Teri McGrath interview: Nurse & Health Educator says: Make reporting of medical errors mandatory

Teri McGrath, nurse and health educator, is very familiar with the paternalistic and misogynistic medical culture - in fact, her own physical symptoms were repeatedly dismissed by doctors until they discovered Teri was hyperthyroid. Turns out Teri’s symptoms weren’t ‘all in her pretty little head’, but actually stemming from an overactive thyroid that would have eventually killed her.

Today, Teri is taking on the behemoth medical system that routinely hides or denies medical harm and death, and the Goliath legal-medico system that effectively makes seeking compensation by medical error victims a traumatizing experience, financially draining, and an exercise in futility.

Canadian doctors have finagled themselves a pretty sweet deal: they have manipulated the political, legal and insurance systems so that when medical malpractice occurs, tax payers pay for the doctors high price lawyers. That is millions and millions of dollars each year coming out of tax payers pockets.  The medical error victims - many of them too injured to work - are left to their own devices with no financial support for legal costs.

And what do these high price lawyers do? They fight the injured victims every step of the way, making it as hard - and expensive - and as long - as possible. The lawyers tactic is to bankrupt the injured victim before the case goes to court, or delay the court case in hopes the patient dies in the interim, thereby immediately ending the lawsuit.

No wonder fewer and fewer people trust their doctor. Or their politicians. They have set up the system so that medically injured patients are also emotionally traumatized and financially bankrupt. It is not by accident -- it is intentional and tactical to inflict more harm.

So Teri is on a mission to do 2 things:  Make reporting of medical errors mandatory -- and increase access to compensation for medical error victims.

SHOW NOTES:

0:06:00	Teri grew up in a small town called Espanola in Ontario, Canada -- Teri went to boarding school and then to studying nursing at college -- the boarding school was run by the nuns and Teri had an idealistic view of the world
0:07:00	When Teri was a child, her father would gut a turkey and tell her about the internal body parts and Teri set a goal of becoming an operating room nurse - but with the idealistic rhetoric in boarding school, her goal was to help people and she's still helping people to this day - Teri ended up teaching nursing in Saskathewan and then found out about 'outpost nursing'
0:08:00	Teri started outpost nursing on a small Aboriginal Reserve north of Saskatoon - then moved to a small town to work as a health educator - Teri saw how poor healthcare was for Aboriginal women and decided to do something about it - she went to a conference in Pheonix called 'Wellness and Women' and Teri wanted to do a similar conference in Canada and it took off - she credits that conference to a number of woman who are now Chiefs on their Reserves and educated about health
0:09:00	The conference covered a wide range of health issues, and Teri says it was the most profound experience she's had
0:10:00	In the 1980s, Teri was having a problem with depression and weakness but couldn't convince her doctor that something was wrong - she was referred to a psychiatrist, but it wasn't until her heart rate went up to 150 in a resting state that they took Teri seriously and finally got treatment - but she didn't file any complaint because in those days it wasn't done and people didn't know how to file a complaint - not like today with the internet and easy access to info
0:11:00	Misogyny played a big part in how Teri was treated at that time - it is the medical culture and Teri could feel the disregard the doctor had for her - Teri felt that disregard again recently when she asked for another doctor, and the current one asked if she wanted to quit treatment, which would have been the worse thing to do
0:12:00	The sexism against women is still in the medical system - while Teri's fatigue symptom was vague, her extreme weakness and crying at the drop of a hat
0:13:00	Teri couldn't walk any distance without having to stop and lean against something to hold her up - it was really bad, but the doctor didn't think it was anything to be concerned about - turns out Teri had hyper thyroidism, which people can die from, and they did before thyroid meds - people becae totally bed ridden, hair falling out, too weak to move, no appetite and a very fast heart rate
0:14:00	Teri got 'zapped', the isotope treatment destroyed her thyroid and she's been on thyroid meds since
0:15:00	Since 1986, Teri has worked as a health educator on Reserves - she moved to Penticton and in 2014 she fell off a ladder
0:16:00	Teri had a major hip fracture and ended up in a hospital room with 2 men and 1 woman with advanced dementia - being raised a Catholic, it did not sit well with Teri to be in the same room as 2 men and was very upset about it - she complained to the Health Authority but they blew her off - she took her complaint to the review board - they told the hospital they had broken the rules and got a slap on the hand
0:17:00	Meanwhile, Teri had contacted the local press and got to know one of the reporters, Susan MacGyver, and she wrote a book - Susan had been on the faculty of medicine at the University of Toronto, U of British Columbia, Guelph U - she had also been coroner, but retired and was writing articles for the local paper - Teri read Susan's book "After the Error" - half the book is stories written by patients or their families about medical errors in hospitals
0:18:00	One of the stories was about a toddler admitted to a hospital - the mother went home to care for her other kids and returned to the hospital a few hours later - she found the IV cord wrapped around his neck and he was dead - Teri was shocked and started researching, that was in 2015
0:19:00	Teri started a federal and provincial petition about medical errors - the federal petition was very long and involved, so for the provincial petition, Teri just took 3 major points to use
0:20:00	Teri believes the petition is the court of public opinion and speaks truth to power - the provincial petition says that 1 in 18 patients will experience medical harm - few patients who experience medical harm get compensation for their suffering - and there are no mandatory rules for reporting medical error to improve safety - Teri wants mandatory reporting of medical error
0:21:00	And an administrative compensation system in place for preventable medical errors, and that the reporting system should be a 'no fault' model - currently BC has laws that prohibit doctors from testifying in medical malpractice lawsuits - there is also a law that physicians and nurses have a duty to report medical errors
0:22:00	The risk analytica report found 28,000 people die each year from medical error in Canada, the 3rd leading cause of death - so Teri put in a freedom of information request to Health Canada and they told Teri that only 154 people had died of medical error in 2017 - Teri realized lots were going unreported
0:23:00	What Teri finds very interesting is that the Canadian Medical Protective Association (CMPA) - our tax dollars are given to the CMPA as a subsidy - but the CMPA, a non profit, has over $4 billion in assets - and was given $520 million in tax dollars to hire top tier lawyers to fight patients - the lawyers give misinformation, change dates, leave info out - this has been going on since 1901
0:24:00	No other country has this system - but New Zealand in 1974 started no fault compensation for victims of medical error and only 7 countries are doing it now - this will increase openness and transparency, and learn from errors and apply to policies and medical education so they don't happen again
0:25:00	Today there are laws that prevent people from compensation - the CMPA protects doctors at all costs, whether they are guilty or not - in Teri's opinion because 28,000 people died in one year, and 1 in 18 are harmed, they have to stay in the hospital and they take up time and space - so Teri is on a mission to do something about that
0:26:00	So tax payers fund the CMPA to defend doctors who have harmed tax payers - the lawyers play dirty, holding back evidence, extending the proceedings to drive up the patient's legal costs - or extend the case in hopes the patient dies and the case disappears
0:27:00	Court cases can take 8 - 10 years and it is hell on the family because they are re-living it over and over again, they are re-traumatized - most people just want answers - stats show only 2% of patients get a result through court cases
0:28:00	They either drop out because they can't afford it - and injury lawyers won't touch a case unless they anticipate a settlement of at least $250k
0:29:00	There was a case in Newfoundland where a baby was born and the doctor failed to give it medication and now the child has cerebral palsy and can't feed itself - the lawyer defending the doctor blamed the baby - another case of a woman who was a runner and had an injury and had a minor surgery - 7 surgeries later her leg was amputated
0:30:00	A law professor has said the system is 'perverse' - in 1990 a report said 'no fault medical error' is a better system, levels the playing field to make it fair, but nothing has been followed through - becaue the CMPA is extremely powerful and have offices in every city employing top tier lawyers
0:31:00	So the lawyers and doctors are tight, belong to the same country clubs - even judges are part of the problem, refusing to consider evidence
0:32:00	People report being more harmed and traumatized by how the hospital responded to the error, then the medical error itself - called 'institutional betrayal' and there is a study at the University of Regina - that is why Teri went to the press
0:33:00	The CMPA way back in 1911 reported that they had 'struck terror' into the hearts of patients complaining - dozens and dozens of cases have been strangled - that is the strength of the CMPA
0:34:00	Doctors must join the CMPA - and the CMPA have convinced the insurance companies to eliminate medical liability in their insurance policies, so the doctors have to go to the CMPA to get liability insurance
0:35:00	The Gough Report, by Judge Gough, had insurance companies on his committee and doctors that were working in the office of the CMPA - the Report recommends that the government not look at no fault compensation system
0:36:00	Teri says all the facts are online, that's why they can't come after her - she half expects to get a 'cease and desist' letter - for the BC petition, 2 Members of Legislative Assembly (MLAs) presented it to the legislature and Teri is hoping for 3 more
0:37:00	The BC government paid the fossil fuel industry subsidies worth $830 million last year - the fossil fuels companies owe the BC govt $3.1 billion in royalties, but they've never paid - and those royalties are marked for health care and education
0:38:00	Fossil fuels contaminte air and water and make us sick - CMPA defends incompetent doctors, harming more people, who need more hospital care - its all connected
0:39:00	Teri say a documentary about health care workers high on drugs while on duty, and that may be contributing to medical error rates - Teri thinks they are self-medicating because the stress of the job is so bad, including bullying - the top of the system has to fix it, but they are only putting on band aids
0:40:00	Scott says he doesn't understand why health care workers are working such crazy long shifts - we wouldn't let people making widgets in a factory work long hours because they'd be making so many mistakes - Teri says some of the workers want those long shifts so they can spend more time with their family
0:41:00	Teri says back in the day, workers were told what and how long to work - she says today there is too much compromise between management and workers - Teri thinks management must limit shifts to 8 hours - overwork is where a lot of the medical errors come from, and short tempers lead to medical abuse - Teri says today health care workers get too much theory and not enough practice
0:42:00	When they start working they are scared and don't know what they are doing because they only have theory - so the education has to be looked at and improved on - and workers are not clear on their duties any more
0:43:00	Teri says patients are striking out at health care workers who are over compensating for the stress - one over compensating defense mecahnism is arrogance and that results in a condescending attitude
0:44:00	Teri says the system needs to be revamped from the top and bottom - they need to listen to patients - Teri found that every patient organization committee she's been on is over loaded with health care practitioners who didn't really regard the patients experience at all
0:45:00	Teri says she felt like a token - there was an independent BC patient organization, but when the funding stopped, the govt took the patients and put them into a govt program, so they were policing themselves - prior to that it was the patients voices and needs that were listened to, and its not that way now
0:46:00	Re the petitions, Scott says mandatory reporting of medical errors should have lots of support, and a no-fault model sounds like a good thing - Teri says it must be adopted across the country because it it is just one province, the politicians fear the doctors will leave and go to another province
0:47:00	Teri is hoping the BC govt will champion this approach - Teri thought it was great that Patients for Patient Safety Canada was holding round table meetings with the provincial Ministers of Health - but there has to be support across the country to remove the power of the CMPA
0:48:00	The CMPA says it is the provincial medical associations that set bargain with the provincial Health Ministers, so not within CMPAs power - Teri gets angry when the provinces say they need more health care money, she says they don't need more money, they need to spend it wiser
0:49:00	Teri is looking for people to share their stories around medical error - Teri can be reached at safept.care@shaw.ca

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I am always looking for guests to share their medical error experiences so we help bring awareness and make patients safer.

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Scott Simpson: 

Counsellor + Patient Advocate + (former) Triathlete

I am a counsellor, patient advocate, and - before I became sick and disabled - a passionate triathlete. Work hard. Train hard. Rest hard.

I have been living with HIV since 1998. I was the first person living with HIV to compete at the triathlon world championships.

Thanks to research and access to medications, HIV is not a problem in my life.

I have been living with ME (myalgic encephalomyelitis) since 2012, and thanks in part to medical error, it is a big problem in my life.

Need a Counsellor?

Like me, many of my clients at Remedies Counseling have experienced the often devastating effects of medical error.

If you need a counsellor for your experience with medical error, or living with a chronic illness(es), I offer online video counseling appointments.

**For my health and life balance, I limit my number of counseling clients.** 

Email me to learn more or book an appointment:  RemediesOnlineCounseling@gmail.com

Counseling / Research

I first became aware of the ubiquitousness of medical error during a decade of community based research working with the HIV Prevention Lab at Ryerson University, where I co-authored two research papers on a counseling intervention for people living with HIV, here and here. 

Patient participants would often report varying degrees of medical neglect, error and harms as part of their counseling sessions.

Patient Advocacy

I am co-founder of the ME patient advocacy non-profit Millions Missing Canada, and on the Executive Committee of the Interdisciplinary Canadian Collaborative Myalgic Encephalomyelitis Research Network.

I am also a patient advisor for Health Quality Ontario’s Patient and Family Advisory Council, and member of Patients for Patient Safety Canada.

Medical Error Interviews podcast and vidcast emerged to give voice to victims, witnesses and participants in this hidden epidemic so we can create change toward a safer health care system.

My golden retriever Gladys is a constant source of love and joy. I hope to be well enough again one day to race triathlons again. Or even shovel the snow off the sidewalk.