In her inaugural address at the CMA’s Annual General Meeting (AGM) on Aug. 16, incoming president Dr. Kathleen Ross recognized the many challenges facing Canadian health while underscoring the power that physicians have to drive change at the time when it’s needed most.
As a family physician, she’s seen the growing hurdles in the system that are preventing physicians from delivering optimal care, consuming their time and sapping much of their energy and joy of practice. “It has become increasingly difficult to stand up for a system that’s falling down around us,” she said.
But, touching on her local volunteering and global humanitarian work, Dr. Ross highlighted the importance of getting involved as both an antidote to burnout and to help transform health care. “Your voice, your leadership matter more now than ever before,” she said. “Small individual actions, life-altering impacts.”
Looking ahead to her term, she called on members to join her in pressing for change to benefit physicians and patients, including reducing administrative burdens, improving team-based care, streamlining licensure and addressing burnout.
“At this critical juncture, the ability of Canadian physicians to guide and lead health system change today will impact the health and wellness of Canadians for many generations to come,” she said.
DR. KATHLEEN ROSS: Good morning. Bonjour. I want to first thank my predecessors, Dr. Alika Lafontaine and Dr. Smart, for their leadership and advocacy, for sounding the alarm on a health care system in crisis and inspiring hope for our future.
A gracious thank you also to Dr. Condé for his important role as our francophone spokesperson in Quebec. I know I can continue to count on their support, and as well as the board's, as we continue moving forward and building on our strong coalitions and relationships that we've forged in recent years. This is a time to press for change when it's needed most.
Now, over the last year as president-elect I've had the opportunity to meet many of my new colleagues. But as I look forward to engaging more with you in the year ahead, I'm really grateful for this brief opportunity to introduce myself and to share a small part of my personal journey in medicine and leadership.
I am first a daughter, a sister, a wife, a mother to two loving and generous children, and descended from European settlers. My family grounds me. Health care and all aspects related to health is personal for us. My family has struggled with chronic disease management, mental health and addictions, including suicide and the tragic death of my nephew a year ago.
Now, as is so true for many of us, I felt called to medicine. Early exposure to first aid training and Girl Guides and lifeguard training really piqued my interest in helping people in medical distress. Absolutely, I knew I needed to be a doctor; that mending of science and a desire to serve others was truly undeniable.
My professional career has been varied from researcher to clinician, from acute to community, from rural to urban and certainly from local to global. In addition to my community family medicine practice, I have harvested kilometers of graft material for open heart surgery and delivered thousands of babies.
To me, there is just nothing better in this world than driving home just as the sun is rising knowing that you've helped a new life into this world. But I also held the hand of patients I've cared for decades delivering them the bad news of a poor prognosis. I've held the hand of those same patients as they lay dying and coached and consoled their families that they leave behind into living a life forever changed.
I acknowledge that it's been both an honour and a privilege to be trusted with these precious moments in the lives of others, but I also know that each of these moments has left a mark, a weight to be carried.
I can assure you that over the course of my career there have always been hurdles in delivering care, but with our health care system now in crisis, significant cracks are making it harder to carry that weight. Cracks when delayed diagnosis led to a young breast cancer patient staying alive just long enough to get married, her last wish.
Cracks filling out form after form over years advocating for a veteran who was ravaged by toxin-related diseases only to have those supports arrive after his death. Being increasingly forced to divert laboring patients to other sites to providers unknown to them simply because our unit doesn't have enough nurses to fill the shift. Cracks.
We know that much has detracted from the practice of medicine over the last several decades from administrative tasks, time pressures, limited resources, inefficient technology and much, much more. I have personally spent night after night awake until midnight doing labs, charts, referrals, care plans, trying to shore up a system that was falling apart around me only to get up the next morning and do it again and again.
Increasing administrative burdens sapped my time, my energy and, frankly, the joy out of caring for patients. In this I know absolutely I am not alone and it is not a surprise to anyone that people are not pursuing family medicine as a career.
Family medicine is the bedrock of our system of care, more cracks, and it is becoming increasingly difficult to stand up for a system that is falling down around us. Yet as Leonard Cohen's ballad goes "There is a crack, a crack in everything. That's how the light gets in". And I do see light.
What has helped me personally in particularly difficult times has been my commitment to be engaged in my community and in my medical community to get involved, to do my part to try and make the world around me better.
From Girl Guides to Scouts to parent advisory committees to coaching sports, empowering and enabling the next generation has been my way of giving back. To share these values globally, I aligned my interests with Rotary International in 2015 to implement community-led health programs from the high Andes mountains of Peru to the savannas of Kenya.
As a reminder of the importance of this work, I carry with me a photo of an adorable baby who is alive because his mother took our first aid course on choking. This is an example of how seemingly small individual actions can have life-altering impacts.
In Peru, I'm known as Doctora Catalina. In a village you cannot drive to I once met another Catalina. She was mother to 12 and extensive invasive breast cancer had ravaged her small frame. Testing and treatment meant taking a long, difficult and expensive trip far away. This was a journey she could neither afford nor had the strength or supports to undertake.
What is doubly heartbreaking is to realize that in our own backyard, many people in rural, remote and Indigenous communities in Canada continue to face these impossibly high hurdles to accessing care, including my own family in northern British Columbia.
Now, each of these experiences has been an irreplaceable lesson and an irreplaceable opportunity. I've been reminded of the importance of looking beyond our immediate view that we see daily and gaining perspective on the challenges that others face – more importantly, our collective role in addressing these challenges. And there are many big challenges in health care to overcome: excessive wait times for investigations and treatment, lack of access, overburdened emergency rooms and closures and health care worker burnout.
Patients continue to struggle to navigate our overly complex system and I see many simply not seeking the care that they need when they should. We recognize also that as physicians we are suffering too, struggling to maintain those human-to-human patient connections, trying to deliver the best care possible despite crumbling systems support.
Now, we know that every system is perfectly designed to get the results that it gets, so if we want different results we are going to have to be prepared to change the way that we do things. Part of this evolution requires that we as physicians speak up and share our experience and knowledge, and drive improvement.
Quality, accessible, equitable and supported primary care is at the core of a strong system of health. Leaning into teams, virtual care and other innovations that support that vision will require upending the status quo and embracing new ways of being.
As we make this shift, we must acknowledge that not all health is medicine. We must consider the role of social determinants of health – food security, education, employment, racism, discrimination and much, much more. And we must absolutely acknowledge the unacceptable barriers to health faced by First Nations, Inuit and Métis Peoples, and we must commit as a profession to do better as we walk the path toward reconciliation.
Solutions will become clearer as we listen to all voices working together with clinical teams, governments, administrators, patient partners and others. When we share and build on our learnings we will progress much more quickly. We will move beyond the "This problem is impossible and unsolvable" mindset to the "How might we?" solutions.
If we're all in this together, and I believe we are all in this together, let's open an honest dialogue with citizens about their health care and what they expect, and what we as physicians aspire to provide.
Together we can move to a future state where change is led by many, a rising tide if you will that raises all boats. While there is much that we can do better, I see existing strengths that we can build on. So, grounded in this space I stand before you committed, supportive of the CMA's impact 2040 strategy, a roadmap for change.
We are also building out our CMA community online to provide more options to connect you to support, resources and opportunities to engage as we push for solutions. The opportunity to connect with you at the height of this crisis will anchor my work over the next 12 months.
Together we will make the necessary strides to reducing administrative burden, improving access to team-based care, implementing pan-Canadian licensure, exploring the question of public and private health care, addressing the systemic causes of physician burnout and much more – all of this work in collaboration with physicians, partner organizations, policymakers, and of course, the patients that we serve.
This is the moment to look up, to become part of something greater than ourselves. And we can each of us do our part to strengthen our community and to strengthen our community of medicine. At this critical juncture the ability of Canadian physicians to guide and lead health system change today will impact the health and wellness of Canadians for generations to come.
Your voice, your leadership matters more now than ever before. Seemingly small individual actions, life-altering impacts. So I encourage you: speak up, lean in, be the light shining through the cracks. Thank you. [SPEAKING IN FOREIGN LANGUAGE]
Manitoba physician Dr. Joss Reimer ratified as president-elect
Dr. Reimer, currently the chief medical officer for the Winnipeg Regional Health Authority, will serve as president-elect until she’s installed as president at the 2024 AGM on May 29.
A strong advocate for wellness, Dr. Reimer’s goal is for physicians to have the necessary resources, support, respect and autonomy to thrive and find joy in their work.
“I want to help create a health care system that allows physicians to provide better care that’s safe, accessible, effective and equitable,” she said in her campaign, “[and] I want that care to be provided in collaborative teams that are diverse, engaged, passionate and valued.”
Owing to a change in the date of the AGM from August to May in 2024, the presidential terms of Drs. Ross and Reimer will overlap by three months. They will each serve for nine months exclusively as president and for three months as co-presidents for the period of May to August 2024.
CMA leadership highlights progress on Impact 2040 strategy, continued work alongside physicians
Members provided input and posed questions to leadership on the actions being taken to address the primary care crisis, enhance health human resource planning, expand health care teams and explore health technology, including artificial intelligence, among other priorities.
Outgoing president Dr. Alika Lafontaine underscored the CMA’s commitment to drive change to benefit the profession and its continued call to governments at all levels to collaborate on shared health challenges, alongside physicians, provincial/territorial medical associations and national health stakeholders.
Board chair Dr. Suzanne Strasberg and CEO Tim Smith also shared upcoming opportunities for physicians to inform the CMA’s work, including consultations on public and private care, the Canadian Conference on Physician Health and the Annual Symposium of Physician Leaders of Quebec.
Evolving how we work: Ongoing governance review
As part of the Governance Committee report, members were invited to learn more about and weigh in on a review of CMA governance, including who’s entitled to vote for CMA president-elect and the role of the CMA past president as chair of the Nominations Committee.
Members who are interested in providing ongoing feedback on CMA governance are asked to email [email protected].