Mayo Clinic seen from Cafeteria
This past January Mr Soapbox and my youngest daughter (let’s call her Mini) went on a pilgrimage to the Mayo clinic in Rochester, Minnesota. Unbeknownst to them they were following in the footsteps of Ms Michele Lahey, former Chief Operating Officer of the former Capital Health Region, who’d made the trek almost six years to the day before them.
Ms Lahey was advised by her Alberta oncologist that she was cancer-free. But her boss, Sheila Weatherill, CEO of Capital Health, told her to get a second opinion from the Mayo.*
Mini Soapbox, on the other hand, had not received a clean bill of health by an Alberta medical specialist. In fact she was stuck in that limbo known as “the waiting list” with more than four months to go before she could move to the next step in the diagnostic process.
The total cost of Ms Lahey’s trip was $7,232. This included $5,215 for the Mayo Clinic, two nights at the Marriott, plus meals at one of the finest restaurants in Rochester. Ms Weatherill magnanimously offered to charge the cost of Ms Lahey’s Mayo trip to the Alberta taxpayer by letting Ms Lahey expense the costs, thereby avoiding the need for approval by the out-of-country health services committee.
Mini Soapbox’s trip to the Mayo cost about $10,000, plus an additional $5000 for air fare, five nights at the Best Western and meals at Appleby’s. It didn’t dawn on her anxious parents to apply to the out-of-country health services committee so that the bill could be passed on to Alberta taxpayers. We simply paid it out of our own little soapbox pockets.
What were they thinking?
To say that Ms Weatherill and Ms Lahey displayed astoundingly bad judgment would be an understatement. When senior executives in Alberta’s healthcare system circumvent the out-of-country review process and flaunt the rules for claiming expenses to confirm a solid diagnosis by an Alberta oncologist they demonstrate an appalling lack of respect for very system they are being paid to administer.
The Government is Accountable
The PC government’s response to this mess is even more shocking. The PCs started with the classic Kubler-Ross stages of denial and anger. They skipped bargaining, depression and acceptance of responsibility to land squarely on “it’s not my fault”.
Consider these pathetic excuses: (1) the Capital Health region no longer exists. So what? Its successor organization, Alberta Health Services, does. (2) Alberta Health Services has clear transparent expense account rules. That’s nice, how do we know they’re working? And the most telling and feeble excuse of them all from Fred Horne: (3) “I was not the Minister of Health in 2007.** True…but the government in which Minister Horne holds a cabinet post was in power in 2007 and is accountable for any and all transgressions that occurred on its watch.
This is a bedrock principle of corporate governance. If successor organizations and successor officials are not held accountable for misdeeds that occurred in the past, they would simply avoid all liability by a never-ending cycle of reorganization. Take the BP Macondo rig explosion that killed 11 people. Using this argument, BP could avoid all responsibility by simply replacing the vice president in charge of operations and rolling the culpable business unit into another corporate entity.
It doesn’t work that way for business and it cannot work that way for government.
What to do
Albertans must wait for the next election cycle before they can replace this government, but we’re not entirely helpless.
The opposition parties are pushing for a full forensic audit of healthcare expenses right back to 2005. The government argues this is not necessary because, to quote Minister Horne: “We have a single health authority with a single set of rules, open and transparent rules that allow Albertans to verify that this situation could not happen and is not happening in Alberta today”.** (With that remark Mr Horne walked into another buzz-saw—under his watch Alberta Health Services reimbursed Alison Tonge, a former AHS executive, for diagnostic services provided at a private, not public clinic).
To put it simply: All the rules, policies and procedures in the world will not instill good judgment and an ethical conscience in those who lack it in the first place.
A forensic audit of all the senior managers and executives at Alberta Health Services, including those who’ve worked their way up through its predecessor organizations, is essential to ensure that the pattern of Tory patronage has not packed the AHS with people who wouldn’t know an ethical dilemma if it smacked them upside the head.
And just to be clear, I’m not saying Ms Lahey should not be able to go to the Mayo Clinic for a second opinion. It’s her life and if she needs additional assurance so be it. But the cost of her piece of mind should come out of her own pocket book, not ours.
Mini Soapbox’s visit to the Mayo
Welcome Art at Mayo
(photo credit “Mini”)
And how is Mini? She received excellent care at the Mayo. The doctors, nurses, staff and volunteers (many of them former Mayo employees) were kind, courteous and efficient. She has a treatment plan and is well on the way to good health. Thank you for asking.
*Ms Weatherill disputes Ms Lahey’s version of the facts but took one for Team PC and paid the $7,232.
** Hansard, Apr 16, 1828.
Susan on the Soapbox 
In another corporate irresponsibility case, RBC vs Foreign Temporary Workers – I suggested to the RBC they should read their own RBC Letter from March 1948. Still relevant in both cases.
http://www.rbc.com/aboutus/letter/march1948.html
As I overheard my grandfather sometimes saying – “Figures never lie but liars can sure figure”. Politicians need to recover their understanding of the human condition to which they so often are afflicted with. The love of power overcomes the power of love to care for others.
Bruce, thank you for sending the 1948 RBC letter. Every CEO and every politician should read it and take heed–the principles set out in that letter are, as you point out, still applicable today. I found this sentence was particularly compelling: Business does not wait for others to make its moralities. It not only polices itself to a large extent, but it is constantly trying to set higher standards. Never before was there such a keen feeling of the responsibility of corporations to stockholders, customers, employees and the public. If the private sector and the political sector held themselves to these ideals we wouldn’t be wasting our time fighting over $7000 in improper expenses, we’d be creating a better life for everyone.
Hi Susan,
I am glad Mini (but not Minor)-Soapbox is doing well. The Mayo Clinic is supposed to be a fabulous place and you both did the loving thing by taking Mini there. Children are about the most essential matters aren’t they?
A story like yours makes it sharply clear the division in ethics and logic between ordinary citizens and the Tories who have been in power too long.
I suggest we all get involved in politics –at first in minor ways by contributing financially to other political parties and then stepping up our citizen efforts, by working for candidates, by writing honestly about politics, by indicating to our politicians that they are to represent us and if they don’t, well too bad –so sad–they will get fired at the next election opportunity. The only power citizens have is the ability to fire the folks who abuse the public purse and disintegrate the public trust. It is sad and hard we have to wait four years before we get rid of the folks who are obviously lacking what it takes to lead the province or the country but I try to think of the four years as educational time. I get to learn the political system and the political animal. It is very interesting.
But the mess in politics isn’t entirely the fault of the political parties. We have been absentee bosses and the employees are now badly trained and even AWOL.
The mess in politics is due to the lack of efforts by citizens (apathy); a media that has systematically failed to uphold democracy in the province by kowtowing to the Tories and diluting the truth to hockey, lies and sucking up; a propaganda machine that infiltrates at all levels from chatter in schools to the street; and unfortunately we have in Alberta– a rather cowardly, flaccid group of folks who find it easier (like I have) to be heifers and steers. This type of citizen group behavior has to change and we have to start to think about the folks we hire and fire them when they have basically given away our resources for decades.
The Tory party has been a plague of locusts upon Albertans but their time is almost over.
Lets spend the next four years contemplating Alberta with a full harvest of bitumen dollars for our children.
An increase in the royalty rate and increased corporate taxes installed by the next political party we hire for the job of government should solve all the past forty years and more of incompetent fiscal management, direct and arrogant pork barrel politics, cronyism and god knows what other corruptions that we will only find out by doing the investigations ourselves of the political system at all levels.
It is a worthy project and something every citizen should do in their spare time (investigate the government that is). I encourage you all to do what I do –which is lift the table cloth and see the legs under the table of government.
Julie, excellent comments. I especially like your realistic suggestions for taking action now to ensure that this morally bankrupt government is gone after the next election cycle. Your identification of our responsibility for this sad state of affairs was bang on. We too must take accountability for being disengaged and ill-informed. Having said that I’d never count you in that “cowardly flaccid group” of Albertans who’ve been too self absorbed or lazy to speak up. I read your blog regularly and know that you personally hold politicians accountable when they’ve crossed a line. If we all get engaged now, just as you suggest, the PCs will be gone after the next election.
My sister received a diagnosis that left her with no hope. She went to the Mayo, they did a bunch of operations and goodness knows what else. She left easily $30000 there. A few month later, what the Canadian doctors had told her turned out to be true. She was indeed incurable. We all sing the praises of the Mayo, but they’ll take your money even when it is pretty damn clear that they are blowing smoke. MB Health had the correct diagnosis, but there is always someone willing to sell you something you want, isn’t there.
I am sorry to hear about your sister. It is tragic that the Mayo was not able to help. In our case, we couldn’t even get to the diagnosis stage and our daughter was getting worse. We were lucky we could go to the Mayo to get matters resolved. One of the physicians treating my daughter told her that Calgary had two of the best GI specialists in North America. There’s no question that we have excellent doctors in Alberta. The difficulty is that so many of us can’t get access to care, while others (as we now know from the queue jumping inquiry) receive the care they need by making a well placed phone call.
I am glad that Mini is doing better and it seems on the way to full health.
Although I respect the Mayo Clinic, like SM I have serious reservations about their ethics. Any and I mean any organization that does something for profit these days, puts their bank accounts before anything at all. With very few exceptions, corporations are no examples of ethics or morals or even competence. I believe they were at a certain time right after the Second World War, but suggesting that in today’s world is not something I can agree with. I am quite certain that the Mayo clinic would have known that SM’s sister was very sick but getting an extra 30 thousand in a situation when they know people are emotionally vulnerable, is easy money. I know from experience that even here in Alberta operations are being done that are unnecessary and sometimes even dangerous to people. Doctors go ahead and do them anyway for the fee that comes from an endless purse.
We live in a society that due to political ideology has evolved into extreme individualism and the results are becoming obvious. Canada is not the best example yet but just looking into the US we see our future very clearly. Just like people are now endlessly debating the reasons behind the atrocious act of two young men in Boston last week, we should also do the same analysis why is it that corruption at all levels of government and corporate power are endemic and everywhere even in the so called first world. I guess first world now means that we were the first to get where we are.
I am now in the last phase in my life, entering my senior years and I feel radicalized from a society that refuses to do anything to leave this world in better shape than what we found. I feel ashamed as an adult of what I am witnessing right here in Edmonton, with politicians behaving like brainless clowns. Lies after lies, cover my ass after cover my as and statements that makes one wonder if suddenly the water has some heavy metal that is making us all incompetent.
I fully agree with Julie and Susan about the apathy but that again is the result of the same message. Over and over even from our police services of ‘Do not get involved – just leave and call police’. Well the intentions are good but the results catastrophic. With the alienation and the do not get involved message because we take care of it, citizens are totally uninterested. I am sure some of you have tried to get involved and you know the resulsts. Nothing goes no where.
So the frustration levels increase, people are angry, there is no escape valve, democracy is a joke, the elites and corporations have trillions in money that have not paid taxes stashed around the world and people have no escape from this and have no choice but swallow it and build up stress slowly but surely. Again experts wonder why mental disorders are on the rise.
It is a great joke.
Carlos, you’re right, these are very difficult times. I’m especially worried about our children. They’re working hard trying to get a good education so that they can get good jobs but these jobs seem to have dried up. Bizarre when our economy is supposed to be booming. My girls both have good undergraduate degrees but that’s not enough anymore so they’ve gone back to school for more training. I’m also trying to help two recent graduates get connected with people in industry but so far they’re not having any luck. This is why we need to look at politics from a social perspective as you suggest and not from a strictly business focused perspective as our government seems to believe.
Susan these are not difficult times, these are abhorrent times. The problem is that it is not difficult at all to realize what is going on. There is a profound legal robbery from the powerful and we are all sleeping waiting for someone to come rescue us. Guess what, they will have no problem taking the rest of it even it means the same levels of poverty we see in other countries. Of this I have no doubts. So fighting back is the ONLY way. For those that think God will help us, just think again.
Here is my favorite activist in Canada
Almost three months has passed since my daughter and I started our journey to the Mayo. The blog brought back lots of memories of the five days we spent in Rochester. I tried to figure out what might have gone through the mind of Ms. Lahey and what she may have observed in her trip. Could she have brought back some “lessons learned”, some ideas of how to improve Alberta Health, or why Mayo is different than any experience in Alberta?
I observed a number of behaviours that started mounting, day after day and in different situations that explained how deep and all encompassing the culture and attitudes associated with Mayo and everyone, however associated with the facility carried deep in their hearts. Ms. Lahey did not appear to learn or report of the things I noticed as a novice observer. If she had, the money she spent may actually have been worthwhile.
I first noticing things were different when we boarded the commuter plane from Minneapolis to Rochester. It only held perhaps 75 people and the flight attendants walked slowly down the aisle talking to a number of passengers. I overheard one of the attendants talking to a passenger just in front of me. She was very calm and reassuring and explained how they would keep a special eye on them. She then did the same to a couple across the aisle and I started to realize that this was not an ordinary planeload of passengers…many of them were carrying special medical devices, wheelchairs, and other things that seriously ill patients need to have by their sides. This was like a flight to Lourdes where miraculous healings can occur. (As it turned out, the ministry that started in Rochester before Mayo arrived was indeed called “Sisters of Saint Francis of the Congregation of Our Lady of Lourdes”)
Our first encounter at Mayo was at 6:30 am where we had to meet with Admissions to put down a deposit of $5,000. For some reason, both my credit cards would not process properly. The lady thought it might be her equipment and suggested that, given Mini Soapboxes first appointment was at 7 am, we should be on our way. She asked if I could stop by later on in the day to make the payment. By comparison, if an AHC appointment is fouled up, the patient is often blamed, or put to the end of the list to wait again for months (as was our daughter).
Over the next few days, I spent a lot of time hanging out at Mayo. I started noticing volunteers in their blue vests helping patients find their way around and managed to chat with a couple of them. The first, started working at Mayo in 1967, retired 40 years later and immediately started to volunteer as she loved the spirit and camaraderie. The second volunteer, who guided us through the heritage museum, was the niece of one of the Sisters who joined forces with Dr. Mayo in the 1880’s. There are more than 500 such volunteers. Any organization that can bring back retirees as volunteers speaks volumes…how many volunteers at AHS are retirees?
One large open space in the Clinic had a beautiful black grand piano in the centre with a small note beside it. The piano was donated by a grateful patient and was to be used to play “soothing and peaceful music” by anyone who felt the need. One afternoon, I saw a senior citizen at the piano bench, while a medical resident was standing beside, playing a banjo in accompaniment. There were more than 100 people watching and finally applauding when they finished and left after five minutes…what an uplifting experience.
A few days later I was in the bar at our hotel and overheard a couple of young waitresses talking about a familiar couple who just checked in. One girl explained she was torn up about this “love/hate feeling”. While she loved seeing the couple, she wished she would not see them again because it would mean they were better…such humanity for such a young age.
Dr. Mayo and the Sisters started with a very simple motto which is still entrenched in all thought and activity today. “The needs of the patient come first”. Perhaps Ms. Lahey did try to bring that message back to her fellow executives, but I think they messed with it a bit to now read “The needs of the executives come first”. It’s too bad the compassion, the humanity and the notions of service that need to be embedded at the executive level of AHS cannot match the culture of the non profit Mayo clinic and indeed everyone associated with it, from waitresses to medical staff.
Hello Susan. Mare just brought your blog to my attention. It is great. As regards AHS executives, both their special access to out of country health consultation and their expenses and “at risk” bonuses ( at risk of what one might ask?) , the more attention that is given to this the better. I am still waiting impatiently to hear of Ms Wetherill’s expenses. I do think the public deserves to know what she expensed since she was so generous to others in her office. Avalon Roberts
Thank you Avalon. You hit the nail on the head with your comment about Ms Weatherill’s expenses. Her spendthrift executives would not have dreamed of submitting expense claims for butlers and Mercedes maintenance (Mr Merali, CFO) or trips to the Mayo Clinic and “dreamy” dinners (Ms Lahey, COO) unless they were convinced Ms Weatherill would approve them. The fact that the government has not compelled Ms Weatherill and her board of directors to produce these records is appalling. I look forward to meeting you and Mare soon!