May 9, 2018

Highlights of the 2018 Spring Representative Assembly

Physicians from across the province gathered to discuss physician wellness, the Saskatchewan Medical Association’s Strategic Plan and a new governance system for the future during the SMA’s biannual Representative Assembly (RA) on May 4-5 in Regina.

Dr. Siva Karunakaran of Regina was elected president of the SMA during the RA. He was inducted during an evening ceremony on May 4, which also featured the announcement of Dr. Bhanu Prasad as the SMA’s 2018 Physician of the Year.

A new Strategic Plan was adopted by RA delegates that will guide the organization from 2018 to 2022. The plan notes that the next three to five years holds great potential for Saskatchewan physicians to be leaders as the health system undergoes tremendous change. The Saskatchewan Health Authority has already incorporated physician leadership at its highest levels.

The Strategic Plan states that the SMA will represent, engage, unite and advocate for physicians so that they thrive in the new health environment.

The mission statement says: “As the common voice of our members, we serve, represent and unite Saskatchewan physicians.

“We advance the honour and integrity of the medical profession; advance the professional, personal, educational, and economic well-being of Saskatchewan physicians; and promote a high-quality, patient-centred health-care system.”

There four pillars of the 2018-2022 Strategic Plan are:

  1. Improve physician wellness
     
  2. Deliver exceptional member-based service
     
  3. Strengthen relationships
     
  4. Grow effective physician leaders

 

President’s address

After his election as president, Dr. Karunakaran noted in a speech to delegates that the practice of family medicine in urban areas is becoming less attractive for medical students. This is due to challenges such as rising overheads, the increasing complexity of an aging population and growing income inequity. But where there are challenges there are also opportunities, he said.

“It is our responsibility to make the practice of family medicine an attractive option to new graduates,” Dr. Karunakaran said. “I cannot imagine patients wanting to go elsewhere for care when they have a respected family physician working diligently to improve their well-being.”

He noted the Saskatchewan Health Authority has physicians in key leadership positions, which bodes well for the profession. Work on SHA bylaws and rules will provide an opportunity to create work environments that treat physicians fairly, he noted, yet keep the focus on patients.

Outgoing president’s address

In her address to delegates and guests, outgoing president Dr. Joanne Sivertson focused her address on the issue of leadership.

Physician leadership was an important component of health care in Saskatchewan during the past year, and she felt physicians were listened to through the establishment of physician advisory networks and ultimately, in the formation of the Saskatchewan Health Authority.

She told delegates that leadership is about service, and she learned during her term as president that it wasn’t about her, but was about her being ready to listen to other physicians.

She urged physicians to step up and be advocates for their patients.

“When doctors speak, people still stop and listen. We are still heard and are influential across the province and in communities.”

Dr. Sivertson later presented Dr. Prasad with his Physician of the Year award.

Minister of Health address

Minister Jim Reiter said recruiting and retaining physicians remains an area of concern, especially in the areas of paediatrics and psychiatry. He has been assured that efforts to recruit paediatricians for the new Children’s Hospital of Saskatchewan are on track, but recruiting psychiatrists continues to be a challenge.

The minister believes while more physicians are needed in some areas, there is also a need to do things better, such as adopting team-based approaches to care and taking innovative approaches to improve patient care.

Accountable care units are starting to show results, he said. Community health centres will allow patients to receive care closer to home, which could reduce ER visits and wait times.

In terms of expanding the scope of practice for pharmacists, he said the government is committed to ensure professions work together. Last year he committed to an evidence-based advisory committee, and by end of June the Ministry of Health will have a proposed committee structure for all parties to look at and provide feedback on.

Physician wellness – Dr. Wendy Gore Hickman, Brenda Senger

Dr. Wendy Gore Hickman recounted her struggles with alcohol abuse and urged delegates to act when they suspect a colleague might be having mental health issues.

“Don’t do nothing,” she said, adding the SMA’s Physician Health Program and other supports in the health system are in place for the benefit of patients.

If a physician suspects a colleague is in trouble, she suggested letting that person know you empathize. Plant a seed and be ready to intervene using the resources of the SMA and the health system.

She added it won’t be easy, and physicians might worry about getting another physician in trouble with his or her employer or regulators. She always said she was fine if approached about her alcohol abuse, but she repeated her suggestion to at least do something, such as call the SMA or someone involved in recovery programs.

Brenda Senger, director, SMA Physician Support Programs, also spoke to delegates on physician wellness. She said physicians have to overcome the stigma associated with mental illness and either seek help or help a colleague who is need.

SHA and its implications for SMA’s regional governance model

Dr. Joanne Sivertson, former SMA president, and Dr. Susan Shaw, chief medical officer of the Saskatchewan Health Authority, co-hosted a session on a new regional government model for the SMA in light of the move to a single health authority.

Dr. Shaw noted that five of the 15 people on the executive leadership team of the SHA are physicians who have been partnered with vice-presidents and will be evaluated on the same basis as the VPs. The first five months of the SHA, which was established Dec. 4, 2017, have involved learning and building the executive and chiefs of staff positions. She suggested to physicians that if they have any concerns to take them where they normally would, or to the SHA VPs, many of whom were in attendance.

In response to a question from Dr. Sivertson on concerns over a loss of regional representation, Dr. Shaw noted the executive and leadership team are scattered across the province. The SHA has six large regions, but is looking for feedback on how these should function.

On the question of bylaws and how these could be improved, Dr. Shaw said a committee is making recommendations on bylaws, which can be amended or improved upon at any time. She suggested bylaws are not a means to manage physicians, as some believe, but are tools needed to create work duties and job descriptions to ensure transparency and fairness.

A final question from Dr. Sivertson concerned the need to focus on physician wellness and find ways to help physicians who are struggling. Dr. Shaw said the SMA’s Physician Support Program is the envy of the country, and the SMA’s new Strategic Plan makes it a primary area of focus.

The RA also collected ideas on a new regional governance model for the SMA from physician delegates who broke up into groups and presented their findings. These responses will form the basis of a report that will be considered by the SMA Board of Directors, with a report back to the RA, possibly in the fall.

On Saturday morning, an in-camera session was held to update delegates on the status of contract negotiations with the provincial government.

The next Representative Assembly will be November 2-3, 2018, at the Hotel Saskatchewan in Regina.

It is our responsibility to make the practice of family medicine an attractive option to new graduates. I cannot imagine patients wanting to go elsewhere for care when they have a respected family physician working diligently to improve their well-being.

Dr. Siva Karunakaran

President, Saskatchewan Medical Association