Value for Money through Effective Stewardship.

The respondents all raised valuable, informative points in response to our Invited Essay. There was convergence around the need to alter governance structures at the same time as payment arrangements for physicians to achieve higher-performing health systems within Canada. At the same time, there were different views on how best to address the disconnect between levels of physician remuneration and accountability for healthcare performance and delivery.

Doctors and Canadian Medicare: Improving Accountability and Performance.

Physician compensation has been a rapidly growing segment of healthcare costs in Canada since the late 1990s. In comparative terms, Canadian physicians are now well compensated compared to physicians in other high-income countries. This has caused provincial governments to begin constraining physician remuneration.

Comparison of the effect of two different bone-targeted radiofrequency ablation (RFA) systems alone and in combination with percutaneous vertebroplasty (PVP) on the biomechanical stability of the metastatic spine.

Introduction: Radiofrequency ablation (RFA) and percutaneous vertebroplasty (PVP) are used independently and in combination to treat metastatically involved vertebrae with the aim of relieving pain, reducing tumour burden and providing bony mechanical stabilization.

Purpose: The aim of this work was to characterize the effect of two bone-targeted RFA devices, alone and in combination with PVP, to improve strength and mechanical stability in vertebrae with osteolytic metastatic disease.

Methods: Simulated spinal metastases (n = 12) were treated with one of two bone-targeted RFA devices (bipolar cooled or bone coil RF electrodes), followed by PVP.

Helical coil electrode radiofrequency ablation designed for application in osteolytic vertebral tumors--initial evaluation in a porcine model.

Background Context: Radiofrequency ablation (RFA) is emerging as a complementary treatment for vertebral metastases. Traditional RFA induces frictional heating leading to local tissue necrosis but often yields small, incomplete, and inhomogeneous zones of ablation in bone. We have developed a new bone-specific RFA electrode that uses a nontraditional frequency (27.

Provincial and regional accountability for performance is critical in non-integrated health systems.

Clinical integration based on care paths and clinical information at the patient level is critical to ensure quality care. Moreover, effective clinical integration can occur in non-integrated health delivery systems. However, one of the challenges of a lack of integration at the system level is that no one organization or provider is responsible for an individual patient's journey.