Vol.1 No.2, September 19, 2000

Time is now for federal renewal of health care For the fourth time since becoming health minister, Allan Rock stood The following is a quick look at several issues discussed during the recent meeting of CMA General Council. A a more in front of the CMA annual meeting to defend his government’s detailed report of the meeting is available at www.cma.ca record on health care and to promise that better days were ahead. /inside/annmeet/133/.

Rock acknowledged that many of the elements for attaining sus- New rural policy tainable health care that he presented to General Council were old Delegates unanimously approved a far-reaching new policy news but he said recent circumstances make him optimistic. For the aimed at ensuring “reasonable access to uniform, high quality first time, “all the governments [provincial, territorial and federal] medical care” in rural and remote areas. It contains 28 recom- are talking about the same elements.” The provincial and territorial mendations on training, compensation, work and lifestyle issues premiers met with Prime Minister Jean Chrétien Sept. 11 to final- concerning physicians working in rural and remote areas. Discussion about the policy was relatively brief and centred main- ize the health care renewal platform (details to come in the next ly on the idea — eventually defeated — of adding a recommen- issue of CMA Interface). dation stating that the CMA support the creation of new medical schools in rural areas. “The fact is, every medical school should Rock promised to include physicians in the renewal plans, which have a strong rural component to its training program,” said Dr. would be “neither credible nor feasible without the involvement David Keegan, a family physician in Placentia, Nfld. and support of health care providers.” Delegates, many annoyed at the length of time it has taken to come up with any sort of plan, Full spin ahead were quick to concur. The National Post took some flak from its Southam Inc. sister publi- cation the Gazette for its coverage of the results of an Angus Reid poll done for the CMA and released at the annual “I don’t think the medical meeting. The poll’s main finding was that 83% of those asked profession will tolerate would support spending more on health, either by reallocating being dictated to and it government spending or raising taxes. In an Aug. 18 opinion arti- won’t allow the discussion cle, writer Lyle Stewart took the Post to task for its misleading story to go on without being about the poll results, which surveyed the attitudes of involved,” said Dr. Stephen toward our health care system. The Post story ran under the front Willis of Saint John, NB. page headline: “Poll: 58 per cent would scale back medicare.” Stewart wrote that Quebec’s french-language newspapers were Rock acknowledged it has the most accurate: “Canadians favour raise in health funding.” “taken too long. The process Federal Health Minister Allan Rock and Saskatchewan Premier Delegates speak out against tuition fee increases of working with 13 govern- Roy Romanow General Council delegates passed several motions related to the ments is cumbersome, but increasing cost of medical education. The principal motion, which we are on the verge of putting things into place and acting on them.” was passed unanimously, calls on the federal, provincial and terri- Many delegates were unconvinced, however, believing instead that torial governments to work together to regulate and reduce under- only an election and the requisite “election budget” will pump more graduate medical training tuition fees. "We heard a lot of talk money into the health care system. about physician supply and how it’s an increasing problem in Canada [in previous discussions]," said UBC medical student Delegates attending the annual meeting passed resolutions calling Kevin McLeod as he introduced the motion. "Medical graduates for health-specific federal cash transfers and a national dialogue finishing their training $100 000 in debt further exacerbates this among physicians, governments, the public and others about what problem and drives many to leave Canada." medicare should cover, among other issues.

Interface is available Tel.: 1 800 663-7336 x2700 on the Web Fax: 613 731-1755 A benefit of CMA membership www.cma.ca/cmainterface E-mail: [email protected] Building the brand

As I look to the nology. The CMA must anticipate the ical records still relates to privacy and coming year I see future and position the organization to confidentiality. The CMA is in the fore- two major issues become a major player in e-health. front of policy on privacy in the elec- that we must However, partnerships will be the key. tronic age with our Health Information address with some In a world where “brand value” is Privacy Code, or the “Hippocratic oath urgency. increasingly important, the CMA is in a for the information age,” as Canada’s unique position to provide the leader- privacy commissioner dubbed it. First, we must con- ship necessary to bring together part- tinue to battle to ners with a shared vision for health The CMA is a trusted source and we Peter Barrett ensure that action is information technology and create a must seize the opportunity to become taken now to sustain our health care fully integrated, connected Canadian the quality portal for health informa- system for the future. Much has been health care system. tion. If we can create that value and said and written about this important hold our brand precious, we can provide issue (see page 1) so for the moment I The foundation upon which this new sustainability for our own organization would like to turn to what I see as the health care system will rest is the elec- as we move forward in the 21st century. second vital issue of my presidency. tronic patient record. Patients are increasingly frustrated with the lack of I would very much appreciate hearing A pressing need exists for the CMA to real-time integration between providers, your comments on these issues, as well play a leadership role in bringing physi- institutions and the rest of the health as the continuing work on other CMA cians into the new world of health community. However, the biggest con- business. Contact me through CMA information and communication tech- cern of patients about electronic med- Interface. I will be happy to respond.

“Delegated” comment

CMA Interface wants to be a timely news digest that responds to the interests of CMA members, but learning those interests depends on member input. We hope to reprint your comments regularly and members are encouraged to forward brief opinion articles on issues of interest, as well as suggestions on content and/or design. We received 140 suggestions about Interface from delegates attending the recent CMA annual meeting, including the ones below. We look forward to receiving yours.

“Include comments on political party positions” “This is a great initiative” “Include breaking news and items not appearing in CMAJ” “No need to list president’s schedule” “Continue with political-type news and updates on CMA presi- dent’s activities” “Superficial” “List where and how to find (Internet) links for locums” “Very colourful” “Add more links to Web information and palm-related downloads” “Short articles (easier to read)” “Needs a mini table of contents” “Cover current political issues, poll results, etc.”

(Continued on page 4) Doctors are not immune from pressures of everyday life

The tragic death of Dr. Suzanne Killinger- still forces many to suffer in silence — or Johnson, who leaped in front of a worse, as the recent tragedy in Toronto subway train with her infant son, Cuyler, in showed. Mental health experts say that the August, reminded the public that doctors general lack of understanding about mental are human and face the same pressures as illness — news reports on the death of Dr. Alzheimer site provides everyone else. And physicians who specialize Killinger-Johnson and her physician info in treating doctors say it is not just the pub- son mentioned her luxury lic that needs to be reminded of this. sport utility vehicle, seem- www.alzheimer.ca/alz/content ingly as an example of how /index-physcor-eng.htm “As many as one-third of doctors happy her life should have The Alzheimer Society of will have a major been — continues to feed Canada launched the Physician’s incident of this stigma. Corner section of its Web site depression dur- two weeks ago to complement its ing their careers,” Overcoming years of misunder- authoritative patient site. The said Mamta standing will not happen overnight, new feature provides a wealth of clinical information on: Gautam, an but physician support programs are avail- • Alzheimer’s disease (AD) psychiatrist able in all provinces and territories. Now, and related (non-Alzheimer) who treats doctors. the CMA is also trying to help unite the var- dementias She also adds that ious programs as an extension of its work on • diagnosing AD depression among medical colleagues is a the CMA policy on physician health and • providing support and treat- vastly under-reported problem. well-being. ment for both patients and their caregivers Dr. Derek Puddester, a psychiatrist at the • other available resources, Physician support programs including a listing local Children’s Hospital of Eastern Ontario in by province Ottawa and president of the Canadian Alzheimer’s disease societies Association of Internes and Residents, says Newfoundland and Labrador across Canada 709 754-3007, 800 563-9133 • a reading list, assessment younger physicians tend to be more aware forms and links to other than their older colleagues of the need for a Nova Scotia Web sites healthy balance in their lives. He adds, how- 902 468-8215 (all calls returned Physicians can also post ques- ever, that the realities of being a physician in within 24 hours) tions or concerns to a doctors’ today’s health care system can quickly Prince Edward Island forum and gain access to special- destroy that balance. 902 368-4120 ists from across the country or around the world. The site also “With fewer physicians, greater patient New Brunswick includes helpful links to caregiver 506 635-8410 expectations, and increased severity of illness, and patient information sheets. many physicians give up more of them- Quebec One interesting component of 800 387-4166 Physician’s Corner is the interac- selves,” he said. “For some, that leads down a tive self-evaluation that allows potentially dark and dangerous path.” Ontario doctors to test their knowledge of 416 340-2972 the clinical diagnosis of AD. This Puddester adds that the profession is lucky to Manitoba test uses RealPlayer technology have physician support programs to rely on. 204 237-8320 to run audio and video of patient simulations. Although some of “We are remarkably fortunate to have pro- Saskatchewan the 30 self-evaluation questions grams in every province,” he said. “Without 306 244-2196 demand common sense more that resource, physician morbidity and mor- Alberta than detailed medical experience tality might be tragically higher.” 403 850-1809 involving AD, the quiz does cover many important issues sur- British Columbia rounding treatment. Despite the best advice and availability of 800 663-6729, 250 384-4424 Registration is required for entry help, the stigma attached to mental illness http://www.psp.victoria.bc.ca/ into Physician’s Corner, but there is no charge. Time spent at the site may also count for CME cred- its, but physicians should confirm this with either the College of Family Physicians of Canada or WHERE How can physician support programs the Royal College of Physicians better reach those who need help? and Surgeons of Canada. DOYOU — Steven Wharry, Editor, CMA STAND? Interface Why practice management? “Delegated” comment

MD Practice Management is for any physician (Continued from page 2) interested in running the business of a medical practice better. Through the Practice Management “How about some lighter or Hotline (800 361-9151) CMA members can: humourous material?” • gain access to our practice management consultants and arrange on-site consulting services “Short but sweet” • get seminar and event information and registration details (direct access to CMA “Easy to read, looks good” Meetings & Travel) • find information specifically for residents “Cover current political issues and relevant meetings” • take advantage of the program’s self-learning modules • use the referral network, a listing of local accountants and lawyers familiar with “Bright and easy to read” physician issues and practices “Coverage of rural and remote issues” Practice management hotline The practice management hotline gives CMA members access to our consultants for “Print too small” 30 minutes of free consultation. Questions fielded cover issues such as: “(Continue to print) news-type • setting up a practice items, more information about ser- • office operation — scheduling, phone systems vices for members.” • contracts — locum, association, partnership, hospital-based practice “Information not dated” • human resources — management, salaries, hiring, firing • incorporation “Too brief” • purchasing and/or selling a practice “Provide political information, (such • information technology — what to buy, compatibility, billing software as) status of physician-government • office design and layout agreements”

The Hotline Service is available free of charge to CMA members, but nonmembers “Short, to the point” are also encouraged to make inquiries and learn more about our services (all semi- “Cover workforce and women nars are open to members and nonmembers of the CMA). physician issues” Practice Management hotline, 800 361-9151 “Too short” Practice management consultants return calls within 2 business days. Service is available in English and French, 8 am to 4 pm EST, Monday to Friday. “Add a travel and business corner”

Talking to the media Media calls taken by the Communications and Public Affairs Directorate in August Total: 135 MD–MP Contact Corner Statistics By issue Federal ridings: 301 General Council: 65 MD Contacts: 393 CMAJ: 23 (approx.) Ridings covered: 199 Public requests for information: 84 New MD–MP Contacts Hill Talk will return next month, Peter Hay (Bruce-Grey) with the re-opening of the House Kevin McLeod CMA Interface is published 12 times a year by the of Commons and provincial leg- (Vancouver-Quadra) CMA Communications and Public Affairs and islatures. Gary Randhawa (Kelowna) Professional Development directorates of the CMA. It is printed by Transcontinental Printing Inc., Owen MPs needing Contacts Sound Division, 1749—20th St. E., Owen Sound, Marcel Proulx (Hull-Aylmer) ON N4K 5R2. USPS periodical postage paid at Tony Ianno (Trinity-Spadina) Champlain, NY, and additional locations. CMA Interface is supplied to CMA’s paid-up mem- bers as part of the benefits of membership.

EDITORS Steven Wharry Patrick Sullivan

PRODUCTION CMA Interface wants to hear your comments. Carole Lalonde YOUR 800 663-7336 x2700 Interface is available on the Web Fax 613 731-1755 OPINION www.cma.ca/cmainterface Tel.: 800 663-7336 x2700 © Canadian Medical Association COUNTS Fax: 613 731-1755 ISSN 1492-9317 E-mail: [email protected]