Tag Archives: quebec

Taking stock of big pharma in Canada

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

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

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.