November/December 2014 - Alberta Medical Association

Transcription

Alberta Doctors'
DIGEST
November-December 2014 | Volume 39 | Number 6
Fall Representative
Forum/Annual
General Meeting
Hard at work on the road to a
better health care system
Emerging Leaders in Health
Promotion Grant recipient
focuses on obesity and children
Don’t just stand there!
The AMA Youth Run Club 2014
fall launch is happening now
Tarrant Scholarship focuses
on rural commitment
Two medical students step up
to the challenge
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CONTENTS
DEPARTMENTS
Patients First® is a registered trademark
of the Alberta Medical Association.
Alberta Doctors’ Digest is published
six times annually by the Alberta
Medical Association for its members.
Editor:
Dennis W. Jirsch, MD, PhD
4 From the Editor
1 8 Health Law Update
20 Mind Your Own Business
26 Dr. Gadget
Co-Editor:
Alexander H.G. Paterson, MB ChB,
MD, FRCP, FACP
FEATURES
Editor-in-Chief:
Marvin Polis
President:
Richard G.R. Johnston, MD, MBA, FRCPC
President-Elect:
Carl W. Nohr, MDCM, PhD, FRCSC, FACS
Immediate Past President:
Allan S. Garbutt, PhD, MD, CCFP
Alberta Medical Association
12230 106 Ave NW
Edmonton AB T5N 3Z1
T 780.482.2626 TF 1.800.272.9680
F 780.482.5445
[email protected]
www.albertadoctors.org
28 PFSP Perspectives
34 In a Different Vein
39 Classified Advertisements
6 Fall Representative Forum/Annual General Meeting
Hard at work on the road to a better health care system
22 Don’t just stand there!
The AMA Youth Run Club 2014 fall launch is happening now
24 Tarrant Scholarship focuses on rural commitment
Two medical students step up to the challenge
30 Emerging Leaders in Health Promotion Grant recipient
focuses on obesity and children
32 The role of Alberta physicians in the formation
of the Medical Council of Canada
January-February issue deadline: December 12
The opinions expressed in Alberta Doctors’ Digest
are those of the authors and do not necessarily reflect
the opinions or positions of the Alberta Medical
Association or its Board of Directors. The association
reserves the right to edit all letters to the editor.
The Alberta Medical Association assumes no
responsibility or liability for damages arising
from any error or omission or from the use of any
information or advice contained in Alberta Doctors’
Digest. Advertisements included in Alberta Doctors’
Digest are not necessarily endorsed by the Alberta
Medical Association.
© 2014 by the Alberta Medical Association
Design by Backstreet Communications
COVER PHOTO: Dr. Richard G.R. Johnston was installed as Alberta Medical Association president
on September 20. ( provided by Curtis Comeau Photography)
CORRECTIONS: In the September-October issue of Alberta Doctors' Digest cover story regarding
influenza immunization for health workers, Dr. Kevin Hay was said to be an MD.
This is incorrect. His correct credentials are MB, BCh, BAO, MRCPI, CCFP.
In the September-October issue of Alberta Doctors' Digest we carried a survey
regarding results from a recent Readership Survey. Due to a production error,
the explanatory legends were missing for the charts included in the story. We
apologize for the error. If you have any questions regarding the survey, please
contact [email protected] and she will happily provide any
information you desire.
AMA MISSION STATEMENT
The AMA stands as an advocate for its physician
members, providing leadership and support for
their role in the provision of quality health care.
NOVEMBER - DECEMBER 2014
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FROM THE EDITOR
Contingency plans
Dennis W. Jirsch, MD, PhD | EDITOR
I
saw recently in the
newspaper that
Dr. Duckett had been
in town.1 The same
Dr. Duckett (PhD) who
was chief executive officer
(CEO) of Alberta Health
Services (AHS) from its
inception in 2008 until his untimely departure in the
spring of 2010. The same Dr. Duckett who mapped out
closures, amalgamations, terminations and so on. Most
remember the “cookie episode” in which he balked,
peevishly, at reporters trying to grill him, with, “I’m eating
my cookie.” It’s still on YouTube, but it was the end for
Dr. Duckett and he was canned forthwith.
Since then we’ve had three premiers, as many ministers
of health and a couple of AHS CEOs. The Duckett cookie
incident seems ancient, given our rate of change, and we
presently have a shiny new premier fighting “entitlement”
and bearing glad tidings. Add to the mix an ex-mayor
health minister bringing promises of quick solutions to
interminable health system challenges. “This isn’t rocket
science,” he says.2
So much and so little has changed. I wonder why former
CEO Duckett has returned, even to lecture. The time he
spent here several years ago must seem like a bad trip
on a rocket.
I gather Dr. Duckett spoke at the University of Alberta.
Newspapers covering the lecture said he cautioned
his audience that Alberta’s inattention to things fiscal
and the healthy income from oil were hampering, nay
interfering, with innovation or creativity.
Pretty self-evident, I think, and this warrants a “Duh”
response. Still, I wish I could have heard him myself,
hoping for something juicier in his recollections of
rattlesnake country.
What keeps him coming back? Real estate that won’t sell,
friendships, university ties or maybe an acquired fondness
for snow? Or is Dr. Duckett urged back by academic types
to give us the view from a remove, as it were?
AMA - ALBERTA DOCTORS’ DIGEST
I want to know what it was like riding the juggernaut
of massive systemic change. His marching orders were
clear: pull, and pull hard at the levers of change ¬ the
“r’s” of regionalization, restructuring, reengineering,
rationing, rostering and so on. The notion of course
is that the “r’s” would all save money. Dr. Duckett
was looking for a billion dollars in savings as I recall,
$250 million a year for four years.
I wonder why former Alberta Health
Services CEO, Duckett has returned, even to
lecture. The time he spent here several years
ago must seem like a bad trip on a rocket.
He was well on his way, and the truth is that the good
economist was doing things that would save money,
would save money without a doubt, and he was beginning
to grapple with the daunting administrative behemoth
he’d been saddled with.
Whether the public and the professions could swallow
his bitter pills of restructuring and so on was another
question. They couldn’t and they reacted loudly. The
tumult became too strident, too bitter and too prolonged.
The honchos in charge pulled the plug and he was gone.
Consider for a minute, however, that Duckett, his board
chair, the health minister, and the premier too must have
had frank discussions in camera ¬ yes most assuredly
in camera, regarding Duckett’s plans for change. I bet
hours were spent mulling the likely “pushback” from
the professions and the proletariat too. I suspect they
thought it wouldn’t go too badly, would dissipate in time.
I can see the general clapping of hands, tub thumping
and thumping on shoulders too that attended these
sessions, with assurances all round:
“Duckett, man, we’re with you all the way.” >
> They were with him that is until the going got rough,
with headlines trumpeting the agony and mischief that
would attend this or that amalgamation of services.
Consider for a moment the power structures at play
for the CEO.
First, there’s the obvious ¬ “political” ¬ power: the
government and the echelons of ministers and party
faithful. Consider that these same worthies were eager
short years ago, that something be done to right past
wrongs, in which the two largest duchies and their
princes and princesses ¬ Edmonton and Calgary ¬ had
become too autonomous, too powerful and too littlekingdom-ish in their own right. Imagine the cries for a
stop to this evil. And curb expenses too. I hear the faint
echoes of former premier Klein and his cryptic promise
of a Third Way. Imagine the politicos and their cries for
change and cost savings. Imagine too their twitchiness,
their pistol-at-the-hip readiness.
Whether the public and the
professions could swallow his bitter pills of
restructuring and so on was another question.
They couldn’t and they reacted loudly.
takes ¬ with the most assertive members of each of the
groups. Still it’s often a short ride for CEOs, especially for
the ones that are more open, more candid, less ardent
students of Machiavelli.
Back to Dr. Duckett. I heard him just once. He stood
down a lion’s den of doctors, apprising them of things
coming down the pike. I didn’t like the things he said.
I didn’t like the inattention to living, breathing souls
with this or that disruption, but as I’ve said, they were
initiatives that hell-or-high-water would save money and
the doctor-economist stood his ground. He didn’t flinch.
He’s most assuredly come to know
the perilous nature of power.
It’s my memory of this presentation that makes me want
to cozy up to him for tea. In particular, I want to know
what he learned from his (assumed) bad trip, if that’s not
too personal a question. He’s most assuredly come to
know the perilous nature of power. I see that Dr. Duckett
is now employed by the Grattan Institute, a public policy
think tank in Australia.
I like to think this means he likely had a “plan,” an escape
hatch all along.
If the politicos have power, so too do the professions. All
of them. Think front-line folk ¬ nurses, docs and the like.
Feeble maybe in ones and twos but when they clamor in
unison they can bring things to a standstill. Think strikes,
walk-outs, sick days, etc. Poke a stick at the professions,
rile them sufficiently to unite, march on the legislature,
and if they point at him, a CEO can be gone at the drop
of, well, a cookie crumb.
The need for a plan “B” is, I think, the main thing to
learn from this saga. Whether one is CEO, a lower-tier
executive, a new hire in one of the professions, or
something in between, it’s just good sense to have a plan
B and possibly plans C and D. Bureaucrats learn this early,
knowing that with the next putsch or the one after, they
will be looking at jobs in Waskabush, remote territories,
even junkets to Sierra Leone. The band plays on.
People ¬ the electorate ¬ are the main source of power.
Their representation on the evanescent uber-board of
the AHS (now you see it, now you don’t), has been at all
times missing, and the token gesture of AHS community
advisory groups must annoy them thoroughly. But don’t
underestimate the citizenry. Rankle them in sufficient
number, get them to howl in protest in headline-making
numbers, and the politicos will sense the resolve of
rank-and-file democracy, will act pronto to stop the clamor.
Docs should listen too. Medicine has long been a harbor
of sorts, but as displaced gynecologists, ophthalmologists
and others can attest, the “times they are a changing.”
It’s no real push to imagine the CEO as potential lamb in
this knotty undertaking. See him then, trying to cut costs
whilst holding at bay nervous political masters, unruly
professions, and a public wary of being hoodwinked,
and experience the crucible of Duckett’s former world.
There’s nothing new here. Past CEOs, the wily ones, the
ones with atavistic tribal tendencies, will have found that
it is helpful to develop pacts, relationships ¬ whatever it
So get a plan B. It’s one of life’s biggest lessons.
That’s it. I want to have tea with Dr. Duckett and I’d like
to talk of plan B.
I’ll bring the cookies.
References
1. http://www.edmontonjournal.com/Alberta+wealth+politics+
blame+rise+health+costs+Duckett/10192812/story.html
2. http://www.calgaryherald.com/news/politics/health+minist
er+targets+long+term+care+crunch/10229383/story.html
5
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FALL RF/AGM
Change, progress and
looking forward
Highlights follow from the valedictory
address of outgoing President
Dr. Allan S. Garbutt. Dr. Garbutt’s term
began September 28, 2013 and ended
September 20.
was not exactly the kind of change
we were hoping and looking for.
Turmoil at the top resulted in
paralysis in the ranks. Few of our
desired changes came to pass, not
because we did not try, but because
we could not get commitments from
our partners in government.
Hopefully, the new premier and
health minister will bring stability and
constructive engagement.
I have had some contact with
Premier Prentice. I am hopeful that
he will work with the AMA and all
the other stakeholders to propel our
health system forward through the
multiple changes that will be required
to provide the health care system
Albertans will need in the second and
third decades of this century.
Dr. Allan S. Garbutt
( provided by Curtis Comeau Photography)
Last year, as I assumed the
presidency, I spoke about the
ways in which the Alberta Medical
Association (AMA) would work with
government to change the way health
care is delivered in Alberta. I spoke
about “a lot of change.”
Well, we certainly got change. So
far this year, there have been three
premiers, two health ministers and
numerous heads of Alberta Health
Services (AHS). Unfortunately, that
As I already said, this past year did
not provide us with the change we
had been hoping for.
But, that is not to say we did not get
some progress on many fronts. The
AMA has many good people, both
in our professional and volunteer
groups, working hard to advance
the ideas that we believe will help
us create the health system that we
will need in 10, 15 or 20 years when
the baby boomers move from being
providers of health care to being
consumers of health care.
For example, the Physician
Compensation Committee (PCC) has
spent much of the past year working
out the ground rules on how it will
operate. It has made some rulings in
areas where decisions absolutely had
to be made, such as the allocation
for this past year. It is now beginning
to look at some (fewer than 1%) of
the codes in the Schedule of Medical
Benefits (SOMB). Even that baby step
has provided a predictable degree of
angst and anxiety among those who
are affected.
So far this year, there
have been three premiers,
two health ministers and
numerous heads of Alberta
Health Services (AHS).
Unfortunately, that was not
exactly the kind of change we
were hoping and looking for.
PCC is working hard, and your
representatives are an integral part
of that effort, to fairly review and
evaluate more than 3,400 codes in
the SOMB. There will undoubtedly
be some growing pains as we move
along the path to a revised billing
schedule that is appropriate for the
evolving health care system we are
working to deliver. >
> When the work is completed, and
that will take several years, we should
have a new SOMB that will fairly
remunerate all physicians, regardless
of where or how they work. This will
undoubtedly mean that some groups
see payment decreases while others
get increases. The processes we use
to make those decisions have to be
fair, transparent and based on good
evidence and input from those who
will be affected. While these changes
will be painful for some, it is a process
that must be completed so we can
match physician work to the changing
needs of a changing society.
Primary care networks (PCNs) and
PCN Evolution are a start on this,
and they will continue to evolve so
that primary care moves forward to a
team-based care model designed to
deal with chronic diseases. This will
require that we bring secondary and
tertiary care into coordinated work
with what has been thought of as
primary care.
Further changes will be needed for
our system of primary care, if we are
to care for our aging population. That
need is not unique to Alberta. Indeed
the Canadian Medical Association
recently put out a call for a national
strategy to care for the seniors of
the future, which includes, (I hate to
admit) myself.
The AMA vision draws heavily
on the medical home model, which
was endorsed by the national
bodies for both family physicians
and nurses. There are dedicated
physicians working on all of these,
and many more, areas. The AMA is
supporting them, and will continue to
do so, with expertise, technical skills,
and finances.
Alberta Health has finally released
its Primary Care Strategy, after many
years in development. This looks as
if it will blend well with the AMA’s
efforts in primary care evolution.
Hopefully, the new
premier and health
minister will bring stability
and constructive engagement.
When we combine our vision and
ability with willing partners in
Alberta Health, AHS, the College and
Association of Registered Nurses of
Alberta, United Nurses of Alberta,
Alberta Pharmacists’ Association and
many others, I am sure we can create
the health care system that the next
few decades will require.
Finally, I would like to welcome
Dr. Rick Johnson to his new role
as AMA president. I hope you will
enjoy your year. It is an unforgettable
experience.
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7
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FALL RF/AGM
Enhancing patient care,
increasing physician satisfaction
Highlights follow from the installation
comments of President Dr. Richard G.R.
Johnston. Dr. Johnston’s term began
September 20.
As many of you know, I have been
very involved in negotiations and
agreement implementation for the
Alberta Medical Association (AMA)
for 20 years. The opportunity to
represent the doctors of Alberta at
the highest level will be a privilege
and a delight.
The recent changes in government
will certainly bring challenges and
opportunities in the next months. I
look forward to working with those
new members of government, the
new members of Alberta Health
and Alberta Health Services, and
the physicians of Alberta to create
changes that will enhance patient
care and improve physicians’
satisfaction with the practice
of medicine.
Dr. Richard G.R. Johnston
( provided by Curtis Comeau Photography)
I would like to thank the members
of my profession for entrusting this
position to me for the next year.
I have always considered the practice
of medicine to be an enormous
privilege and a lot of fun. I would like
to find a way to make every physician
feel this way. I truly believe that if
we focus on doing what is best for
our patients that we will be able to
find a way to work with government
to maintain our professional
I look forward to
working with those new
members of government,
the new members of Alberta
Health and Alberta Health
Services, and the physicians
of Alberta to create
changes that will enhance
patient care and improve
physicians’ satisfaction with
the practice of medicine.
independence and provide a good
standard of living for our families.
Editor’s note:
For more thoughts from the AMA’s
new president, please view his video
at http://youtu.be/PTOSzxQPI7Y
FALL RF/AGM
Dr. Carl W. Nohr
2014-15 PRESIDENT
2014-15 PRESIDENT-ELECT
Dr. Richard G.R. Johnston,
an Edmonton-based
intensivist, is the Alberta
Medical Association’s
(AMA’s) 2014-15 president.
Dr. Johnston received his
MD, with distinction, from
the University of Alberta
in 1977. In 2002 he
received an MBA from
the Ivey Business School
at the University of
Western Ontario.
His awards include
the Mewburn Memorial Gold Medal in Surgery, the
University of Alberta Undergraduate Prize, the Allan
Coates Rankin Prize in Bacteriology and the Sam
Fefferman Memorial Gold Medal in Honors Physics.
Dr. Johnston is a clinical professor in the Department
of Anesthesiology and Division of Critical Care in the
Faculty of Medicine and Dentistry at the University of
Alberta. He is also a member of attending staff in adult
intensive care at the Royal Alexandra Hospital.
Previously, his positions included Chief of Critical Care
at the Royal Alexandra Hospital and Director of the
University of Alberta’s Division of Critical Care Medicine.
An active AMA member, Dr. Johnston has served as:
• Co-chair, Secretariat of Trilateral Agreement (2008-11)
• Chair, AMA Negotiating Committee (1997-2013)
• Member, committees administering the negotiated
agreements (1993-2012)
• Representative to Canadian Medical Association,
Health Policy and Economics Committee (1993-98)
• Member, Board of Directors (1993-96)
• Chair, Finance Committee (1998), Co-chair, Finance
Committee (1999-2003), member, Subcommittee on
Finance (1993-96)
His contributions to the association and the profession
have been recognized with the AMA’s Long-Service
Award (2004).
Medicine Hat surgeon
Dr. Carl W. Nohr is
the Alberta Medical
Association (AMA)
president-elect. He
assumed the office
during the annual general
meeting September 20
in Calgary.
Dr. Nohr has had a
notable record as a
general surgeon, clinical
teacher and administrative
leader. Clinically, he is
active in practice, and is the site chief for general surgery
and endoscopy for the south-east zone.
He has a diverse record of service to the profession.
He has been heavily involved in his local medical staff
association for many years. He has served as a member
of council of the College of Physicians & Surgeons of
Alberta (CPSA), sitting on the college’s Finance, Medical
Informatics and other committees. He served in the
Physician Achievement Review Program of CPSA for over
a decade. He was the chair of the Legislation Committee
of the college until resigning to assume the office of
president-elect of the AMA.
AMA members will know him as the respected Speaker
of the Representative Forum (RF) since 2012, and chair
of the RF Planning Group. He was the AMA co-chair of
the joint AMA-Alberta Health Services (AHS) working
group to establish the AHS Medical Staff Bylaws and
Rules. He has been an AMA representative on the
Provincial Physician Liaison Forum and Canadian Medical
Association General Council delegation. Other service
included the Physician and Family Support Program
Advisory Board, Nominating Committee, Council of
Presidents of the regional medical organizations and
geographic delegate to the Representative Forum.
Service to the profession is both a duty and an honor,
says Dr. Nohr. “It is a privilege to counsel with colleagues
and other leaders about our health care system, and how
it can best be managed to put Patients First®.”
9
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FALL RF/AGM
Recognizing outstanding
achievement in health care
T
he Alberta Medical
Association (AMA)
Achievement Awards were
created to honor physicians and
non-physicians alike for their
contributions to quality health
care in Alberta. The Medal for
Distinguished Service and the Medal
of Honor are the highest awards
presented by the AMA.
Medal for Distinguished Service
The AMA Medal for Distinguished
Service is given to physicians who
have demonstrated an unwavering
commitment to their communities
and passion for their work. This
year, three recipients have made
outstanding contributions to the
medical profession and to the people
of Alberta and, in the process, have
raised standards of medical practice
for our province.
Dr. Donald E.N. Addington
Credited
with putting
Alberta “on the
map” with his
development
in 1989 of
the Calgary
Depression
Scale for
Schizophrenia,
Dr. Donald Addington has
contributed immeasurably to the
art and science of medicine in
Alberta for the past 33 years. His
scale has been translated into 36
languages and is the international
gold standard measure for research
on depression in schizophrenia,
with over 1,000 citations.
He has helped raise the standards of
quality health care, particularly with
respect to programs of psychosis,
in Alberta, Canada and around
the world. Dr. Addington works
to improve patient outcomes by
integrating research, advocacy,
education and clinical practice.
Teaching and mentorship have been
professional and personal priorities
for Dr. Addington.
Dr. Steele C. Brewerton
Since he began
his medical
career in rural
Alberta in
1948, general
practitioner and
obstetrician and
gynecologist
Dr. Steele
Brewerton has
had a distinguished medical career
and life. Dr. Brewerton has lived the
classic image of the country doctor.
He rode in a horse-drawn sleigh a
mile in a snowstorm to deliver a baby
by a kerosene light, saved a drowned
child and carried an ailing, elderly
woman on his back one kilometre
through a blizzard to his car parked
down an impassable road.
Wanting health care accessible to
all, Dr. Brewerton and his partners in
the Raymond and Magrath practices
initiated an early version of a health
care insurance plan, whereby a
family could purchase a contract
for $25 a year. This covered the
costs of any medical care needs
that could arise for the families, and
those who couldn’t afford to pay the
whole amount at once could pay in
instalments.
Dr. Brewerton lives in Cardston,
Alberta.
Dr. Thomas E. Feasby
Dr. Tom Feasby
has been
recognized
as one of the
country’s
most notable
neurologists,
scientific
directors
and medical
leaders. He has worked to create
nationally and internationally
recognized clinical/research
programs and has recruited clinical
and scientific talent to Alberta.
Dr. Feasby has contributed
frequently to the public debate
on key health issues through
opinion-editorial submissions to
major Canadian newspapers, as in
numerous board advisory roles.
In 1993, Dr. Feasby founded the
internationally recognized Calgary
Stroke Program, as well as Calgary’s
Neuromuscular Clinic and the
ALS Clinic. He recruited renowned
clinician scientists to the Calgary
Multiple Sclerosis Clinic resulting
in Canada’s leading MS program.
As dean of the Faculty of Medicine
at the University of Calgary >
> (2007-12), Dr. Feasby worked
to improve Albertans’ access to
family physicians by increasing
the undergraduate medical class
enrolment. Dr. Feasby continues
to practice medicine at the
Urgent Neurology Clinic and the
Neuromuscular Clinic at Foothills
Medical Centre.
Medal of Honor
The AMA Medal of Honor is
presented to non-physicians who
have made significant personal
contributions to ensuring quality
health care for the people of Alberta.
Samuel Weiss, PhD
From his
office at the
Hotchkiss
Brain Institute
(HBI) on the
University
of Calgary
campus,
Dr. Samuel
Weiss oversees
the creation of groundbreaking
programs in neuroscience research,
the resourceful pursuit of new
avenues of philanthropic support
for neuroscience and the building of
new provincial networks, all of which
benefit Albertans and their families
who are struggling to live with the
many health issues associated with
disorders of the nervous system.
After attaining his PhD in chemistry
from the University of Calgary
in 1983, Dr. Weiss pursued
post-doctoral studies in France
and the US before returning to the
University of Calgary in 1988 as an
assistant professor in the Faculty
of Medicine.
An accomplished neuroscientist,
Dr. Weiss is well known for his
seminal discovery in 1992 that neural
stem cells are present in the adult
mammalian central nervous system.
Dr. Weiss’s discovery triggered
aggressive research activity and
excitement about the potential
therapeutic roles of neural stem cells
in treating neurological disorders.
Dr. Weiss’s leading role in the
establishment and operation of
the HBI has raised the standards of
health care in Alberta and influenced
brain and mental health study and
treatment around the world. Known
for his infectious enthusiasm,
Dr. Weiss serves as an inspiring
guide and mentor, as he supervises
a pair of post-doctoral fellows, two
Master of Science students and a
PhD candidate.
Recognizing outstanding service
Each year the Alberta Medical
Association (AMA) and Canadian
Medical Association bestow awards
on a group of dedicated physicians
whose service and contributions to
the association and the profession
have made a significant difference. In
the entries below we highlight
the 2014 recipients, along with
their personal reflections on the value
of service.
AMA Long-Service Award
The AMA Long-Service Award
recognizes physicians with 10 years
of AMA service who contribute
their knowledge, skill and time to
the advancement of the profession.
Their work, whether on the Board
of Directors or its committees,
supports and encourages the
association’s development.
Dr. Richard G. Bergstrom
Cardiac anesthesiology, Edmonton
(No photo available)
What I have found most rewarding is
the integrity of the staff at the AMA
and their hard work at providing
a forum for physicians to advance
the care they provide to patients.
Representative Forum is a respectful
and effective group in which
physicians can debate, discuss and
decide. It is instrumental in helping
the greater physician community
focus on what we do for patients. I
also believe the work on the Council
of Presidents helped with a greater
understanding of the provincial
challenges that the physician
community experiences.
Physicians have an honored
profession in serving patients and
this is enhanced in so many ways
by the work of the AMA. The most
important thing I learned from the
AMA is the idea of “service” and
the focus on a physician community.
The one thing I would tell physicians
early in their career is “get involved
with the AMA” – only good things
will happen.
Dr. Steven M. Edworthy
Rheumatology, Calgary
I particularly enjoyed my time as
the co-chair of the Physician Office
System Program Committee and
as a member of the Information
Management and Information
Technology Committee. I also
found the work as co-chair of the
Information Sharing Framework
Governance Committee rewarding.
The entire process of helping to bring
information technology to physician
offices, including the introduction
of electronic medical records, while
addressing the issues and challenges
of medical professionalism in the new
area of electronic communication,
was exciting and interesting. In
addition, I enjoyed representing
physician views to other stakeholders
such as Alberta Health Services,
Alberta Health and the Canada
Health Infoway.
Being part of the AMA has allowed
me to develop a broader connection
with my profession beyond patient
care. I have deepened friendships
with colleagues across the province.
AMA service has allowed me to feel
a stronger sense of satisfaction with
my career.
Dr. R. Michael Giuffre
Pediatric cardiology, Calgary
My 2012-13
term as
president
occurred during
a pivotal time
for the AMA
and for Alberta
physicians.
Together we
achieved a
seven year, $25 billion agreement
that created certainty, allowed for
long-term planning and defined
programs of critical importance
to patients and physicians going
forward. The AMA/Alberta Health
agreement emphasizing three
critical areas is a renewal effort
going forward including: a provincial
framework for electronic medical
records; primary care evolution
through primary care networks; and
creating efficiencies in our health
care system with tools such as
“Choosing Wisely Canada.” >
11
12
> In Alberta there are only two major
influences on the overall delivery of
health care, the AMA and Alberta
Health Services. Since AHS is now
governed and run by the Alberta
government, AMA is the important
counterbalance and the true voice of
physicians, representing all doctors,
rural and urban, primary care,
specialist and subspecialist, academic
and non-academic. The AMA is the
best at giving a voice to physicians
and at “putting Patients First®.”
Dr. Robert A. Halse
General practice/anesthesia, Ponoka
The Council of Zonal Presidents
presented an opportunity to
network and obtain feedback from
other regions, which had distance
issues. We were then able to share
those experiences with a wider
group of like-minded physicians and
AMA staff.
The AMA is our organization and
works for us. It is our responsibility
as physicians to support the AMA
and work for the association as it
works for us.
Dr. Kevin M. Hay
Specialist in family medicine, Wainwright
Being a part of
Representative
Forum was
a lot of fun
and seeing
how issues
move through
the AMA
process was
enlightening.
The most recent one that has been
really engaging was the Voluntary
Physician Influenza Immunization
Program. I’ve learned so much
through my involvement with the
AMA, but most importantly to enjoy
the dynamism and debate that
comes with the process.
One of the biggest benefits of
being involved in the AMA is the
collegiality. It’s refreshing to realize
that many doctors are facing the
same problems and trying to
figure out solutions. It teaches you
that you’re not alone. We need to
remember that even though some
health care issues seem bleak and
seem to change for the worse as each
year goes by, they will not improve at
all unless we stay involved.
Dr. Susan J. Hutchison
General practice, Edmonton
hardworking and knowledgeable
staff of the AMA.
I have enjoyed
the opportunity
to serve the
profession
through my
participation
in the AMA.
The experience
has allowed
me to
understand how the changing
health care environment impacts on
physicians’ ability to deliver medical
care in Alberta.
Dr. Douglas M. McCarty
Family practice, Edmonton
I hope that I have contributed to
improving the ability of physicians
to deliver quality medical care. I
believe we have a good health care
system, but am of the opinion that
we have the ability to make our
system excellent.
Dr. Alan N. Lin
Plastic surgery, Calgary
My longest service on an AMA
committee is as a member of the
AMA/Workers’ Compensation
Board (WCB) Advisory Committee.
Understanding the challenges
facing physicians in dealing with the
WCB and recognizing the WCB’s
requirements for managing claims
for injured workers is an endeavor
both challenging and rewarding.
I believe the committee’s work thus
far has achieved positive outcomes
for both physicians and the WCB
and I believe additional cooperative
changes in the future will benefit
all the parties involved. I hope that
eventually this will create a better
working relationship with the WCB
and that it will lead to a more timely
provision of health care to workers
and the safe return of workers to
their job sites.
Serving with the AMA has
many benefits for physicians
at any stage in their careers.
Hands-on committee work
provides a physician with greater
understanding of the issues that
collectively impact our profession
than can be realized solely in one’s
practice and provides an opportunity
for a serving physician to advocate
for positive actions and outcomes.
However, the most valuable benefit
of AMA service is in meeting
and working with the wonderful,
I’ve been a member of the Workers’
Compensation Board (WCB)
Negotiating Committee for the
last three contracts and worked
to ensure there was fairness to
everyone on those negotiations.
Dealing with the WCB can be
a complicated process, and it’s
important that physicians are fairly
compensated for their time. But
more than that, I wanted to be there
for my patients so that they get the
care they need and get back to work.
It was a valuable experience because
you get different perspectives and
different opinions. It helps you see
beyond your own cocoon and realize
what other physicians are dealing
with. I tell physicians that if you’re
not involved, then your opinion
isn’t heard and if enough people
are heard, things can change.
Dr. Christine P. Molnar
Radiology/nuclear medicine, Calgary
My most
meaningful
long-term
accomplishment
– which started
in 1993 with
advocacy and
participation
on a ministerial
task force
– has been
working through the AMA Section
of Diagnostic Imaging to bring about
a comprehensive provincial breast
cancer screening program. Serving on
the AMA Board of Directors allows
me to advocate for our profession
and quality patient care. I learned
a lot from other physicians and the
AMA staff and hope we helped to
shape the future of medicine in some
small way.
Service to our profession is
enlightening, instructive and
rewarding. I believe it is also our
professional obligation. With the
AMA you can share and learn from
physicians apart from the groups
that one would typically be aligned
with. Start with what makes your
heart sing. >
> Dr. Rowland T. Nichol
General practice, Calgary
The highlight
of serving the
AMA was
representing it
as its president.
The trust and
responsibility
of guiding the
organization
at that point
of its journey,
acknowledging its history and the
values that the AMA represents
and then translating them into the
solutions to the challenges then
facing it, was an honor.
The AMA works to validate the
individual communities of physicians
while addressing the systemic
issues that face the profession.
The challenge was making sense of
these issues and finding ways for
physicians to see that success could
be achieved by staying united. The
AMA is exemplary in its capacity
to stay focused and is disciplined
while maintaining a values and
principle-based organization. Being
true to your values while striving
to manage the tensions between
self and serving others is one of the
most difficult aspects of leadership.
Participating with the AMA supports
that journey.
Dr. Jasneet K. Parmar
Geriatric medicine, Edmonton
I have served
as the
Edmonton Zone
Medical Staff
Association
(EZMSA)
representative
at the AMA
Representative
Forum for two
years in my
position as president of the EZMSA
and then for a year as Edmonton
Zone representative at the RF. This
opportunity has served as a medium
for advancing many issues requiring
advocacy for the medical staff in
Edmonton, including the physician
Practitioner Advocacy Assistance
Line (PAAL). The RF
is a very good example of a
democratic process.
I see the AMA as physicians helping
physicians to provide the best
advocacy for patients. I have very
much enjoyed my participation
with the AMA and have grown as
a professional and as an individual.
The AMA is one of the finest
organizations I have ever worked
with and it allows me to advocate
for patients, physicians and for a
better health care system.
Dr. Patrick M. Pierse
Pediatrics, Edmonton
What stands
out most
for me was
working
towards
attaining
more equality
between all
physician
groups. It
demonstrated
and formalized that all physicians
had equal worth. There was a lot of
collaboration, as each group within
the AMA helped define what it
meant to be a physician in that area
and it taught us all a lot.
The AMA is one of the most
fantastic organizations I’ve ever
been involved with in my career, in
that their interests are that of the
profession. Everyone at the AMA
is truly working on behalf of
members and committed to you
and your future.
Dr. Jeffery S. Pivnick
Family practice, Calgary
The time I
spent on the
AMA Board of
Directors gave
insight into the
workings of our
membership
organization.
Participation
in decision
making and
in the shaping and interpretation
of government policy that impacts
the medical profession was
both intellectually stimulating
and satisfying. Contributing to
computerization of medical practice
in Alberta is also both instructive
and rewarding.
The AMA Board of Directors’
decision-making process is
remarkable. It brings together
credible and broad-based
information, focused intelligence,
and a willingness to solve problems
with openness to insights. It is
interesting to see how many
different informed opinions from
physicians contribute to final
decision making. Collectively,
physicians are the individuals most
aware of how medical care in Alberta
can be best optimized and what
needs to be done. The AMA is the
expression of this collective voice.
Dr. Daniel R. Ryan
Family practice/addiction
medicine, Edmonton
Although I had
done some
committee
work for the
AMA in the
past, the most
important was
the time leading
up to the
formation of the
Section of Addiction Medicine. The
small group of us that were working
in this area had been trying for years
to involve physicians in the front-line
treatment of these diseases and also
at the policy making level. Becoming
an “official” part of the AMA to give
us credibility and some influence with
the government was very exciting.
I also really enjoyed being the first
Representative Forum delegate for
my section and the total immersion
I experienced at RF. I am amazed at
how well a large group of doctors
can get along and play by the rules.
We as a profession must stay united
to be strong advocates for our
colleagues and our patients.
Dr. Judith K. Ustina
Child and adolescent
psychiatry, Edmonton
The AMA is an
organization
that has inspired
relationship
building to
further patient
care. During my
term as section
head of Child
and Adolescent
Psychiatry,
I created an affiliation agreement
between the Section of General
Psychiatry and the fledgling Section
of Child and Adolescent Psychiatry,
strengthening the ability of both to >
13
14
> make an impact on mental health
issues in Alberta.
The process that the AMA works
through to forge relationships
and build networks in order to
further physicians’ standing in this
province and improve patient care
is exemplary. I have carried with
me the AMA philosophy of respect
for all, encouragement, and truly
hearing all voices, as I know it is
often the dissenting opinions that
guide us to the best decisions.
Dr. Robert S. Warshawski
Diagnostic radiology/nuclear
medicine, Edmonton
Working on the Negotiating
Committee was especially
rewarding, as was my role as
Edmonton representative to the
RF and subsequently chair of the
Section of Diagnostic Imaging with
involvement with RF. I was involved
in the computerization of community
delivery of health care (with emphasis
on radiology) and in educating third
parties about care delivery.
AMA is an advocate for patient
care and has a clearly defined goal
of appropriate health care. We each
have an individual responsibility
to our patients, but we also have
a collective responsibility to the
system as a whole. I came away
from my experience with a much
better understanding of our
responsibility for the welfare
of individual patients and the
entire health care system.
Dr. Eric A. Wasylenko
Rural family medicine/palliative
medicine/clinical ethics, Okotoks
My first
experience
with the AMA
working on the
Professional
Review
Committee
as a resident
31 years ago
still stands
out for me. I also really enjoyed
being the AMA co-chair on four
or five iterations of the Physician
Workforce Planning Group and
representing the AMA as a member
and chair of the Canadian Medical
Association’s (CMA’s) Committee
on Health Policy and Economics. I
helped lead the physician workforce
efforts in the 90s and 2000s to
reverse government efforts to
restrict physician numbers and
opportunities; our groups worked
diligently to protect graduating
physicians from the practice
restrictions, billing numbers and
return for service arrangements
experienced in other provinces.
Being part of the solution, learning
how to advocate with the support
of a strong organization, and
working together with excellent
staff and physicians at the AMA
for the betterment of our patients
and colleagues, has enriched me
as a physician.
AMA Member Emeritus
Dr. William W. (Bill) Anderson
Diagnostic imaging, Edmonton
My presidential
year involved
negotiations,
job action and
eventually
a two-day
“locked down”
negotiation
directly with
the minister.
That long-term agreement set up
our relationship with the government
for the next decade, and saw the
establishment of both the Physician
Office System Program and primary
care networks. The job action proved
that if physicians speak with one
voice and are willing to demonstrate
our commitment, we can achieve
significant improvements in the
system. It hasn’t occurred since,
but it shows future generations how
important the AMA is for physicians
and patients. My two years on the
Standing Policy Committee gave
me a glimpse into how government
really works – influencing policy at
that level was exciting.
Advocacy is a critical role for
physicians and we must continue to
demonstrate to the government, the
public and our patients the benefit
of our health care system and ways
to improve it for future generations.
Health competes with all other
government services for budget
and is always in the spotlight for
reductions.
Dr. Daniel J. Hryciuk
Emergency medicine, St. Albert
I go a long
way back with
the AMA and
I know some
people at the
AMA wonder
why I don’t
just have an
office there.
I sat on several
committees over the years and have
participated in the re-alignment
of the after-hours compensation
for physician services and in the
development of a transparent
allocation process for the AMA.
It is an honor to have worked with
the many exemplary physicians
who volunteer their time to the
committees of the AMA, the RF, and
the AMA board. I am grateful for
the respect and personal friendships
that I have had with everyone that
I have worked with over the past
20 years and continue to work with
now. I’ve learned so much about
the professionalism of Alberta
physicians in their dedication to
the AMA and would encourage all
physicians to volunteer their time at
the AMA.
Critical care and
anesthesiology, Edmonton
My involvement
in negotiating
the long-term
agreements
that allowed
us to create
new practice
models like
primary care
networks, new
payment methods such as
alternative relationship plans,
and the benefit programs to fund
electronic medical records are some
of my proudest achievements. In
1993 the government cut payments
to doctors, even though payments
had been falling behind inflation
for many years. Since then, we
have been able to negotiate >
> increases in fees and funding
while demonstrating the value of
physicians to the public, to the
government and to the members
themselves.
I tell young physicians that if
physicians won’t make time to
manage and run the system,
someone else will. If you choose not
to be involved, you can’t complain
about the outcome. It’s much like a
requirement of democracy, and we
have to get involved.
Dr. D. Jill Konkin
Rural family medicine, Edmonton
I had the
privilege of
being a board
member right
after the major
reorganization
that created the
Representative
Forum and,
along with it, a
much smaller Board of Directors. It
was a stimulating and creative time.
The AMA was in transition with a
new governance and organizational
structure during the time of upheaval
in our health care system after the
first regionalization experiment. That
board accomplished many things of
importance, including the transition
of the AMA to the smaller board.
The implementation of these
changes produced a nimbler, more
responsive organization.
Advocacy is an important role for
a physician. Clearly, advocacy for
our patients, the populations and
communities we serve is paramount.
However, it is also important to
advocate for our colleagues and
for our profession. Back seat
criticism is easy. Finding a way to be
constructively critical and to engage
with one’s colleagues – particularly
those who don’t agree with you – to
find ways to make positive change is
hard work, but also fun and rewarding.
Dr. Dale C. Lien
Internal medicine/pulmonologist,
Edmonton
I have been
involved with
the AMA
since I started
practice here
in Alberta and
have been
continuously
involved
in AMA
activities since
1986, when I began as the AMA
representative for Respiratory
Medicine. Since then, I’ve served as
fees representative for our section,
was involved in the Relative Value
Guide process, and more recently
served as president of the Section of
Respiratory Medicine and delegate
to the Representative Forum. Being
the voice for respiratory medicine
is an honor and I have tried to
represent my colleagues to the best
of my ability.
Alberta physicians are privileged
to have this effective professional
organization. The AMA’s strength
lies in its members and their
willingness to champion the
interests of our profession and
our patients through both good
and difficult times. I encourage all
members to participate, as this is
the key to maintaining our strength.
Dr. Fredrykka D. Rinaldi
Family practice, Medicine Hat
I have had the privilege of working
with the most amazingly talented
and dedicated physicians and AMA
staff. My service on the AMA Board
of Directors and Section of General
Practice Executive has reaffirmed
the power of a united and engaged
professional voice in advancing the
working environment of physicians
and their ability to provide and
define excellent patient care. I hope
that the impact of the work I’ve been
involved in will result in a proactive
approach to patient care where
we can embed the value of putting
patients first into everything.
I encourage all physicians to look
beyond the walls of your practice
setting for ways of advancing your
profession. Never sacrifice your
professional autonomy; it is what
enables us to put patients first.
Dr. Ernst P. Schuster
Family practice, Edmonton
I have been
actively
involved with
the AMA
since I joined
the Board
of Directors
in 1993. I
served on the
board then
and was re-elected to the board in
2013. I have been the chair of the
Government Affairs Committee and
was the AMA representative to the
CMA’s Political Action Committee.
It was an honor to have served as
the speaker and deputy speaker of
the Representative Forum for a total
of 14 years. I have also served on the
Nominating Committee and have
attended numerous CMA General
Council meetings on behalf of the
AMA, and had the opportunity
to be an AMA representative to
the government’s Standing Policy
Committee on Health in the 90s.
The ability to advocate for
physicians and their patients has
been key during board involvement.
My message to younger physicians
is that besides providing excellence
and compassion in clinical practice,
AMA involvement helps shape
the health care system through
leadership and advocacy. It may
seem like added work, but it
broadens the perspective and brings
variety and system thinking into
your professional life.
Dr. Wendy L. Tink
Family medicine, Calgary
Opportunities to inspire and work
with thoughtful, compelling physicians
and staff leaders defined my AMA
experience. It has been an honor
to represent physicians who care
deeply about their patients and
discipline, and to make a difference
locally, provincially and nationally. I’m
especially proud of having advanced a
comprehensive, coordinated primary
care system to keep care closer to
home and reduce emergency visits
and hospital admissions. >
15
16
> To early career physicians: your
perspective matters. Juggling career
and family? Find the best fit, a little
or a lot; make time to reap the
rewards of personal development, to
engage with leaders and contribute
to direction setting.
Dr. Patrick J. (P.J.) White
Psychiatry, Edmonton
My years with
AMA were
a wonderful
experience for
me. My time as
deputy speaker
stood out for
me because it
was always a
challenge to
keep the meeting running efficiently
so we could make sure we stayed
focused on the decision at hand.
Providing leadership while our
negotiations were going on was a
challenge because it was stressful
and controversial but it brought
the doctors together. The future
of primary care is assured by the
reorganization initiatives, which
will protect this valuable service
for everyone. The focus on primary
care networks brings a front-loading
of resources, which will serve our
patients well in the future.
I would encourage young doctors
starting out to become engaged and
informed about the issues we face.
We can never underestimate the
role of providing an active voice from
our profession to ensure patient care
is always the first priority. I intend
to continue to advocate for mental
health care and for my patients in
the future. Our patients rely on us to
advocate for them since they cannot
advocate for themselves.
Dr. Josephine M. Wilson
Family medicine, Canmore
My work with
the AMA was
a very valuable
experience.
Working on
the Health
Issues Council –
looking towards
the future
and planning
for preventative measures – is a
novel and exciting process. My time
on the Board of Directors was an
eye-opener, as I had not appreciated
until then how well-run the AMA
was. I was also involved in the initial
integration of regional medical
staff organizations with the AMA
structure and believe the project’s
overarching concepts benefitted us
all. My participation in the AMA
made me realize how much leverage
we have in our profession.
The public looks to us for guidance
on their individual care and on
issues that affect the entire health
care system. Our influence should
never be underestimated. What I
learned at the AMA has made me a
better advocate for my patients.
Canadian Medical Association
(CMA) Honorary Members
Dr. Robert A. (Bob) Burns
Physician executive/administrative
medicine, Nanaimo BC
I was privileged
to be a part of
the leadership
of medical
associations
during times
of huge change.
Negotiations
outcomes
with AHCIP in
1988 were covered in a one-pager
– and parts of them were agreed
to on a dance floor! (Thanks, Ruth
Collins-Nakai and Minister Moore!).
By 2000, they were volumes long
and required skilled lawyers to both
negotiate and to interpret. I was
a Canadian Medical Association
General Council delegate from
1988 to 2004 and saw great Alberta
physicians play a leading role
in the affairs of the national
physician association.
Most satisfying was the work on the
Task Force on Governance, and its
legacy, the Representative Forum,
the best physician governance
structure in the country, followed
by the acquisition of outstanding
professional staff – many of whom
still work for the AMA. A voluntary
professional association is only as
strong as its members.
Dr. Ken Chow
Family practice, St. Albert
Being a member of the Negotiating
Committee and the Subcommittee
on Finance at the same time was
most memorable. I saw the good
and the bad negotiated and then
implemented. Although there was
plenty of good, I also recall the
capped budgets, the clawbacks
and the delisting of lab services.
I was involved with two major
accomplishments during my
time with the AMA, first with
negotiations, where we started
the dialogue to have the AMA
recognized as the representative
for all Alberta physicians. Secondly,
I was involved with the creation of
alternate payment models.
My experience has taught me that,
as a profession, to remain strong
we must remain united. The AMA/
CMA provide us with the vehicle
to remain strong. In the words of
Benjamin Franklin, we must all hang
together or assuredly we shall all
hang separately.
Dr. Ruth L. Collins-Nakai
Pediatric cardiology/adult congenital
cardiology, Edmonton
Being president
of both the
AMA and
CMA is, for
me, especially
memorable.
With the AMA,
I was delighted
to spearhead
the initiative
to make seat belts mandatory, to
have mandatory reporting of shaken
babies, and to bring in a new era
of principled negotiating with the
Alberta government. With the CMA,
I made the motion to ask Air Canada
to become a smoke-free airline – the
first in the world. Our focus on early
childhood also drew awareness
to the need for supportive
and nurturing early childhood
development and care. Going to
Afghanistan focused attention on
the need for quality health care
services for our Canadian Forces and
brought honor to the CMA. >
> Along with opportunities to learn
leadership, the AMA and CMA
help physicians focus on what is
important to patients in a health
care system that is in constant
flux and often in chaos. They
teach about group dynamics and
arguing for one’s position, while
respecting and listening to other
perspectives. Finally, they create
friends and a supportive “family”
to help during life’s vicissitudes.
Dr. Allan S. Garbutt
Family medicine, Crowsnest Pass
I’ve been
involved with
the Section of
Rural Medicine
for what seems
like forever, as
its president,
past-president
and then
president again.
We’ve done a lot that I’m proud of,
but two of the biggest things were
establishing the Dr. Michael Tarrant
Scholarship for third-year medical
students at the University of Alberta
and the University of Calgary and
creating the Enhancement Program
that helps rural students apply to
medical school.
This past year, as AMA president,
I was left with a new appreciation
for how hard previous presidents
must have worked and the sacrifices
their families made to allow them
to do that work. It showed me that
you can’t do this job without the
incredible support of everyone at the
AMA. It also reaffirmed my belief
that you have to make time to be
involved in organizations like AMA
and CMA if you want to improve
the system.
Dr. Wayne M. MacNicol
Obstetrics/gynecology,
Whitehorse, Yukon
I was always
amazed by the
extraordinary
commitment
of the board
to improving
the quality of
medical care
and working
conditions for
the physicians of Alberta. During
my time on the board, we dealt with
the outfall of the Barer-Stoddart
Report and the beginnings of a
Relative Value Guide to address
disparities in physician earnings.
Government had also begun the
move towards regionalization and
payment models for hospital/facility
services based on severity of illness/
output formulas. These issues had
huge implications with respect to
physician services and access to
medical care and our focus was on
keeping the membership working
toward common goals.
It’s important for physicians to
recognize their strengths, knowledge
and skills and to become a part of
the broader medical community to
improve the standards of medical
care, access to medical services and
working conditions of physicians.
Dr. Dennis L. Modry
Cardiothoracic surgery, Edmonton
During my
time with the
AMA, I’ve
served on two
Relative Value
Guide (RVG)
committees
and for me
the most
interesting part
was the process of understanding
what RVG really means, its purpose
and its risks and benefits. Everyone
involved with RVG contributed to
the discussions to improve health
care delivery. I’ve also worked to
influence the implementation of
retention benefits with government,
and provided a rationale as to why
they shouldn’t cut $100 million
from fee for service. In dealing with
multiple physicians you get multiple
perspectives, and when it works
you get people aligned on how to
resolve a problem.
I think the AMA and the CMA have
done an excellent job and are a force
for good. They listen to divergent
opinions on patient and professional
(individual sections) advocacy and
make a legitimate attempt to be fair.
It’s important to get involved if you
want your opinion heard.
Dr. Harvey P. Woytiuk
General practice, St. Paul
After
implementing
an electronic
medical record
in 2000,
a career
milestone
occurred in
2006 with the
opportunity
to be involved in developing and
nurturing a primary care network
(PCN) in our community. A
six physician community PCN
blossomed to 30 physicians when
the opportunity to join our PCN
was extended to the surrounding
communities. It has been a pleasure
to be involved in the provision of
medical services to rural Albertans.
Significant progress has taken place,
but more work remains before a
home grown sustainable program
for rural health care delivery can
be acknowledged.
If you want to make a difference,
get involved and stay involved.
The rapport and relationships you
make through your involvement
will stay with you throughout your
career and it’s always good to have
other people who can commiserate
and understand the issues you’re
dealing with.
17
18
HEALTH LAW UPDATE
Conflicting regulations?
Alberta court rules third-party records to be “health information”
Jonathan P. Rossall, QC, LLM | PARTNER,
I
n a decision issued
in mid-September
of this year, Justice
T.W. Wakeling of the
Alberta Court of Queen’s
Bench1 has arguably
expanded the scope of
what has been commonly
understood to be health information as that term is
defined in Alberta’s Health Information Act (HIA). The
case arose from a judicial review of a decision of the
Office of the Information and Privacy Commissioner
(OIPC) relating to a family member’s request for
information regarding her parents’ care.
Background
Briefly, the family member in question had her visitation
privileges restricted by Covenant Health, allegedly to
protect the health care regime provided by Covenant
Health for her parents in one of its long-term care
facilities. The conditions imposed limited the times she
could visit, prescribed permitted activities during visits
and identified certain Covenant Health representatives
with whom she could discuss her parents’ care. Her
parents had appointed a different family member to be
their agent under the Personal Directives Act, so she had
no status in that regard. She had taken numerous steps
to cause Covenant Health to remove these conditions,
to no avail. Ultimately, she filed an access request under
the Freedom of Information and Protection of Privacy Act
(FOIPPA) for “… everything and anything that Covenant
Health has a record of, relating to me.”
The response from Covenant Health was to disclose
those parts of the records, including excerpts from the
parents’ health records that Covenant Health regarded
as responsive to the request. The family member, in turn,
contested the lawfulness and completeness of Covenant
Health’s response and filed a complaint under the
FOIPPA which also brought into play the provisions of
the HIA relating to the request.
MCLENNAN ROSS LLP
The OIPC ruled that the HIA did not apply to any parts
of the records disclosed by Covenant Health and ordered
Covenant Health to conduct a new search for producible
records. That decision was then brought before the court
for judicial review.
The Health Information Act
The HIA is focused on the protection and privacy of
“health information,” and prescribes circumstances
where such information may be disclosed to third parties
in the absence of patient consent. As the court advised
in this decision, “…(o)penness is not the goal of the
HIA. The preservation of the privacy of an individual’s
health information is one of the purposes of the Act.”
Even if it is accepted that the family
member’s information is part of the parents’
health record, and therefore immune from
disclosure under the Health Information Act
(HIA), is that family member’s information
nevertheless “personal information” as defined
in Freedom of Information and Protection of
Privacy Act (FOIPPA) and therefore subject
to disclosure?
Necessarily, then, one of the questions posed by the
court was, “(is) some” of the information in Covenant
Health’s records that refers to (the family member) the
health information of her parents and subject to the
disclosure principles in the HIA?” >
> Health information is defined as either diagnostic,
treatment and care information, or registration
information. The definition of “diagnostic, treatment
and care information” is as follows:
“… information about any of the following:
(i) the physical and mental health of an individual;
(ii) a health service provided to an individual….
and includes any other information about an
individual that is collected when a health service
is provided to an individual…”
The act goes on to define what health services are, but
does not touch on what “any other information about an
individual” might be.
The decision
Recall that the request put forward by the family member
was for “… everything and anything that Covenant Health
has a record of, relating to me.” Presumably the family
member seeking the information recognized that she was
not entitled to information regarding the physical or mental
health of her parents or the health services provided to her
parents in the absence of their consent or the consent of the
agent (neither of which were forthcoming).
However, Covenant Health’s response was that where
records of the family member’s actions/activities formed
part of the parents’ health records, those third-party
records were the parents’ health information and could
not be disclosed. The OIPC disagreed with this approach
and directed that these records were not part of the
parents’ health information and therefore fell within
the broader confines of the FOIPPA.
The court, in reviewing this decision, pointed out that the
OIPC had failed to address the phrase “… and any other
information about an individual….” that forms part of the
definition of “diagnostic, treatment and care information”
and posed the following questions:
“Obviously, health information also includes “any
other information about an individual that is collected
when a health service is provided to the individual.”
What does this phrase mean? What are the
boundaries of its meaning?”
Utilizing traditional principles of statutory interpretation,
Justice Wakeling pointed out that it must mean something
other than information about either the physical and
mental health of the individual or health services provided
to an individual, as those aspects are expressly provided
for in the definition. In attempting to define this phrase
he relied on hypothetical examples, including a scenario
where a physician documents that a patient’s sleep
disorder is caused, in part, by her husband’s excessive
snoring. He analyzed that scenario as follows:
“If A tells the physician or another member of the
sleep-disorder team that B, her husband, snores
loudly and interferes with her sleep, and the
doctor records this information in her chart, is the
information about the snoring husband the health
information of A? I think so.”
His analysis was that, even though the information is
about B, it helps the doctor in the course of treatment,
and therefore in this context, the information about B
is actually information about A.
Applying this logic to the existing fact situation, his
conclusion was that the information about the family
member’s interactions with her parents on the parents’
health record was, in fact, the parents’ health information
and therefore could not be disclosed.
Discussion
While at first blush this may seem needlessly technical
and impractical, it makes sense when viewed in the
context of the HIA. Recall that the court correctly points
out that the HIA is about protecting the health information
of patients from unwarranted or unauthorized disclosure.
The focus, therefore, must be on what information is in
the patient’s health record that relates to the patient’s
diagnosis, treatment or care. If some of that relevant
information specifically refers to, and identifies third
parties, it is no less information about the patient. Had
the legislature intended to exclude third-party information
from the scope of “… other information about an individual
that is collected when a health service is provided to an
individual,” it could have done so.
The question was raised: Even if it is accepted that the
family member’s information is part of the parents’
health record, and therefore immune from disclosure
under the HIA, is that family member’s information
nevertheless “personal information” as defined in FOIPPA
and therefore subject to disclosure? The answer to that
question is simple: The disclosure regime in the HIA and
under FOIPPA, are mutually exclusive; FOIPPA does not
apply to the disclosure of health information, and the HIA
does not apply to the disclosure of information that is not
health information. Once the determination is made that
the family member’s information in the parents’ health
records is “health information” as that term is defined,
then FOIPPA has no application.
Having said that, likely this is not the last word on this
issue. It is anticipated that the family member affected
by this decision may appeal Justice Wakeling’s ruling to
the Alberta Court of Appeal. There is already before the
Court of Appeal a question of the scope of the OIPC’s
right to challenge a decision such as this. But until either
of those matters is resolved, the law would seem to favor
the restriction of disclosure of third-party information
found in an individual’s health record.
Reference
1. Covenant Health vs. Information and Privacy Commissioner
and Shauna McHarg, 2014 ABQB 562.
19
20
MIND YOUR OWN BUSINESS
Fraud alert!
Does your business have immunity?
Practice Management Program Staff
F
raud will never
happen in my
business. We’re much
too small. We’re immune.
few employees, basic controls and procedures can protect
your assets and detect mistakes.
Think again.
Awareness of scams that occur with small businesses
is the first step in prevention. Educate your employees
about basic fraud protection and how easily scams are
committed on unsuspecting employees. Common scams
include phoney invoices sent to a business for website
listings or subscriptions that were never authorized or do
not exist, and office or medical supplies that were never
ordered and were not received.
Small businesses are particularly vulnerable to fraud
because they have fewer resources and often fewer
controls. In July 2014, ATB Business Beat reported that
25% of small businesses in Alberta had experienced
fraud or attempted fraud in the past year. According
to the Association for Certified Fraud Examiners,
small organizations with less than 100 employees
experience the highest rate of fraud of any business
category at 31.8%.
Not all frauds are reported because of embarrassment,
family members being involved or no chance to recover
losses. Most businesses absorb the losses as a cost of
doing business.
Fraud can take many shapes and forms. Some types of
frauds that are attempted include credit card fraud, actual
theft of property, phishing or email hacking, supplier fraud
with fake invoices or advertising scams. It’s a scary world.
The majority of fraud cases are committed by one person,
acting alone, trying to conceal the crime from everyone,
including family members. They often are in good
standing, have worked for a company on average of four
to five years and are mostly first time offenders. Given the
opportunity and the need when faced with personal stress,
sometimes even the best employees will commit fraud.
They also “rationalize” that they will only temporarily
borrow the money and return it later. Small business
owners who have experienced fraud will almost always
tell you that it was someone they trusted.
Or mistakes happen. Sometimes, undesirable activities
occur that cost you money or result in other items of
value disappearing.
You can do some things to reduce the chances of fraud
happening to you. Even in small organizations with only a
Be aware of scams that target small businesses
Protect your business with a few simple rules. Never
give out business information unless you know what the
information is to be used for. If it sounds too good to be
true, it likely is. Always ask for a proposal in writing. And
always check that goods or services were both ordered
and delivered before you pay an invoice.
Set a tone for success
Model the behavior that you want in your business.
If the owner is seen borrowing from petty cash,
neglecting to record a cash payment from a patient,
or charging personal expenses through the business,
an atmosphere is created where “if the boss can do it,
so can I.” Always follow the procedures that you have
established for your employees.
Ask for and review financial reports regularly
and randomly
Awareness of the financial status of your business can
reduce the possibility of fraudulent activity occurring.
Having a budget in place, reviewing actual expenses on
a regular basis, asking questions about the financial
reports, and taking action can lead to predictable results,
less stress about your finances and greater success in
your practice.
Occasionally ask for back up documentation for a bill
being paid ¬ especially if you don’t remember why the
purchase was made or were not involved in placing the >
> order. Inquire about new vendors and why the change
was made. Review payroll reports on a regular basis for
overtime and vacation payments.
Divide the work wherever possible
Even in small offices, it is possible to have more than
one person handle different aspects of any financial
transaction. Consider where more than one person
could be involved. Or rotate job responsibilities for
financial transactions.
An example of all activities required for an expense
in your business are ordering the service or supplies,
negotiating the price, validating that the materials were
received or the services completed, writing the cheque,
signing the cheque, recording the payment in the
accounting records and reconciling the bank account.
Split up the work and reduce the opportunity for fraud
and errors in your business. Where possible, have a
different person recording the transaction than the one
who authorizes a payment.
Have all bank and credit card statements mailed directly to
your home or go on-line regularly to review the bank and
credit card account. Look at the transactions for unusual
amounts or payees that you do not recognize. Do you
know what the payment is for? Ask for backup. Look at
the cheques that cleared for altered payees or amounts.
Review all automatic payments for your bank account and
validate that they are only for valid business expenses.
Prevention is the key
Medical practices are not immune to fraudulent activities.
Safeguard your practice and protect your assets. Just as
you lock your doors, set up some basic controls to detect
or prevent fraud. Sleep better knowing your cash and
assets are safe.
The Practice Management Program is available to assist in
a number of areas related to the effective management of
your practice. For assistance, please contact Linda Ertman at
[email protected] or phone 780.733.3632.
Treat cash with extra care
Establish a process to record all payments that are made
directly in your office. Have a policy with signage that
receipts are issued for all payments. Use pre-numbered
receipts and review occasionally to ensure that all cash is
recorded. Cash and cheques should be deposited in the
bank as soon as possible ¬ at least weekly.
Ann Dawrant
RE/MAXReal
EstateCentre
Treat blank cheques like cash
780-438-7000 - office
780-940-6485 - cell
Limit the number of people who have access to blank
cheques. Keep them locked up. Use pre-numbered
cheques or have the accounting software print the
cheques if possible.
• Consistentlyintop5%
ofEdmontonrealtors
• PrestigiousRE/MAX
PlatinumClub
Have all cheques require two signatures. Don’t pre-sign
cheques. The convenience of having the ability to issue a
payment without being present eliminates any control that
you intended to establish.
Pay attention to what is happening
Trust ¬ but verify. Notice when employees complain
consistently about financial problems. Be aware of
employees who appear to live beyond their means or
employees who refuse to take vacation because when
an employee is away changes in certain patterns can
become apparent.
“Please call me to
experience the dedicated,
knowledgeable, and
caring service that I provide
to all my clients.”
Website
www.anndawrant.com
• 29yearsasa
successfulresidential
realtorinwestand
southwestEdmonton
• Bornandraisedin
BuenosAiresand
haslivedinEdmonton
since1967
• BilingualinEnglish
andSpanish
E-mail
[email protected]
21
22
FEATURE
Don’t just stand there!
The AMA Youth Run Club 2014 fall launch is happening now
¬ has taken on two new partners: the Running Room and
Physiotherapy Alberta, both of whom helped get the YRC
off to a running start, in early October.
At the McKernan School launch, YRC coach (and teacher)
Jennifer Klein, husband and co-coach, Dr. Doug Klein,
principal Mary-Lou Cleveland, other school staff and EAS
representatives corralled over 200, rambunctious K-6
run participants and joined them in two laps around the
school field, culminating in a sprint across the finish line to
receive gold medals donated by the Running Room: one for
everyone! Preceding the run with some encouraging words
and cheers were Dr. Richard G.R. Johnston, AMA President;
John Stanton, Founder and chief executive officer the
Running Room and Brian Torrance, Director of EAS.
And they're off! Over 200 McKernan School students got the fall 2014 season of the AMA's
Youth Run Club off to a running start October 1. ( provided by Ever Active Schools)
I
n typical Alberta fashion, the 2014 fall session of
the Alberta Medical Association (AMA) Youth Run
Club (YRC) launched on a beautiful, warm and sunny
October 1 at McKernan School in Edmonton. In contrast,
the very next day it launched amidst blustery winds
and wintery-cold temperatures at Panorama Hills
School in Calgary.
Unpredictable weather aside, both events echoed with
the resounding pitter-patter of hundreds of small feet
(and some big ones) as the booming bass of the Running
Room’s “Get Moving!” tunes put an extra jig and wriggle
into everyone’s step and made it impossible to stand still
(helped along by the cold in Calgary, of course!).
It’s been 1.5 years since the birth of the AMA YRC,
modelled after the Kids’ Run Club, started by Doctors Nova
Scotia 10 years ago. AMA’s YRC is a collaborative effort
of the AMA and Ever Active Schools (EAS), a provincial
organization that promotes and supports healthy, active
school communities. And what a year of growth it has been:
from the program’s start in spring 2013, with 74 schools
and 4,000 participants, the AMA YRC has blossomed to
include 233 schools and 11,000 participants.
In the process, the YRC ¬ which strives to get students
K-12 out from behind electronic screens and gadgets and
into their running/walking/jogging gear and the fresh air
It was “Take Two” for AMA, EAS and Running Room
representatives bright and early the next morning at
Panorama Hills School in Calgary, where coaches Sara
Laslo and Chris Fenlon-Macdonald and principal Sherry
Goldenberg gathered approximately 100 K-3 participants
and, fueled by rousing warm-up exercises led by EAS’s
Megan McKinlay, led the little troops around the school
field and over the gold medal finish line.
Calling all physicians and looking for champions
For everyone involved, the AMA YRC is a feel-good-dogood double dip, serving as a thoughtful reminder of the
real need that exists today to create opportunities for
physical activity for youth, as all our lives ¬ young and
old alike ¬ become increasingly comprised of technologydriven, sedentary activities.
Having observed the quiet playgrounds and school
fields in her Edmonton neighborhood, Dr. Kim Kelly is
the original physician champion of the AMA’s YRC and
continues to be involved with the program at Belgravia
School in Edmonton.
“The YRC presents a perfect opportunity for our physician
members to get involved with their communities and
serve as healthy, active role models for youth. Whether
as a coach, joining the kids on a run, speaking to them
about healthy lifestyle choices or even sponsoring a
local run club, any and every effort counts,” Dr. Johnston
commented at the launches. >
23
(L to R) Dr. Richard G.R. Johnston, AMA President, Leanne Loranger, Physiotherapy Alberta,
John Stanton, Running Room Ltd. and Brian Torrance. ( provided by Ever Active Schools)
> Edmonton family physician Dr. Klein is putting in that
effort and reaping the rewards of being a YRC physician
champion. The YRC is a family affair for the Kleins, who
have three children attending McKernan and participating
in the school’s YRC. Both Doug and Jennifer Klein
appreciate being able to set a good example of active
and healthful living for the kids.
(L to R) Dr. Doug Klein (YRC coach), Alexandra Teboul, Esperance Siwe Siwe, Jamie Bruce
(McKernan School teachers), Jennifer Klein (McKernan School teacher and YRC coach).
( provided by Ever Active Schools)
“Seeing the kids laughing, chatting and having fun as they run
two-to-three kilometres before school is one of the highlights
of my week,” says Dr. Klein. “I hope that more parents and
physicians get involved with this great program.”
To view a video on how to get involved in the AMA Youth Run
Club, please visit: www.albertadoctors.org/yrc/resources.
We want your feet!
Like to run? Have an interest in healthier kids
and healthier communities?
We’re rolling out all kinds of resources to help you get kids
running where you live. If you’d like to participate in a school
have other suggestions to get kids’ feet moving, we can help.
You don’t need to be a parent of a school-aged kid to
participate. Your willingness and interest are all you need.
[email protected]
Ready to get involved? Drop us a line: runclub@
albertadoctors.org
24
FEATURE
Tarrant Scholarship focuses on rural commitment
Two medical students step up to the challenge
I
n its 11th year, the Tarrant Scholarship was awarded
to third-year medical students from the University
of Alberta (U of A) and the University of Calgary
(U of C) who have demonstrated a strong interest in
focusing their medical career and undergraduate studies
on rural medicine and related issues. As one of Alberta’s
largest unrestricted medical school undergraduate
awards, the scholarship provides a full year’s tuition for
both recipients.
The 2014 Tarrant Scholarship recipients are U of A medical
student Adam Mildenberger from Beaverlodge, AB and
U of C medical student Darby Ewashina from Barriere, BC.
“We always have strong candidates for this scholarship
and this year is no exception,” said Dr. Tobias N.M. Gelber,
President, AMA Section of Rural Medicine. “There are
ongoing concerns with the current state of health care in
rural Alberta so it’s reassuring and heartening to see the
rural commitment of these bright, young and talented
medical students. Like the Tarrant Scholarship winners
who preceded them, Darby and Adam will be true assets
to the rural communities in which they may choose to
practice medicine.”
The scholarship is named in honor of the late Dr. Michael
Tarrant, a Calgary family physician who championed rural
medical undergraduate education.
Since its inception in 2004, the Tarrant Scholarship has
been awarded to 29 medical students and has provided
close to $300,000 to its recipients.
Adam Mildenberger (U of A)
Adam was born and grew up in Beaverlodge, AB. He was
actively involved in his high school and community as a
member of the school leadership club, a player on the
school’s football team, a volunteer at the hospital, a youth
basketball and soccer coach, and the organizer of a weekly
youth drop-in activity night.
During his undergraduate studies at the U of A, Adam
joined the Golden Key Society, an academic, leadership
and service organization to which students who achieve
an academic standing in the top 15% are invited to
join. Adam served as vice-president and president of
the U of A chapter, during which time he worked on
numerous events, including organizing an annual tour of
the university by inner-city junior high school students,
for purposes of introducing them to the world of
post-secondary education. Since joining the Golden Key
Society, Adam has served at national and international
levels with the organization.
Since its inception in 2004, the
Tarrant Scholarship has been awarded to
29 medical students and has provided close
to $300,000 to its recipients.
Over his summer breaks, Adam worked on projects
involving chemistry, and Aboriginal and global health and
educational initiatives developed by the Department of
Family Medicine. Adam has volunteered with the Campus
Food Bank and with the Alberta Hospital, Edmonton.
In medical school, Adam has volunteered with the Faculty
of Medicine, the Medical Students’ Association and the
Canadian Federation of Medical Students. The student
representative on the AMA’s Health Issues Council, Adam
lives in Peace River while he participates in the Integrated
Community Clerkship program.
“I appreciate the strong feeling of community that comes
with rural medicine and I’m interested in working with
communities that don’t have easy access to health care,”
says Adam. >
> Darby Ewashina (U of C)
25
Darby grew up in Barriere, BC, just outside Kamloops.
She participated in many sports and outdoor activities
through her childhood, enjoying the active, communityfocused life of a small centre.
For her undergraduate studies in Cellular, Molecular and
Microbiology, Darby attended Thompson Rivers University
in Kamloops. Initially leaning towards a career in veterinary
medicine, a volunteer stint as a physician assistant in
Guatemala influenced Darby to pursue her medical degree.
In addition to her studies at the U of C, Darby has been
involved with the local community, as a clinician at
the Student Run Clinic and as the initiator of a literacy
campaign ¬ Rewards of Reading ¬ that provides books
and activities to children staying at the shelter where
the clinic operates.
Through the course of her involvement with other
university groups and rural electives, Darby has found
the “one-on-one teaching and learning that occurs
when removed from the larger centres” to be the
most rewarding.
(L to R) Adam Mildenberger, U of A recipient; Dr. Tobias N.M. Gelber, President, AMA Section
of Rural Medicine; Darby Ewashina, U of C recipient. ( provided by Vanda Killeen)
“There’s a sense of cohesiveness and community that
comes with smaller towns,” says Darby, who plans to
acquire advanced skills training in emergency medicine
and addictions medicine, and apply these skills one day
in a rural community practice.
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26
DR. GADGET
Dog or fob?
Wesley D. Jackson, MD, CCFP, FCFP
A
few weeks ago,
at the conclusion
of a periodic
health exam of one
of my overweight
patients, we were
discussing the benefits
of a healthy lifestyle and
particularly the importance of exercise. He told me that
a well-meaning physician had given him an exercise
prescription a couple of years ago and that, despite his
best efforts, it had failed miserably. So, based on an
article1 I had read pointing out the fitness benefits of dog
walking, I suggested that he consider this option. The
next minute or so is a blur as I vaguely remember words
like ‘carpet stain,’ ‘pooper scooper’ and ‘yappy’ along with
others that I cannot repeat in this venue, leading me to
believe this solution would not be ideal for my patient.
We then began to discuss the possibility of wearable
devices as a motivational tool for exercise and weight loss.
Pedometers have been available for several years and
have been shown to improve fitness, particularly with
long term use,2 and have been generally adopted by
runners and others interested in fitness. Inexpensive,
highly portable and readily available health tracking
wearables (HTW) combined with apps that can also
monitor dietary intake have the potential to significantly
increase motivation and therefore compliance with
daily diet and exercise.3,4,5 These devices come in
many shapes and colors, including fobs, wrist bands,
smartphones and, coming soon, headphones.6
All HTWs contain motion detector chips, which
through complex algorithms, estimate steps and stairs
fairly accurately. Some algorithms also attempt to
estimate active vs. passive or slower exercise. Most
apps associated with these devices allow for personal
goal-setting and connection to secure social media,
promoting friendly competition and encouragement
from close friends and family. Personalized reminders,
while not as cute as the large puppy eyes or annoying
as scratching at the door, help users to meet their
own goals. Newer devices are combining functionality,
allowing for control of music, emails, texts, etc., as well
as monitoring other vitals such as pulse and oxygen
saturation when paired with a nearby smartphone,
making them very appealing to the general North
American population.
In the United States of America, HTWs generated more
than $1.6 billion in sales last year, a number projected
to rise to $5 billion by 2016. Software and hardware
providers have been keenly aware of both the need and
the scope of this rapidly growing industry, producing
many fitness related apps that utilize the data created by
the various HTWs.
Pedometers have been available for
several years and have been shown to improve
fitness, particularly with long term use.
Google Fit (Google) and HealthKit (Apple) are new
offerings that consolidate data received from hardware
and other apps to provide a more complete, personalized
health profile of the user. Proactive businesses have
been actively promoting the use of HTWs, while many
physicians believe that smartphone applications for
medicine are going to be a part of mainstream medical
practice in the coming years.7,8 Health care institutions
and electronic medical record providers, including Mayo
Clinic, Epic, Stanford, Kaiser Permanente, Harvard and
others are currently conducting trials using data obtained
from HTWs.
This technological advance, although very promising,
is not without risks. Recently the US Food and Drug
Administration has stated that apps that are not
marketed to monitor a disease or condition, or to treat or
diagnose a patient will not be regulated. As far as I am
aware, there is no regulatory body in Canada. The quality
of data can vary considerably between devices and the
software is far from flawless at this point in time. >
> Privacy Rights Clearinghouse, a California based
non-profit corporation with a mission to provide consumer
information and advocacy around issues of privacy, in a
recent report9,10 noted that of 43 health-tracking apps
studied (2012-13), only 15% send encrypted data to
servers and approximately 25% had accurate privacy
polices to which they adhered. This report also noted
that advertisements in apps increased the privacy risk,
suggesting that users be cautious with free offerings. On
the positive side, this group published a how-to guidebook
for future use for developers of health-related apps. Other
resources are available to guide users on how to safely use
HTWs and associated apps.11
27
While HTWs may not yet be ready for useful integration
into medical care because of these and other concerns,
they are still very useful for significant positive lifestyle
change and can certainly be promoted by physicians
for this purpose. Comparisons and reviews of several
of these devices can be found on the Internet.12,13,14
If only the next health tracking wearable could warm
my feet and fetch my paper …
References available upon request.
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28
PFSP PERSPECTIVES
The beginning of wisdom
Jared D. Bly, MD, CCFP (EM) | ASSESSMENT
PHYSICIAN, PFSP
O
nce when Frederick II, an 18th century king
of Prussia, went on an inspection tour of a
Berlin prison, he was greeted with the cries of
prisoners, who fell on their knees and protested their
unjust imprisonment. While listening to these pleas of
innocence, Frederick’s eye was caught by a solitary figure
in the corner, a prisoner seemingly unconcerned with all
the commotion.
doctor.3 Or a good nurse, social worker or counsellor.
Or if you want healthy development as a child. Or if you
want effective social interactions, etc.
Knowing our weaknesses
When Alice in Wonderland came to a fork in the road,
she was pretty lost.
“Why are you here?” Frederick asked him.
“Which road do I take?” she asked.
”Armed robbery, Your Majesty.”
“Where do you want to go?” responded the
Cheshire Cat.
“Were you guilty?” the king asked.
“Oh yes, indeed, Your Majesty. I entirely deserve my
punishment.”
At that Frederick summoned the jailer. “Release this
guilty man at once,” he said. “I will not have him
kept in this prison where he will corrupt all the fine
innocent people who occupy it.”1
Why is this funny? A criminal actually accepting his
punishment? An administrator actually recognizing his
institution’s inept policies and procedures? Would it be
as surprising for any of us to recognize our mistakes,
shortcomings or idiosyncrasies? Whatever the reason,
honesty about oneself seems rare.
Becoming more self-aware is a subject of literature
throughout history. Ancient Greek philosophers
(thank-you to Aristotle for the title of this article),
religious leaders, business executives and educators have
all praised this attribute. It’s relevant in the professional
life of medicine, but no less important in personal life.
Fulfilling relationships, satisfying workdays and effective
personal development all require a high degree of
self-awareness.
Is soul-searching that important? Well, it is if you want to
be a successful leader.
“Leadership searches give short shrift to ‘self-awareness,’
which should actually be a top criterion. Interestingly, a
high self-awareness score was the strongest predictor of
overall success.”2
Not concerned about being a good leader? Well that's
a topic for another article, but okay. Even if you don’t
believe that leadership is somewhat intrinsic to being a
physician, it’s independently important for being a good
“I don’t know,” Alice answered.
“Then,” said the Cat, “it doesn’t matter.”4
Like Alice, to know where we want to get to, it helps to
have some idea of where we are. If we want to improve,
it helps to know what we need to improve upon.
There’s a story of a woman who goes to see her doctor
about losing weight. First, the physician has her step on
a scale. “I can’t believe I weigh that much,” she protests,
seeing the needle soar.
“Look down at the scale and tell me whose fat feet those
are standing on it,” the physician answers.
Maybe insensitive, but illustrative of the need to own
one’s problems.
To become more self-aware, you
have to be self-aware enough to realize how
self-aware you are not.
Knowing our strengths
Hopefully in our years of schooling we have understood
how we learn. Because if we know how we learn or how
we work, we can understand how we might contribute
best in an organization or relationship. We contribute
best when we work from our strengths. >
> I had a medical school classmate that came to every
lecture, sat on the front row, didn’t write a word of notes,
but remembered, apparently, everything that was taught.
Other classmates took volumes of neat, well-organized
notes, even kept them through clinical years and
residency. Some didn’t go to class at all, preferring to
spend the time in the library reading the material.
“(United States of America president) Lyndon B.
Johnson destroyed his presidency in large measure,
not knowing that he was a listener. His predecessor,
John F. Kennedy, was a reader who had assembled a
brilliant group of writers as his assistants, making sure
they wrote to him before discussing their memos in
person. Johnson kept these people on staff ¬ and they
kept writing. He never, apparently, understood one
word of what they wrote. Yet as a senator, Johnson
had been superb because parliamentarians have to be,
above all, listeners.”5
29
Our reflections can say a lot about who we are. (
provided by David Bly)
Then he worked with a counsellor who delivered some
hard truths: “The good news is you do not have a
wife-selection problem. The bad news is you have a
husband-behavior problem.”
Some people, then, are listeners. Some are readers. Some
people need to talk about things to process them. Some
learn best by doing. Some people write. William Faulkner
said, “I never know what I think about something until I
read what I’ve written on it.”
Now what?
It’s especially important to be aware of relationship
dynamics if one partner is a talker and one is a writer,
or a doer, for example. And it’s an important part of
self-awareness to know how you learn and work.
Developing self-awareness starts with introspection. This
can be difficult for the naturally self-ignorant. “To become
more self-aware, you have to be self-aware enough to
realize how self-aware you are not.”7
Knowing our influence on others
Introspective practices can help you identify and
evaluate your emotional responses to various life events.
Journaling, meditation, prayer, taking a moment to reflect
after a day at work, or sitting on the porch with a warm
beverage at the end of the day all fall into this category.
Knowing how you learn may be most useful in planning
your Continuing Medical Education (CME) activities, or
planning what you expect to get out of CME activities
(maybe a suntan is the only realistic outcome from a
didactic conference in a sunny locale if you are a doer
and not likely to get much out of a morning lecture).
For clinical practice we all need to be listeners to some
extent. And understanding how we are perceived and
what influence we have on others is an important aspect
of self-awareness.
One business leader’s rocky road to self-awareness
involved seeing his impact on others. Here’s his story
as told in Discovering Your Authentic Leadership.6
“Dave, your colleagues do not trust you.”
As Dave recalled, “That feedback was like a dagger
to my heart. I was in denial, as I didn’t see myself
as others saw me. I became a lightning rod for
friction, but I had no idea how self-serving I looked to
other people. Still, somewhere in my inner core the
feedback resonated as true.”
Feedback is important. An honest answer can be hard
to get ¬ friends might say what they think you want to
hear, enemies might only aim to wound. Probably both
are important as well as anything in between. Feedback
from all angles, like a larger study sample, can increase
overall accuracy. The term ‘360 degree’ assessment
encompasses this concept.
And if you know your strengths, build on them. Try to
find the environment where you are likely to flourish.
“Only when you operate from a combination of your
strengths and self-knowledge can you achieve true ¬
and lasting ¬ excellence.”5
“And you may find yourself.…” - Talking Heads
[He] realized that he could not succeed unless he
identified and overcame his blind spots.
This same executive discovered similar blind spots in
his personal relationships. It was only after his second
divorce that [he] was finally able to acknowledge that
he still had large blind spots.
“After my second marriage fell apart, I thought I had a
wife-selection problem.”
PHYSICIAN AND FAMILY SUPPORT PROGRAM
30
FEATURE
Emerging Leaders in Health Promotion Grant
recipient focuses on obesity and children
B
eginning last January, Dr. Maryana Duchcherer
took her concerns about the increasing number of
overweight children in Alberta and, as part of the
Alberta Medical Association’s (AMA’s) Emerging Leaders
in Health Promotion Grant program, she developed a
multi-faceted project that focused on increasing children’s
awareness of:
• Healthy eating habits
• The power of physical activity
manifest themselves as an entire generation of Albertans
who can expect poor quality of life and a shorter life
expectancy than their parents.”
By developing this three-step, school health promotion
program for a segment of Alberta population facing a
growing risk for health issues, Dr. Duchcherer fulfilled
the requirement of the Emerging Leaders in Health
Promotion grants program: to promote development of the
physician’s role as an advocate for healthy populations.
• The importance of mental well-being
Working with 183 K-6 students (five-to-12 years old) from
Edmonton’s St. Martin Elementary School, Dr. Duchcherer
and her project team developed and delivered the program
in three steps via presentations on: the health outcomes
of obesity and the importance of emotional well-being; a
debate about why obesity should be prevented; and whole
school activities (healthy breakfast school initiative and
physical activity promotion).
Childhood obesity is a rapidly
emerging health concern in Alberta that has
been steadily increasing over the last decade.
Her team included Dr. Sandip Gandham (project
mentor), Yanina Vihovska (elementary school teacher),
Taras Podildky (school principal), Natalie Harasymiw
(school vice-principal), Kathy Kachmistruk (learning
coach), Natalia Tyschuk (volunteer teacher) and Sharon
Kyrzyk (yoga instructor).
“Childhood obesity is a rapidly emerging health concern
in Alberta that has been steadily increasing over the last
decade” says Dr. Duchcherer. “You can look around and
see its effect, as it translates into various chronic medical
conditions in children. Ultimately, these trends can
You can look around and see
obesity’s effect, as it translates into various
chronic medical conditions in children.
“With this program, because of the varying ages of the
students, I needed to adapt the tools ¬ the presentations,
the activities and exercises ¬ to the various audiences,”
Dr. Duchcherer explains. “As a physician, I went in
and worked with the staff and volunteers at St. Martin
Elementary School to engage them in the three steps
that would help create an awareness of health (eating,
physical activity and mental well-being) among the
young school population.”
The program’s first step was to host a 30-minute
interactive “Food Fun” session identifying the benefits
of nutrition and healthy eating, supporting that with the
serving of a healthy and nutritious snack to the students.
For the second step of the program, Dr. Duchcherer and
members of her project team educated the students on
the value of emotional well-being and self-esteem, using
self-regulation exercises, relaxation tools, creativitybased activities and interactive games enhancing the
cognitive and sensory systems used in behavioral
regulation. Participants were broken into age groups,
based on level of attention and comprehension. >
In the mentored and supportive environment provided
by Dr. Sandip Gandham, Dr. Duchcherer met the third
requirement of the Emerging Leaders grant program,
as she acquired strong leadership and advocacy skills
while overseeing the members of her project team and
interacting with the elementary school children.
“I plan to collaborate further and expand upon this
project, including sharing the results with primary care
providers across the country via a poster at the Family
Medicine Forum this fall,” Dr. Duchcherer comments.
“My project team is confident that we’ll be able to
successfully develop and improve this program for
long-term sustainability, which is one of the mandates
of the interventions in primary care medicine.”
(L to R) Yanina Vihovska and Dr. Maryana Duchcherer. (
Dr. Maryana Duchcherer)
provided by
> The last step of the program was physical activity, with
children again broken into two age groups and provided
with a couple of age-appropriate yoga lessons, delivered
by a licensed yoga instructor with the Bikram Yoga East
Edmonton Studio.
Through the course of the program, Dr. Duchcherer
learned the importance of being aware of children’s level
of development, comprehension and attention span when
designing any type of primary care retention programs
for children.
The experience I acquired from this
program, particularly with respect to health
promotion, is something I know I’ll be
applying to my medical practice in the future.
As she comments on the second requirement of the
Emerging Leaders grant program ¬ to provide experience
in health promotion as integral to medical practice ¬
Dr. Duchcherer says, “The experience I acquired from this
program, particularly with respect to health promotion, is
something I know I’ll be applying to my medical practice
in the future.”
Out of options for resolving
problems with intimidation in the
workplace and patient advocacy?
Call the Zone Medical Staff
Association (ZMSA) operated
PractitiOner advOcacy
assistance Line (PaaL)
1.866.225.7112

When an advocacy or intimidation concern
is so serious that you need confidentiality, the
PAAL is a 24-hour confidential service you can
call to share the issue and obtain advice from
your ZMSA. All calls are answered by Confidence
Line, an independent provider of confidential
reporting lines.
The PAAL service has been
transferred out of Alberta
Health Services and is now
operated at arm’s length
by ZMSAs.
Scan for more information
or visit bit.ly/1a4LOsm.
31
32
FEATURE
The role of Alberta physicians in the
formation of the Medical Council of Canada
J. Robert Lampard, MD
T
he most prolonged debate in the history of the
Canadian Medical Association (CMA) has been
over the establishment and implementation of a
national medical licensing examination.
It took from 1867 to 1913 to secure the approval of all the
medical associations, legislatures, House of Commons
and CMA, for the Canada Medical Act to be created. The
act created the Medical Council of Canada (MCC).
The two official histories of the MCC (Kerr, Vodden)
make no mention of the pivotal role of western Canadian
and particularly Alberta physicians in its formation. As
2014 celebrates the 100th anniversary of the knighting
of Sir Thomas Roddick for his leadership in passing what
was then known as the “Roddick” Act, it is time their role
was recognized.
The saga began in 1867 when the British North America
(BNA) Act assigned health as a provincial responsibility.
That meant physicians could only move from province to
province by being re-registered.
The most prolonged debate
in the history of the Canadian Medical
Association (CMA), has been over the
establishment and implementation of a
national medical licensing examination.
The first attempt (1867-72) by the CMA’s first president
Dr. Charles Tupper, to pass a national act, failed. A
national act was a perennial CMA topic, but it was not
until 1894 that another CMA committee was appointed
under Dr. Roddick, to revisit the topic.
The issue had not come to a head when 40 physicians
from the east participated in the NW/Riel Rebellion
of 1885 under Deputy Surgeon General Dr. Thomas
Roddick. At that time, the Northwest Territories did not
require medical registration.
As a new MP elected in 1896, Roddick proposed the
Canada Medical Bill be passed in 1901. Roddick pointed
out that military, penitentiary and Northwest Mounted
Police (NWMP) physicians could not move from province
to province. Interprovincial incidents were already arising.
A Quebec physician treating a patient across the bridge
in Ontario was fined three times. The public, Roddick
said, were dismayed as “these barriers existed in no other
country under the sun. Even between France and Germany
there was a 15 mile neutral zone for medical care.”
When Prime Minister Sir Wilfred Laurier realized that
any province could opt out, he acquiesced. The act was
passed in 1902, subject to every provincial legislature and
medical association approving it.
In 1903 the Manitoba, Nova Scotia and Prince Edward
Island Medical Associations and Legislatures approved
the act, as did the NWTMA and assembly in 1905. An
enabling act was included in the Medical Profession Acts of
Alberta and Saskatchewan of 1906. Enthused, Manitoba
physicians began the Western Canadian Medical Journal
(WCMJ) in January 1907. One of its two objectives was
to have a western Canadian licensing authority approved,
to allow licentiates to move throughout the west. The
problem was partially resolved when NWT physicians
were grandfathered into both Alberta and Saskatchewan
in 1906.
At the 1908 Alberta Medical Association (AMA) annual
meeting in Banff, three of the four western provinces
agreed to support the Western Canadian Medical
Federation concept. British Columbia (BC) physicians
feared inundation by doctors from the rest of Canada.
They also favored a national federation over a western
one. At the same time, Quebec physicians asked their
legislature not to pass an enabling act.
In anticipation of the CMA’s 1909 annual meeting in
Winnipeg, Dr. George Kennedy of Fort Macleod wrote
a letter in the January 1909 WCMJ recommending the
concept be readdressed. Dr. J. Patterson of Manitoba
suggested Kennedy lead the charge as the “Western >
> Roddick.” A month later Dr. Robert G. Brett of Banff,
addressed Winnipeg physicians on the need to “weed
out quacks and illegals, and avoid legislatures licensing
physicians through private member bills.” Manitoba’s
Dean Dr. Henry H. Chown agreed with the concept so
long as Manitoba graduates did not have to write
two examinations.
33
The seminal contributions of
Alberta physicians to the establishment of the
Medical Council of Canada and the national
licensing examination system we now have,
has been buried for over a century, until now.
Members of the first Dominion Medical Council, November 7-9, 1912. Dr. Kennedy is third
from the left and Dr. Brett fifth from the left in the back row. Dr. Roddick is fourth from the
left in the front row.
Finally, after meeting with Dr. Roddick, the proposed
amendments were approved at the 1910 CMA convention.
In July 1909 a team of four doctors (Brett, Kennedy,
T.N. Mulroy and J. Patterson) visited BC to present their
rationale. A curricular was sent out to all BC physicians.
Dr. Mulroy of Manitoba wrote to the CMA outlining
the western proposal. The Ontario Medical Association
was asked for a reciprocity agreement. In their reply, the
Ontario Council demanded a BA or BSc and successful
passage of the western exam, or five years’ experience
and passage of the Ontario exam. The westerners threw
the reply out of hand.
At the Winnipeg CMA meeting the western initiative
was discussed. It led to a renewed interest in the
Roddick proposal by eastern physicians. A committee
was struck to suggest amendments and then secure
Dr. Roddick’s approval.
At a committee meeting that fall, BC and Saskatchewan
physicians suggested a 10-year grandfathering clause.
The premedical entrance requirement was dropped.
Homeopathic doctors were included. Writing the exam
was made voluntary. Each province could continue
to require their own exam be passed. As the BC
representatives still wanted to circulate the proposed
amendments to their members, the bill was delayed for
another year.
In April 1910 Kennedy summarized the progress. He
noted his eastern colleagues held a debt of gratitude to
the westerners for “stimulating life into the project.” If
the CMA failed, he said, the fallback would be a western
federation. His Alberta colleague, registrar Dr. James
Lafferty, noted, “it’s unlikely the opportunity will present
itself again.”
Drs. Braithwaite, Brett and Kennedy visited the
Saskatchewan Medical Council in July 1910 and
persuaded them to support the western federation
movement, because advancement toward a national
examination again stalled.
In November, BC physicians responded positively to the
second circular. So on January 23, 1911, Dr. J.B. Black
presented the amendments, as a private members bill in
the House of Commons. They were passed.
But the deliberations weren’t over. In February 1911
Manitoba, Alberta and Saskatchewan physicians met
because they felt under-represented on the Dominion
Medical Council, as they had only one medical school.
They asked, and every association agreed, that two of the
three federal cabinet appointees could be from the three
western provinces. The first ones were Drs. Kennedy
(AB), Baptie (BC) and Roddick. The three remaining
provinces passed enabling acts in BC (February 1912),
Quebec (April 1912) and Ontario (April 1912). Royal
assent was given on May 19, 1912. Authority to grant a
license to practice was still left to the provinces, while
writing the national exam remained voluntary.
At the annual CMA meeting in Edmonton on August 12,
1912, retiring CMA President Dr. Harry G. Mackid of Calgary,
accepted a motion to appoint Dr. Roddick as the honorary
president of the CMA for the rest of his life. The motion was
passed with a chorus of cheers and a standing ovation.
By June 1913, the regulations to the act were passed and
the federal government began contributing $15,000 per
year, which they did until 1917, to support it.
The first LMCC examinations were held on October 7, 1913,
in French and English in Montreal; 41 out of 71 passed. By
then 85 physicians had applied for registration under the
grandfathering clause.
On June 16, 1914, Dr. Roddick resigned as the first MCC
president (and registrant number one), and was made
its honorary president for the rest of his life. He was
knighted that spring.
The seminal contributions of Alberta physicians to the
establishment of the Medical Council of Canada and the
national licensing examination system we now have, has
been buried for over a century, until now.
34
IN A DIFFERENT VEIN
The union and the re-union
Alexander H.G. Paterson, MB ChB, MD, FRCP, FACP | CO-EDITOR
“Twas the Scots that built
this country,
It should never be forgot.
In each Canadian family
Somewhere there
is a Scot.”
(Bowser and Blue, Montreal Song Book 1994)
E
dinburgh! My 45th anniversary medical school
re-union! Edinburgh, dour city of Scots law,
medicine, famous writers and regiments; city
of sceptics who must be won over to achieve any
recognition in arts or sciences ¬ Athens of the North,
Edina the Capital ¬ the seat of the enlightenment, the
fortress that must be taken and secured to control the
Kingdom of Scotland.
Forty-five years! My God, a milestone reached in a
twinkling since strutting around the quad of the old
medical school in a rented cap and gown, glowing faces
with a few blobs of fresh acne, priggishly calling each
other “doctor” and receiving a diploma in the McEwan
Hall that actually indicated that we were only Bachelors
of Medicine and Surgery, not real doctors.
It’s disturbing and invigorating to see old friends,
acquaintances, rivals and enemies again after so many
years ¬ the safety of slow, imperceptible change in
people you see all the time contrasting with the shock,
laced with a cackle of amusement, at seeing young faces
become old, hair greying, balding with a fattening of
facial features and thickening of bone structure like
a PowerPoint slide presentation of before and after
45 years, youth and age. Racial characteristics seem to
become emphasized with age, faces becoming craggy,
losing the softening effect of young bone and sex
hormones ¬ wrinkled faces reflecting the sadness or
harmony of their preceding life, with fleeting behavior
characteristics that you remember ¬ an inane grin,
a tilting of the head, a silly laugh.
I was also there two days after the Referendum for
Independence ¬ a vote that had taken the world, and
certainly the London politicians, by surprise. There
was an atmosphere of fatigue ¬ like the morning after
a raucous party ¬ and also a sense of relief, at least in
the capital ¬ that the UK had survived. It was the same
feeling Canada had in the days after the second Quebec
referendum, a feeling that the 300 year old Union of
the United Kingdom ¬ just as the unity of Canada ¬
had survived by the skin of its teeth, a feeling that the
leadership had been caught napping, realizing too late in
their conceit and arrogance that they could go down in
history as fools and losers in a great tidal wave of change.
And the irony of David Cameron (an ancient Scots
family) the British Prime Minister ¬ just as Jean Chrétien
(the French Canadian) the Canadian Prime Minister both
unpopular in their home territory and unable to sway the
vote away from independence.
It’s disturbing and invigorating to see
old friends, acquaintances, rivals and enemies
again after so many years.
Scots ¬ whether in Scotland or Canada ¬ can be
tiresomely nationalistic. They know there is more
expected of one when claiming Scots descent ¬ the extra
mile that has to be walked, the extra effort to see the
job completed. This curse has been instilled by a Scots
granny, a fearsome disapproving arbiter lurking in the
subconscious, whose body language and pithy comments
conveyed approval or disapproval. Scots also believe
that they are known throughout the world as thrifty,
adaptable people who invented pretty much everything
that the Chinese forgot to invent.
And in the rest of the world there is a bemused
agreement that this might be so, and often a feeble
effort to join the club by offering up a great grandmother
who was from Bogandreip or a second cousin from
Strathkipper. >
> Well ... not all. Try telephoning and booking an Avis rental
car for an Edinburgh airport pick-up:
35
“Your call is important to us. This call may be used for
quality purposes…”
“My name is Wanda. How can I help you?”
“I’d like to book a rental car September 29th for a week
from Edinburgh Airport.”
“Edi-burr? Where’s that? ....Sc-ah-tland? Zat Sc-ah-tland,
Texas? Can you spell that?”
Not everyone has a Scottish granny.
The world, then, was taken by surprise that trouble was
brewing, that a free vote, a referendum on complete
independence, a break-up of the historic UK, had been
set for September 18, 2014, the 700th anniversary of
the Great Battle of Bannockburn (1314) outside Stirling
when the Scots (outnumbered three to one) sent packing
homeward a mighty army under Edward the Second of
England “tae think again.” By the beginning of September,
the world was indeed hanging on the battle of the Scottish
independence referendum with implications for Catalonia,
Quebec, Brittany, Flanders and many other wannabe
sovereign regions.
James Bond OO7, Sean Connery, growled “It-sh about
bloody time Sh-cotland threw off the Sh-assh-enach
yoke.” David Bowie and David Beckham supported the
“No ¬ Better Together” campaign, with Harry Potter
(funded by J.K. Rowling) putting up $2 million to help.
On the day of the referendum, people reported seeing
a cloud formation of the face of Bono hovering over
Edinburgh Castle.
But in this sad, brutal world the referendum was perhaps
an event to be proud of ¬ although wariness is now
creeping in. No one was stuffed into the boot of a car
and killed; no one was beaten up or shot by the police;
no one was sent to prison for life like Illham Thoti
(a Uyghur economist asking for dialogue between the
Han Chinese and the Uyghur population in China’s
Xinjiang Province); and no one publicly had their head
hacked off. It’s true that in Glasgow some discussions
ended with the “Glesca nod”1 outside pubs and several
discussants received a “Glesca smile”2 but statistically the
incidence of punch-ups was no greater than an average
month. It was only the topic of dispute that had changed.
This was a nice demonstration of a civilized democracy
at work with only a few gatherings getting out of hand.
It showed (as in Quebec) that it is possible to consider
major shifts in power without resorting to the gun
or knife. This is a jab in the eye to the promoters of
pseudo-democracies.
Our medical school re-union intertwined with the
referendum on the Union not only in political discussions
but in a feeling of unexpected and too rapid change,
change that had crept up on us without our realizing
that the old ways of thinking were gone, that we were
no longer the instruments of change, that a younger
generation was forcing us to think differently.
Dr. Paterson beside Greyfriars Bobby, symbol of Loyalty, decked in the Saltire, the
St Andrew's Cross, the flag of Scotland. ( provided by Dr. Alexander H.G. Paterson)
The Yes campaign for Independence, led by the
non-telegenic Alex Salmond, a fairly quick-witted
chap with beady eyes, surged ahead in the closing
days with promises of a better life for all ¬ paid for by
North Sea Oil. He has what in Glasgow is called “the
patter” ¬ a cousin of “the blarney” but with an aspect
of showmanship that leaves opponents or doubters
gobsmacked. The “patter merchant” has a ready answer
for everything and what is more, he looks like he has
already won the argument.
The No campaign, led by the more telegenic but
patter-lacking Alistair Darling, an Edinburgh lawyer
and ex-Labor Party Chancellor of the Exchequer
(uncomfortably taunted by the Yes side of being an
“Edinburgh toff”) struggled with trying to warn the
electorate that difficult financial negotiations would take
place if they voted for an isolated socialist paradise.
While money from North Sea Oil may keep things
going for a year or two, he said, it was not a great gift to
bequeath to the coming generations. All influence on the
financial system, the military, immigration and foreign
affairs would dwindle. Nationalistic Socialism did not
have a happy history.
Scotland however, unlike Quebec, is a ready-made
country with its own legal system based on Roman
law, its own religion, its own education system, and its
banks even print their own bank notes with pictures of
the Forth Bridge and Adam Smith. It does not, however,
have a Central Bank having given that over to the Bank of
England in 1707 at the time of the Union. The bank of dad
would be pretty small given the population of five million
in an independent country. Canada’s own Mark Carney, >
36
> now the governor of the Bank of England, made that
clear. Scotland would be on its own. The Yes side sneered
that it was all fear mongering.
The Union of Parliaments in 1707 had resulted from
the wishes of a Dutch king (William of Orange) tired
of dealing with two separate, troublesome parliaments
and a financial disaster when half the available capital in
Scotland was invested and lost in a forlorn attempt to set
up a colony in Panama ¬ an idea of a trading port between
the Atlantic and the Pacific 200 years ahead of its time.
The aristocrats who lost money in the Darien Scheme
were compensated from the English national debt:
“We’re bought and sold for English gold ¬
Such a parcel of rogues in a nation!”3
I was also there (in Scotland) two days
after the Referendum for Independence – a
vote that had taken the world, and certainly
the London politicians, by surprise.
Union Jack still flying on Edinburgh Castle the day after the Independence vote was
defeated. ( provided by Dr. Alexander H.G. Paterson)
If you ask people in Scotland what new tax powers they
want, they usually say they don’t want more tax powers,
they want more tax transfers. Like Quebec, the issue
is a feeling ¬ not supported by statistics ¬ that money
collected from Scotland was staying in London just as
Ottawa is the bogeyman here in Canada.
But few think this is the end of the story. In contrast to
Quebec where most of the young have eschewed fighting
another sovereignty referendum provided they have cheap
education, in Scotland it was the young who voted in favor
of independence and the old who voted “better together”
¬ the safe but uninspiring slogan of the “No” campaign.
“You’ll hear a lot more from us,” said Gordie, an old friend
who voted 'Yes.' “There’s a growing youth movement
called Radical Scotland that will come of age as old bozos
like you, worried about your pensions, kick the bucket.
That’ll swing the vote at the next referendum.”
In a panic, the three mainstream British political parties
offered up “devolution maximum” with few details
(where the devil lives). Independence was defeated in
a vote 55% for “No” versus 45% for “Yes.” But now the
mud-wrestling will begin.
“The UK treasury will resist ¬ and not without reason
¬ ceding fiscal policy. The result is likely to be an
unsatisfactory patchwork of reforms that decentralizes
some minor aspects of tax policy but puts in place a
complex formula beloved of lawyers and accountants
that appears to give new powers without really
ceding anything.”4
How could it have all come to this?
Wreaths on Covenanters execution block Grassmarket. (
Dr. Alexander H.G. Paterson)
provided by
I had not been to a re-union dinner for years and you
tend to stick with the people you knew well at school.
Seeing the ravages of time was unsettling. It was also
fascinating to catch up with the peculiar turns in careers
of some acquaintances. Mary, a shy girl, had become a
well-known forensic psychiatrist and medical director
of the State Hospital for the Criminally Insane; she
deals with the most hardened psychopathic rapists and
murderers. I imagined her tiny presence interviewing a >
> Silence of the Lambs psychopath with two burly guards
standing behind her.
And Elspeth had become a palaeontologist of quaternary
fossils. I asked Elspeth why she had voted “Yes.”
“Simple. We’d be able to influence our own lives better,”
she said.
It was the same feeling Canada
had in the days after the second Quebec
referendum, a feeling that the 300 year old
Union of the United Kingdom – just as the
unity of Canada – had survived by the skin
of its teeth.
retirement cottage with a boat, appearing pinched
and sallow. He was dying of aggressive prostate cancer.
I am ashamed to admit, I didn’t have the heart to sit with
poor Rob.
As my dear old friend, John, in Edmonton, says: “You
never know what’s coming round the corner.”
There was Gollock, the class comedian, in a fancy scarlet
dinner jacket and waistcoat, now a successful general
surgeon. (“He’s so amusing,” my mother-in-law had said
before he took out her colon.) And Pam, a radiologist
who had just been diagnosed with an asymptomatic
lung cancer:
“It was only 3.3 centimetres,” she said. “So I guess
I’m lucky. I’m a bit breathless though. Probably
the lobectomy.”
Only 3.3 centimetres! I said nothing.
An old friend, Robin, a radiation oncologist, and I
compared plastic snoring gizmos. And John, an
endocrinologist, who has made a fortune after founding
Shire Pharmaceuticals ¬ now a take-over target of
AbbVie Corporation who are attempting to avoid United
States of America corporate taxes by “inverting” as they
call it in the accounting business. And Rocky, hale and
hearty with a full head of hair ¬ even covering his Friar
Tuck crown, with the merest tinge of grey flecks.
But underneath it all was an undercurrent of death, that
this might be the last time we would see each other ¬ the
dark spectre of the Man with the Scythe looking over all
of our shoulders. Roger, Cliff, Jim ¬ grey haired old men
in glasses ¬ I barely knew them then and still don’t
know them.
All this was in The New Club (named so in 1787)
overlooking the Castle and Princes Street. You enter
by an unnoticeable door on Princes Street and walk
through the narrow entrance hallway which then
magically expands into massive halls, rooms and
landings with magnificent oil paintings like the wardrobe
entry to the Land of Narnia in “The Lion, the Witch and
the Wardrobe.”
"Yes" signs in tenement house windows. (
provided by Dr. Alexander H.G. Paterson)
The politics of “Yes” was a mix of anglophobia,
resentment and suspicion that North Sea Oil money
was staying in the London area, the notion that
decision-making and “social justice” would be served
better by an Edinburgh parliament, all salted by an
appeal to noble, ancient Scottish traditions. The Saltire5
was draped everywhere (see photograph) even round
the neck of the statue of the little dog, Greyfriars Bobby,
symbol of loyalty.
And there was Rob, just retired as a consultant
obstetrician and gynecologist and settled in his
It was a re-union of medical friends, most of us fairly
successful, grown old and a bit weary meeting in an
ancient land where the young and the poor had grown
tired of a successful Union. A new generation was taking
over, willing to risk a lot for the illusion ¬ or possibly the
reality, who knows? ¬ of a better life, turning inwards
and back to an old regime, in a world where it seemed
to us greybeards that this was a mistake, that the way to
turn was outwards, looking fearlessly at an increasingly
connected, increasingly brutal and rapidly changing
world. But the 'Yes' side has momentum. We’re pseudoconnected by technology, but people, nearly half of the
Scottish voters, are looking for palpable, real connections.
We have not heard the last of this.
37
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CLASSIFIED ADVERTISEMENTS
LOCUM WANTED
CALGARY AB
Internal medicine locum required
for busy multidisciplinary clinic from
December 12 to January 26, 2015.
Contact: Dr. Chan
T 403.909.7300
PHYSICIAN WANTED
CALGARY AB
Part- or full-time physician(s) needed
for a new walk-in/family clinic project
on Macleod Trail S and Heritage
Drive. Physicians would be able to
sublease their space or for a good
split of 80/20. Great location and
visibility facing Macleod Trail. On-site
pharmacy. Sublease rate negotiable.
Contact: Rafik
T 403.796.4441
CALGARY AB
MCI The Doctor’s Office™ has family
practice options available in Calgary.
With more than 27 years of
experience managing primary care
clinics and eight locations, we can
offer you flexibility with regard to
hours and location. We provide
nursing support and electronic
medical records. We’ll move your
practice or help you build a practice.
Walk-in shifts are also an option.
All inquiries will be kept strictly
confidential.
Contact: Margaret Gillies
TF 1.866.624.8222, ext. 133
[email protected]
CALGARY AB
Dr. Neville Reddy is recruiting
family physicians and specialists for
his two medical clinics, Innovations
Health Clinic SE and Innovations
Health Clinic SW. Competitive
expenses offered.
Contact: [email protected]
CALGARY AND EDMONTON AB
EDMONTON AB
Imagine Health Centres in Calgary
and Edmonton have an immediate
opening for a psychiatrist certified
or eligible for certification with the
College of Physicians & Surgeons
of Alberta (CPSA).
Physicians with compassion for the
population of downtown Edmonton
are encouraged to apply at the Hope
Mission Health Centre. Part- or
full-time are welcome.
Imagine Health Centres are dynamic
multidisciplinary clinics with a large
array of services including family
physicians, specialists and many
other allied health professionals such
as pharmacists, physiotherapists,
psychologists and more. Imagine
Health Centres is dedicated to
promoting the health of patients
utilizing the most up to date
preventative and screening strategies.
The successful candidate will work
closely with our multidisciplinary
team to optimize management of our
patients with mental health issues.
Collaborate with our large network of
family physicians and their referrals to
maximize outcomes for your patients.
Opportunities for group therapy and
corporate health are available. There
are also opportunities to help develop
leading programs for mental health
at all levels of primary care within
our multiple sites located throughout
Calgary and Edmonton.
An attractive compensation
package will be offered to the
successful candidate.
All candidates must be immediately
eligible for licensure or already
licensed with the CPSA and provide
proof of malpractice insurance from
the Canadian Medical Protective
Association. Compensation is
fee-for-service.
All inquiries will be kept strictly
confidential and only qualified
candidates will be contacted.
Contact:
Submit your CV to: Joanne Oliver
[email protected]
Physicians will be salaried through
Alternative Relationship Plan funding
from Alberta Health Services at
competitive rates.
Contact: Clinic Manager
T 780.422.2018, ext. 278
[email protected]
EDMONTON AB
All Healthy Medical Clinic is a new
clinic inside the Great Canadian
Superstore at 12350 137 Avenue.
We are looking for a family physician
who can work part- or full-time with
flexible hours. We offer a 75/25 split,
use Healthquest electronic medical
records and member of the Edmonton
North Primary Care Network.
We have three specialists on site,
rheumatologist/internist, neurologist
and pediatrician. We operate by
appointments and walk-ins.
Contact: Dr. Mohamed Albrbar
12350 137 Ave NW
Edmonton AB T5L 4X6
T 780.293.9394
T 780.406.5514 (clinic)
[email protected]
EDMONTON AB
Urban Medical Clinic in vibrant
southeast Edmonton is a new state
of-the-art medical clinic that is rapidly
expanding. The clinic uses TELUS
PS Suite electronic medical records.
Our team currently includes two
family physicians and we are part of
Edmonton Southside Primary Care
Network with full-time nurse and
dietician. We have 8,000 patients
registered. The clinic is growing and
we are recruiting part- and full-time
physicians. Competitive overhead
for long term commitments. We
have eight examination rooms, one
procedure room and one specially
designed wheelchair room. >
39
40
>
Contact: Dr. Oshean Naidoo
[email protected] or
Dr. Dhanakodi Rengan
[email protected]
T 780.757.9545
EDMONTON AB
North Town Medical Centre is
looking for part- and full-time family
physicians and specialists to join our
team. North Town Medical Centre is
a multidisciplinary clinic with three
family physicians, two specialists and
two chiropractors. The clinic is in a
strip mall with plenty of free parking,
close to medical imaging, pharmacy
and laboratory. Modern well-equipped
facility with highly trained staff
allow for no administrative burdens,
electronic medical records, no hospital
on-call, plenty of examination rooms,
offices for physicians and competitive
fee split. Flexible schedule can
accommodate physicians who are
looking to pick up extra shifts or a
new physician wanting to open their
practice to new patients.
If interested in knowing more
regarding this great opportunity,
please contact us.
Contact: Dr. Hassen Taha
T 780.905.0027 or
Dr. Ataher Mohamed
T 780.298.2986
[email protected]
EDMONTON AB
Beverly Medical Clinic is a new
state-of-the-art medical clinic that is
rapidly expanding. Our team currently
includes three family physicians, two
internists and a pediatrician.
The clinic is growing and needs more
dedicated family physicians as one of
the physicians is planning on slowing
down. Competitive overhead for long
term commitments; 75/25% split.
We have 10 examination rooms, one
treatment room and one specially
designed pediatric room.
Contact: Dr. A. Elfourtia or
Dr. Z. Ramadan
Beverly Medical Clinic
4243 118 Ave
Edmonton AB T5W 1A5
T 780.756.7700
C 780.224.7972
EDMONTON AB
Ellerslie Medical Centre in southwest
Edmonton is seeking part- and
full-time physicians. The busy clinic
is in a prestigious and fast-growing
community which has a high public
demand for family physicians. The
physician income will be based
on fee-for-service with an average
annual income of over $300,000. The
physician must be licensed or eligible
to apply for licensure by the College
of Physicians & Surgeons of Alberta
(CPSA). For the eligible physicians,
their qualifications and experience
must comply with the CPSA licensure
requirements and guideline.
Contact: Walid
11140 Ellerslie Rd SW
Edmonton AB T6W 1A2
T 780.884.4124
[email protected]
EDMONTON AB
Evansdale Medical Clinic, 8214 144
Avenue in Edmonton is looking for a
part- and full-time family physician to
be part of our community to support
and help with patients continuing
health care needs. We are looking for a
doctor on a permanent basis. We are a
growing busy clinic in north Edmonton
with friendly, supportive and outgoing
staff. Income per year depending on
fee per service would be approximately
$300,000. Our clinics offer pleasing
working conditions with well-equipped
modern facility and electronic medical
records in each room.
Contact: Dr. A. Aradi
T 780.478.0975
F 780.478.0976
Evansdale Medical Clinic
8214 144 Ave
Edmonton AB T5E 2H4
Send résumé to:
[email protected]
EDMONTON AB
Two positions are immediately
available at the West End Medical
Clinic/M. Gaas Professional
corporation, located at unit M7, 9509
156 Street, Edmonton AB T5P 4J5.
Full-time family physician/general
practitioner positions are available.
The physician who will join us at
this busy clinic will provide family
practice care to a large population of
patients at west end and provide care
to all patients of different age group,
pediatric, geriatric, antenatal and
prenatal care.
The physician income will be based
of fee-for-service payment and the
overhead fees are negotiable. The
physician must be licensed and
eligible to apply for the licensure by
the College of Physicians & Surgeons
of Alberta (CPSA). Their qualifications
and experience must comply with
the CPSA licensure requirements
and guidelines. If you are interested
please contact us.
Contact: Dr. Gaas
T 780.756.3300
C 780.893.5181
F 780.756.3301
[email protected]
EDMONTON AB
Alberta Health Services in partnership
with the University of Alberta, Faculty
of Medicine & Dentistry, Department
of Family Medicine, is inviting
applications from family physicians
with expertise in geriatrics to join
the Glenrose Rehabilitation Hospital
Geriatric Inpatient Rehabilitation
Program in the Edmonton Zone.
The Glenrose Rehabilitation Hospital
is the largest free-standing tertiary
rehabilitation center in Canada serving
patients of all ages who require
complex rehabilitation to enable
them to participate in life to the
fullest. As a leading-edge academic
teaching hospital, the Glenrose
participates in educational training
programs for health sciences
professionals and offers an array
of research and technology
development opportunities.
The successful candidates will join
an integrated group of health care
professionals. Geriatric patients are
the focus of our service. Treatment
includes an integration of medicine,
nursing, rehabilitation, social work and
pharmacotherapies. These patients
have had acute physical, cognitive
and social decline in the past two
to three months and have reduced
independence. The responsibilities for
successful individuals would include
clinical rehabilitative care for six >
> in-patients, working collaboratively
with the interdisciplinary team,
participating in an on-call roster
(average one in eight second call),
completing all administrative data
related to cared-for patients, and
participating in regular meetings
related to patient care and quality
improvement. Remuneration is
competitive and based on a clinical
alternative relationship plan.
The successful applicants shall have
a MD or be eligible for certification
in family medicine with the Royal
College of Physicians and Surgeons of
Canada or with the College of Family
Physicians and be eligible for licensure
with the College of Physicians &
Surgeons of Alberta. Training in
geriatrics and/or experience in the
care of the elderly would be an asset.
We offer core geriatrics training
to anyone interested. A proven
track record of collaboration and
mentoring trainees is preferred. This
individual will be encouraged to apply
for a clinical academic colleague
appointment in the Department
of Family Medicine, University of
Alberta, which will be considered
through a separate process with the
Faculty of Medicine & Dentistry.
Edmonton, with a growing
population of over one million, is the
cosmopolitan capital of Alberta. With
an abundance of services, beautiful
river valley, community activities and
attractive and financially reasonable
living accommodations, this energetic
city has something for everyone.
Edmonton boasts a superior public
education system for school-aged
children through Edmonton Public
Schools. For more information, visit
http://www.epsb.ca/
Details about the University of Alberta,
Faculty of Medicine & Dentistry and
the Department of Family Medicine
can be found on the faculty’s web
site at www.med.ualberta.ca; Alberta
Health Services can be found at
www.albertahealthservices.ca and
the City of Edmonton is available at
www.edmonton.ca.
Interested candidates should submit a
curriculum vitae outlining their current
clinical and leadership experience, and
three reference letters. We will begin
reviewing applications as soon as they
are received however the competition
will remain open until the position
is filled.
All qualified candidates are encouraged
to apply; however, Canadians and
permanent residents will be given
priority. The University of Alberta and
Alberta Health Services hire on the
basis of merit. We are committed to
the principle of equity in employment.
We welcome diversity and encourage
applications from all qualified
women and men, including persons
with disabilities, members of visible
minorities and Aboriginal persons.
Contact: Dr. Hubert Kammerer or
Dr. Elisa Mori-Torres
Co-facility Chiefs, Geriatrics
Glenrose Rehabilitation Hospital
10230 111 Avenue NW
Edmonton AB T5G 0B7
T 780.920.4773 or 780.910.2509
F 780.735.8846
[email protected] or
elisa.mori-torres@
albertahealthservices.ca
EDMONTON AND
FORT MCMURRAY AB
MD Group, Lessard Medical Clinic,
West Oliver Medical Centre and
Manning Clinic each have 10
examination rooms and Alafia
Clinic with four examination rooms
are looking for six full-time family
physicians. A neurologist, psychiatrist,
internist and pediatrician are required
at all four clinics.
Two positions are available at the
West Oliver Medical Centre in a
great downtown area, 101-10538
124 Street and one position at the
Lessard Medical Clinic in the west
end, 6633 177 Street, Edmonton.
Two positions at Manning Clinic in
northwest Edmonton, 220 Manning
Crossing and one position at Alafia
Clinic, 613-8600 Franklin Avenue in
Fort McMurray.
The physician must be licensed or
eligible to apply for licensure by the
College of Physicians & Surgeons
of Alberta (CPSA). For the eligible
physicians, their qualifications and
experience must comply with the
CPSA licensure requirements
and guidelines.
The physician income will be based
on fee-for-service with an average
annual income of $300,000 to
$450,000 with competitive overhead
for long term commitments; 70/30%
split. Essential medical support and
specialists are employed within
the company and are managed by
an excellent team of professional
physicians and supportive staff. We
use Healthquest electronic medical
records (paper free) and member
of a primary care network.
Full-time chronic disease management
nurse to care for chronic disease
patients at Lessard, billing support and
attached pharmacy are available at the
Lessard and West Oliver locations.
Work with a nice and dedicated
staff, nurse available for doctor’s
assistance and referrals. Also provide
on-site dietician and mental health/
psychology services. Clinic hours are
Monday to Friday 8:30 a.m. to
8:30 p.m., Saturday and Sunday
10:30 a.m. to 5 p.m.
Contact: Management Office
T 780.757.7999 or
T 780.756.3090
F 780.757.7991
[email protected]
LEDUC AB
Exciting opportunity for family
physicians wanting to start or relocate
his or her practice in Leduc. We are
an established family medical practice
closing due to retirement. Office,
medical equipment and supplies
included. Office staff willing to
continue with practice.
Contact: Jodie (Office Manager)
T 780.986.1714
RED DEER AB
Well-established family practice
clinic with four physicians has
an opportunity to add a part- or
full-time physician. Diverse patient
population, electronic medical
records and primary care network
support. Hospital privileges necessary,
obstetrics optional. Excellent support
regarding on-call schedule.
Contact: Dr. L. Ligate
F 403.346.4207
[email protected] >
41
42
> SHERWOOD PARK AB
Well-established clinic with five family
physicians recently expanded and has
opportunities for one to two part- or
full-time physicians. Flexible hours
and competitive fee split. We are in a
professional building with laboratory
and X-ray on site. We have current
electronic medical records, primary
care network nurse support and
excellent support staff.
PHYSICIAN(S) REQUIRED FT/PT
Also locums required
Contact: Dr. Lorraine Hosford
T 780.464.9661
[email protected]
PHYSICIAN AND/OR
LOCUM WANTED
CALGARY AND EDMONTON AB
You require balance … you demand
the best. Join the fastest growing
medical group in Alberta to practice
medicine the way it was meant to be.
Imagine Health Centres (IHC) is
currently looking for family physicians
and specialists to come and join our
dynamic team in part-time, full-time
and locum positions available in
Calgary or Edmonton. Physicians
will enjoy extremely efficient
workflows allowing for very attractive
remuneration, no hospital on-call,
paperless electronic medical records,
friendly staff and industry-leading
fee splits.
Imagine Health Centres are
multidisciplinary family medicine
clinics with a focus on health
prevention and wellness. Come and
be a part of our team which includes
physicians, physiotherapists, massage
therapists, psychologists, nutritionists
and pharmacists.
Imagine Health Centres prides itself
in providing the very best support for
family physicians and their families in
and out of the clinic. Health benefit
plans and full financial/tax/accounting
advisory services are available to
all IHC physicians. There is also an
optional and limited time opportunity
to participate in ownership of our
innovative clinics.
We currently have three Edmonton
clinics with a fourth coming to
ALL-WELL
PRIMARY CARE CENTRES
MILLWOODS EDMONTON
Phone: Clinic Manager (780) 953-6733
Dr. Paul Arnold (780) 970-2070
Windermere (southwest Edmonton)
in early 2015. The current clinics are
near South Edmonton Common,
Old Strathcona and West Edmonton.
We currently have one clinic in
southeast Calgary with a second clinic
that opened downtown in September.
If you are interested in learning more
about our exceptional clinics, please
contact us. All inquiries will be kept
strictly confidential.
Contact: Joanne Oliver
T 780.907.3777
[email protected]
EDMONTON AB
Summerside Medical Clinic and
Edge Centre Walk-in Clinic require
part-time and full-time physicians.
Locums are welcome. The clinics
are in the vibrant, rapidly growing
communities of Summerside and Mill
Woods. Examination rooms are fully
equipped with electronic medical
records, printers in all examination
rooms and separate procedure room.
Contact: Dr. Nirmala Brar
T 780.249.2727
[email protected]
PRACTICE FOR SALE
CALGARY AB
Well-established group family
medicine practice for sale in
northwest Calgary. Part of the Calgary
Foothills Primary Care Network
co-located with physiotherapy,
rehabilitation, dentist, optometrist
and pharmacies. Turn-key solution,
furnished, all equipment and new
computer hardware included. Large
patient base and sufficient Physician
Office System Program funding
remaining to assume. Ten examination
rooms, five physician practice,
leased premises, clinic manager with
experienced staff including registered
nurse and licensed practical nurse.
Contact: Dr. Virani
[email protected] >
>
COURSES
CME CRUISES WITH
SEA COURSES CRUISES
• Accredited for family physicians
and specialists
• Unbiased and pharma-free
• Canada’s first choice in CMEatSEA®
since 1995
• Companion cruises FREE
AUSTRALIA AND SOUTH PACIFIC
January 16-30, 2015
Focus: Rheumatology,
gastroenterology and
infectious diseases
Ship: Oosterdam
ANTARCTIC AND SOUTH
AMERICA
February 3-24, 2015
Focus: Explorations in medicine
Ship: Seabourn Quest
EASTERN CARIBBEAN
March 14-22, 2015
Focus: Primary Care Update
Ship: Independence of the Seas
TAHITI AND TUAMOTUS
March 18-28, 2015
Focus: Geriatrics, physician health
Ship: Paul Gauguin
HAWAIIAN ISLANDS
April 20-May 1, 2015
Focus: Improved patient care
Ship: Celebrity Solstice
DALMATIAN COAST
May 28-June 9, 2015
Focus: Cardiology and dermatology
Ship: Celebrity Constellation
EXOTIC ASIA
June 15-24, 2015
Focus: Women’s health
and endocrinology
Ship: Quantum of the Seas
BRITISH ISLES
July 15-27, 2015
Focus: Endocrinology,
gastroenterology and
infectious diseases
Ship: Celebrity Silhouette
ALASKA GLACIERS
August 2-9, 2015
Focus: Cardiology and respirology
Ship: Celebrity Infinity
MEDITERRANEAN
September 19-October 2, 2015
Focus: Challenges in medicine
Ship: Celebrity Equinox
ST. LAWRENCE
September 19-27, 2015
Focus: Third annual McGill
CME cruise
Ship: Crystal Symphony
FIJI TO TAHITI
November 10-21, 2015
Focus: Endocrinology and diabetes
Ship: Paul Gauguin
SOUTH AFRICA
November 24-December 9, 2015
Focus: Adventures in medicine
Ship: Regent Seven Seas Mariner
CARIBBEAN NEW YEAR’S
December 27, 2015-January 3, 2016
Focus: Dermatology and
women’s health
Ship: Freedom of the Seas
AUSTRALIA AND NEW ZEALAND
January 5-19, 2016
Focus: Caring for an aging patient
Ship: Celebrity Solstice
For current promotions and pricing,
contact: Sea Courses Cruises
TF 1.888.647.7327
[email protected]
www.seacourses.com
SERVICES
RECORD STORAGE & RETRIEVAL
SERVICES INC.
Closing your practice? RSRS provides
free paper and electronic record
storage, retention, notification,
transfer and shredding for Alberta
doctors. RSRS is physician-managed
since 1997. We also provide scanning
and storage services for active
practices.
Contact: RSRS
TF 1.888.563.3732, ext. 2
F 1.877.398.5932
[email protected]
www.rsrs.com
RUTWIND BRAR PROFESSIONAL
ACCOUNTANTS
With an established medical PC
clientele, we are able to efficiently
and effectively meet all of your
financial needs. Our services include
PC incorporations, tax planning
specifically designed for physicians,
their families and their PCs, as well as
full accounting services.
Contact: Rutwind Brar Professional
Accountants
T 780.483.5490
F 780.483.5492
[email protected]
www.rbpa.ca
DISPLAY OR
CLASSIFIED ADS
TO PLACE OR RENEW, CONTACT:
DOCUDAVIT MEDICAL SOLUTIONS
Daphne C. Andrychuk
Retiring, moving or closing your
family or general practice, physician’s
estate? DOCUdavit Medical Solutions
provides free storage for your paper
or electronic patient records with no
hidden costs. We also provide great
rates for closing specialists.
Communications Assistant,
Public Affairs
Contact: Sid Soil
DOCUdavit Solutions
TF 1.888.781.9083, ext. 105
[email protected]
Alberta Medical Association
T 780.482.2626, ext. 275
TF 1.800.272.9680, ext. 275
F 780.482.5445
daphne.andrychuk@
albertadoctors.org
43
“I INVEST
WITH MD
BECAUSE
THEY’RE
EXPERTS.”
− Dr. Ralph Jones, Family Physician
MOST CANADIAN PHYSICIANS CHOOSE
MD AS THEIR PRIMARY INVESTMENT FIRM.1
MD is the only financial services firm created to meet the specific
needs of physicians. We offer personalized, objective advice on
everything from investments and incorporation, to insurance,
banking, borrowing and estate and trust.
WHY WILL YOU INVEST WITH MD?
CONTACT AN MD ADVISOR TODAY TO DISCUSS
YOUR INVESTMENT NEEDS.
1 877 877-3706 | md.cma.ca/invest
1
MD Physician Services Loyalty Survey, June 2014. Respondents (MD clients and non-MD clients) asked to identify
their primary financial institution (MD or Other), and then rate their level of trust associated with that institution.
MD received the highest trust rating compared to all other firms rated.
MD Physician Services provides financial products and services, the MD family of mutual funds and investment
counselling services through the MD group of companies. Incorporation guidance limited to asset allocation and
integrating corporate entities into financial plans and wealth strategies. Professional legal, tax and accounting
advice regarding incorporation should be obtained in respect to an individual’s specific circumstances.
Banking products are offered by National Bank of Canada’s Partnership Branch through a relationship
with MD Management Limited.

November/December 2014 - Alberta Medical Association

Transcription

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