The Canadian health care system is characterized by a vast number of highly trained and skilled professionals providing countless quality episodes of  health care to millions of Canadians.
Yet Canada by many measures of system effectiveness  among developed nations is close to the bottom in international rankings  for money spent. Within Canada, Manitoba ranks worst among Canadian provinces by some measures, but spends more of the provincial budget on health care than any other Canadian province (43%). So entrenched does the Manitoba system appear that none of the political parties have been able to offer a  solution.  Reform has become  a negative topic on which governments can put forth policy, and in  the 2015 federal election, none of the  presented solutions for systemic problems.

We believe the model of health care presented by Manitoba Bone and Joint Health (MBJH) is a first and essential step needed to revitalize the Canadian health care system, and is achievable and practical. It is a simple concept of placing a patient centred  care framework at the very top of the health care system organizational structure. This  appears to conflict with the existing system of regionally directed health care, but it does not.
The framework we present, can only be put into practice with an understanding of the official and unofficial pathways comprising the current system.
The current system is poorly understood .  Utilization of the framework starts with adoption by government, as no other provincial or federal body is legislated to do this.
As members of the only health care system in the nation, we must be circumspect in our presentation of this framework to Manitoba.
The MBJH presentation on this website, was prepared  and modified over the past decade, and discusses further the nature of the transformative upstream tweak required to stabilize and advance the health care system. During the 2016 Manitoba provincial election campaign, we decided apply principles of the MBJH framework, to a broad approach applicable to the entire provincial health care system. Titled ” Manitoba Model for Patient Centred Health Care”, this will be presented on another site

The Vision

A provincial framework for patient centred musculoskeletal (MSK) care in Manitoba.

The Mission

To use the framework as a template and tool for the health ministry to have a patient centred bidirectional relationship with providers, patients and payers, for effective, progressive, inclusive MSK care.

The Values

Thank you to Cancer Care Manitoba for the following values description.
Patient Focus. Patient focused care, combined with most effective application of human, physical, and financial resources results in best possible individual and population outcomes.
Respect. All involved in providing and receiving care have a contribution to make.
Teamwork. Collaborative and interdependent work, to enhance cooperation.
Leadership. Established and evolving roles and goals for leaders at all levels in the system.
Continuous Learning and Improvement. Positive synergy of coordinated, orchestrated, and evaluated care outperforms dysynergy of fragmented efforts in a system based on scarcity and internal competition.
Stewardship. Responsible use of resources offers the best opportunity to expand and grow capabilities, including public and private resources.
Timing. Regionalization, subspecialization and consolidation continues in the health care system. A provincial MSK framework is the next and essential thing to revitalize the system.

Why the shoulder X-ray was selected for the header

Governments have bolstered orthopaedic hip and knee replacements resources to reduce long wait lists for one group of MSK patients and providers. But Medicare is comprehensive, so MSK care must include the surgical and related management of spine, foot & ankle, upper limb, emergency and geriatric patients
The shoulder was selected to representing “shouldering” the challenge of provincial Bone and Joint Care (responsibility), “putting the shoulder to the wheel” (commitment and perseverance) and “standing shoulder to shoulder” (with all those in the MSK effort). We “stand on the shoulders of giants” (those who have gone before in MSK care).
Functionally, the shoulder is positioned to enable the arm and hand to their work, as a provincial MSK framework enables  comprehensive MSK care provincially.
The human shoulder, between the neck and upper limb, is interdependent with these structures, as MSK is interdependent with the rest of health care.
The shoulder is included in other MSK disciplines, including surgery, anesthesia, radiology, sport medicine, rheumatology, physiatry, neurology, family medicine, cancer care, and the allied health disciplines of nursing, kinesiology, physiotherapy, chiropractic, and massage therapy.
Image credit: “AC Separation XRAY (enhanced)” by Jay F. Cox (2006). Licensed under CC BY 2.5 via Commons