Physicians calling out racial injustice in health care and advocating for change must also work toward reconciliation with the people who they feel are causing the problems, according to Canadian Medical Association incoming president Dr. Alika Lafontaine.

“Some of the greatest allies in fixing problems can be those who are creating them,” Dr. Lafontaine told Saskatchewan physicians during a virtual session on June 7, 2022, sponsored by the Saskatchewan Medical Association (SMA). “Keeping that door open to let people know there is an opportunity to work past those issues that maybe they weren’t aware of – or maybe they were and didn’t realize the magnitude of their negative impact – that’s something that will lead to better outcomes for everyone. Reconciliation is about transforming who people are and how they treat those around them.

“People do not like coming to hostile workplaces,” Dr. Lafontaine continued. “They do not like feeling when they sit down with patients that they’re going to have a bad experience. Patients don’t like that either. Fixing issues with racialization and the other problems that we have will create better working environments. Everyone will be happier coming to work. Stressing to colleagues that this will lead to a better life for you, too, is something that’s really, really important in health care.”

Dr. Lafontaine spoke on Hostility in Healthcare: Racism, Working Environments and Culture Change. Born and raised in southern Saskatchewan, he is of mixed Indigenous ancestry of Métis, Anishinaabe, Cree and Pacific Islander. He is an award-winning physician and social innovator. 

Dr. Lafontaine’s presentation is helping inform the work of the SMA’s Equity, Diversity, and Inclusion Committee and was the first in a series of educational opportunities the SMA is organizing to build awareness about EDI issues in the medical profession.

During a question-and-answer session, Dr. Barb Konstantynowicz, chair of the EDI Committee and moderator for the SMA event, asked what physicians can do individually and as part of an organization to work toward improvements in the health system.

‘Without truth … there can be no genuine reconciliation.’

Dr. Lafontaine referred to the 2015 final report of the Truth and Reconciliation Commission which stated: “Without truth … there can be no genuine reconciliation.”

“We have to find a way to talk about what really happens,” Dr. Lafontaine said. “We have to find a way to talk about these issues without modifying the content of the discussion to the point that it doesn’t reflect people’s lived reality anymore.”

He noted the talks he gives today would not have happened a decade ago, when he would go on speaking tours throughout Alberta. “At the time 10 years ago, we couldn’t actually say the word ‘racism’ out loud. It would completely turn off the entire audience and we wouldn’t have anyone to talk to. We don’t have that problem today, but if we did have that problem, it would be impossible for us to unpack these issues with any sort of authenticity.”

Dr. Lafontaine was asked how to respond when health authorities themselves don’t appear to recognize the truth about racism in the system. He responded that the health bureaucracy may guide the conduct of physicians to some degree, but it doesn’t control their conduct.

“We can make voluntary choices to improve things without needing the rubber stamp of the places where we work,” he said. “Calling for change or just going ahead and implementing change, within the context of what you can actually control, can have a lot of power.”

He expressed confidence that physicians in Saskatchewan and across Canada are willing to wield that power. “I truly believe if we take the time to understand where people are coming from and if we do our best to understand the stories we hear about racialization and other challenges, I think we truly have a huge opportunity to make a change for ourselves and each other, and also the patients that we serve.”

The Saskatchewan Medical Association 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 Physician Wellness+ Initiative supports various SMA initiatives.