A proposal for a patient-focused charter
Written by Dr. Brian Day on November 30, 2012 for CanadianHealthcareNetwork.ca
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by Dr. Brian Day
An ethical physician’s role is to attempt to ensure quality healthcare that is appropriate, effective, and provided in a timely fashion. When forced to choose between loyalty to regulations that conflict with that role and the well-being of patients, we have a duty to favour the latter.
Consider this: The government-owned North Korean airline—Koryo—is a monopoly that dictates the amount it spends and has the ability to extract whatever funds it wants from its clients. It owns and controls the facilities that deliver the service. It decides its locations; trains, employs, regulates and funds the workers; and governs how, when and where the population is served. It also determines the level and quality of services provided, while regulating and evaluating its own performance. Koryo is rated as the worst-performing airline in the world. Our government-run Canadian health system operates under the same set of rules.
In addition to the need to introduce competition from non-government funders and providers into our health system, our publicly owned agencies must be subject to penalties for poor performance, and rewards for good service. If hospital global budgets are replaced by patient-focused funding, token commitments to excellent patient care in mission statements will have to be matched by action in order to produce sustainable financial statements.
I would like to propose the following actions, based on rewards and penalties, that would ensure transformation to a patient-focused system:
1. Patients awaiting elective consultation with a specialist should be seen within two to four weeks. Those assigned a longer period would receive funding from the health region to arrange their own consultation with anyone, anywhere, including out-of-province or out-of-country care.