There are some news items that will leave you shaking your head. Sometimes it is in disbelief. It could be the passing of a celebrity. It could be about a person that does something that makes you say “what were they thinking?”. Welcome to Weiner-Gate.

And this is what brings me to Episode 17 of the Ruminations. Here are some random, assorted news items that had me shaking my head this past couple of weeks.

1. All I need to say is “Governor Rick Perry” and you probably already know why I am in disbelief. The Governor of the great state of Texas seems to be faced with a tough challenge these days. Is he running for President – or isn’t he?

He spent the last week on the road like a travelling road show. Maybe it was more like a circus than anything else. Perry appeared just about anywhere that people were gaga (and I don’t mean Lady Gaga) about his far right conservatism, including an appearance at the Republican Leadership Conference. There was a lot of ego stroking going on.

Meanwhile, back at the ranch, Perry had over 1,000 bills sitting on his desk, awaiting his attention before Sunday.

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Does a patient really know what quality is in health care?

I never thought this was a debate (more on my rationale later) until I participated in a discussion on Twitter last week (#solvePT for those who would like to follow and contribute).

It was a tale of contrasting opinions. Some noted that they didn’t think that the patient could adequately define quality of care, and that there had to be some “objective” means of measuring it. Others remarked that quality and value to the patient may in fact be inter-related. It was also noted that even if you provide a patient with effective care defined by evidence-based guidelines, they still might not feel like there was value – even if the problem was resolved!

Health care providers would benefit from looking at other groups that provide services in a market economy. So what happens with other trades or professions that provide services? And how do their customers define quality?

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The last time a Canadian team won the Stanley Cup was in 1993: the Montreal Canadiens. Since then, hockey’s Holy Grail has had 18 years of living south of the border, far away from it’s historical home. It has taken residence in New York, Detroit, and Chicago, all relatively acceptable as they were in the “Original Six”. But it has also made an appearance in Tampa Bay, Carolina, and Anaheim, locales that are probably more worthy of football than hockey.

Speaking of the Original Six, I will be the first to admit: when I was a kid, I used to be a fan of the Boston Bruins. That was back in an era when they won their last Stanley Cup – 1972. Those were the days of the Phil Esposito, Derek Sanderson, Wayne Cashman, Bobby Orr, and Gerry Cheevers.

Fast forward to 2011. The Bruins were in the Stanley Cup Final, looking for their first win since 1972. Their opponent this year was the Vancouver Canucks, owners of the league’s best record in the regular season. It was an epic series, going to a Game 7 finale. But if you are a Canadian waiting for the Cup to head north once again, the wait will last at least one more year.

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Transparency. It has a way of breeding trust amongst groups and individuals. But there is so little of it anymore – with hidden agendas at every turn – that I think most consumers think it doesn’t even exist anymore.

Those hidden agendas exist throughout health care. But what about the evidence? For example, the data to support consumer direct access to physical therapy has existed for years. All of the “issues” presented by our counterparts simply don’t exist, nor have they in any other country in the world.

So why is it that the legislative powers-that-be aren’t listening?

We actually have that answer. It can be found in the back room finagling and lobbying that consumers and physical therapists alike don’t see and just won’t discuss publicly. Until now.

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