Thursday, January 5, 2012

Provinces, schmovinces! This is a chance for front-line workers to shine!

Anonymous left a cryptic comment on my "Feds, schmeds!" post:

"I agree Kishore .... let's start today!"

Silly Anonymous, whatever do you mean? In the post, I exhorted provincial governments to quit relying on the feds for leadership around national healthcare change.  But, I don't have anything to do with the provincial government, so it's not my responsibility to get the process going.

Unless you're suggesting, Anon., that in the same way that provincial governments shouldn't wait for the feds to get the ball rolling, clinicians (and patients!) shouldn't wait for provincial governments to make the first move.  Is that what you're getting at, you closet subversive?

But without funding and administration, how can front-line workers (especially private practice clinicians like our urology group) ever make a significant impact on patient care?  You're probably going to quote Margaret Mead:

"Never doubt that a small group of thoughtful, committed people can change the world.  Indeed, it is the only thing that has."

Alright, Anon., you're on!  As it turns out, we're starting a new improvement project in our office.  While it will involve changes for Saskatoon Health Region policies and staff (as well as our own staff and physicians), we're not waiting for outside permission to get started.  I'll commit to telling the story of our progress in this blog, if you, Anonymous, will commit to spreading the word to front-line workers that we can all start making small changes without waiting for permission from Leaders With Titles.



  1. Agreed, Kishore, don't wait for permission - start now! As administrators, we often create barriers but our role should be to facilitate these changes at the front-line by providing support, incentives, opportunities for training, etc. In the words of Berwick, the administration's role should be to "help those who help patients." So, start without us but even better - let's do this together!

  2. Why don't we take this opportunity to pressure the provinces to work together too? They could use the push.

  3. Administration / government should facilitate and enable frontline workers. When frontline workers come up with new ideas to improve on the status quo and encounter policy type obstacles along the way they (govt) should remove the barriers. Innovation spreads better bottom up and when enabled top down has opportunity to flourish.

  4. I also totally agree with the statement about not waiting for permission to start making changes to improve the status quo. (It is easier to ask for forgiveness than to ask for permission ...)

  5. Kishore,
    Somehow, you have indeed captured my (between the lines) point that we must all start and work within our circles of influence to make this change happen. I agree with you and, admittedly, now wonder why I was anonymous in my encouragement of your recent post.

    The truth is that I am indeed trying to do my part to move forward the organization I work within via a shift to a more quality intensive and patient-centred approach to the care we provide. I probably should do even more but also (like all of us) am working within a system that tends to gravitate towards the status quo.

    Now that we have made this 'deal' together, we can proceed on a level playing field. Thanks for encouraging me to come out of the (subversive) closet!