While the COVID-19 pandemic is a terrible storm, it has also revealed the inherent good in people, Saskatchewan Medical Association (SMA) president Dr. Eben Strydom told delegates to the 2021 Fall Representative Assembly (RA).

“I marvel at how much strength physicians and health-care workers have shown over the past 19 months,” Dr. Strydom said during his address to the RA, which was held virtually on Friday, Nov. 5, 2021.

“The past 601 days have tested everyone to varying degrees and the pandemic challenges have made us all see things with new eyes, and from differing perspectives,” he said. “You should all be proud. What I see consistently these days is physicians doing their utmost to provide care to their patients, despite exceptionally challenging circumstances.”

While vaccinations are the single best means to the end of the pandemic, physicians have also been at the forefront asking for additional public health measures to blunt the effect of the fourth wave, Dr. Strydom added. Physician voices have appeared on social media, TV news and radio, and in print media providing credible health information. This advocacy is an important and inspiring contribution to the health of the province, he said.

“The SMA has been advocating for physicians throughout this pandemic and will continue to do so as long as the health of our patients and the well-being of our health system demands it,” he said. Every passing day of inaction prolongs the burden on the health-care system, he said.

“Wave 4 is not only about the unvaccinated. It is about the stress and strain being put on a system because of the unvaccinated, a strain which is borne by everyone. There is also collateral damage on our system: unprecedented low levels of morale and an erosion of trust in elected officials. When political leaders and the medical profession are aligned, a stronger, clearer message is sent about what needs to be done.”

Physicians are tired but need to stay healthy and look after themselves, Dr. Strydom noted, adding the SMA’s Physician Health Program is available to provide support.

(Click here to read Dr. Eben Strydom’s president’s address, and click here to view the address.)

Racism in medicine: ‘Narratives from Saskatchewan physicians’

Lorelei Nickel interviewed five Saskatchewan physicians from diverse backgrounds and perspectives for her presentation: “Narratives from Saskatchewan Physicians.” She is a faculty member at the University of Saskatchewan, Edwards School of Business, where she teaches strategy, ethics, and leadership. She is an equity, diversity, and inclusion (EDI) champion at the U of S, a founding member of Edwards’ EDI Collective, and board chair of Global Gathering Place, a newcomer settlement agency in Saskatoon. (Click here to view the presentation.)

Nickel told RA delegates that the physicians talked candidly about their experiences with racism, what it looks and feels like to them, how it is manifested, and how they came to understand it. Physicians should keep in mind that just because something isn’t happening to them personally doesn’t mean it isn’t happening to others, she said.

The participating physicians told her what they thought was needed to bring about meaningful and lasting change, and the role the SMA could play. They were asked what they want of their colleagues in the medical community, what other physicians could do and how they could respond.

Nickel said racism is systemic and socialized in society. Indigenous people experience systemic racism, while people from other countries face xenophobic attitudes. The physicians interviewed said racism is ingrained in Canada; for example they must establish their credentials and keep proving themselves, while others get a smoother path in their careers.

She urged physicians to acknowledge the existence of racism and xenophobia as a starting point. The medical profession needs a cultural revolution to change a pervasive culture of fear and loneliness. Physicians are hardest on each other, leaving feelings of being devalued and dehumanized, she said. Physicians need to be intentional about addressing racism; they need to commit themselves to engaging their colleagues and making change a priority.

Nickel noted the five physicians say the SMA is well-positioned to be a voice of influence, but it needs to serve and unite all physicians in the province. The SMA should focus on fellowship and unity, creating an enabling environment where everyone is supported. She presented the following recommendations to the SMA:

1. Provide more physician, student, and resident supports and resources.
2. Facilitate diversity and inclusion in the SMA and on committees while being cognizant of tokenism and the “saviour syndrome.”
3. Equip, enable, and empower all physicians to call out racism and discrimination.
4. Develop the system infrastructure to support this cultural shift.
5. Share stories and highlight what is working but do your due diligence when it comes to who and what is being celebrated.
6. Provide further mentorship, orientation, and integration support.
7. Improve competency assessment and training.

The SMA appreciates funding from Scotiabank, MD Financial and the Canadian Medical Association as part of their Physician Wellness+ Initiative to address the urgent, ongoing health and wellness needs of our medical community. The SMA is grateful for the sponsorship of this session.

Next steps for SMA governance review

The SMA Board of Directors has discussed SMA governance since the 2021 Spring RA, where delegates supported a resolution calling for an external review. The board has considered current processes, models and structures, and reviewed approaches used by other provincial medical associations. SMA CEO Bonnie Brossart made a presentation to delegates titled: “SMA Governance: Overview, Review and Proposed Next Steps.” (Click here to view the presentation.)

The proposed next steps, which were endorsed at the 2021 Fall RA, included the establishment of a five-member Special SMA Governance Committee comprised of RA delegates. The committee will propose recommendations on governance processes to improve SMA transparency and accountability at the 2022 Spring RA on May 6-7, 2022. Committee members will be selected by the end of November.

Physician of the Year, leaders honoured

Physician leaders were honoured and service awards presented during the 2021 Fall RA.

• Dr. Breanna Davis of Prince Albert is the 2021 SMA Physician of the Year.
• Leadership awards for 2021 were presented to Dr. Michael Bayda, Physician Leader of the Year; Dr. Amit Persad, Resident Leader of the Year; and Carissa McGuin, Student Leader of the Year.
• Retiring chairs of SMA committees were recognized: Dr. Bruce Berscheid, Insurance Committee; Dr. Peter Butt, Physician Health Program Committee; and Dr. Larry Sandomirsky, Committee of Rural and Regional Practice.
• Former Board of Directors members were also acknowledged: Dr. Naeem Parvez and Dr. Allan Woo, also a former SMA president.

Ministers of health address delegates

Health Minister Paul Merriman acknowledged physicians are feeling the strain of the pandemic, and he expressed gratitude for the care they are providing through challenges that are affecting their ability to respond to all their patients’ needs.

He told RA delegates the government is aware that physicians have adapted to extraordinary circumstances, noting three million virtual care appointments have been logged; physicians have covered in ICUs, public health, and clinics in the north; they have stepped into leadership roles; and they have been public advocates for vaccinations.

The government hopes to engage with the SMA as plans develop to resume services that have been cancelled during the pandemic, he added.

Everett Hindley, Minister of Mental Health and Addictions, Seniors and Rural and Remote Health, noted physicians and health-care workers are serving patients at the expense of their own health. The government recognizes burnout is an issue and he urged physicians to make use of resources that are available, such as the SMA’s Physicians Support Programs.

He said the pandemic has disrupted many aspects of health care, including access to services in rural Saskatchewan. Difficult decisions have been made to postpone some services, he said. In rural Saskatchewan physicians have taken on additional duties, such as emergency coverage, which the government appreciates.

In the area of mental health, he noted overdoses and overdose deaths have increased during the pandemic. The government has increased funding for mobile services and access to support for detox and treatment beds, with a commitment to add 150 beds over the next three years, he told delegates.

(Click here to view the session, including a question and answer period.)

‘The Human Cost of Providing Care’

Brenda Senger, Director, SMA Physicians Support Programs, and Jessica Richardson, Clinical Coordinator, Physician Health Program, made a presentation to delegates titled: “The Human Cost of Providing Care.” (Click here to view the presentation.) Highlights include:

• Physicians need to value themselves, acknowledge what they do well, and acknowledge others and the things they do well to assist them in their work.
• Physicians may be experiencing compassion fatigue. They should ask themselves when they last had a conversation that did not involve COVID-19. While they are caring for others, is there anyone caring for them?
• During the pandemic physicians may face moral injury when forced to decide who receives care, or when they know care they are providing is substandard.
• Resiliency is a quality that can be learned and strengthened. Physicians should “name it and tame it,” identify what they need to do to function and change how they manage it.
• Physicians need to reconnect – to remember the reasons why they got into the profession as well as reconnect with colleagues.
• The transition from work to home is difficult for some, but physicians need to separate the two. They should establish their own self care by doing activities that help them make that transition.