Doctor Charles Smith Seen As Part Of A Larger Pathology And Medicare Crisis In Canada In Globe And Mail History: "Much More Than Mere Incidents";

"IN ONTARIO, A PEDIATRIC FORENSIC PATHOLOGIST - SOMEONE WHO TRIES TO DETERMINE THE CAUSE OF DEATH IN CHILDREN - MADE CHRONIC ERRORS DURING THE 13 YEARS HE HEADED UP THE DEPARTMENT FOR THE ONTARIO CHIEF CORONER'S OFFICE."

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"CANADIANS HAVE BEEN, BY AND LARGE, WILLING CAPTIVES OF THE PUBLICLY FUNDED MONOPOLY OVER NECESSARY HEALTH CARE.

BUT IF THOSE CAPTIVE CONSUMERS ARE TREATED SO CAVALIERLY, IN A SYSTEM THAT SEEMS NOT TO CARE ABOUT HIGH STANDARDS, THEY WILL GO SOUTH, OR INSIST ON CHOICE AT HOME.

THE CRISIS IN PATHOLOGY IS A WARNING SIGN THAT CANADIAN MEDICARE SHOULD NOT IGNORE.

GLOBE AND MAIL EDITORIAL: JUNE 9, 2008;"
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In recent posts, this Blog has made the sorry point that Canada is currently suffering not only a crisis in pathology - but a crisis in our medicare system.

This point is echoed in an editorial published the the Globe and Mail on June 9, 2008, under the heading, "Much more than mere incidents."

"When the president of the Canadian Association of Pathologists raises the alarm about the quality of medical testing in Canada, it's time to worry," the editorial begins.

"Major errors by pathologists in four provinces, some of which continued for more than a decade before being identified, have "occupied the minds of Canadian pathologists for months and eroded public confidence," write Jagdish Butany, the association's president and a University of Toronto professor, and Kathy Chorneyko, an Ontario pathologist, in an editorial in the Canadian Medical Association Journal," it continues.

But even these two authors don't appreciate the potential scale of the disaster.

"Canadian laboratories deliver high-quality pathology results," they say, "and it would be incorrect to generalize from specific incidents to the overall state of pathology in the country."

Specific incidents?

This is an avalanche of incidents.

Canadians would have to be asleep not to feel deep anxiety.

After all, as Sir William Osler said - as quoted by Drs. Butany and Chorneyko - "As is your pathology, so is your medicine."

Canadian pathology is ill, and so, it appears, is Canadian medicine.

The "specific incidents" cut a wide swath.

In Newfoundland and Labrador, crucial laboratory tests on more than 300 breast-cancer patients were misread by the Eastern Health Authority, the province's biggest lab, between 1997 and 2005.

In New Brunswick, a pathologist was found to have an error rate of 6 per cent, which is six times higher than normal, in reading laboratory slides; an Ottawa lab is now reviewing 24,000 of that pathologist's cases from 1995 to 2007.

In Ontario, a pediatric forensic pathologist - someone who tries to determine the cause of death in children - made chronic errors during the 13 years he headed up the department for the Ontario Chief Coroner's Office.

The result was that up to 20 people were charged or convicted of major crimes such as murder that they did not commit.

Also in Ontario, an Owen Sound hospital is probing a pathologist's high error rate.

In Manitoba, a review of cancer tests found errors in 20 per cent of a senior pathologist's cases; seven hundred cases from the past year are under review.

No wonder public confidence is at risk.

The public has every right to wonder how accurate tests are, and not just at the labs with known problems.

The two doctors prescribe a variety of treatments, from the creation of a national quality-assurance system to more money for labs to hire more pathologists and do regular audits of their work and tests of their competency.

But they don't ask a crucial question: Where is the commitment to quality in the system?

Does no one in institutions have the job of doggedly insisting on a high standard of medical professionalism?

Where is the institutional will to be excellent, or even accurate?

As judicial inquiries in Newfoundland and Labrador and Ontario have shown, warning signs were ignored, followed inevitably by excuses.

The excuses threaten to aggravate the damage already done.

Canadians have been, by and large, willing captives of the publicly funded monopoly over necessary health care.

But if those captive consumers are treated so cavalierly, in a system that seems not to care about high standards, they will go south, or insist on choice at home.

The crisis in pathology is a warning sign that Canadian medicare should not ignore.

Harold Levy...hlevy15@gmail.com