Canada’s doctors must develop and adopt measures of “meaningful accountability” if they’re to rehabilitate their increasingly tarnished reputation, outgoing Canadian Medical Association President Dr. Louis Hugo Francescutti argued Tuesday.
“Fat cats” and “hobby docs” are terms that are increasingly applied to Canadian doctors, while their status as leaders in the health care system substantially declined in the public’s mind between 2003 and 2013, Francescutti said in his valedictory address to the CMA’s 147th annual general meeting.
Lack of compassion
“Patients, I guess, aren’t quite as happy with their doctors as they used to be,” Francescutti said, citing surveys which indicate that the public perception of physicians plummeted with regard to measures ranging from their availability to the quality of their performance.
With respect to compassion, for example, just 35 per cent of Canadians believed doctors were compassionate in a 2013 survey, as compared with 61 per cent in 2003.
“Never, ever, at least in the 30 years that I’ve been practicing medicine, have I felt that there’s a greater need to really stand up and look like the profession that we have the potential to be,” Francescutti said.
Francescutti added international comparisons of the performance of the Canadian health care system are equally unflattering to physicians. In a recent Commonwealth Fund report, Canada only ranked higher than the United States and only because Americans sink far more money into their system. Otherwise, “Canada would rank last.”
If the health care system was viewed as a patient, “I think our patient is kind of traumatized. What we have to do is step up and find ways to make our patient better.”
With respect to compassion, for example, just 35 per cent of Canadians believed doctors were compassionate in a 2013 survey, as compared with 61 per cent in 2003.
Francescutti also noted that a U.S. Institutes of Health report indicated there is in the neighbourhood of US$750-billion in waste within America’s $2.8-trillion health budget.
The same algorithm applied to Canada would suggest that there’s “at least $30-40-50 billion” in health care spending north of the 49th parallel that is “not being used efficiently,” he said.
“Quit pointing the blame at everyone else,” Francescutti told delegates.
New Measures
Among the measures that physicians could adopt to improve the health care system are new accountability models, such as the Cleveland Clinic’s use of one-year contracts to pay physicians, to determine what approach might be suitable for Canada, Francescutti added.
In other developments Tuesday at the CMA’s 147th annual general meeting:
- Former Quebec Premier Jean Charest argued in an education session on readiness for the 2015 federal election that governments around the world are all grappling with the impact of technological change, aging populations, structural changes resulting from the economic crisis of 2008, climate change as it affects economic growth and human health, as well as “unprecedented militarization and radical nationalism.”Among specific challenges faced by the Canadian health care system is designing compensation models that would be suitable for various health care professionals (doctors, nurses, etc.) that provide care, Charest added. Others include finding a way for the federal government to make a contribution to the administrative costs associated with health care, possibly by paying for such costs as they relate to health infrastructure, such as electronic medical records.
- Proponents of “active living” often don’t back up their words with action. Not so Canadian Medical Association President-elect Dr. Cindy Forbes. In fact, the family physician has three medals to prove it, including a gold medal from the C4 200 m. 40+ Women sprint canoe/kayak race, and a pair of bronze medals in K1 and K2 events, at the 8th World Masters Games in Torino, Italy in 2013.Forbes, who hopes to promote more active lifestyles and participation in sports during her tenure as president, which commences in August 2015, also believes Canadians need to turn their attention to developing “national” solutions to some of the endemic problems the health care system faces. “We’ll all be better off” for it, she says.In campaigning for the presidency, Forbes identified positioning the CMA “as the national leader in providing physicians with opportunities to develop and implement practical and effective solutions that will result in improved patient outcomes” at the top of her list of objectives.“We can make this happen through appropriate use of resources, reducing unnecessary tests and procedures, improved information systems, advancing electronic decision and e-Health tools, and national strategies for pharmacare and caring for the elderly,” she added.Other objectives included a promise to “focus on physician wellness and work-life balance as areas of top priority for the CMA,” and to pursue the development of a national physician human resource strategy. An active runner, scratch golfer, paddler and war canoeist, Forbes and husband Greg have two adult daughters, Andrea and Kristie. She also amuses herself gardening and is an aficionado of mystery novels.
- Canada’s Chief of Defence Staff Tom Lawson awarded the Canadian Forces Medallion for Distinguished Services to the CMA for its efforts in providing support to Canadian soldiers during their stint in Afghanistan, particularly the recruitment of physicians willing to serve abroad, the training of medical staff and the provision of treatment to soldiers and their families.
Re-published with permission.
