-Regulation Dead?

 

Was the registrar simply making an observation, or was he stating what he believes to be good? Does he believe self-regulation belongs in the dustbin?

I know many doctors who became Chiefs of departments. Chiefs oversee quality. They handle patient complaints.

Chiefs see problems before they become patterns. A good Chief tries to build safety into a department to prevent problems becoming patterns.

Good Chiefs try education, encouragement and incentives as ways to improve quality.

But they never eliminate problems, and many Chiefs start to despair.

So, they take charge.

They make tough decisions.

They put their faith in power: rules, oversight, punishment.

After 10 years in charge, some Chiefs are damaged; irreversibly anti-physician. They lose hope in clinical judgement and put their faith in systems instead of people. Continue reading “Is Self-Regulation Dead?”

Moral Hazard and OHIP+

We scrambled to book massages and orthotics for our children.

The year was almost over. We had unused health benefits.

Did they need a massage?

Who determines need versus want?

Do need and want overlap? If not, where does one end and the other start?

Economists teach us that demand for free products and services is infinite.

Voters experience the limits of free government products and services as rationing. Stuff runs out. Wait lines form. Continue reading “Moral Hazard and OHIP+”

Simply Overwhelmed

Dr. Lynsey Bartlett made national news when she let 100 patients go last week.  CTV reported it as 200.

She was charting until midnight, spending 1/3 of her day with complex mental health patients and could not afford to hire more staff to help out.

She was simply overwhelmed.

Many docs do what Bartlett did, but they go quietly. They trim office hours or join larger groups.

Patients wait longer for next-available appointments. But no one sees it in the news. Access changes like the tide, quiet and slow.

The tide has shifted, in Ontario. Continue reading “Simply Overwhelmed”