The subtitle of my book How Hockey Can Save Healthcare is A Principle-Based Approach to Reforming the Canadian Healthcare System.” So what are these principles, and where did they come from? The principles are listed below. It is not an all-encompassing list –there are other principles that may also be relevant to system transformation. They were derived from the healthcare reform literature, observing successful organizations, and general common sense (which is not necessarily common!). The idea behind a principle-based approach…..
Seriously Canada! We have to set a higher bar for evaluating our healthcare system! In the March 10th Globe Editorial: Killing Obamacare will make Canadians feel smug, again there is clear gloating about the relative performance of the Canadian healthcare system when compared to our southern neighbors. Is it really productive to make comparisons to the United States system? The system in the US, at least the traditional private fee-for-service component, is staggeringly dysfunctional. We should be comparing our system…..
Scoring goals is critical in hockey. It determines which team wins, and which team loses. So, why don’t we pay pro hockey players strictly based on the number of goals they score? “There are other elements of the game that matter” you say! Assisting on goals. Winning face-offs. Killing off penalties. Well, why don’t we add these specific isolated elements into the mix as well? Pay a certain amount for each goal scored, a certain amount for each penalty killed,…..
In my book How Hockey Can Save Healthcare I outline a series of principles that need to be embraced in order to optimize a healthcare system. One principle that at first glance may appear controversial is the need to limit individual physician autonomy. By physician autonomy I mean a physician’s ability to make ANY patient-care related decision he or she feels is appropriate regardless of the literature or the norms that have been established by the health system. Individual physician’s…..
In 2006 Donald Berwick introduced the concept of the “triple aim“. It is a concept I emphasize in my book How Hockey Can Save Healthcare (chapter 6). The triple aim promotes the idea that healthcare systems should have three broad aims: Improving the Experience of Care Improving the Health of Populations Decreasing the per Capita Cost At first glance the triple aim may seem counterintuitive. How can you improve the quality/experience of care will simultaneously decreasing the cost? However, once…..
Healthcare in Canada is a prisoner to its history. The present challenges confronting the Canadian healthcare system cannot be fully understood without knowing how the system has evolved. Well-intentioned decisions made more than a half century ago have created a rigid organizational structure that is now paralyzing innovation. I am referring to the Hospital Insurance and Diagnostic Services Act (HIDS Act) of 1957 and the Medical Care Act of 1966. These two acts provided Canada with “universal healthcare,” but they…..
Why should we fundamentally reform our healthcare system? Seriously? When someone like me comes forward and says we need to totally revamp the Canadian healthcare system in order to deliver care whose quality and cost matches our ideals you have every right to be skeptical. This is particularly the case given the spectacular successes in healthcare during the past 100 years. One such success, emblematic of the dramatic improvement in healthcare over the last century is Canadian Sir Frederick Banting’s…..
The title of my new book How Hockey Can Save Healthcare: A Principle-Based Approach to Reforming the Canadian Healthcare System probably raises at least two questions. First, does healthcare need saving? Second, what could hockey possibly contribute to reforming healthcare? Does healthcare need fundamental reform? Does it need saving? Can we not treat the existing Canadian healthcare system merely with continued ongoing tweaks around the edges? The system is based on great ideals! Isn’t the reality reflective of these ideals?…..
What has been your experience as a patient within the Canadian healthcare system? Perhaps you have a great family doctor that you can get an appointment with on short notice. Maybe you or someone you love has received exemplary care in hospital (and afterwards) following a major accident or heart attack. If this has been your experience, that’s great! This is what a healthcare system should do. However, for many Canadian patients this has not been their experience. Access to…..
Canadians embrace the ideals of our publicly funded healthcare system. These ideals have become central to our national identify. There is a reason why Tommy Douglas, father of the Medicare system (and Kiefer Sutherland’s grandfather) was voted “The Greatest Canadian.” However, ideals and reality are often two very different things. In 2010 when I returned to Canada to take on the leadership of the department of orthopedics at a major British Columbia hospital I was like most Canadians. I thought…..