The status quo is not working.
Change must happen.
June 2015 - Vancouver, BC
Meet the real Dr. Brian Day with this "biographical" video:
(Disclaimer: Also having a little fun!)
I have heard from many colleagues regarding their concerns with the way our Association conducted the recent election for President-Elect. As an outsider, but long term member, I shared those concerns. However, it is often the outsider that brings new perspectives aimed at instituting change, and clearly change and a new vision are needed if we want a health system that fulfils its promises to our patients.
Patients are not being served well by our current health system. As doctors we must take a leadership role in creating and implementing creative solutions. My challenge to BC’s doctors is to help make BC’s health system the best in Canada by 2020 – let’s call the plan “Vision 2020”.
The media loves to polarize this as a public versus private debate. It is no such thing. I believe in a strong universal public system. But the current single payer, state operated monopoly (for doctor and hospital services) has failed to achieve that goal. We must change and learn from those who do better. The Commonwealth Fund promotes improved access, quality, and efficiency for society’s most vulnerable, including low-income and minority groups. They rank our system as 10th of 11 developed countries. The top performers (universal access, wider coverage, no wait lists) all have a hybrid system. Even those with a minimal component of private insurance and delivery see that it improves their public system. The European Consumer Powerhouse (a Swedish / Belgian based group) ranks Canada 23rd in quality and last in value for money when compared with 29 European countries that have universal public health systems.
Notable Quotes Regarding Dr. Brian Day
(regarding his tenure as President of the CMA)
"Brian Day was here to listen."
- Dr. Kathryn Bigsby (past-president of the Medical Society of PEI)
"We realized Brian Day's heart is with his patients."
- Dr. Louise Cloutier (chair of the Board of Directors of the Canadian Medical Association from 2004 to 2008)
"We never saw that Brian Day was out for for-profit medicine in Canada. He was out to make sure that Canadians had access to great healthcare."
- Dr. Suzanne Strasberg (past-president of the Ontario Medical Association)
"Brian Day represented us well and he's an intelligent, articulate and good doctor who I think was a tribute to the CMA... He was able to put on the public agenda in an objective, intelligent and unbiased way the whole issue of where we're going in our healthcare system."
- Dr. Colin McMillan (past-president of the Canadian Medical Association)
"I think he's done a great job... a lot of what he has to talk about resonates with many of the physicians in Canada."
- Dr. Shireen Mansouri, Yellowknife
"Brian Day has really allowed people to take off the traditional polarized look at funding in healthcare and taken a patient-centered approach... and starting from our root values as Canadians has built upon that."
- Dr. Shaheed Merani (medical student at the time)
"Brian Day has embraced the initiatives of the CMA such as more doctors, more care."
- Dr. Susan Fair (president of the Manitoba College of Family Physicians)
"Brian Day came as a total unknown to us and I think he's a shining star leaving."
- Dr. Bill Anderson (Chair of the CMA's Political Action Committee)
"It's all about the efficiency of Brian Day's process... all of his talk results in action."
- Dr. Jean-Bernard Trudeau (president of the Québec Medical Association)
Some have, incorrectly, suggested that I do not, or “don’t fully”, support a public-funded health system. I do not support privatization of the system. I do not know a single physician in Canada who does. The media love to focus on that falsehood. We need solutions now for those with serious and chronic illnesses. The private sector is not positioned to accomplish that. There are, for example, no full service private hospitals in Canada. However, in BC we already have an example of an operating hybrid system. WorkSafeBC patients receive timely access to all services. They operate as a private insurance scheme funded by employers. They have effectively added resources to the public system. That is the kind of model we need to explore.
Within Canada, the Wait times Alliance identifies BC as the worst performing province. Over 95% of Canadians believe that their health system needs a major overhaul or complete rebuild. The poor and underprivileged in our system have the worst access and the worst outcomes. The opposite of what it was supposed to accomplish. We can create a better system and doctors must help lead that effort.
Family physicians have too many patients and too great a demand on their time. Most specialists have excessively long waiting lists. Yet, we have newly graduated specialists – over 150 in my specialty alone – who cannot get work because they are denied hospital access. We need more doctors delivering more care to more patients.
Just this week we heard from Health Minister Terry Lake that supply is not keeping pace with demand. His predecessors have acknowledged that sustainability is a major issue. He stated “It can be a frustrating problem to introduce change”. He is right, but change will not come by just waiting and watching. We need to act. Government is trying, but we need to help them do better. I have positive experiences in working with government.
As CMA President I pushed hard for patient focused funding, where funds follow the patient rather than the global funding of hospitals, which treats patients as cost items. The BCMA was the first in Canada to promote this policy, later adopted by the CMA. It empowers patients and realigns priorities in their favour. Your patients, and you, become valued consumers and valued providers respectively.
Let’s not succumb to a divide and rule approach. Rural versus city and specialist versus generalist divisiveness will not help us achieve our goals. Rather, as a united profession, we can help and support each other. I believe there are Doctors of BC policies that need to be re-examined, and we must be transparent as we engage our membership at large in that process.
Doctors want a better health system for all. We must encourage debate, but avoid internal conflict. I am seeking a mandate from BC’s doctors to pursue an agenda aimed at solidifying and further uniting our profession as we seek the reforms necessary to elevate our health system from its lowly ranking.