Volume 2 Number 3 In This Issue

Has regionalization of the Canadian health system contributed to better health?

Johny Van Aerde, MD, PhD

When the concept of regionalization was introduced, there was at best only anecdotal evidence that it would bring improvement. Two decades later, evidence of its efficacy or efficiency is still very limited. This paper addresses the history and relevant background of health care regionalization in Canada, explores real and perceived evidence that it has made health better or worse, and ends with basic principles from leadership and systems theories necessary for transforming our health care systems. read article

Part-time practice, full-time safety for physician leaders

Tracy Murphy and

Mary MacDonald-Laprade, Canadian Medical

Protective Association

Physicians who accept leadership responsibilities and activities may choose to limit their clinical work. By paying close attention to how they arrange their practice to meet their responsibilities in areas such as coverage, handovers of care, referrals, and follow up on test results, physicians can minimize risks and provide effective care to patients. Physicians also have a responsibility to maintain a commitment to professional development to ensure quality and safety of care. read article

Balancing patient satisfaction and quality of care

Mamta Gautam, MD, MBA

Although measures of patient satisfaction contribute valuable feedback, they do not represent the complete picture. Use of a more balanced scorecard — including accessibility, continuity of service, effectiveness, and appropriateness, for example — to plan, manage, and monitor health care activities and performance will yield more useful information to assist in continuous improvement in health care. read article

OPINION Advocacy in one’s own practice: appropriateness in ordering investigations and management decisions

Kathryn Andrusky, MD

Physicians must be advocates within their own practice, ensuring that appropriate investigations and management decisions are made with consideration, not complacency. Inappropriate ordering may lead to patient harm via anxiety and unnecessary further investigations. Both the clinical context and the “why” to justify the actions taken need to be at the forefront of a physician’s decision-making processes. read article

Strategic leadership development for physicians Evaluation of the Physician Leadership Development Program at Schulich

Peter Dickens, PhD,

Sandra Fisman, MBCh,  and

Kathi Grossman, BA (Hons)

Spearheaded by the Ontario Medical Association and created by a number of dedicated individuals, the Physician Leadership Development Program has “changed the lives” of its participants. Results of a survey and interviews with physicians from the first four cohorts reveal the program’s key strengths and how it is beginning to have a significant impact on the province’s health care system. read article

Measuring physician performance using the CanMEDS framework: proposal for an innovative approach

Kiran Rabheru, MD

GRASP (Global Review and Assessment of Staff Physicians’ Performance) is a proposed new tool for assessing physician performance. Integrating the familiar CanMEDS framework with the global assessment scale, Observed Structured Assessment of Technical Skills, it uses milestones to measure the progress of all physicians. Readers are invited to comment and participate in further development of GRASP. read article

BOOK REVIEW: Leaders Eat Last: Why Some Teams Pull Together and Others Don’t

Simon Sinek

Penguin Group, 2014

Reviewed by Johny Van Aerde, MD, PhD

read review

BOOK REVIEW: No More Lethal Waits: 10 Steps to Transform Canada’s Emergency Departments

Shawn Whatley, MD

BPS Books, 2016

Reviewed by Owen Adams, PhD

read review