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Canadian physicians seeking to improve the way they communicate with patients who've been harmed are getting plenty of assistance this year as provincial governments and national organizations unveil measures to promote accountability and transparency.
Ontario and Alberta will likely become the fourth and fifth provinces, respectively, to pass "apology acts" after introducing legislation in October.
And earlier this year, guidelines for disclosing harm to patients were released, separately, by the Canadian Patient Safety Institute and the Canadian Medical Protective Association.
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British Columbia was the first province to pass an apology act, in 2006, with Manitoba and Saskatchewan following suit in 2007.
It's too early — and may never be possible — to credit Canadian legislation with having a clear impact on the number of medical–legal cases, says Dr. William Tucker, president of the protective association.
But expressions of sympathy can improve relations, he adds. "Families feel better if there is an acknowledgement that there has been an adverse event" and, after expressing regret and sympathy, it may be easier for a physician to carry on the therapeutic relationship.
Canadian apology legislation is broader than legislation in some Australian and US states where laws deal only with "expressions of regret" and stop short of addressing the issue of apology, says Windwick.
In August, the Canadian Medical Association and its provincial and territorial counterparts voted to jointly lobby governments for appropriate apology legislation in all Canadian jurisdictions. — Ann Silversides, CMAJ
WHO report
Countries must focus on primary care to address the growing gap between the world's rich and poor in health care access, costs and outcomes, the World Health Organization (WHO) says in its annual report on world health.
"The world health report sets out a better way to manage and deliver health care," said WHO Director-General Dr. Margaret Chan at the report's Oct. 14 launch in Almaty, Kazakhstan. "Primary care is a people-centred approach to health that makes prevention as important as cure."
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According to the report, people in the richest countries can expect to live 40 years longer than people in the poorest countries, where governments spend up to 300 times less per person on health care. The WHO claims the gap in access to care is greatest in areas that regard health care as a commodity for generating profit. Another problem, the report claims, is that health care organizations in many countries tend to focus too much on individual diseases. — Roger Collier, CMAJ
This article has been cited by other articles:
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  N. MacDonald MD MSc and A. Attaran LLB DPhil Medical errors, apologies and apology laws Can. Med. Assoc. J., January 6, 2009; 180(1): 11 - 11. [Full Text] [PDF]
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N. MacDonald MD MSc and A. Attaran LLB DPhil Erreurs medicales, excuses et lois sur les excuses Can. Med. Assoc. J., January 6, 2009; 180(1): 13 - 13. [Full Text] [PDF]
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