Ralph Waldo Emerson’s salutation to old friends is worth considering:
“What’s become clear to you since we last met?”
It has become clear to me that those who are in leadership positions often don’t lead. Rather, they focus on managing the daily routine and tinkering with the status quo instead of assuming responsibility for shaping their organizational practices to adapt to a changing environment.
It has become obvious, for example, over the past few years that the regulation of the medical profession requires strong leadership. The practice of medicine is vulnerable to the problem of “bad apples,” that is, those doctors who fail to meet their professional commitments and betray the trust of their patients and peers.
The most notorious example of this phenomena occurred in Britain where Dr. Harold Shipman, a general practitioner, was convicted of murdering 15 of his patients and suspected of killing as many as 250 patients. The Shipman case and media coverage of other individual and systemic failures in Britain’s health-care delivery system brought about change that dislodged the medical profession as the senior partner in the regulation of doctors.
More recently here in Manitoba we have experienced our own medical scandals. Katrina Clarke, an investigative reporter with the Free Press, has reported on two cases where patients allege misconduct by doctors who were supposed to have chaperone requirements in place. In one case a Ste. Anne family physician was charged with six counts of sexual assault in 2020, charges which were later stayed, and 16 more charges in 2021, which are still before the courts.
In Britain, leaders responded to the medical scandals by establishing a new clinical governance structure that sets out the responsibilities of various parties for changing the culture, systems, and outcomes in the medical field. Within this new structure the rights of patients as consumers of health services have been expanded to better meet their needs and expectations.
As this British example proves the solutions to the challenge of significantly improving medical care are there. But what has been the response in Manitoba to our medical challenges?
Sadly, Health Minister Audrey Gordon has declined to comment on the issue of medical self-regulation and its lack of accountability and transparency.
She did, however, comment on the medical crisis related to the long wait lists for surgeries and diagnostic procedures. Ms. Gordon offered “thoughts and prayers” to people whose medical procedures have been delayed due to the COVID-19 pandemic.
It is the responsibility of those in leadership positions to respond to challenges by articulating new ideas and policies that change the basic metabolism of an organization. It is a dereliction of duty to refuse to comment on an important issue. And it is no better to make a platitudinous response.
It is also not sufficient for someone in a leadership position to suggest that the solution to a problem is simply to toss money at it. While the health minister has said that that the government has a $200-million plan to add 2,000 people to the province’s health-care staff, a leader must articulate a vision that is proactive rather than reactive and that creates confidence in new and, in some cases, dramatically different approaches. Systemic problems require systemic solutions.
We need health care leaders that can provide the public with the reassurance that they are developing solutions to deal with challenges related to medical professional self-regulation and the impact of the pandemic on a beleaguered health-care system.
Patients are suffering and in some cases are being abused by physicians who should not be practising medicine. ERs are overcrowded. There are severe doctor and nurse shortages. The waiting times for surgeries are unconscionable.
Patients and demoralized health-care professionals need leaders to provide a clearly articulated vision of how necessary change is going to occur.
Mac Horsburgh is a sepsis survivor and patient advocate who lives in Winnipeg.
