That’s left Henley, like so many Canadians, doing her own research on the Internet. So far, she’s determined that Shepherd was trained at the University of the West Indies in Trinidad and Tobago, and is now an associate professor of pathology at the University of Western Ontario in London, Ont. Shepherd declined comment this week through an office assistant, and Henley’s allegations have not been tested in court. But the Newfoundland woman is not about to let up. “I would like to know whether my case was unique,” she says. “I’m not sure how you miss cancer on nine out of 14 slides.”
Her frustration points to a lingering problem when it comes to getting doctors to face up to their shortcomings: they are powerfully protective of their reputations, and have the money to be so. While some physicians point to declining numbers of malpractice suits as proof they are making fewer mistakes, others claim lawyers for the MDs have been discouraging such claims by dragging out litigation and exhausting the patients’ financial resources. Even when an issue doesn’t go to court, doctors are quick to go on the defensive, says Dr. Brian Goldman, host of the CBC Radio program White Coat, Black Art and author of The Night Shift, a forthcoming book that explores doctor error, among other issues. “I think physicians have been the single greatest impediment to patient safety in Canada,” says Goldman, who is an emergency room doctor at Toronto’s Mount Sinai Hospital. “I’m not saying they actively block the search for truth in some evil and nefarious way. But they tend to feel a powerful sense of shame at any insinuation that they’ve been less than competent.”
That attitude is born of an atmosphere in which errors can have catastrophic impact on one’s career, he says. “It’s hard to take a non-emotional look at mistakes when you’re thinking, ‘I’m terrified.’ ” But as the proverbial smartest people in the room, MDs are also prone to overconfidence—if not plain arrogance. Worried by U.S. studies suggesting such doctors can have a negative impact on patient care, professional colleges across the country have adopted guidelines to combat physicians who belittle colleagues and disregard the feelings of patients, à la Gregory House of TV fame. And physicians’ reputation for supreme self-confidence may explain why other health care professionals score higher ratings from the public when it comes to personal integrity. A 2009 Gallup poll indicated that Americans rate nurses’ honesty and ethical standards higher than doctors’—83 per cent versus 65 per cent (the Maclean’s poll also found marginally more respect for nurses and farmers than for doctors).
The good news is that the profession as a whole is starting to get the message. The Canadian Medical Association (CMA), representing some 68,000 physicians across the country, has supported numerous initiatives aimed at curbing medical errors, such as the introduction of pre-surgery checklists, the establishment of health-quality councils across Canada that measure and report on quality of care, and the creation of disclosure guidelines by the Canadian Patient Safety Institute, which promote transparency about medical errors. Last week, the association published a report called “Health Care Transformation in Canada,” calling for a culture of patient-centred care, including more timely access to services and greater accountability in the profession. “The report,” says CMA President Dr. Anne Doig, “is predicated on the principle that we need to do our jobs better.”
Doig acknowledges concern about some of the findings of the Maclean’s poll. But she wonders whether perceptions that doctors care less about patients and are more likely to make mistakes speak more to lack of access to, or long waits for, medical care. She also notes that increased disclosure of medical errors can be falsely interpreted as an increased incidence of mistakes: “We’re not making more mistakes than we ever have, necessarily.” Treatment, she adds, is more complex than it used to be and expectations are now higher. “Life was simpler,” she says, “when the doctor went around in a horse-drawn buggy with a little black bag and did the best he could.”
Perhaps. But such reassurances offer small comfort to patients like Lee Dix. These days, she quietly struggles through her shifts at a downtown Toronto law firm, pondering reforms that might save others the misery she’s endured—greater transparency when it comes to doctors’ past blunders, say, or pre-surgery checklists. “But there’s a lot of things that occurred in my case that wouldn’t have existed on any checklist,” she says. Mostly, she wonders what might have been. “Not being able to have children haunts me pretty much every day.”
Poll results are from an online survey of 1,024 randomly selected Canadian adults contacted by Angus Reid Public Opinion on Aug. 5 and Aug. 6, 2010. Respondents are Angus Reid Forum panelists. Margin of error is ± 3.1 percentage points.
