'Let's get past this'

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Barb Sweet
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NLMA wants co-operation on lab issues

The Newfoundland and Lab-rador Medical Association (NLMA) is calling for a simmering down of what has become an explosive feud between doctors at Eastern Health, the authority's administration and Health Minister Jerome Kennedy.

"I want to assure everyone that the NLMA and the pathologists stand ready to work with the provincial government and Eastern Health to achieve excellence and restore confidence," NLMA president Dr. Brendan Lewis told reporters Tuesday.

Officials with the Newfoundland and Labrador Medical Association (NLMA) went before the microphone at their MacDonald Drive headquarters on Tuesday afternoon to respond to recent issues regarding Eastern Health. From left were Robert Ritter, executive dir

The Newfoundland and Lab-rador Medical Association (NLMA) is calling for a simmering down of what has become an explosive feud between doctors at Eastern Health, the authority's administration and Health Minister Jerome Kennedy.

"I want to assure everyone that the NLMA and the pathologists stand ready to work with the provincial government and Eastern Health to achieve excellence and restore confidence," NLMA president Dr. Brendan Lewis told reporters Tuesday.

"The overriding position is 'Let's get past this and start to work in a co-operative fashion," NLMA executive director Rob Ritter added.

"I think the best way for things to settle down is for people to come together and now say, 'OK we have a problem here.' Guess what, we all own the problem - not just one clinical chief or one group of doctors. The system has a lot of problems and it's going to take - Hillary Clinton used the term 'it takes a village' - well it's going to take the co-operation of everybody, all the different stakeholders, to get this thing right."

Following the revelation of testing errors in Eastern Health's biochemistry lab, clinical chief of laboratory medicine Dr. Nash Denic was forced to resign because he didn't tell the authority's senior executive quick enough about the problems. It was also revealed afterwards he offered his resignation in December over workload issues.

The errors surrounded testing on a machine called a mass spectrometry analyzer, which was being used to monitor immune disorder and organ transplant patients' blood for the drug cyclosporine. Those errors - initially attributed to the way the machine was calibrated - are currently the subject of an external investigation.

Health Canada also told The Telegram it is reviewing the testing issue at Eastern Health.

Denic's resignation was followed with three more resignations of supervisory duties, one pathologist resigning from a quality committee and another narrowing his practice. Four or five pathologists went off sick as of Monday.

Last week Health Minister Jerome Kennedy called the pathologists "childish" and the lab environment "toxic" after reading an external review of the lab that he called "scathing."

That report by Dr. Gregory Flynn of the Institute of Quality Management in Healthcare in Ontario was released to the media Monday.

Tuesday, Lewis said he was disappointed at the "inflammatory" comments from Kennedy last week.

"This level of discourse is unhelpful and only serves to undermine the public's already fragile confidence in our health-care system."

He also said it might discourage physicians from coming to work in the province.

Lewis assured the public that the clinical expertise of pathologists working in Eastern Health's lab is not in question. He said the issues are rooted in "administrative and operational aspects."

He said patients are receiving top notch care and while the sick leave is causing a strain, the pathologists left working are capable.

"And I remain confident a way will be found to do the work we have to do," Lewis said.

The NLMA favours release of the report.

Dr. Barry Gallagher, president of the Newfoundland Association of Pathologists, said the pathologists would have preferred the interviews they did as part of the Flynn report be kept out of the public as they believed the process to be confidential. But he said he had no problem with the recommendations being released.

Lewis said Denic and other pathologists recognized problems in the lab and that's what prompted Flynn being brought in. Lewis said Flynn came to find solutions not to condemn the pathologists.

"This effort was seen as being helpful, but ended up being used as a sledgehammer instead of a compass," Lewis said.

"The portrayal of the Flynn report as 'scathing' misrepresents the substance, spirit and intent of the initiative."

Ritter said the NLMA was blindsided by some of what's happened in the controversy and that there needs to be communication between Eastern Health CEO Vickie Kaminski, the NLMA and Kennedy.

The NLMA stands by Denic, who it described as being "deeply wounded."

Denic declined comment Tuesday but is expected to give a statement in the near future.

Lewis said Denic never wavered from his leadership and commitment to patient care.

"In the wake of the Cameron Inquiry, under the leadership of Dr. Nash Denic, the laboratory medicine program has put in place quality assurance initiatives, and implemented a system of rigorous review to ensure patient safety and the highest possible standards of clinical practice," Lewis said.

He said Denic should have been praised not condemned.

Lewis said the problems in the lab stretch back to before the hormone receptor errors that sparked the Cameron Inquiry. Those errors affecting tests that determine treatment for breast cancer patients began more than a dozen years ago - 1997 - and went on for five years.

Lewis said the NLMA has offered solutions by suggesting to then health minister Ross Wiseman in 2008 a "multi-stakeholder steering committee" to stabilize lab services in the province. It also recommended to the Cameron Inquiry a "health quality council." Neither has materialized.

Ritter said the NLMA through negotiations hopes to revitalize a physician services committee to concentrate on sustainability of services, quality and accountability.

Neither Kennedy nor Eastern Health were available for comment Tuesday.

bsweet@thetelegram.com

Organizations: NLMA, Newfoundland and Lab, Medical Association Health Canada The Telegram Institute of Quality Management Newfoundland Association of Pathologists

Geographic location: Ontario

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Recent comments

  • From the
    July 02, 2010 - 13:32

    Most people have no concpet how teh lab works, who's responsible for what etc... however everyone has an opinion and who is at fault.

    These comment sections ar like Open Line for people with computers.

    Bogged down with intelligence, yeah right

  • jim
    July 02, 2010 - 13:31

    Hey Patient, when did you ever see an over worked person in the frontline of healthcare (or is it healthwhocares). I dont see any one breaking a sweat, and if they do punch a hard days work, you can be guaranteed that they will be off sick for a day of two or even thirty if they want. There are more than the doctors that are cry babys in the health care system. Union work at its very best.

  • Colin
    July 02, 2010 - 13:30

    Seems like doctors are saying don't criticize us over this mess or we'll leave the province or we'll tell other doctors not to come here . My advice - please go and don't let the door hit you on the way out! Maybe then we can hire some competent doctors.

    Didn't some doctors threaten to leave last year if their salaries weren't increased substantially? Seems like whenever doctors want something, they get very sooky and threaten to leave in order to get what they want. It is very unprofessional. These people will never be satisfied. Go ahead and leave NL if you want to and stop the threats.

  • Surprised
    July 02, 2010 - 13:26

    Dr. Lewis says: patients are receiving top notch care and while the sick leave is causing a strain, the pathologists left working are capable Does he really think that anyone in Newfoundland believes this right now? I think NOT! 4 or 5 Doctors off on SICK LEAVE in one week are they for real? Yes the Breast Cancer debaucle may have been a dozen years ago but we still feel the affects of it now in this Province and the recent mess is very present. Of course the NLMA didn't want this report made public that should tell us all something!

  • ABACUS
    July 02, 2010 - 13:25

    MEMBER OF THE 93% SHOULD PERHAPS TAKE A LOOK AT THE SALARIES AND PERKS OF
    ADMINISTRATORS STARTING WITH CEO'S. THAT WOULD GIVE HIM SOMETHING MORE SENSIBLE AND FACTUAL TO WRITE ABOUT.

  • Larry
    July 02, 2010 - 13:25

    Colin P. from NL but you are missing the most important point, we can't just hire new doctors like walmart employees, it doesn't work like that. No doctor would touch this place with a 10 foot pole. These doctors are competent, no one questions this. I don't want to belittle you, but you don't seem to have any idea on what the problems are or how to solve them. Also, the doctors are not threatening to leave the province, what they are doing is saying here, here are the keys, YOU try driving this heap for a while since you criticize how we are doing our best to deal with what we have.

  • Doug
    July 02, 2010 - 13:23

    If the NLMA and its members had been as enthusiastic about doing their jobs as they are in the ongoing (and evidently infinite) pursuit of higher and higher salaries, perhaps the labs would be somewhat more reliable.

    Clearly, a certain number of physicians are more concerned with getting paid for their jobs than they are with actually doing them.

  • House
    July 02, 2010 - 13:22

    Well at least the Doctors are trying to get the problems fixed. How much longer before those in charge(?) get down to doing their jobs.

  • Patient
    July 02, 2010 - 13:22

    Huge salaries are being paid to executivies while the frontline workers suffer from overwork due to lack of staffing. Mistakes happen when one person is trying to do the job of two or three. Look at frontline staffing, hire where needed and it that means getting rid of some of the inefficient people at all levels of Eastern Health to provide better,safer service so be it.

  • Steve
    July 02, 2010 - 13:20

    Hopefully this news release signals a beginning of a dialogue with the media and Eastern Health officials in an effort to get to the bottom of the problem(s) that exist and rectify them. This would certainly go much farther in trying to restore our confidence in our health care system and that someone is genuinely trying to do something to fix it. br br The thing is, this is our health care system we are talking about not your local plumber. When some of these people make mistakes or errors in judgment it could lead to a matter of life or death, not simply a flooded basement. br br It is obvious to the person on the outside that there are some major issues within Eastern Health. No doubt some may be in the upper levels of the system but it does seem to extend the internal day to day functioning of the lab itself. Dr. Denic is not the first person to carry a heavy work load in any level of our health care and he certainly won't be the last. Unfortunately when you are being paid to be an administrator ultimately the buck has to stop somewhere.

  • Marie
    July 02, 2010 - 13:19

    Jerome Kennedy, all you're any good for is shooting off your big mouth and getting hysterical now and then. For what good you are, you might as well go on so-called sick leave with the rest of
    them.
    Should these doctors decide to leave
    NL, we will have an even more extreme problem on our hands because who would want to apply for these positions here after all this chaos and fault finding and shifting the blame, etc. They can easily get another job elsewhere for higher or the same pay, plus a better working environment.
    It sure can't get any worse than it is here.
    Now, once again, before all this is straighened out, how many more people have to go through unnecessary suffering and deaths? My God, hasn't it registered in your brains and conscience yet that hundred of people have DIED.

  • Pam
    July 02, 2010 - 13:15

    I wonder if admin might be better off firing them all and sending lab tests out of prov for a while. Maybe later, restructuring and hiring back those who are competent and a new work force with a healthy mentality. I agree that healthcare takes up most of the money by paying salaries to physicians and nurses. br As much as employment is important in NL, it is not at the expense of lives. I believe these doctors enjoy a dysfunctional system so they can leverage their salaries and how busy they say they are. Where is the efficiency and pride and good hard work in making patients better not sicker. Good god. Get rid of them all and rehire a new work force later even if they are paid more. BUT make sure they can do the job and would be driving for excellence and catch these errors when they happen. br br We also need a system whereby employees on all levels in lab can report these errors, daily and weekly and someone/ management do something about them. We need our own Quality br Control program and experts and not just in the lab. We need to make change and Health Canada needs to make it mandatory (a program or rules for pathology labs or else the province does) on mandatory reporting on these errors and they get reported instantly to hosp mgmt, with someone in place to catch these and do something about them. OR else people get fired or lose lisences for not complying with rules/regulations. It is that simple. In the US, each state has such mandatory requirements of professionals enshrined in their state laws. br br br There is no excuse for not having something in place and if there is some program in place as current maybe (even if not enshrined in prov law), no excuse for why/ how these errors get missed. It is not acceptable, no matter what the reason. The pathologists may not feel it is their responsibility to report because there is no law or that the procedures in place have no teeth anyway to penalize doctors or others who do not comply. Lets force these doctors and others (some with bad attitudes) to take responsibility for their salaries earned, as they do in the US. They practice here, many of them because they can get away with things, unlike a big centre with many rules/reg's or lot of malpractice. NL patients have always been complacent taking it on the chin and not suing doctors here as they do elsewhere. So doctors know that they have the best of all world's here or would not be here. That simple. Let them go elsewhere like everyone else in NL, if they do not like any new rules to be enforced on behalf of patient safety. If they have HR problems, again, let them go elsewhere if they do not like. br br That is what the rest of us - public employees have to do when bullied in this gov system. The doctors do their own share of bullying as a large privileged group of professionals earning large salaries. Remember that. They hide behind their Defence Insurance Fund also and the Med Assoc & Unions. Can always go to the US and learn some new skills but they in the US do not put up with crap and politics like this and expect only excellence in their doctors or be fired, if not up to snuff. Only gov here will put us with less than adequate doctors with (surgery) skills that are behind by about 15 years, many. You might have to retrain in the meantime to work in the US. br br But please enough bullying by doctors and please treat us better as patients. I am sick of the long waiting lists and lack of respect from some who write horrible unprofessional things in reports that are not objective and should not even be in some of the reports; Personal subjective information that has no bearing on report. They obviously are covering their behinds by writing rotten subjective trash about patients who are not happy with them or their service or if they have screwed up. I have seen it and it is getting to be a trend with many doctors and should be stopped. Very unprofessional and oppressive to say the least. Yes money means more to most of them these days, then doing their jobs or patient safety, for sure. It is called greed.

  • mcfan
    July 02, 2010 - 13:14

    can i outline that pathologist are MD reading out diagnosis and identifying the bad cells or interpreting results for diagnosis
    The machine calibration is not the job of a physician, it's a technical thing. Eastern health need to get people to check the technical aspect more frequently as leave pathologist do their work in peace.
    It's so unfair to get pathologist to do the technical work as well when they are not qualified to do it and then get blamed when the machine fails. It's pure scapegoat act!

  • Member of the 100%
    July 02, 2010 - 13:14

    haha, each time 93 shoots off his mouth the very highly specialized doctors salaries increase. now 93 says they are in the 400 grand range. hey 93, i guess u have no idea what the expected salary range for mcdonalds employees is either, funny since thats where u work, u are that dumb br br now we have the Newfoundland and Labrador Medical Association (NLMA) and Newfoundland Association of Pathologists backing up these highly trained specialists, the top echelon of professionals in any society, anywhere - in the other corner we have a temper tantrum-prone politician and an obese health ceo br br here we have these doctors trying to solve problems and neither kennedy or kaminsky were available for comment, no surprise there - we are waiting for your apologies u 2 boneheads, start back pedalling before you drive this health care system completely into the ground

  • Member of the 93%
    July 02, 2010 - 13:11

    I don't think we need a simmering down, I think we need to be screaming at the top of our lungs. We have tried the quiet subtle approach with the labs, and obviously it doesn't work. We pay these people enormous amounts of money, three to four hundred thousand dollars a year, plus perks. We thought after Cameron, the salary increases, more staff, less hours that these guys could get their act together...wrong. Obviously, if these people can't do their job properly, and they are putting people's lives in danger, then they have to go, no matter what. I think that if we have to close all the labs, and have every test sent out, it would be an improvement over what we now have. If we can't get people here, who know what they are doing, for these huge sums of money, then we should go in another direction. We spend the most per-capita on health care in this Country, yet we get crap. I would say doctor, and nurses salaries are what is consuming the lion's share of the health care budget. It is never enough for these guys.

  • From the
    July 01, 2010 - 20:21

    Most people have no concpet how teh lab works, who's responsible for what etc... however everyone has an opinion and who is at fault.

    These comment sections ar like Open Line for people with computers.

    Bogged down with intelligence, yeah right

  • jim
    July 01, 2010 - 20:19

    Hey Patient, when did you ever see an over worked person in the frontline of healthcare (or is it healthwhocares). I dont see any one breaking a sweat, and if they do punch a hard days work, you can be guaranteed that they will be off sick for a day of two or even thirty if they want. There are more than the doctors that are cry babys in the health care system. Union work at its very best.

  • Colin
    July 01, 2010 - 20:18

    Seems like doctors are saying don't criticize us over this mess or we'll leave the province or we'll tell other doctors not to come here . My advice - please go and don't let the door hit you on the way out! Maybe then we can hire some competent doctors.

    Didn't some doctors threaten to leave last year if their salaries weren't increased substantially? Seems like whenever doctors want something, they get very sooky and threaten to leave in order to get what they want. It is very unprofessional. These people will never be satisfied. Go ahead and leave NL if you want to and stop the threats.

  • Surprised
    July 01, 2010 - 20:13

    Dr. Lewis says: patients are receiving top notch care and while the sick leave is causing a strain, the pathologists left working are capable Does he really think that anyone in Newfoundland believes this right now? I think NOT! 4 or 5 Doctors off on SICK LEAVE in one week are they for real? Yes the Breast Cancer debaucle may have been a dozen years ago but we still feel the affects of it now in this Province and the recent mess is very present. Of course the NLMA didn't want this report made public that should tell us all something!

  • ABACUS
    July 01, 2010 - 20:11

    MEMBER OF THE 93% SHOULD PERHAPS TAKE A LOOK AT THE SALARIES AND PERKS OF
    ADMINISTRATORS STARTING WITH CEO'S. THAT WOULD GIVE HIM SOMETHING MORE SENSIBLE AND FACTUAL TO WRITE ABOUT.

  • Larry
    July 01, 2010 - 20:11

    Colin P. from NL but you are missing the most important point, we can't just hire new doctors like walmart employees, it doesn't work like that. No doctor would touch this place with a 10 foot pole. These doctors are competent, no one questions this. I don't want to belittle you, but you don't seem to have any idea on what the problems are or how to solve them. Also, the doctors are not threatening to leave the province, what they are doing is saying here, here are the keys, YOU try driving this heap for a while since you criticize how we are doing our best to deal with what we have.

  • Doug
    July 01, 2010 - 20:09

    If the NLMA and its members had been as enthusiastic about doing their jobs as they are in the ongoing (and evidently infinite) pursuit of higher and higher salaries, perhaps the labs would be somewhat more reliable.

    Clearly, a certain number of physicians are more concerned with getting paid for their jobs than they are with actually doing them.

  • House
    July 01, 2010 - 20:07

    Well at least the Doctors are trying to get the problems fixed. How much longer before those in charge(?) get down to doing their jobs.

  • Patient
    July 01, 2010 - 20:07

    Huge salaries are being paid to executivies while the frontline workers suffer from overwork due to lack of staffing. Mistakes happen when one person is trying to do the job of two or three. Look at frontline staffing, hire where needed and it that means getting rid of some of the inefficient people at all levels of Eastern Health to provide better,safer service so be it.

  • Steve
    July 01, 2010 - 20:02

    Hopefully this news release signals a beginning of a dialogue with the media and Eastern Health officials in an effort to get to the bottom of the problem(s) that exist and rectify them. This would certainly go much farther in trying to restore our confidence in our health care system and that someone is genuinely trying to do something to fix it. br br The thing is, this is our health care system we are talking about not your local plumber. When some of these people make mistakes or errors in judgment it could lead to a matter of life or death, not simply a flooded basement. br br It is obvious to the person on the outside that there are some major issues within Eastern Health. No doubt some may be in the upper levels of the system but it does seem to extend the internal day to day functioning of the lab itself. Dr. Denic is not the first person to carry a heavy work load in any level of our health care and he certainly won't be the last. Unfortunately when you are being paid to be an administrator ultimately the buck has to stop somewhere.

  • Marie
    July 01, 2010 - 20:00

    Jerome Kennedy, all you're any good for is shooting off your big mouth and getting hysterical now and then. For what good you are, you might as well go on so-called sick leave with the rest of
    them.
    Should these doctors decide to leave
    NL, we will have an even more extreme problem on our hands because who would want to apply for these positions here after all this chaos and fault finding and shifting the blame, etc. They can easily get another job elsewhere for higher or the same pay, plus a better working environment.
    It sure can't get any worse than it is here.
    Now, once again, before all this is straighened out, how many more people have to go through unnecessary suffering and deaths? My God, hasn't it registered in your brains and conscience yet that hundred of people have DIED.

  • Pam
    July 01, 2010 - 19:54

    I wonder if admin might be better off firing them all and sending lab tests out of prov for a while. Maybe later, restructuring and hiring back those who are competent and a new work force with a healthy mentality. I agree that healthcare takes up most of the money by paying salaries to physicians and nurses. br As much as employment is important in NL, it is not at the expense of lives. I believe these doctors enjoy a dysfunctional system so they can leverage their salaries and how busy they say they are. Where is the efficiency and pride and good hard work in making patients better not sicker. Good god. Get rid of them all and rehire a new work force later even if they are paid more. BUT make sure they can do the job and would be driving for excellence and catch these errors when they happen. br br We also need a system whereby employees on all levels in lab can report these errors, daily and weekly and someone/ management do something about them. We need our own Quality br Control program and experts and not just in the lab. We need to make change and Health Canada needs to make it mandatory (a program or rules for pathology labs or else the province does) on mandatory reporting on these errors and they get reported instantly to hosp mgmt, with someone in place to catch these and do something about them. OR else people get fired or lose lisences for not complying with rules/regulations. It is that simple. In the US, each state has such mandatory requirements of professionals enshrined in their state laws. br br br There is no excuse for not having something in place and if there is some program in place as current maybe (even if not enshrined in prov law), no excuse for why/ how these errors get missed. It is not acceptable, no matter what the reason. The pathologists may not feel it is their responsibility to report because there is no law or that the procedures in place have no teeth anyway to penalize doctors or others who do not comply. Lets force these doctors and others (some with bad attitudes) to take responsibility for their salaries earned, as they do in the US. They practice here, many of them because they can get away with things, unlike a big centre with many rules/reg's or lot of malpractice. NL patients have always been complacent taking it on the chin and not suing doctors here as they do elsewhere. So doctors know that they have the best of all world's here or would not be here. That simple. Let them go elsewhere like everyone else in NL, if they do not like any new rules to be enforced on behalf of patient safety. If they have HR problems, again, let them go elsewhere if they do not like. br br That is what the rest of us - public employees have to do when bullied in this gov system. The doctors do their own share of bullying as a large privileged group of professionals earning large salaries. Remember that. They hide behind their Defence Insurance Fund also and the Med Assoc & Unions. Can always go to the US and learn some new skills but they in the US do not put up with crap and politics like this and expect only excellence in their doctors or be fired, if not up to snuff. Only gov here will put us with less than adequate doctors with (surgery) skills that are behind by about 15 years, many. You might have to retrain in the meantime to work in the US. br br But please enough bullying by doctors and please treat us better as patients. I am sick of the long waiting lists and lack of respect from some who write horrible unprofessional things in reports that are not objective and should not even be in some of the reports; Personal subjective information that has no bearing on report. They obviously are covering their behinds by writing rotten subjective trash about patients who are not happy with them or their service or if they have screwed up. I have seen it and it is getting to be a trend with many doctors and should be stopped. Very unprofessional and oppressive to say the least. Yes money means more to most of them these days, then doing their jobs or patient safety, for sure. It is called greed.

  • mcfan
    July 01, 2010 - 19:54

    can i outline that pathologist are MD reading out diagnosis and identifying the bad cells or interpreting results for diagnosis
    The machine calibration is not the job of a physician, it's a technical thing. Eastern health need to get people to check the technical aspect more frequently as leave pathologist do their work in peace.
    It's so unfair to get pathologist to do the technical work as well when they are not qualified to do it and then get blamed when the machine fails. It's pure scapegoat act!

  • Member of the 100%
    July 01, 2010 - 19:53

    haha, each time 93 shoots off his mouth the very highly specialized doctors salaries increase. now 93 says they are in the 400 grand range. hey 93, i guess u have no idea what the expected salary range for mcdonalds employees is either, funny since thats where u work, u are that dumb br br now we have the Newfoundland and Labrador Medical Association (NLMA) and Newfoundland Association of Pathologists backing up these highly trained specialists, the top echelon of professionals in any society, anywhere - in the other corner we have a temper tantrum-prone politician and an obese health ceo br br here we have these doctors trying to solve problems and neither kennedy or kaminsky were available for comment, no surprise there - we are waiting for your apologies u 2 boneheads, start back pedalling before you drive this health care system completely into the ground

  • Member of the 93%
    July 01, 2010 - 19:48

    I don't think we need a simmering down, I think we need to be screaming at the top of our lungs. We have tried the quiet subtle approach with the labs, and obviously it doesn't work. We pay these people enormous amounts of money, three to four hundred thousand dollars a year, plus perks. We thought after Cameron, the salary increases, more staff, less hours that these guys could get their act together...wrong. Obviously, if these people can't do their job properly, and they are putting people's lives in danger, then they have to go, no matter what. I think that if we have to close all the labs, and have every test sent out, it would be an improvement over what we now have. If we can't get people here, who know what they are doing, for these huge sums of money, then we should go in another direction. We spend the most per-capita on health care in this Country, yet we get crap. I would say doctor, and nurses salaries are what is consuming the lion's share of the health care budget. It is never enough for these guys.