Infighting impedes health system change: new CMA president

By Lauren Vogel | CMAJ | Aug. 24, 2016

Infighting impedes health system change: new CMA president

By Lauren Vogel | CMAJ | Aug. 24, 2016

Dr. Granger Avery took the helm of the Canadian Medical Association today with a call for collaboration. (Courtesy of G. Avery)

Doctors need to stop fighting with governments and amongst themselves, and start thinking collaboratively to improve health care in Canada, said new Canadian Medical Association (CMA) President Dr. Granger Avery in his inaugural address to members on Aug. 24.

“If we are going to seize this moment in time and actually bring about the crucial changes to our health care system … we will need to do it by working together,” he told doctors at the CMA General Council meeting in Vancouver. “We must not succumb to polarization and infighting.”

Avery cited the ongoing contract battle between Ontario and its doctors as the “latest in a sad litany of confrontation.”

“The playbook is the same: governments impose financial targets; doctors rail against them,” he said. Meanwhile, “health system managers are caught in the middle with insufficient dollars” and patients “are confused, lost and ignored as the health care system spirals into turf protections, dysfunction and cost explosion.”

Canada’s slipping performance in international health system comparisons and the tragically poor health outcomes of indigenous people are two further signs that the status quo isn’t working, Avery said. “Breaking that vicious circle requires that we think differently.”

He called for collaboration between all parties involved in health care – governments, health professionals, academics, health care managers and the public – to develop a new vision for the system. This must emphasize “patient-centred, integrated, continuing care.”

It will also require a switch from issuing demands of one another to a stance of “appreciative inquiry,” Avery said. “The CMA is really the national organization to help broker this positive approach.”

However, the talk was short on concrete ways CMA would do this, beyond connecting physicians with members of parliament through an MD-MP program.

The playbook is the same: governments impose financial targets; doctors rail against them.

Asked at a later press conference about how this collaborative approach would work when parties disagreed, Avery argued it’s a matter of the attitudes brought to the table. “It’s conceptually relatively easy,” he said. “Where there are disagreements, I think we have the opportunity to say there is a better way to do things. We have this collaborative approach, which is a model for a better way to make decisions and protects every single partner.”

This might include enshrining physician rights to arbitration in contract negotiations under a new health accord, he added. “That’s an option that provinces and medical associations and others should explore.”

Heading into health accord talks, however, Avery stressed the importance of keeping all eyes on the prize of system transformation.

“What we have now is an opportunity with the health accord and with the federal government and some of the provincial governments that we have not had for decades, and if we miss this opportunity now we could conceivably miss it for a long time again.”

 

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