Melfort family physician Dr. Eben Strydon was elected president of the Saskatchewan Medical Association (SMA) during a virtual meeting of the 2021 Spring Representative Assembly (RA) on May 7, 2021.

Dr. Strydom is the SMA’s 55^th president, succeeding Dr. Barb Konstantynowicz, who was elected in June 2020 during the first RA held virtually. She will continue to serve on the Board of Directors as past-president. Also elected to the board executive were Dr. John Gjevre as vice-president and Dr. Annette Epp as honorary treasurer.

Members of the SMA board for 2021-22 were elected at the 2021 Spring RA. They are Drs. Pamela Arnold, Geethan Chandran, Patrick Duffy, Andre Grobler, Carla Holinaty, Crystal Litwin, Nnamdi Ndubuka and Roona Sinha. Dr. Konstantynowicz was presented with an SMA Award of Merit.

‘Long road ahead with the pandemic’

In his address to delegates, Dr. Strydom told physicians they still have “a long road ahead with the pandemic,” which has put much of the health-care system on hold. Physicians need to begin to explore solutions and identify resources to address the backlog of services and procedures that have accumulated, he said. They also should refine new patterns of care spawned by the pandemic.

“Virtual care is a shiny new tool in the physician’s toolbox, one that was a lifeline for many patients and physicians, but it is not a cure all,” he said. “Virtual care needs to be managed in a way that we don’t compromise the safety of our patients.”

Maintaining health and wellness for physicians is vital now and will continue to be as the mental health effects of the pandemic become more widely known, or as more physicians seek help, Dr. Strydom added. To that end, the SMA will receive $1 million over four years from the Physician Wellness+ Initiative, a partnership of the Canadian Medical Association, Scotiabank, and MD Financial Management. The money will be used for initiatives that address urgent and ongoing health and wellness needs of physicians and medical learners.

During his one-year term, Dr. Strydom said he will also draw on his experiences as a Melfort physician to advance issues of concern in regional and rural medicine. “I am a doctor in a regional setting, and I see family medicine as the backbone of regional and rural care,” he said.

Rural physicians must be able to develop the skill sets necessary for their work, which includes primary and secondary care. Their patients face wait times for appointments, while some residents don’t have access to a family physician at all. Dr. Strydom said a priority for his term will be to advocate for rural physicians to receive the tools required to care for their patients.

Dr. Strydom noted the SMA Board of Directors has established an Equity, Diversity and Inclusion Committee, which has begun work on an action plan to address issues of racism within the medical community and the health system. The SMA’s Annual General Meeting, held May 8, 2021, focused on anti-racism and discrimination, with a presentation by Dr. Manuela Valle-Castro, director of the Division of Social Accountability with the College of Medicine, University of Saskatchewan. “We have a lot to learn, as a profession, and as the SMA, and I think this is a good start,” Dr. Strydom said.

COVID-19 exposes inequities

In her address to delegates, Dr. Konstantynowicz touched on major issues from her term:

• Seniors and vulnerable populations bore the brunt of the COVID-19 pandemic. Children, teens, and young adults have faced isolation and education challenges, while others had mental health issues. The pandemic exposed inequities in society and in the health system.
• The medical profession is not immune from pandemic depression, anxiety, and stress. The suicide of a Quebec physician brought home the need for physicians to care for themselves and their colleagues. She said the Physician Wellness+ Initiative will make a difference.
• Adapting to virtual meetings and communication by phone or video became a necessity.
• During the past 12 months, the SMA Board of Directors concluded and signed a new MCRC agreement and managed to put on a President and Vice-President’s Tour virtually. Important work on the bylaws and rules review continued.
• The SMA kept its voice in the public when mandatory masking and other public health orders were in question. The SMA also stood firmly against harassment of physicians. Many physicians took to the airwaves and newspapers to present physicians’ concerns to the public.
• Physicians hope for the future with increased knowledge and understanding of COVID-19, but they face backlogs and patients who have been unattended.

CMA honours four Sask. physicians

The Canadian Medical Association (CMA) presented honorary memberships to four Saskatchewan physicians:

• Dr. James Irvine
• Dr. Joe Pfeiffer
• Dr. Rob Weiler
• Dr. Joel Yelland

CMA president Dr. Ann Collins touched on the supports provided to physicians through the SMA and the CMA, including the Physician Wellness+ Initiative. The CMA has also provided funds to the SMA for COVID efforts, long-term care, community hospitals, front-line providers and medical school learners.

In response to the pandemic, the CMA developed its Impact 2040 Strategy, which is a long-term commitment that focuses on:

• A more sustainable, patient-focused health-care system.
• The physical and mental well-being of physicians, with a health system that embraces equity and diversity.
• Equal opportunities for all to be healthy.

Challenging the status quo and means challenging themselves, Dr. Collins told delegates. The CMA is proposing governance changes that reflect the diversity of the profession and ensure all physicians see themselves as represented in the association.

“Physician advocacy is powerful and is something we must leverage now and for future,” she said.

Health minister touts spending in budget

Health Minister Paul Merriman thanked physicians for their dedication to the health system and their patients during the trying circumstances brought on by the pandemic. Physicians adapted through tools such as virtual care, and the government is committed to continuing to provide whatever is needed for physicians to do their jobs, he said

He noted the provincial budget earmarks $890 million for further responses to COVID-19, which will be directed at mass vaccination clinics, PPE, contact tracing, COVID assessment sites and long-term care. Mass vaccinations are enabling a reopening plan that provides a roadmap for residents on how to get through the pandemic, he said.

The budget also built on previous investments in mental health and addictions, acute care, infrastructure, and Saskatchewan Health Authority and Saskatchewan Cancer Agency administration.

Merriman said the five-year contract with physicians, which was ratified in the summer, will maintain competitive compensation and benefits for Saskatchewan’s physicians. He noted work is underway in two areas: To include non-fee-for-service physicians in contract negotiations and to develop a primary care compensation model.

Everett Hindley, the Minister of Mental Health and Addictions, Seniors and Remote Health, followed by also noting expenditures in the budget for addictions and mental health. The government committed to hire more care aides for long-term care and is funding long-term care facilities in Grenfell and La Ronge.

The government, in talks with the SMA, has addressed emergency room hospital coverage in rural Saskatchewan that should provide stability for rural ER services, he said. He hopes new approaches improve physicians’ working conditions and assist in recruitment and retention. He thanked physicians for mobilizing and assisting when rural facilities have been forced to close due to lack of resources.

Governance model proposes 12 Medical Staff Associations

Dr. Briane Scharfstein and Emmanuelle Morin presented a new regional governance structure for the SMA. Delegates endorsed by resolution the proposed Medical Staff Association (MSA) structure with 12 individual associations as presented, a revised MSA constitution to serve as a template for each association, a terms of reference for a proposed Presidents’ Forum, and a request that the SHA revise practitioner staff bylaws committees so that they align with new MSA structure.

Dr. Scharfstein told delegates that much of what was being proposed will enhance alignment with the SHA’s existing division of the province by areas. He believes there is a high level of agreement in the SHA toward the new MSA structure. The next step will be to enhance the ability of physicians in a particular MSA to influence decisions that affect them. To do that the SHA will need to provide proper representation to physicians who are in MSA executive positions, he said.

Transparency and accountability are crucial in the new structure, Dr. Scharfstein added. The expectation is that trust and relationships will build over time. Each association will have its unique challenges, so flexibility has been incorporated into the design of the constitution template, he said.

‘Bolstering self-worth in the face of adversity’

Brenda Senger, Director, Physicians Support Programs, and Jessica Richardson, Clinical Coordinator, Physician Health Program, made a presentation to delegates titled: “Bolstering self-worth in the face of adversity.”

They presented two components of self-worth – recognition of self and validation of self – and outlined strategies for recognizing and validating worth. They showed delegates how to appreciate others in words and in actions, presenting examples of internal and external validation. Physicians should think of themselves as a “human being” and not a “human doing” – or think of themselves as a person who works as a physician but who is not defined by that role and has other interests in life, rather than a person who is a physician first, who has other interests, too.

AGM addresses systemic racism in health system

Dr. Manuela Valle-Castro, director of the Division of Social Accountability with the College of Medicine, University of Saskatchewan, told SMA members attending the Annual General Meeting on May 8, 2021, that anti-racism can enhance their personal and professional development.

The world changed rapidly in 2020, she said. Many people felt alienated by calls to address systemic racism in all facets of society, including medicine. Some feel overwhelmed, exhausted, or confused about what to do, or not do. The goals for her presentation were to provide an understanding of:

• Cultural responsiveness and safety
• Intersectionality: Identifying barriers for equity
• Trauma informed practice

The next meeting of the Representative Assembly – the 2021 Fall RA – is scheduled for Nov. 5-6, 2021.