Secrecy Hurts Patient

Nick Bala, a Queen’s university professor who complained to the College of Physicians and Surgeons of Ontario about a pathologist for misdiagnosis of his skin cancer, came to my Kingston book launch. He wanted to give me the details of his case and thank me for helping shed light on our medical laboratory system.

One of the factors that contributed to Mr. Bala’s misdiagnosis was that CML HealthCare, the for-profit company that employed the pathologist, misplaced the original biopsy slide. This raises a series of questions. How often do these organizational mistakes occur? How serious are they? Are patients notified of possible errors? Is the College informed or interested?

In Ontario a quality assure program funded by the Ministry of Health and administered by the Ontario Medical Association (OMA) does formal quality testing of medical laboratories. By formal I mean that it is both a structured program and that it uses a formalized testing routine: they notify labs of the impending test and identify the test samples. Even with this advance knowledge about 1% of the tests have problems. Considering that there are millions of tests performed annually this means that an alarming number of tests may not provide a reliable result: but we do not know serious the problem is.

The OMA’s program is shielded by provincial legislation and only provides general information on laboratory quality. The secrecy in the quality program is reflected in the secrecy maintained by Ontario’s Ministry of Health on laboratory policy. As often as not efforts to obtain information from the government on the laboratory sector are meant with silence or a barrage of objections from ministry officials and company lawyers.

Nick Bala raises a very valid point: it is time to shed light on this sector of health care delivery. Laboratories are a core service providing key information that affects patient care and we know very little about them. Doctors and the for-profit corporations have often resisted opening up the discussion, probably because it would restrict their power and income, but it is more necessary than ever with the new push for more for-profit delivery of our publicly funded health care.

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One Comment on “Secrecy Hurts Patient”

  1. Whitney Says:

    Great and interesting read. Really insightful.


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