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Monday, August 13, 2007

Doctors' self-regulation is dangerous: André Picard

The Globe and Mail public health reporter (left) argued in a recent column that .

In the piece, Mr Picard provides less-than-compelling evidence that there is indeed a need for a change in regulatory methodology. His sample size? One.

"The failings of Jocelyne Genest, a family doctor and surgeon in Sainte-Agathe-des-Monts, Que., are eye-popping.

"According to testimony before a disciplinary panel of the Collège des médecins du Québec, among other things, she:

"Performed a sigmoidectomy (a removal of part of the colon) though she was not qualified to do so. Before the operation, Dr. Genest looked up the procedure on the Internet. Not surprisingly, surgery went badly and dragged on for 12 hours, putting the patient at risk for brain damage;

"Failed to install a chest drain in a patient suffering from emphysema who was being transferred to another hospital, even though she was told to do so by an emergency room doctor, again putting a life at risk;

"Administered 'massive, unprecedented and unjustified' doses of morphine to a terminally ill patient - at the request of a family member, not the patient himself - until he died."

Incidentally, the fact introduced two paragraphs later -- that Dr Genest had her license to practise revoked by the College -- doesn't satisfy Mr Picard because she's still permitted to work as a surgical assistant.

Based on the single example, the column concludes:
"Right now, we have an inappropriate tolerance for aberrant conduct and deviant practice, and a culture of deference for doctors that serves us poorly.

"Good doctors make for safer patients. And that is why we must spare no effort in weeding out the bad doctors."

Other, more egregious miscarriages of justice abound in the medical profession. In the UK, one need look no further than the case of (right) and the through the 80s and 90s. In Canada, the public was scandalized to learn of .

Inquiries and investigations into all three incidents have been exhaustive. The British system has been significantly reformed since then, and , albeit in a somewhat "watered-down" form compared to what some have proposed.

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