Sample of the article by Dr. Robert Gagnon which appeared in The Montreal Gazette at www.montrealgazette.com on July 25, 2009

Recent articles and letters in The Gazette describing pregnancy cases at the Royal Victoria Hospital of the McGill University Health Centre (MUHC) might lead some readers to believe that overcrowded emergency rooms and staff shortages are to blame for the lack of support and compassion that certain patients feel they received.
As the recently appointed director of obstetrics at the MUHC, a professor, researcher and parent, I share these families' concerns, and I respect the significance of their personal traumas. To suggest, however, that this is the norm at the MUHC is both unfair and inaccurate.

The MUHC is one of the most comprehensive centres for peri-conceptional, infertility, pregnancy, newborn, child and adult care in Quebec. Since the Royal Victoria Hospital first opened its doors, it has brought close to half a million babies into the world, trained generations of health-care professionals, and conducted invaluable research. Some births are precipitous, others involve hours of labour, still others require medical interventions such as caesarean sections or complex in-utero surgeries to save mother and child. Other cases involve in-vitro fertilization and other assisted-reproduction technologies to give the gift of life. In other words, each pregnancy is unique and special.

As a tertiary academic hospital that treats complex and high-risk patients, quality and risk management are priorities. A miscarriage is an emotional and painful experience on many levels. Miscarriage is sadly very common, ending one in eight pregnancies prematurely. When unfortunate events such as this occur, and/or when the MUHC receives a complaint, it follows strict protocols to investigate, to assure that patients and their families receive all the respect, compassion and professionalism to which they are entitled, while we protect patient confidentiality. The MUHC also pursues important maternal and fetal health research to improve pregnancy outcomes, and implements programs that will foster a better care environment.

The MUHC was therefore the first tertiary-care centre in Quebec to implement Management of Obstetrical Risk Efficiently, known as MOREOB, a pan-Canadian program associated with increased safety for pregnant women. In addition, we are now working to establish an innovative Early Pregnancy Assessment Unit to provide care for first-trimester pregnancy problems outside an emergency- room setting. This facility should open later this year.

By nature, hospitals face daily challenges and no one will deny that there will always be room for improvement. The MUHC's remarkable history, however, is a testament to the fact that this institution strives for excellence, and achieves it. That is one of the reasons why I accepted a leadership role in obstetrics. I look at each day as an opportunity to evaluate practices and develop a clinical, research, and teaching model that will anticipate future challenges and meet them.
The MUHC's health-care professionals do an exceptional job of caring for patients. Their dedication should not be overshadowed by unfortunate events that are not the norm. Compassionate, exemplary care matters very much to the MUHC.

Dr. Robert Gagnon is director of obstetrics of the McGill University Health Centre.