Saturday, December 12, 2015

A Letter to Christine Elliott: Ontario's First Patient Ombudsman

On Dec 10, Christine Elliott was named the first patient ombudsman of Ontario.

As a Manitoban, it would seem odd that this would matter to me.  Today, as my wife and I, sat in the Heart Failure Clinic at St Boniface Hospital (in Winnipeg) we learned that she will be referred to the Toronto General Hospital for cardiac care.  Several hurdles have to be crossed before we get there but the "game plan" will be to escalate Susan's level of care which may require open heart surgery at some point.  This would be Susan's second open heart surgery.  The state of health care in Ontario just became a real issue to us.

I have been anticipating, for some time, the announcement of this ombudsman position ever since I became aware that Ontario had announced their intent to create this new position.

The concept of an ombudsman who is only answerable to patients and to represent the interest of patients makes a lot of sense to me but will the government listen?  Will this position be able to exercise "real" authority?  These are all questions that have yet to be answered.

Anyone who has experienced the health care system has experienced the power imbalance when they are a patient.  It is not so much that there is a technological disadvantage...but health care is a monstrous bureaucracy with many layers requiring a great deal of skill to navigate.  You, as the patient or in many cases the caregiver are "out-gunned."  It is not just a matter of dealing with a doctor, nurse, HCA, or clerk.  If you have an issue, let's take a look at what you are up against:

  • Regulatory Bodies
  • Medical Associations
  • Unions
  • Health Regions
  • Government Agencies
  • Health Care Boards
Within these broadly described groups, there are numerous sub-groups.  All of these groups have two things in common.
  1. They claim to be advocates for patients
  2. Primary mandate is to represent someone (or group) other than the patient.
The point i am making is not to vilify any group.  The point I am making is that there is no one group who solely represents the interest of the patient.  This is why the concept of a patient ombudsman is an appealing idea.  The only mandate of this position is to advocate for patients, free of any influence.

Will this new position give patients a much needed voice in health care?  Honestly, I don't know.  The success of this position will depend on the scope, authority, and autonomy of the Ombudsman's Office.  The bottom line is that if this is to work the office needs real power.

From someone who sits on several boards, committees, and councils in health care I have a few suggestions that I believe many people who are involved in advocacy will agree with.

1)  Engage with Patients, Caregivers, and Patient Families

There are numerous experts within this group who have logged hundreds (if not thousands) of hours in the health care system.  This experience in invaluable.  In addition to these people being knowledgeable about the challenges of navigating the health care system but many of them bring other professional skills.  Many of the people I have encountered in my volunteer experiences, are business owners, engineers, accountants, and leaders in their own area of expertise. These people are unique, skilled, and strong voices for patients.  A skilled group of patient advisers will be an invaluable resource.  These adviser positions should have extensive experience requirements and some monetary compensation should be involved.  Many of these people have repeatedly volunteered their time in the past.  It is time we recognize the expertise these people have and offer some remuneration.   I think many people are volunteered out.

2)  There is no need to be nice.

Health Care is in critical condition (to use a medical term).  The time for a gentle nudge is over.  People in Ontario, and all across Canada, are having to contend with challenges in health care that are too numerous to mention.  Harm is being done to our population.  These are not just poor metrics we are dealing with but human beings.  Try explaining to someone who is suffering from debilitating pain and headaches that they will have to wait 6 months for an MRI.  During that 6 month wait, that person may be in constant pain and unable to work.  Where is the dignity in that?  The issues are real and they are effecting thousands of people.  It's time to get past the posturing and the BS and acknowledge a system in crisis.

3)  Health Care needs the ePatient

An ePatient is a patient who is Empowered, Engaged, Equipped, and Enabled.  These are people who own their own health care.  It is my belief that meaningful positive change in health care will come about because of ePatients.  Do you take a laptop or a notebook to your doctor appointments with several years of blood test results?  An ePatient does.  An ePatient asks questions.  Do you have your oncologist's email address?  Do you text your nurse clinician?  Do you suggest (based on your own research) an alternative beta-blocker, as opposed to what your cardiologist is recommending?  e Patients will do all of these things (and more.)  They challenge the status quo.  Until the patient starts to demand more; change will not happen.  ePatients are key to that change.  My hope is that a patient ombudsman can further empower the ePatient, by giving them a voice, and enable many more people to own their own health care.
As an empowered patient, or in my case an empowered caregiver, I have been able to assist in changing erroneous hospital policies.  I have been able to investigate incident we were involved in and resolve the problem quicker than the Minister of Health of Manitoba.  Patients working cooperatively within the health care system can make a difference.


My hope is that Ms Elliott becomes an effective advocate for patients and most importantly empower the patients of Ontario.  The obvious challenge for her will be transferring her leadership and skills as a lawyer and politician to understand the challenges and complexity of health care.  She is not a a Doctor or Nurse.  I am encouraged that someone who is not a medical professional was chosen for this position.  Only a person who is non-medical can identify with patients and the power imbalance they encounter within the health care system.  Best of Luck!

No comments:

Post a Comment