Fresh from an executive MBA study tour of the Danish health care system, medical administrator David Butcher took a break from his work backlog in Prince George, B.C., to reflect on what lessons Copenhagen might hold for Canada.
What struck him most, Dr. Butcher said, was the degree of co-operation between practitioners, institutions and the different levels of government in Denmark.
Allowing students to step outside their established way of thinking is one of the aims of this August's exchange, and generally the alliance with Copenhagen, say Sauder administrators.
Dr. Butcher elaborates on what he learned: "For instance, when a person is referred to a hospital, and then returns to their home community [in Denmark], they have worked out how to ensure there is accountability at the local level to receive that person back, to make sure they have the services they need – whether they be home-care services, whether they be residential services," said Dr. Butcher, vice-president of medicine and clinical services for the Northern Health Authority in B.C. and a student in the specialized EMBA health-care program at the University of British Columbia's Sauder School of Business.
"Here, when somebody needs to move through the system – be it from the emergency room into an acute-care bed, or from an acute-care bed into residential care or even to return home – more often than not, we get the experience of pushing on a closed door. The next level of care ... tends to push back and say, 'Wait, we're full,' so we get the phenomenon of people sort of lying in corridors waiting to move to the next level."
While both countries have universal health care and common concerns about cost, accessibility and efficiency, their systems are structured quite differently, with more centralized control and prescriptive policy-making in Denmark. It would be simplistic to assume that Danish practices could just be imported and replicated in Canada, Dr. Butcher said.
"Having said that, I would dearly love to be able to adopt some of their thinking around the way they have built incentives for moving patients through the system effectively," Dr. Butcher said.
This is just the type of thinking that Robert Smith, a veteran Canadian health care executive and adjunct professor at Sauder, was hoping to stimulate with the inaugural health-care EMBA exchange between UBC's business school and the Copenhagen School of Business.
"Whenever students have an opportunity to step outside of the world they understand and experience a study tour such as the one we had with CBS, it gives them the opportunity to look at things through a different lens," said Mr. Smith, Canadian tour leader and former president and chief executive officer of the Fraser Health Authority in B.C.
Between lectures at the Copenhagen Business School, Mr. Smith's nine-member entourage met front-line health-care workers, senior government policy makers and medical specialists. They toured hospitals and a seniors' residence, peppering their hosts with questions and weighing what they learned against their own practical experience in the Canadian medical, pharmaceutical, health-care management and mental-health fields.
Mr. Smith expects the research and analysis will continue long after his EMBA students' return to Canada.
Earlier this year, Sauder and the Copenhagen Business School announced a strategic alliance "that will allow our institutions to innovate together for the benefit of our students, faculty and researchers in support of businesses and organizations in Canada and around the world," Sauder Dean Daniel Muzyka said at the time. "This represents yet another important move for Sauder toward creating an international platform for learning and research," he said.
Bruce Wiesner, associate dean of executive education at Sauder, said UBC's EMBA students are increasingly demanding a global perspective in addition to a first-class business education.
"It means more than just world-class content," Mr. Wiesner said. "It means creative delivery options. One way is bringing in speakers from around the globe, bringing the world to Sauder. The other way is to bring our Sauder students to the world."
Dr. Butcher said many of the business skills he and other physicians need as they are promoted up the ranks are not taught in medical school. "To be an effective member of the management team, you really need that skill set. If someone's career trajectory takes them into the management side of health care, then an MBA is an invaluable tool, although it's not the only tool, in order to take on these kinds of roles."
Dr. Butcher's Northern Health Authority serves more than 300,000 people scattered over 600,000 square kilometers in Northern B.C. He has a clinical background in family medicine, and continues as a general practitioner and anesthetist in addition to his administrative role, which has him constantly on the look-out for best practices that will improve medical care for the communities under his jurisdiction.
"As a medical professional, I started out looking after patients one by one," he said in an interview.
"As I have moved through my career, it is more focused on trying to make the system work better for patients collectively."
Special to The Globe and Mail