By Christopher Cornue

In Canada last month, a newsstand magazine caught my eye. In bold letters on the cover of the August 23 edition of Maclean's Magazine were the words: "Crisis in Confidence: Do You Trust Your Doctor?" According to the article, an increasing number of Canadians don't.

The article detailed some examples of medical errors (for example: misdiagnoses, misread pathology, and incorrect surgery) and the erosion of trust in medical professionals. The article cited surprising results from a recent poll they conducted that suggest trust in physicians has eroded over time:

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*Forty percent of respondents believe Canadian doctors care less about their patients than they did 10 years ago.
*Twenty percent said they believe doctors are more likely to make mistakes than they were 10 years ago.
*More than 50 percent of respondents believe doctors do not readily acknowledge their mistakes.
*Thirty-nine percent believe physicians are more concerned with seeing patients quickly.

The article suggests many reasons why this may have happened, such as the expansion of media and Internet which gives consumers/patients more information sources on health and physicians. One example they cited was the website www.rateMDs.com where over 85 percent of Canadian doctors are reviewed with user-submitted ratings. This website has seen significantly more activity over the past few years and close to half of the international readers are from Canada.

The media has covered some high-profile medical error cases in Canada recently, which most likely gives rise to the perception that it's more prevalent than before. Given the rise of the Internet and more media outlets bringing attention to these issues in recent years, perhaps the results of this poll are to be expected.

There have been some "landmark" studies about medical errors in Canada over the past decade. The first was a joint research project between the University of Calgary and the University of Toronto from 2004 suggesting that 2.5 million people in Canadian hospitals suffer from medical errors. Additionally, between 9,250 and 23,750 died in 2000 from "avoidable mistakes in treatment." The Health Care in Canada survey conducted in 2002, indicated that 20 percent of those surveyed experienced an "adverse event while receiving care" and a follow-up survey in 2007 suggested a similar finding. What's more, since 2005, the number of complaints about physician misconduct has climbed from 5,482 to almost 6,000.

Physicians, and the organizations which represent them, are taking this information and public perceptions seriously. Recently, the Canadian Medical Association (CMA) has proactively supported key initiatives to help stem this perceived (or real) rise in medical errors, including pre-surgery checklists, the creation of health quality councils across the nation who focus on quality outcomes, and the establishment of "disclosure guidelines" to promote transparency in medical error reporting. Just last month, the CMA published the "Health Care Transformation in Canada: Change the Works. Care that Lasts" report which calls for a culture of patient-centered care, greater, and more timely,access to care, and greater accountability in the medical profession.

Great efforts are being made by physicians to improve healthcare in Canada and, whether intentional or not, to address the perceptions that Canadians have about their physicians.

Christopher Cornue is principal for slainte global partners and is the former CEO at McKee Medical Center in Northern Colorado. He has also served as vice president at Mount Sinai Hospital and Health System in Chicago, and has held leadership roles at University Health System Consortium and the University of Chicago Hospitals.