Monday, August 25, 2014

The Irony of Insisting That "Patients Must Demand Better Care"

Ever read the statistics on Malpractice suits in Canada? Maybe peruse the reports from the BC Patient Care Quality Office? Read up on the incidence of medical error? Maybe you have read the latest Commonwealth Fund report on healthcare in Canada – you know the one that places Canada second to dead last among OECD countries in terms of health system performance? Are you at all familiar with who the patients who use the health system actually are? Are you familiar with how the system is structured?

There are those who insist that patients are the ones who should be responsible for changing the healthcare system – that patients should demand better care. It is a shame that those who take this stance have not really given much thought to the reality of being a patient. It is a shame that they seem to have neglected that it is one thing to “Demand Better Care” and quite another to have the demand that is made, heard and then actually result in “Better Care”. It is a harsh truth that there are patients who have been “Demanding Better Care” – in whatever ways they can – but that many of these patients find that their demands are met with the same indifference that the demands of a toddler asking for a non-existent popsicle are met with.

It is all well and good to think that patients should have the ability to demand better care, and that those demands should result in meaningful and positive change. But the reality is that the system is designed in such a way, that the patients are the people ‘in the system’ whose voices are least likely to be heard but who are impacted most when the system fails.

Think about it – think about the resources at the disposal of the government. Think about the organization of doctors, nurses and healthcare providers. Think about the knowledge of “the system” that these other parties to the system have. Think about the levers available to affect change in the system – and exactly how few of them are available to patients. Now think about the reality of facing a health challenge – and then having the burden of “Demanding Better Care” hoisted upon your shoulders when you are at the mercy of the system.

As it currently stands, patients in Canada are in a position where they have tremendous potential to affect meaningful change, but until those who are in control of the system meaningfully empower patients to affect that change, they remain unable to do what they are being called upon to do.

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