Juno News - December 22, 2020


Putting Patients Before Politics


Episode Stats

Length

25 minutes

Words per Minute

189.30276

Word Count

4,745

Sentence Count

292


Summary


Transcript

00:00:00.000 Welcome to Canada's Most Irreverent Talk Show.
00:00:06.520 This is the Andrew Lawton Show, brought to you by True North.
00:00:12.560 Coming up, diagnosing the problems of Canadian healthcare with a bit of hope on how we can fix them.
00:00:20.000 The Andrew Lawton Show starts right now.
00:00:23.540 Welcome, everyone, to another edition of Canada's Most Irreverent Talk Show.
00:00:30.740 This is the Andrew Lawton Show on True North, just a few days before Christmas.
00:00:34.920 So we're going to dispense with this idea of trying to keep track of all the negative, nasty things that are happening in the world.
00:00:41.240 We've done enough of that this year.
00:00:42.580 And I want to spotlight an important issue that is more relevant than ever this year, but also getting spoken about less than it needs to.
00:00:50.360 And that is the dire state of Canadian healthcare.
00:00:54.060 We've talked about this in a couple of forums in the past, with the famous Canby case that's going on out in British Columbia,
00:01:00.460 a case that really determines whether access to a waiting list accounts for access to healthcare.
00:01:06.780 But the problem with healthcare in Canada and the discussion of it is that so often people are focused on the politics of it
00:01:13.480 and not the actual patients, not the people who should matter the most.
00:01:16.960 As it stands, we have a healthcare system in which the government virtually monopolizes, in most areas, the quality of care you can get.
00:01:25.200 But this means care is also rationed.
00:01:28.020 And again, access to a wait list is not access to care.
00:01:31.300 One of the big problems we have is that so many people view the idea of even discussing it as akin to grabbing onto the third rail,
00:01:38.380 which is why a lot of people in politics, even those who probably think that, yeah, deregulating or getting government to back off a bit would be a good idea,
00:01:45.720 people on the right don't want to go anywhere near it.
00:01:48.540 Well, we never shy away from tackling the contentious subjects on this show.
00:01:52.680 So it is with that that I want to talk to Dr. Sean Watley, who is also the former head of the Ontario Medical Association,
00:02:00.620 but more notably right now is the author of the new book,
00:02:03.740 When Politics Comes Before Patients, Why and How Canadian Medicare is Failing.
00:02:09.140 Dr. Watley, great to talk to you. Thanks very much for coming on the show.
00:02:12.360 Thank you, Andrew.
00:02:12.840 So this is, again, a book that really melds politics and medicine in a way, but you're also trying to separate the two, it seems.
00:02:21.920 Yeah, I'm so glad that you identified that.
00:02:24.280 Actually, most of what we talk about, especially when you're looking at headlines and you hear about this crisis and that crisis,
00:02:29.580 is really at the level of care and coordination of care.
00:02:33.380 So how did you experience what you experienced when you went to the emergency department?
00:02:37.960 Did you get the care you needed?
00:02:40.140 Did you have to wait a long time?
00:02:41.580 Did you have to go to the walk-in clinic first or your family doctor first and then run here, there and everywhere?
00:02:46.200 So it's all about care and coordination of care.
00:02:48.700 I think we need to have a deeper discussion at the level of culture and concepts.
00:02:53.940 And so I've put both parts in the book.
00:02:56.700 You need to have the stories.
00:02:57.780 You need to talk about care and the disasters, but you really need to dig deeper.
00:03:01.700 And that's where this book comes in.
00:03:03.780 I know your previous book, which you've identified this as being really part of a trilogy after,
00:03:09.020 covered wait times specifically.
00:03:11.580 And I wanted to ask you if the problem goes beyond wait times when you're looking at what the failings are of the health care system,
00:03:18.240 because that's, I think, the most poignant for a lot of people.
00:03:21.020 That's the one they notice.
00:03:22.140 That's the one that governments, when they say they're fixing it, tend to try to use as the predominant metric.
00:03:27.060 Yeah, so great.
00:03:28.740 I'm really glad that you brought that up.
00:03:30.040 You know, people have heard Chief Justice Beverly McLaughlin's famous line from the Chiaouli decision in 2005,
00:03:37.120 where she said, access to a waiting list is not access to health care.
00:03:42.400 But if you look just a few lines up in her ruling, she says this line, waiting times under the Medicare system are,
00:03:51.000 and then she puts this next three words in special quotation marks, real and intentional.
00:03:58.160 And so it seems like we've put a lot of emphasis on the real part.
00:04:01.340 And KIHI, Canadian Institute of Health Information, has done a great job of tracking wait times, reporting wait times.
00:04:06.940 I think we have much more work to do there, but we haven't had that discussion about the intentionality of it.
00:04:14.160 Someone actually decided to create this system, to run the system such that people wait.
00:04:20.860 Other countries have this discussion up front.
00:04:24.300 So in the United Kingdom, the NHS addressed this head on in the 1960s,
00:04:28.380 and now they're very comfortable talking about the R word, rationing.
00:04:32.780 They write white papers about it.
00:04:34.380 They write books about it.
00:04:35.480 Whereas in Canada, we're not there yet.
00:04:37.560 And I think patients need to realize that it wasn't just a special event that made things busy for them.
00:04:42.580 It wasn't a particular rush on MRIs that makes them wait for 10 months.
00:04:47.240 Someone actually planned this.
00:04:49.520 And that's where the book gets into the ideas that, you know,
00:04:53.620 who says it was okay for someone to plan that in the first place?
00:04:57.900 Who says it's okay for a group of really smart people to decide when you need care versus you and your doc and your nurses and the team that you're working with.
00:05:06.440 So that's where we try to dig deeper, that real and intentional.
00:05:10.900 And I think Chief Justice Beverly McLaughlin nailed it in 2005 with that comment.
00:05:15.340 And you address this in the book very well when you talk about people that might be on a bed in a hallway waiting for health care.
00:05:23.220 And you say that when the doctor or the nurse isn't coming, it's not necessarily just because they're tied up,
00:05:28.420 but because someone has, as you've just alluded to there, made a decision that prevents money from having there be an extra doctor or a nurse who can actually help that patient.
00:05:37.400 Yeah, absolutely.
00:05:38.960 And so I think what we need to do is to have a fearless, dispassionate discussion about how socialized medicine has actually delivered on our dreams for it.
00:05:49.420 Did it live up to providing what we were hoping it would provide for patients?
00:05:53.620 Or have the ideas that are baked into the system actually led to anti-patient policies, which often deny care and dignity to patients?
00:06:03.680 And just a quick comment about the word socialized medicine.
00:06:06.080 So, you know, Jim Carrey was on Bill Maher's show about two years ago, and he said, OK, I'm a Canadian, OK?
00:06:12.400 He said, we have socialized medicine.
00:06:14.220 And he went on to describe how wonderful it is and how important it is as a Canadian to have this thing called socialized medicine.
00:06:21.400 I mentioned this not because I agree with his comments, but I wanted to highlight the fact that he made no apology for calling it socialized medicine.
00:06:29.940 Socialism is back.
00:06:31.200 You know, a Harris poll in 2019 showed that 50 percent, actually more than 50 percent of voters under the age of 38 would prefer to live in a socialist country.
00:06:41.580 So we don't have to shy away from using that term socialized as a descriptive term now.
00:06:46.960 We're not trying to criticize someone.
00:06:48.620 We're just trying to be descriptive.
00:06:50.140 And so I think we need to look at socialized medicine itself and ask, how is it doing for patients?
00:06:56.620 That's actually an interesting point you just raised there, because I don't hear it talked about as socialized by its defenders in Canada.
00:07:05.220 The term they use, and I think I even use this in my preamble, was universal, because that's how Canadians view the system.
00:07:11.760 And for any number of reasons that you address in the book and that I've covered on the show and that I've experienced in my own life, the system is not universal.
00:07:19.260 But you are correct that it does change it slightly.
00:07:22.600 And I think people's perception, if you use that term, socialize, which is really at its core what it's supposed to be.
00:07:29.040 Right. So I'm so glad that you gave me the opportunity to expand on that, because universal care, you can get universal care many different ways.
00:07:37.100 I think Canadians are very supportive of insurance, right?
00:07:40.080 We love insurance. We're insured for just about everything.
00:07:42.280 You can even insure your pets. You can insure your cows and all the rest.
00:07:45.380 So we love insurance. And I think it would be wise to be insured against medical care or catastrophic illness, that sort of thing, or even regular, regular care.
00:07:55.860 So let's move the insurance part out of the way.
00:07:58.460 We can provide care for everyone, a universal approach without saying the only way to do it is with the government approach.
00:08:05.700 So we'll move that to the side. You know, Tommy Douglas, he was the greatest Canadian, right?
00:08:11.880 He was voted the greatest Canadian a while back and the father of Medicare by some people.
00:08:16.980 In 1979, he was at the SOS Medicare conference.
00:08:20.320 So the funding taps had been turned off by the federal government and everyone was really worried.
00:08:26.040 Medicare was in crisis. He said, we all knew that there were two phases in Medicare.
00:08:30.840 The first phase was to remove the barrier of payment between patients and care.
00:08:36.520 But he said, the second phase is much more difficult. He said, the second phase, and he said, we've been talking about this in the 40s, 50s, and 60s.
00:08:43.840 The second phase requires a redesign of their delivery systems.
00:08:49.520 So we need to completely remake how patients get care.
00:08:53.700 What is the focus of the system?
00:08:55.380 Do we focus on acute care or prevention and team care and that sort of thing?
00:08:59.420 So that's where you get into socialized medicine, where you take the state, assuming, or I would argue usurping, I didn't use that word in the book, but I'm using it here now, taking control to try to rationally allocate care based on central planning ideas.
00:09:16.740 Well, that's radically different from the way doctors and nurses think at the bedside.
00:09:20.400 When we're talking about the dollars and cents required, obviously, there's a finite number.
00:09:26.440 And one of my big frustrations outside of health care with government in general is oftentimes treating money as though it is this bottomless pit from which you can just keep drawing.
00:09:36.500 But with health care, I'm of the mindset that if the government is to say, we are providing this and we are the only people that can provide this, you have to actually provide it.
00:09:45.600 Now, we can talk about all the other ways we would rather see that system funded and constructed, but if government's going to do it, you have to do it effectively and efficiently.
00:09:54.380 And what you've pointed out in the book here that I'm curious if you could elaborate on is how this kind of, in your words, pits legislators against care providers.
00:10:03.340 And I know that prior to your role now with the Macdonald-Laurier Institute, and I know you're still practicing as a physician as well, you were actually at the helm of the Ontario Medical Association.
00:10:13.300 So you've been in these very battles with governments.
00:10:16.740 And explain how that really manifests, that pitting against that you talked about.
00:10:22.060 And so we have an hour and a half for this television.
00:10:25.040 So that is a fantastic question, Andrew, and really you nailed it on the head.
00:10:31.400 And so just I'll try to be as brief as possible because you've asked a very, very complex question.
00:10:36.320 Essentially, medicine is about provision, priority, and patients, individual patients.
00:10:43.180 So doctors and nurses as well, nursing is this way as well, I believe, where we focus on providing care.
00:10:50.020 So someone's in front of us, how can we provide care?
00:10:52.480 We focus on priority.
00:10:54.460 So who is the sickest?
00:10:55.720 And we'll pour everything into this one sick patient, even though we all know, you know, this person may die in the next 20 minutes.
00:11:03.080 Doesn't matter.
00:11:03.940 All hands on deck.
00:11:05.000 Try to save that life.
00:11:06.060 Try to save that limb.
00:11:07.520 And then finally, we're focusing on individual patients.
00:11:11.460 Socialized medicine or the people who have to actually plan this whole thing on the civil service side, they're thinking about distribution of care.
00:11:19.820 How is it distributed from province to province, from individual to individual, region, you know, urban, rural?
00:11:26.720 Are we delivering an equal product?
00:11:29.840 So is it equally distributed?
00:11:32.200 And then finally, they're thinking at the population level.
00:11:35.300 Are we doing what's best for populations as a whole?
00:11:38.580 And those three sets of priorities on each side are often at loggerheads.
00:11:42.960 And so I argue in the book that I think these are fundamentally opposed.
00:11:46.660 In the 1970s, like you said, we had lots of cash.
00:11:49.880 We had way more hospital beds than people to fill them.
00:11:53.020 And it was wonderful.
00:11:53.980 I mean, you got sick.
00:11:55.120 Boom, we got you in a bed.
00:11:56.320 We got your diagnosis and your treatment.
00:11:59.280 It was really, really nice.
00:12:00.800 You never had to ask a bed allocating department whether or not you could accept a sick patient in transfer from another small outlying hospital.
00:12:09.140 That ended in the late 1980s, certainly by the 1990s.
00:12:14.000 You had to get approval before you could actually provide care.
00:12:16.960 But at the same time, there is something about this that has always been unsettling to me, which is that you've got doctors and nurses who are not in a position to strike.
00:12:28.900 So any grievances that doctors and nurses want to raise about very legitimate concerns they have with their deal from the government, if you can even call it that, they're not like other professions that can say we're walking off the job.
00:12:40.900 So at a certain point, they have to just deal with it and move on, and that is what happened here.
00:12:45.960 But are doctors and nurses sounding the alarm about these issues?
00:12:50.220 Because I know that there are loud groups like Canadian Doctors for Medicare that will very loudly and vocally claim to speak for the health care industry against anything they see as being a drift towards privatization.
00:13:02.760 But when it comes to the system itself, where are the actual health care professionals on this?
00:13:07.340 So you can't speak up.
00:13:08.620 You'll get in trouble.
00:13:09.260 I learned the hard way.
00:13:10.300 I was certainly out of residency, and I wrote a very short letter in our local paper.
00:13:15.640 I mean, who reads our local paper, right?
00:13:17.400 I made two mistakes.
00:13:19.020 Number one, I mentioned the Minister of Health.
00:13:20.680 It was George Smitherman at the time.
00:13:22.680 You know, Mr. Smitherman, would you like to come down to our hospital?
00:13:25.540 And I named the name of our hospital.
00:13:27.380 And I said, let me show you the wait times in our emergency department.
00:13:30.920 Very, very short letter, very small paper.
00:13:33.980 The next day, our CEO of the hospital got a call from the Minister of Health and said, and he said, listen, I've been helping you guys out.
00:13:42.200 Do you need me to come down there and fix those wait times for you?
00:13:45.040 So that's the level of involvement and sort of attention that hospitals have when it comes to their staff or people who work in their hospitals actually saying anything.
00:13:56.600 So people are very, very scared about speaking out.
00:14:00.080 If you have hospital privileges, I'd advise you don't speak out.
00:14:03.640 Certainly if you're a nurse, you don't have the liberty, the option to actually raise alarm.
00:14:09.380 There was a great case just a few years ago where a nurse actually just made a comment on Facebook.
00:14:14.060 And she's I don't know if that court case is even settled, but she got in big, big trouble, lost her job.
00:14:19.820 There was money involved.
00:14:21.200 So just for simply saying, hey, my relative didn't really get proper care.
00:14:25.560 And she was the one who could really see what was proper care because she's a nurse.
00:14:31.500 She knows what what good nursing care looks like.
00:14:34.840 So, yes, people want to speak out.
00:14:37.840 But really, unless you're speaking out, saying the system is great and this is why we need more of it, you need to be cautious.
00:14:44.680 Now, to be clear, I'm not just trying to bash the system.
00:14:47.940 I'm trying to ask.
00:14:49.320 I think we have a great opportunity to opportunity to improve what we have.
00:14:54.120 And that's the focus we need to have.
00:14:56.120 You know, how have we done so far?
00:14:57.480 But most importantly, how can we make it better?
00:15:00.100 Where can we go from here?
00:15:01.280 The first step in that process is diagnosis.
00:15:04.000 So this book is focused on diagnosis.
00:15:06.120 And diagnosis is the hardest part about getting to treatment.
00:15:11.280 To a lot of people, though, fixing it just involves throwing more money at it.
00:15:16.300 And we spoke earlier about rationing.
00:15:18.600 And when you have the conversation framed in those terms, some people might think it's, okay, well, just turn on the tap at full speed and let the money flow.
00:15:25.160 And the problems will resolve themselves.
00:15:27.440 And that's the concern I have when I do hear sometimes from healthcare professionals is that there seems to be this idea that, you know, if you just kind of unlimit or delimit the money, it's all going to make the problems go away.
00:15:39.000 What's your response to that?
00:15:40.340 And is that the prevailing sentiment among your colleagues in healthcare that the issue is just more money is needed?
00:15:45.880 Well, certainly that's what not only people working within healthcare, but the general public has heard this over and over.
00:15:52.760 You hear it so many times about cuts, cuts, cuts.
00:15:55.780 I've said, you know, I've complained about cuts publicly many, many times.
00:16:00.220 And certainly irrational cuts are not the way to go.
00:16:02.780 And I'm not suggesting we need cuts now.
00:16:04.800 More money always seems to help.
00:16:06.660 But will more money solve it?
00:16:08.300 Absolutely not.
00:16:09.200 We've been through this cycle numerous times.
00:16:11.800 The biggest infusion of cash happened in the early 2000s with the federal government.
00:16:18.000 You know, a fix for a generation, I believe, was how Paul Martin said it.
00:16:22.280 And I haven't seen that that actually fixes care because we need to.
00:16:27.760 So we talk about care and coordination of care.
00:16:30.120 That's what we think we're fixing.
00:16:31.280 But we need to actually address the culture underneath it and then the concepts that feed that culture.
00:16:36.060 So culture is just something, for example, in your office, let's say all meetings start at five minutes late.
00:16:42.820 Well, then that's the culture in your office.
00:16:44.940 That's the accepted norms of behavior.
00:16:47.380 We have a whole bunch of norms of behavior in our system, which include it's okay to make people wait.
00:16:52.320 And it's okay to push people off for 10 months for a referral to orthopedics.
00:16:57.940 It's okay to get people seen in 10 days if it's a workplace injury.
00:17:01.920 So we have all these norms that are okay.
00:17:04.700 And that's part of the culture.
00:17:06.060 Which I'm calling socialized medicine.
00:17:07.780 But we have to even dig deeper into the concepts.
00:17:10.780 Who said it was okay for someone else to decide whether or not your care is warranted?
00:17:15.980 And so when you talk about more money, more money has to rely on the concepts and the culture that will determine how that money is used.
00:17:26.880 And so if you never have a conversation about the culture and the concepts, more money just goes to make more of what you already have.
00:17:34.940 And so that's why I think money keeps failing.
00:17:36.880 You talk a little bit about the way government's involvement tends to shape or, I guess, distort the role of health care.
00:17:46.340 And you talk about this weirdly one-sided employer-employee relationship where government wants the control of an employer, but not the overall responsibility for the company's output.
00:17:57.240 And the company in this case would just be the health care system of whichever province.
00:18:01.780 And you talk about, I mean, in a lot of ways, the demise of self-regulation.
00:18:05.860 And what do you mean by that?
00:18:06.880 So, again, I don't know why you're asking such great questions.
00:18:11.020 This is not a simple question you've just asked.
00:18:13.300 Sorry, I'll go next time with, you know, like, what's your favorite story from the emergency room or something like that?
00:18:18.860 Come on, give me the fluffball questions.
00:18:20.960 No, you are asking exactly the right question right now.
00:18:25.320 Self-regulation, maybe I'll just focus on that for 30 seconds.
00:18:28.420 Self-regulation was supposed to be a process where you could get both sides working together to solve complex issues.
00:18:39.280 And so there's a huge body of research on this, a bunch of literature that shows that you can't just have a shame and blame approach.
00:18:46.500 Otherwise, people go quiet.
00:18:47.800 You won't actually solve problems that are meaningful to patients.
00:18:51.560 So you need to have a collaborative approach as opposed to a oppositional approach.
00:18:56.300 What happens, though, is as time goes on and you get more and more regulations, you have this regulatory ratchet, which gets tighter and tighter and tighter.
00:19:04.880 Both sides lawyer up.
00:19:06.540 I need to know exactly where every comma and period is in a particular piece of regulation so that I can fight it and both sides fight.
00:19:13.420 Well, the patient gets lost in the middle of that.
00:19:16.400 And maybe I'll end with this one comment also.
00:19:18.680 So no business or organization lobbies government for a new law to help improve quality, service, and efficiency.
00:19:27.560 You don't see Tim Hortons lobbying for a new law to improve the efficiency of Tim Hortons.
00:19:32.240 And I guess I shouldn't even have mentioned the company name, but you know what I'm saying.
00:19:36.660 Whereas we do that all the time in Medicare.
00:19:38.320 We pass a new law to help improve access or efficiency or quality or to prevent cue jumping.
00:19:46.680 This is absurd from the outside.
00:19:49.320 You can't run a knowledge-based industry by passing legislation.
00:19:54.160 I don't think you can even improve a factory, you know, a carb manufacturing plant by passing legislation.
00:20:02.160 So I hope that sort of touches on your question, but brilliant question.
00:20:05.860 I mean, I think I spend probably 100 pages trying to answer that question in my book.
00:20:10.480 Yeah, and in a lot of ways, I kind of absconded with my requirement to summarize it by just asking you to do it.
00:20:17.760 So I appreciate you doing so as adequately as you did.
00:20:21.960 As we wind down here, then, I'll give you not a fluffball question, but a more general one, which is,
00:20:27.620 what do you want the real takeaway of this to be?
00:20:30.300 Because I know you did say that you want to diagnose in this book, and you're planning another book that will deal with the prescriptions,
00:20:37.360 pardon the pun, and in a way that you said would be very difficult for people to take had they not read this one,
00:20:42.680 laying out the problem so clearly.
00:20:44.400 So what is the message you want to give people with this?
00:20:47.560 Well, I think the first message is to scoot right back to the start.
00:20:51.560 How are patients experiencing the system right now?
00:20:54.880 And I opened the book with a story, actually, it's a true story, about a patient who needed to go to the bathroom.
00:21:01.820 He was sitting in a hallway bed, and this guy was copus mentis, clear head, smart, super nice guy.
00:21:08.660 And he needed to go to the bathroom, had to go pee, and finally get someone's attention.
00:21:13.520 They rush by, they're rushing off to do something else, and they stop and they say, well, you have a diaper.
00:21:19.900 And we need to just pause and think about that for a second.
00:21:23.520 Why is it okay in our system for people to be even, for that thought even to even enter your mind?
00:21:31.840 You have a diaper.
00:21:32.960 Okay, so you work that through.
00:21:35.120 So you go in your diaper.
00:21:36.140 Now you're sitting in a wet diaper.
00:21:37.440 Who changes your diaper?
00:21:38.540 Where do you get cleaned up?
00:21:39.480 You're in a hallway.
00:21:40.660 There's no privacy.
00:21:42.080 How do you deal with that situation?
00:21:43.940 And so I could give story after story about no blankets, no beds, no pillows, you know, sitting on a rubber mattress.
00:21:49.800 So we need to focus first, I think, on patients, and are we treating them with dignity?
00:21:56.680 Do the ideas within the system lead to dignified care?
00:22:00.420 Now, people who are very supportive of socialized medicine will say, we can't blame that on socialized medicine.
00:22:06.720 And to a point, they're right.
00:22:09.340 But I argue in the book that actually the whole system of thinking underlying Medicare right now leads to those kinds of behaviors inevitably.
00:22:17.820 So we need to face up to the ideas behind it and say, well, what other ideas might we think about first?
00:22:26.740 And so I talk about obviously focusing on a patient, but I'll just give you one idea from the end of the book.
00:22:33.460 Relationships.
00:22:34.560 How has medicine solved the issue of access to fantastic care for 3,000 years?
00:22:41.300 Well, it's the same way you solve your problem when you have a plumbing problem or an accounting problem or a legal problem.
00:22:46.500 So everybody wants to know a guy.
00:22:48.460 Everybody wants to know a gal, right?
00:22:50.460 Do you know a guy who can help me with this?
00:22:52.480 I'm in trouble.
00:22:53.240 I need help.
00:22:53.900 And that's what patients want.
00:22:55.400 They want to know somebody somewhere.
00:22:58.020 They need a relationship.
00:22:59.320 Because within relationship, you place expectations on the other person.
00:23:04.700 If you and I have a relationship and you say, Sean, I'm in the emergent and like no one, everybody's ignoring me.
00:23:10.420 I'm like, I can't just say, okay, ah, it's Andrew.
00:23:12.740 I'm hanging out.
00:23:13.060 I'm not going to talk to Andrew.
00:23:14.360 I'm not answering his call.
00:23:17.500 I have to answer your call.
00:23:19.400 I have to respond.
00:23:20.360 I have to call and say, hey, my buddy Andrew's in the emergent.
00:23:24.400 It seems like you forgot about him.
00:23:26.120 And then someone checks and, oh, yeah, they did forget about you.
00:23:28.920 And your name fell off the tracking board or whatever.
00:23:31.580 So I think starting with a refocus on relationships is just one small idea that if we make sure everybody gets a great relationship, then we'll start seeing a more robust focus on giving the care and dignity of care back to patients.
00:23:49.900 But that's only one tiny bit.
00:23:51.720 And really, again, you've asked me to give the answer for the whole next book.
00:23:55.080 Yeah, and it is really that distinction between my doctor versus the doctor.
00:24:01.480 And in a lot of cases, the distinction between a relationship someone might have with a family doctor cultivated over years and just, you know, whichever resident, you know, was able to come by for 90 seconds at the bedside in the emergency room.
00:24:13.520 So I do think there's an important distinction there.
00:24:16.220 And that ownership is key.
00:24:17.860 So I'm glad you wrote the book.
00:24:19.320 I look forward to the third part, When Politics Comes Before Patients, Why and How Canadian Medicare is Failing.
00:24:25.400 Dr. Sean Watley joins me on the line now.
00:24:27.800 Dr. Watley, thank you so much for coming on.
00:24:29.700 And Merry Christmas to you as well.
00:24:31.120 And Merry Christmas to you.
00:24:31.840 And thank you for making time for this important topic on your show.
00:24:34.040 I really appreciate it, Andrew.
00:24:35.480 That does it for me, not just for this show, but also for all of our shows prior to Christmas.
00:24:40.600 So I do say to all of you a big thank you for tuning in, listening in on whichever platform you are partaking in this program in.
00:24:48.880 I hope you and your family have an absolutely wonderful Christmas.
00:24:53.400 Merry Christmas to you all.
00:24:54.580 Thank you, God bless, and good day.
00:24:56.660 Thanks for listening to The Andrew Lawton Show.
00:24:58.740 Support the program by donating to True North at www.tnc.news.