Hospital News, February 2010
com
2 News
Painting honours Humber River doctor
By Sarah Quadri
Magnotta
I
f you ask Harriette Caplan,
Dr. Sam Berger deliv-
ers the best medicine.
Not only because he’s a lead-
ing Oncologist, specializing
in Hematology at Toronto’s
Humber River Regional
Hospital (HRRH) for the last
33 years – but also because his
bedside manner is one-of-a-
kind.
“Dr. Berger was the only
medical person that each of
my parents would see without
hesitation,” explaines Caplan, a
high school teacher and a health
advocate for her parents when
they were alive. “He is kind,
caring, soft-spoken and brilliant.
He also did everything he could
to help me out.”
Although Caplan’s parents
passed a while ago – her father
in 2003 and her mother in 1987
– Caplan hasn’t forgotten Dr.
Berger’s care and compassion.
“I even remember calling Dr.
New changes to benefits for car accident victims
By Steven Polak
O
n November 2, 2009,
the McGuinty govern-
ment announced a pack-
age of proposed reforms to the
accident benefit (no-fault) car
insurance system in Ontario.
The proposed changes are
expected to be implemented by
the summer of 2010. The pro-
posed changes will considerably
reduce the standard benefits
available to most people who
have been injured in car acci-
dents. Ontarians will still have
the option of buying extra cov-
erage when they purchase their
auto insurance.
While catastrophically
injured patients will be affected
by the changes, patients who are
deemed to be “non-catastrophic”
will face the most notable
reductions in benefits. Non-
catastrophic patients, in most
cases, do not have access to
funding for case management,
which means that they may well
require more benefits advice and
Harriette Caplan donated this painting to Humber River
Regional Hospital’s Chemotherapy Department, in memory
of her parents and in honour of their physician, Dr. Sam
Berger, for his excellence in care.
Berger at home on a Saturday
night,” Caplan says. “My moth-
er had a rare blood disorder and
I had a million medical ques-
tions. Dr. Berger was always
happy to help.”
On Monday, January 18,
Caplan had a chance to publicly
express her gratitude for Dr.
Berger and honour her parents’
assistance from social workers,
discharge planners and nurses
in the period before they retain
counsel.
Under the current legisla-
tion, there are often disputes
about whether the injured victim
(patient) is “catastrophically
impaired”. The outcome of the
disputes are important because
of the significantly increased
benefits available to cata-
strophically injured persons. The
number of disputes may well
increase as non-catastrophic
benefits are reduced. While
some “catastrophic impair-
ments” are easy to identify (ie:
quadriplegia), there are many
that are not as easy (ie: some-
one who has sustained a 55%
impairment of their whole per-
son). It should be noted that the
proposed changes include an,
as of yet undefined, amendment
to the definition of what “cata-
strophic” will mean.
While not all of the changes
have been identified yet, some
of the significant changes that
memory in a special presenta-
tion hosted by Humber River’s
Foundation. Together, Caplan
and Berger unveiled a painting
– commissioned by Caplan – in
the Chemotherapy Department
at Humber River’s Church site.
The painting depicts a young
girl running with a kite, flowers
in the foreground and a country
have been announced for non-
catastrophic claimants are:
• Housekeeping benefits:
Eliminated completely
• Caregiver benefits:
Eliminated completely
• Attendant care benefits:
Cut in half to $36,000 maximum
• Interest rate penalty to
insurers for failure to pay
timely benefits: Cut in half
• Medical/Rehabilitation/
Assessment benefits: *Cut by
more than half, leaving $50,000
for all medical/rehabilitation and
assessment needs.
• “Minor Injury” Medical/
Rehabilitation/Assessment
benefits: restricted to $3,500. It
remains to be seen how “minor
injuries” will be defined
The current system for acci-
dent benefits provides $100,000
for non-catastrophic medical
and rehabilitation needs, plus
reasonable amounts for assess-
ment costs requested by the
injured person. It also allows
injured persons to obtain “rebut-
tal reports” to reply to insurance
www.hospitalnews.
home, similar to an Anne of
Green Gables setting.
“Shortly after my father
passed away, I approached
Dr. Berger with the idea that
I wanted to contribute some-
thing in my parents’ memory
that would be a permanent
fixture, but that also had
something to do with Dr.
Berger and his wonderful care
for both of them. Without
hesitation, Dr. Berger sug-
gested a work of art for the
patient area in Humber River’s
Chemotherapy Department.”
Caplan was thrilled. But
after searching for something
in retail stores, she said could
not find anything that captured
the essence of what she thought
patients and their families would
like to gaze at during a painful
and stressful time.
“I wanted something that
individuals could look at and
get lost in, even if only for a
moment or two,” Caplan says.
“I expressed my vision to artist
Rod Della Vedova, and asked
company reports that they feel
are unfair. Funding for rebut-
tal reports will be completely
eliminated under the proposed
changes.
Although $50,000 may be
more than enough to satisfy
the medical, rehabilitation and
assessment needs of many car
accident victims, there will
likely be other cases where the
available benefits are used up
before the patient’s needs are
satisfied. Further, because some
patients are not deemed cata-
strophic until quite some time
after the accident, there may
well be patients whose benefits
expire before they reach the
point where they can even meet
the definition of being cata-
strophic.
While catastrophically
injured persons will continue to
have access to one million dol-
lars for medical and rehabilita-
tion benefits, the cost of assess-
ments will now be deducted
from that amount.
The assessment funding
if he could create such a piece.
This painting is his interpreta-
tion of my request.”
For 28 years, Caplan relied
on the guidance, advice and sup-
port of a doctor she says many
others should aspire to become.
“Even though Dr. Berger is
an expert in his field, he’s a per-
son first and that really shows,”
Caplan adds. “His interaction
with his patients and his com-
mitment to their families is sec-
ond to none. For the duration of
28 years, it wasn’t just a matter
of taking my temperature or
giving me a prescription, it was
serious stuff,” Caplan noted.
“He respected me and treated
me as someone who had the
right to know. He allowed me to
function with my parents being
very ill and I will always be
grateful.”
Sarah Quadri Magnotta
Senior Writer/Communications
Specialist at Humber River
Regional Hospital.
changes are significant because
of the cost of assessments, the
long wait to obtain specialist
appointments through OHIP
and the frequent need to reply
to reports obtained by insurance
companies. There will have to
be a calculated balance between
the need for no-fault assessment
funding and the need to fund
treatment.
Non-catastrophic patients
may need guidance from social
workers, nurses and discharge
planners about what type of
assessments are vital and may
also need other advice about
how best to meet their treatment
needs while conserving their
medical and rehabilitation ben-
efit limits.
If a patient has a viable
lawsuit against the persons
who caused the accident, the
assessments could potentially be
funded by the claimant’s lawyer
and claimed for in the lawsuit,
freeing up the full no-fault
medical and rehabilitation limits
for treatment.
Continued on page 19
www.hospitalnews.com Hospital News, February 2010
Patient Safety 19
Technology in health care:
When pictures aren’t worth a thousand words
By Ryan Sidorchuk dered if it might be a good time Without doubt, as our Another additional element also help ensure clarity of drug,
to muse on some considerations technological capacities have of the EHR in Canada is the dose, and method of admin-

M
ost all of us have
heard of the phrase,
“A picture is worth
a thousand words”. One of
the “downsides” to improved
imaging technology, from ana-
logue to digital, is the fact that
‘face to face’ discussion time
between attending and resident
physicians has decreased mark-
edly wherever such technol-
ogy has been implemented.
This practice, while improving
‘efficiency’, has had a detri-
mental effect on the ‘teachable
moments’ that might occur
between experts with decades
of clinical experience to
residents with mere months of
experience, particularly in the
‘rich communication’ setting
of face-to-face dialogue. As
we are nationally in the midst
of building a framework for
the EHR, or Electronic Health
Record, across Canada, I won-
that will be of keen interest
to patients and families over
the next several years as this
technological infrastructure
becomes realized across the
country.
One of the foundational ele-
ments of the EHR infrastructure
will be functionality that will
support empowering patients to
manage their own care. Without
doubt, I personally see this as
an extremely positive aspect of
the plans for the national EHR.
I also support Canada Health
Infoway’s practice of holding
stakeholder roundtables to help
inform their actions to make
sure they are on the right track
with initiative prioritization
and realization over the coming
years. The ‘danger’, as I see it,
is that these new technological
tools may reduce the amount of
actual ‘face time’ with health-
care providers for patients.
increased in health care, there
has been an attendant decrease
in the ‘laying of hands’ by
health-care practitioners on
patients. Diagnoses are more
and more focused on what clin-
ical tests and images paint as a
picture than what patients actu-
ally report as part of a discus-
sion and physical examination
to build an accurate history.
This can be a good thing, and
I’ve also heard enough stories
to last a lifetime from patients
and families where situations
have gone poorly that when
things were going downhill, cli-
nicians simply stopped listen-
ing to what patients and family
members had to say. Family
and friends know patients; cli-
nicians know medicine; only
through the use of this knowl-
edge together can preventable
tragedy be avoided, and even
that is no guarantee.
continuous enhancement of
patient safety. The most obvi-
ous benefit of EHR in this
regard is the electronic manage-
ment of medications, as well
as the elimination of sloppy
handwriting that is known to
contribute to medication errors.
It will allow for Computerized
Physician Order Entry (CPOE),
but as this tool implementation
has shown in many jurisdic-
tions, you can indeed lead a
horse to water, but you can’t
force it to drink! Many hos-
pitals and health authorities
throughout the globe have had
to maintain two systems (one
electronic, one paper based) for
clinicians who, through either
discomfort with new technol-
ogy or simple old-fashioned
reluctance to change with the
times, have refused to adopt
new technology meant not only
to make their lives easier, but to
istration for increased patient
safety and quality of care.
From this regard, I hope
that the exceptional amount of
resources we as taxpayers have
dedicated to this national EHR
will be supported by significant
training for not only clinicians,
but also patients and families.
A tool is only as useful as the
person holding it knows what
to do with it, and while it looks
like we will indeed have a
very useful tool very soon in
the EHR available across the
country, ‘back-end’ investment
in the people who will be using
that tool is at least as important
as the ‘0’s and 1’s’ being used
to create it today.
Ryan Sidorchuk is the
Communications Co-Chair
of Patients for Patient Safety
Canada.

New changes to available no-fault benefits,
benefits for car patients can, in many circum-
stances, still pursue compensa-
accident victims tion as part of a lawsuit against
Continued from page 2 the people who caused the
If patient needs exceed the accident. However, patients will
have to wait until the success-
ful completion of a lawsuit to
get the money necessary to pay
for their treatment or assistance
with tasks of daily living. This
may lead to an T:9.875”
increased num-
ber of patients who undergo Steven Polak is a partner
treatment, or receive assistance, with Lerners LLP in Toronto
on the promise to pay for it clarification, you may contact
upon settlement or resolution of Steven at 416-601-2355 or by
their lawsuit. emailing SPOLAK@LERNERS.
CA

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