Complaints about wait times to see family physicians, anger over government pay cuts for specialists, and specialists threatening to leave town made the news this past weekend—in Ontario.
I was sitting in Toronto Pearson International Airport reading the Toronto Globe & Mail trying to find information on the Chicago White Sox. Instead I found an article, editorial and editorial cartoon all focusing on disputes between the Ontario Medical Association and the provincial government, which is targeting healthcare expenses as it addresses a $15 billion (Canadian) deficit. Hmmm, sounds familiar.
In the U.S., the 50 states act as our problem-solving laboratories, trying out individual approaches to shared dilemmas. But, as the situation in Ontario shows, it can't hurt to also try to learn from what the Canadian provinces are doing.
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Getting excited about the American Medical Association's 1% increase in membership is almost like getting riled up about the Chicago White Sox getting back to .500 after a three-game sweep of the Cubs.
By winning three straight over their cross-town rivals on the North Side, Chicago's South Side baseball team is now officially mediocre with a record of 21 wins and 21 losses.
The same level of sarcastic euphoria could be viewed by the membership numbers in the latest AMA annual report, which showed an increase from 215,854 members to roughly 217,000 in 2011.
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Before Jerry Seinfeld started writing jokes and appearing on television, there were doctors and scientists named Seinfeld writing medical research papers and getting their work published in medical journals.
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The most eye-catching reference in a recent Health Affairs report on patient fears when dealing with “authoritarian” doctors did not get a citation. That's because, instead of coming from a medical journal, it came from a classic episode of the “Seinfeld” TV show.
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Proponents of caps on malpractice damage awards argue that they effectively control the cost of malpractice premiums in California and Texas, but the evidence of positive effects toward increasing patient safety or decreasing defensive medicine practices remains murky.
Others push for special health courts where healthcare experts could provide unbiased analysis that leads to fair and equitable rulings and place meritless, junk lawsuits on the ash heap of history.
Despite whatever merits they might have, health courts remain an academic and untested concept, and caps have become absorbed by the forces of the political yelling machines that see their passage or defeat as keys to maintaining freedom in our time.
A third option has entered the stage that is quietly gathering evidence of its efficacy: Disclosure, Apology and Offer, which calls for disclosing when adverse events occur, investigating why they happened, sharing that information with patients and their families and then offering compensation.
A coalition of Boston-area organizations is launching an initiative to test the concept, and it is basing its “Roadmap to Reform” on a similar program in place since 2004 at the University of Michigan Health System. The University of Illinois Hospital & Health Science System in Chicago has been doing the same since 2006.
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