Take As Directed

Neil MacKinnon

Informations

• Publié par: Ecw Press
• Date de parution: 01 septembre 2010
• Nombre de lectures: 0
• EAN13: 9781554903702
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

TAKE AS DIRECTED
Your Prescription for Safe Health Care in Canada

Rhonda Church, M.D. & Neil MacKinnon, Ph.D.
ECW Press

ECW Press
Copyright © Rhonda Church and Neil MacKinnon, 2010
Published by ECW Press, 2120 Queen Street East, Suite 200,
Toronto, Ontario, Canada M4E 1E2
416.694.3348 / [e-mail]
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any process — electronic, mechanical, photocopying, recording, or otherwise — without the prior written permission of the copyright owners and ECW Press. The scanning, uploading, and distribution of this book via the Internet or via any other means without the permission of the publisher is illegal and punishable by law. Please purchase only authorized electronic editions, and do not participate in or encourage electronic piracy of copyrighted materials. Your support of the author’s rights is appreciated.
LIBRARY AND ARCHIVES CANADA CATALOGUING IN PUBLICATION
MacKinnon, Neil J. (Neil John), 1971-
Take as directed : your prescription for safe health care in
Canada / Neil MacKinnon and Rhonda Church.
Includes bibliographical references and index.
ISBN 978-1-55022-952-3
1. Drugs—Canada—Safety measures. 2. Pharmaceutical
services—Canada. 3. Patient education—Canada. I. Church,
Rhonda II. Title.
RM300.M33 2010 615'.10971 C2010-901370-0
Editor: Alison DeLory
Cover and text design: Tania Craan
Cover images: iStock photo
Typesetting: Mary Bowness
ePrinting: Easy ePub / Easy Press
The publication of Take as Directed has been generously supported by the Government of Ontario through Ontario Book Publishing Tax Credit, by the OMDC Book Fund, an initiative ofthe Ontario Media Development Corporation, and by the Government of Canada through the Canada Book Fund.




For my parents, Karen and Ron MacPherson, my husband, Chris, and our children, Ben and Sophie. For everything. — Rhonda Church
For my parents, Elliott and Shirley MacKinnon, my wife, Leanne, and our children, Breagh, Ashlynn, and Kaylee. For all the current and future users of the Canadian health-care system. — Neil MacKinnon
Contents

Cover

Imprint

Dedication


FOREWORD


PAUL’S PERIL


HEALTH-CARE SAFETY

Oprah Winfrey and Health-Care System Adverse Events

Is the Health-Care System Safe?

Is the Health-Care System in Canada Safe?

Do Canadians Believe Their Health-Care System Is Safe?

How Do Patient Perceptions Compare to Health Professional Perceptions?

What Places an Individual at Risk for a Medical Error?

Medication Use in Canada

Spending on Medications

Access to Medications

The Medication-Use System

What Is the Cost of These Problems?

Which Medications Are Associated with the Most Problems?

Conclusion


RUBBER-GLOVED REQUIEM

The Canada Health Act

Case Files: Seeing the Big Picture

Universal Health Care: A Middle-Aged Muddle

Case Files: Desperately Seeking Doctors

Where Did All the Doctors Go?

Rebooting the Front Lines

We Prescribe . . .

Conclusion


FIRST, DO NO HARM

The Family Physician

From Chief Complaint to Correct Diagnosis: How Your Doctor Gets There

Booking an Appointment

Rethinking “The List”

Why Is Ten or Fifteen Minutes All the Time the Doctor Has?

The One List You Should Never Be Without

Finding a Family Doctor

When the Best Remedy Is No Remedy at All

It’s Just a Harmless Little Antibiotic, Isn’t It?

Conclusion


THE DEVIL IN THE DETAILS

The Medical Cast of Characters

Why Medications Are Prescribed

What the Doctor Needs to Know About You to Safely Prescribe

Information, Information, Information: Don’t Leave Without It

Prescription Refills

Complementary and Alternative Medicine

Conclusion


A PLACE WHERE EVERYBODY KNOWS YOUR NAME

Pharmacies, Pharmacies, Everywhere

Which Type of Patient Are You?

What Is the Pharmacist Doing Behind There?

The Evolving Role of the Pharmacist

Services Provided by Community Pharmacists

How to Increase Your Satisfaction with Your Pharmacy

The Cheers Effect

Conclusion


EXPECTING THE UNEXPECTED

Opening Pandora’s Pill Box: Common Urgent Medication-Related Problems

It’s Not Working, Doc!

I’ll Take a Side Order

Horses and Zebras — Managing Medication Side Effects

Gut Grief

Burn, baby, burn: Vaginal yeast infections

Catching a few zzzz’s

Dry-as-the-Mojave mouth

Dizzy Lizzie

Medication allergies

Case Files: Rash Decisions

Who You Gonna Call?

The Big Kahuna: Navigating the Emergency Department

Conclusion


HOSPITALS

A Self-Contained City

You’ve Been Admitted to a Hospital — Now What?

You’ve Entered the Twilight Zone

Privacy, Please

Processes Upon Processes of Care

Places of Healing

Places of Harm

You’re Being Discharged! Oh Happy Day!

Conclusion


HOME SWEET HOME

Do I Really Have to Take This Stuff?

A Health-Care Centre in Your Home?

The Patient’s Role in Between Doctor and Pharmacy Visits

The Future at Your Fingertips?

Conclusion


DEMYSTIFYING DRUG AND HEALTH-CARE INFORMATION

The Journey from Drug Discovery to Bedside and Beyond

A Guide to the Scientific Literature

“Wait a Minute . . . Now That Is Bad for Me?”

Specific Sources of Drug and Health-Care Information

Conclusion


PRESCRIBING A BRIGHTER FUTURE FOR HEALTH CARE

A Catastrophic Drug Plan — And Then Some

A Family Physician for Every Canadian

Enough Face Time with the Doctor

Electronic Health Records

Engage Patients in Safety and Quality Activities

Develop a National Information System for Health-Care Safety and Quality

A Known Goal with Each Prescription

Implement Best Demonstrated Practices


NOTES

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11


ACKNOWLEDGEMENTS


About the Authors


Praise for Take as Directed
FOREWORD
By John G. Abbott, B.A., M.A.
There are many “how to” books for the Canadian consumer, but this one — written for users of our universal, public health-care system — is long overdue. Shouldn’t we already have a manual to help guide us through the crucial process of managing our own health? How often have we returned from a visit to the family doctor or a specialist only to find we forgot to ask that one significant question about our care? While we trust our health-care providers, what is our role? Isn’t the onus on us to take some control over our own health and our encounters with the health-care delivery system, beginning with the initial office visit to our family doctor, the gateway to our medical care?
An important component of primary health care is self-management: when a patient participates in — or educates themselves about — their own treatment. The more information we have about our own health and the care we receive, the more we become involved, the better our health outcomes. The Health Council of Canada has released several reports on the role primary health care plays in our health-care system. We recognize that the family physician and other health-care providers are pivotal players in our care. With more Canadians developing one or more chronic health conditions, we have come to rely more heavily on our health system. But is this what we really want? Shouldn’t we want, instead, more information about our disease? More knowledge of what we can do to prevent and/or manage it without total reliance on (read abdication to) our health-care system? And, once we engage the health-care system, do we have the understanding to engage as true partners in our own care?
The beauty and real contribution of Take as Directed is that the authors understand the importance of the patient being an informed and equal participant in his or her own care and that each encounter should benefit both the patient and the provider.
As a health-care policy specialist, I examine whether our public policies and programs — often promoted with much fanfare — resonate with Canadians. One way to assess these solutions is to see how clearly the messages are written and understood, with the most successful being written with the patient in mind. This book will succeed where others have failed for just that reason. We can now do our homework before our next trip to the doctor’s office.
John G. Abbott is currently chief executive officer with the Health Council of Canada. In addition, he is a management consultant with the Institute for the Advancement of Public Policy, a private consulting firm specializing in public policy analysis and development. Abbott has held a number of senior positions with the Newfoundland and Labrador government, including serving as deputy minister of health and community services, where he oversaw the reorganization of the province’s system of regional health authorities and the expansion of the provincial drug program. He was recognized in 1999 with the Lieutenant Governor’s Award for Excellence in Public Administration by the Institute for Public Administration of Canada.
CHAPTER ONE
PAUL’S PERIL
A Cautionary Tale



Before Paul’s wife, Katharine, left to go shopping in the city earlier this morning, she gave him explicit instructions. “Go get an antibiotic for that cold. You don’t want it to get any worse and spoil our cruise. And I don’t want to catch it.” She left their family doctor’s phone number on the kitchen table beside his breakfast and his morning pills.
Both former teachers, Paul and Katharine had retired a few months earlier. After perusing an array of glossy brochures, they settled on a cruise of the Greek Islands to celebrate the beginning of this exciting phase in their lives. They were to leave in six days and visit their daugh