In the mid-80’s, we received a grant to study the effect of continuing education courses on the performance of doctors, developing what we thought was an innovative concept. We sent unidentified standardized patients into the doctors’ offices over the following year to track the course’s impact: did the physicians follow what we thought were best practices, like asking about patients’ smoking habits? Did they routinely check blood pressures even if the presenting problem pointed somewhere else? The research showed not much difference between the course formats (a variety of small or large group teaching techniques) but the course itself? It was, for the most part, successful.

The spectacular innovation of an unannounced visit by a standardized patient though? Not so novel, it turns out. Someone said, “Just like a secret shopper, don’t you think? Like an anonymous restaurant critic?” They didn’t say “big deal,” but I heard it in their voice.

For a dozen hours last week, I was a secret shopper, or maybe a highly interested observer. I’ll tell the story briefly.

One evening last week, my wife complained of a sudden headache, a highly unusual event for her. The symptoms were so severe that the old doc inside me screamed “brain hemorrhage,” a symptom we couldn’t ignore — in her, or in anyone for that matter. An ambulance ride, a CT scan, multiple tests and 12 hours later I’m relieved to say that they found nothing serious, and the headache and its accompanying fear were vanquished.

This story isn’t about the patient though. It isn’t about the reports that we read of the delays and wait times (all of which are true, the product of a health-care system under severe strain). It isn’t even about the crowded, busy ER that evening. (I do have to paint a picture of one patient: a young woman, in a top way too thin for the cold fall air, a bruise prominently on her arm, holding on for dear life to her suitcase. I didn’t listen to her story of course, but one look told it all: Friday night in an inner-city ER.)

No, this story is about none of those, it’s about the health-care team that looked after my wife.

How do you judge the competence of a team? When I worked in Washington, my boss, one of the U.S.’s most respected and thoughtful medical educators, used her white board to answer the question: what do we want our physicians to be? After a few minutes, the little board was filled with five “C’s”: competent, caring, collaborative, current, communicative. Hallmarks of the good physician, any health-care professional and their team, we agreed.

Those five “C’s” were demonstrated all through the long evening and night in the ER: from the paramedics at the door (in under 10 minutes, thanks), to the triage nurse, to the bedside nurses, to the McMaster residents I heard interviewing patients all around us, to the staff doctor himself. Even, I have to say, to a porter, as polite and caring as any member of the team. “You’re going to be OK,” he said to my wife as he left us.

In the opinion of this pretty-seasoned secret shopper, these health professionals passed the five “C” test with flying colours.

Why write this article now? Good question. One, to underline the fact that doctor’s absences from the office are, as often as not, spent in keeping up-to-date, as necessary as eating and sleeping to you and me. Two, we hear enough about the complaints, don’t we? And three, as a shout-out to the staff of this particular ER department, who under what might be described as the most difficult of circumstances (the young woman was just one of dozens and dozens of patients to be seen that night) performed as an amazing team. I might even add another C - Canadian - examples of our great, if strained, healthcare system.he body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.