Taking the pulse of provincial health care
The head of Health Quality Ontario wants to improve the experience of all patients
Dr. Joshua Tepper still keeps his stethoscope handy.
He uses it in an active practice that caters on many evenings to marginalized patients in places like Toronto’s Seaton House men’s hostel.
But more and more, the multi-degreed physician is listening to the pulse of the health-care system as a whole.
And in his day job as president and CEO of Health Quality Ontario, Tepper is helping to write new prescriptions for more accountable and responsive medical care across the province.
“I see myself as a family doctor, but one who is really committed to changing the system in which I provide care,” says Tepper, who took over the arm’slength watchdog agency last year.
And in 2015 those systemic changes could include the creation of a new health-care ombudsman in Ontario who would work out of the group’s Bloor St. W. offices.
Legislation creating the office is expected to pass before the new year, says Tepper, 43, whose organization is already charged by Queen’s Park with monitoring and reporting on various aspects of health care.
The ombudsman, he says, would direct aggrieved patients to appropriate authorities and agencies and ensure that just and due processes were followed.
The office would also monitor larger health trends and problems across the system and issue reports on them.
While he has held several health policy positions, Tepper says his continuing clinical practice has had a huge influence on his reform philosophy.
“Most of my clinical care is for people who are really marginalized, people who are refugees, people who are homeless and people for whom the system often does not do as well as it could.
“And so I see my other activities really trying to change the bigger picture so that the one-on-one interactions I have are better.”
Helping to change the communication dynamics between doctors and their patients — and patients and the system — are ambitious projects that Tepper will also try to advance in the new year.
“What I think we want to be doing better now is improving it with the patients and not just for the patients.”
This means giving patients from all social and ethnic groupings a stronger voice in health-care decisions, whether they be systemic or personal, Tepper says.
“It’s not good enough to define (medical care) quality as I see it as a doctor or I see it as a health policy leader. We need to improve quality as the patient understands it and values it as well.”
To this end, Tepper’s group will soon launch both a patient education program and training initiatives for doctors and other health-care providers.
The former will include sessions meant to give representative patients and members of the public a better understanding of the workings and vocabulary of the health-care system.
This will allow these volunteers to be more effective participants on the panels and committees which make decisions on the system’s directions.
A native of Ottawa, Tepper earned a bachelor’s degree in public policy from North Carolina’s Duke University and a master’s in public health from Harvard.
He received his medical degree from Hamilton’s McMaster University and recently completed an MBA at Western University.
Despite those managerial credentials, Tepper insists on continuing to practise medicine. “People sort of say, ‘Why don’t you stop being a doctor and just do this big stuff?’ and it’s probably because of two reasons,” Tepper says.
“One is society sort of paid for my medical education and that was a huge gift (and) I need to continue to use the skills that society paid for.
“And the second is that it’s just tremendously rewarding.”