Medical Practice

I studied medicine in Montreal, where I worked with other students to establish the Point St. Charles Community Clinic. To this day, the clinic is controlled by the patients and community members it serves. It was there I learned about the impact of the “social determinants of health” – many patients could not afford to buy medications, eat nutritious food, or find warm homes. Stable jobs were scarce and this led me to question whether access to healthcare alone was a top priority.

My love for direct patient care brought me to a large emergency department where I became a specialist emergency physician (Royal College Certified). I maintained a full-time practice in the intensity of emergency medicine for more than twelve years.

Risk Management and Conflict Engagement

My interest in risk management in the early 1980’s led to a shift to the medico-legal field. During a ten year period, I learned that adversarial approaches like litigation rarely solve problems and often produce negative learning for all concerned. The lack of learning is a barrier to improving the way care is provided, often with dire consequences for patients.

In the late 1990’s, I trained as a healthcare mediator and founded a mediation services company. Conflict engagement became a passion for me. I brought this focus to my role as Chief Patient Safety Officer in a large urban setting. I learned that traditional approaches to safety often created little change for patients. I began to explore other options.

System Safety and Resilience

I completed my Master’s degree in Human Factors and System Safety at Lund University in Sweden. Under the energetic leadership of Sidney Dekker, the program became a cauldron for thinking about safety in fresh new ways, often stimulated by guest lecturers, including Erik Hollnagel, an innovative leader in the field of resilient healthcare. I applied my new knowledge of system safety and developed a systemic nonlinear method to analyze events (SNAP) and led a team of safety investigators in reviewing more than 1500 clinical cases over a six year period.

The Master’s program at Lund deepened my interest in systems thinking and complexity science and led to my current involvement in the Resilient Health Care Network. The Network’s focus is to advance understanding of the gap between “work as done” and “work as imagined” (often reflected in excruciating detail in policy and procedure manuals).

Teacher and Coach

I enjoy teaching, mentoring and coaching colleagues and students. I have a passion for learning and applying new insights. I am keen to share what I don’t know and explore with colleagues and students possible new perspectives. I am currently working to expand my understanding of the role coaching plays in improving healthcare delivery.

For an overview of my values and world view follow this link to My Philosophy.