Tag Archives: canada

CBC, grad students cover palliative care and death in Canada

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The CBC’s new series on dying has a unique provenance: The stories are the work of 16 graduate students at The University of Western Ontario, as well as that of CBC health reporters, and are the final product of a unique journalism course focused on reporting on death and dying. gooddeathThe collaboration seems to have started with a definition of its title, “A Good Death.” In this case, it means one that is “peaceful, loving and comfortable.” Access to such an end, the journalists found, varied widely depending on economic, geographic and cultural circumstances.

The introduction to the package has wonderful descriptions of all the stories that went into it but they don’t link to the pieces. I’ve taken the liberty of adding relevant links, then copying and pasting that section below.

Ontario considers exempting some hospital records from FOI law

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Legal Feeds blogger Glenn Kauth, of the Canadian Law Times, reports that Ontario’s legislature is currently considering a law containing a little-known provision that would exempt from FOI law “information provided to, or records prepared by, a hospital committee for the purpose of assessing or evaluating the quality of health care and directly related programs and services provided by the hospital” starting Jan. 1, 2012 (scroll down to Schedule 15).

The leader of a provincial nurses’ organization took issue with the provision, telling the London Free Press that “The public has a right to know what’s happening in its local hospitals,” but Ontario health officials say hospitals need the exemption.

Health Minister Deb Matthews has defended the move to exempt information related to quality of care from public release. According to the Free Press, Matthews believes subjecting hospitals and doctors to greater scrutiny would prevent open dialogue about problems and how to fix them. “They must have a very open and frank discussion,” she said.

(Hat tip to Paul Levy, whose post on the matter also has some great first-hand material from Denmark)

CBC analysis finds resistant bacteria in raw chicken

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporters from the CBC’s “Marketplace” program visited supermarkets in Canada’s three largest cities, bought 100 samples of chicken, and sent them off to a lab for analysis. When the analysis came back, they weren’t particularly surprised to find that two-thirds of the samples were contaminated by bacteria – that’s the sort of thing you expect from raw chicken. What they didn’t expect was that every one of the bacteria strains present in those bits of raw chicken, purchased from major supermarkets and labeled with big-name brands, was resistant to at least one antibiotic. Some were resistant to as many as eight.

“This is the most worrisome study I’ve seen of its kind,” said Rick Smith, the head of Environmental Defence, a consumer advocacy group.

The culprits in this case of superbug proliferation will be all too familiar to regular Covering Health readers.

Doctors and scientists told Marketplace co-host Erica Johnson that chicken farmers are overusing antibiotics — routinely giving healthy flocks doses of amoxicillin, tetracycline, erythromycin and ceftiofur to prevent disease and to make the chickens grow bigger, faster.

The full CBC program is available for free online. The reporters have even shared a spreadsheet of their test results.

Taking stock of big pharma in Canada

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

CBC and Radio-Canada have cooperated to produce a comprehensive look at the nation’s pharmaceutical industry, which centers on Montreal, Canada’s second largest city.montreal

Pharma’s Canadian outposts have sputtered in recent months, and Quebec’s government has struggled to keep the companies in-country.

Part 1: Government incentives to pharmaceutical companies.
Part 2: Regulation of clinical trials.
Part 3: Pharma’s role in continuing medical education.

In addition to the stories, be sure to take a look at the top few comments below the story. Also, the “Quick Fact” box, which taught me that “Montreal has the largest number of clinical trial organizations of any city in North America.”

After 8 years, Quebec’s adverse event reporting law remains unenforceable

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Montreal Gazette‘s Charlie Fidelman has assembled a round-up of what has, and hasn’t, happened in the eight years since Quebec passed a law requiring hospitals to tell patients about all adverse events as soon as staff became aware of them.

According to Fidelman, “the provincial Health Department has yet to set up its registry of adverse events,” which it was supposed to track in order to improve patient safety. It’s expected to finally get started next year.

Until then, hospitals are supposed to track their own events and report them each year, yet “no hospital contacted by The Gazette includes adverse events in its annual reports.” This may have something to do with the fact that the requirement came with no clear enforcement mechanism.

Montreal reporter finds that envelopes of cash improve access to care

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Montreal Gazette‘s Charlie Fidelman has uncovered a shadowy pay-for-care system in that city’s public hospitals which promises patients quicker access to preferred doctors in exchange for envelopes of cash.

dollarsPhoto by coaxeus via Flickr

In his first story, Fidelman revealed a remarkably detailed fee system.

Minimum $2,000 to guarantee that a woman’s doctor will be there for the birth. “And it can go up to $10,000,” he added.

For general surgery, the cost runs between $5,000 to $7,000 to jump the wait list into the operating room, he said.

For Green and Marcus [sisters featured earlier in the story], the $2,000 got their mother’s operation bumped up – but not the surgeon they wanted.

“People have offered me money and I’ve refused it,” (Primary care physician Paul Saba) said. “Today … one patient offered me cash. People are desperate for services and they want to move things along.”

Fidelman’s story prompted an investigation by the Quebec College of Surgeons, which he also covered. Then the province’s top health minister followed suit.

All this attention prompted a fresh wave of cash-for-care allegations, which Fidelman chronicled in another follow-up story. One example in particular seemed to point to systemic issues.

Another patient undergoing a medically necessary breast reduction at Santa Cabrini Hospital in October, said she was told not to forget to slip $100 under the pillow – for the anesthesiologist. She had already paid her surgeon $900 for “administrative fees.”

“The nurses were asking me: ‘Where did you put the cash?’ like they’d asked if I had eaten that morning or taken medication.”

In the end, the official response seems to boil down to the request that more members of the public start blowing whistles, despite the fact that they cannot make anonymous complaints.

Round two?

Now that he was wise to the informal economy behind the patient side of Montreal health care, Fidelman began to wonder about billing and fraud.