On June 7, Dr. Alika Lafontaine, the incoming president of the Canadian Medical Association, will present a session to Saskatchewan physicians titled Hostility in Healthcare: Racism, Working Environments and Culture Change. Dr. Lafontaine’s presentation is just one part of the work of the Saskatchewan Medical Association’s (SMA) Equity, Diversity, and Inclusion Committee which the SMA board crated a couple of years ago.

Since its creation in 2020, the EDI Committee has been raising awareness about racism within the profession. Dr. Lafontaine’s session will be an excellent opportunity for physicians to share experiences and explore the issues with colleagues.

As a member-driven organization representing physicians diverse in ethnic background, religion, and gender, the SMA’s work to promote equity, diversity, and inclusion is of paramount importance, says Prince Albert physician Dr. Nnamdi Ndubuka, who is a member of the EDI Committee. “This work will strengthen our organization and profession. When we’re able to harness the ideas and perspectives of physicians from different backgrounds, it makes us stronger and helps ensure our organizati

Regina family physician Dr. Barb Konstantynowicz chairs the group. She says world events such as the killing of George Floyd by Minneapolis police brought into sharp focus that issues such as racism are systemic – they exist in institutions and affect individuals’ beliefs and biases. “To truly have an organization that is healthy, I think a commitment to advancing EDI is fundamental to the SMA.”

Last year, the EDI committee hired an external contractor to do in-depth interviews with five Saskatchewan physicians who have lived experience with discrimination in order to learn more about the nature and scope of the problem in this province.

Their personal stories were shared with delegates at the 2021 Fall Representative Assembly, as were a series of actions the SMA can take to create a more supportive working environment for all physicians. Through an online survey conducted after the presentation, RA delegates shared their perspectives on – and experiences with – racism, and offered suggestions on how the association should address the issue.

To support the work of the committee, SMA staff are developing a dedicated webpage related to equity, diversity, and inclusion issues and resources, and are arranging learning opportunities for members on a range of topics related to racism – including microaggressions, unconscious bias, and allyship. Dr. Lafontaine’s presentation is the first in a series of educational opportunities the SMA will organize to help build awareness. Dr. Lafontaine is an Indigenous physician from Saskatchewan who has signaled that addressing racism in health care will be a priority during his term as CMA president. 

SMA has long history of assisting physicians

While the creation of an SMA committee dedicated to increasing equity, diversity, and inclusion is relatively recent, the organization has – through its Physician Support Programs – long assisted physician members experiencing racism and prejudice.

“This isn’t new,” says Brenda Senger, SMA’s Director of Physician Support Programs. “The difference is we have now said, ‘This is important enough to provide targeted resources and personnel in the workplace.’ ”

At least 54 per cent of all physicians in Saskatchewan are international medical graduates. “Many times those people reach out for support in dealing with the issues they might be facing in a community,” says Senger. “Sometimes they’re the only person of color in some of these small rural areas, so often there isn’t a community for them or their families, culturally. Through our support program, we work to help them – whether that’s with their own physical or mental health, or in navigating their experience of practising medicine in Saskatchewan.”

The SMA Board of Directors has committed to seeing EDI issues as being part of the larger discussion of physician wellness. A half-time Physician Advocate, Equity, Diversity and Inclusion has been created to complement a reorganization of SMA physician support programs.

The SMA’s EDI work also involves collaborations with other health care bodies. The SMA has been discussing the possibility of undertaking a joint survey with the College of Physicians and Surgeons of Saskatchewan. It has also been drawing on some of the educational EDI-related expertise and resources of the College of Medicine.

Appointments, elections reviewed through an EDI lens

The EDI Committee has met twice with the Special Committee on SMA Governance earlier this year to provide guidance on how best to ensure the association’s governance processes are fair, inclusive, and transparent – especially for nominations and elections. It has also offered input to staff who will be leading the SMA’s upcoming negotiations efforts.

Dr. Ndubuka says it’s important the organization reviews the way members are appointed or elected to different boards and committees through an EDI lens, to ensure there are not unintended barriers to participation.

“We need to ensure that these opportunities are open to everyone,” says Dr. Ndubuka. “All members must be encouraged to participate, and we need to support them to acquire and develop the necessary skills and competence to be able to perform effectively as committee members or support members.”

Ensuring EDI language is incorporated into position descriptions is another key step in making the SMA more equitable, diverse, and inclusive, he said. “That is what we want as an organization.”

Drs. Ndubuka and Konstantynowicz both feel a strong personal commitment to the work of the EDI Committee.

“When I encounter issues of discrimination, racism, injustice, bias with our medical profession that are affecting some of our members, it really pains me,” says Dr. Ndubuka. “My heart goes out to those members who have been directly affected by racism and discrimination.”

He acknowledges it will take time to address systemic biases and inequities that are built into existing structures and processes within the health system. “I’ve taken it upon myself to put in the time, on behalf of underrepresented groups, to be a voice for change.”

Dr. Konstantynowicz says that as a child growing up, she witnessed racism in small town Saskatchewan, and again as a young physician in the medical culture.

“I would like to see a world where all people are respected and acknowledged as equal,” says Dr. Konstantynowicz. “And I would love for us to have a medical culture where health care providers don’t make the wrong assumptions about each other and about our patients – where we approach one another with curiosity, openness, and respect.”

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. This article was made possible by the Physician Wellness+ Initiative.