Change is happening now in Ontario healthcare. It has been needed for some time, but a new provincial government with a demand to deliver high value for public dollars is making the change imminent. So what, exactly, is “value”? Value is best defined as quality (in all of its domains) divided by cost. It can be measured from…
A version of this article was first published in the Canadian Journal of Physician Leadership, Volume 3, no. 2 (2016) As physicians, we are part of an influential community, one that initiates, influences and perpetuates important conversations. Our community has a collective culture and it is shaped completely by them. Our conversations get noticed. They…
Last month I wrote about Transitions in Care from the lens of quality, published in early April both here and in HQO’s QI Forum called Quorum. The article described what prevents transitions from happening smoothly, and highlighted some solutions, both technical and non, that have made hand-overs somewhat easier. Yet, as a family doctor, I struggle with…
** This article was originally posted April 3, 2017 on HQO’s new Quality Forum called “Quorum“. This is an online community for those interested in and doing quality improvement work in Ontario healthcare every day! For patients, caregivers and providers alike, a transition in care is often a frustrating experience. When looking at why,…
Recently, Primary Care has been moving toward conversations about how we should approach the health of our patients in a more global way. Talk of population health is front and centre. We hear that 5% of the people we look after consume 64% of Ontario’s healthcare budget, and that if doctors and nurses would only…
Despite the obvious advantages to both patients and providers of using virtual care tools, they have had very little uptake in the average community practice. There are many reasons for this hovering in the background, from payment models to variable high speed internet access, but the most important of these has to do with office…
It’s amazing to watch a conversation evolve. Over the past month I have had some great feedback from physicians, nurses and patients about medical professionalism and the concept of physician accountability. In my last blog post I explored the idea that accountability is not based on finger pointing or blame and need not be feared.…
Recently there has been more and more talk at the health system level about the concept of physician accountability. In Ontario this discussion is part of Patients First LHIN-based initiatives that will have primary care accountable at a local level, possibly with dedicated accountability agreements built into our clinical structures. The issue became even more prominent at…
Recently, after my last blog post, a physician colleague shared that in his opinion, “as usual”, I was “overly cheerful and optimistic”. His comment got me thinking. Could this be true? When conveying a complex message or guiding people toward an often difficult goal, can one be too optimistic? Does optimism alienate people? Is it authentic? What effect…
For the longest time I have loved writing. As a kid, I used to escape in letters to friends in far away places, stories of adventure and recorded observations of the world around me. I hated diaries, though. I didn’t want to write things that simply listed the events of the day, attached to static…
