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A publication of the Saskatchewan Medical Association Volume 61 | 2021

DIGEST

RURAL ROOTS

HIGHS AND LOWS

of rural practice in the midst of COVID-19

SMA president Dr. Eben Strydom has been influenced by his small-town background

TWO TAKES ON COVID a retiring physician and the doctor taking over the practice share perspectives

PATIENCE & HUMOUR

PANDEMIC FATIGUE

Sask. medical community affected by chronicity of COVID-19

tools for dealing with vaccine hesitancy

THE

PANDEMIC ISSUE

Challenges, rewards of leadership during a pandemic 2021 | VOLUME 61 SMA Digest is the official member magazine of the Saskatchewan Medical Association. It is published annually and is distributed to practising physicians, students and residents in Saskatchewan.

Since the pandemic was officially declared in Saskatchewan on March 18, 2020, physicians around the province have given tirelessly of themselves to keep patients safe and healthy. Meet four physicians who have stepped out of their regular roles to help lead the province’s medical response to COVID-19.

Editor:

Maria Ryhorski (SMA staff )

Editorial board

Dr. John Gjevre (physician rep) Dr. Susan Hayton (physician rep) Ivan Muzychka (SMA staff ) Girard Hengen (SMA staff )

Upcoming issues

The next issue of SMA Digest is planned for distribution in 2022.

Advertising

Please contact the editor for 2022 advertising deadlines. Rates for display advertising are available upon request. Classified ad placement is free for members promoting physician, locum and practice opportunities; ads should be submitted via email and must not exceed 150 words.

Feedback

Member feedback is valuable and encouraged. Please direct comments, letters, ideas and advertising inquiries to: Maria Ryhorski (306) 657-4582 maria.ryhorski@sma.sk.ca Saskatchewan Medical Association 201-2174 Airport Drive Saskatoon, SK, S7L 6M6

SMA mission

As the common voice of our members, we serve, represent and unite Saskatchewan physicians. We advance the honour and integrity of the medical profession; advance the professional, personal, educational and economic well-being of Saskatchewan physicians; and promote a high-quality, patient-centred health-care system.

SMA DIGEST | FALL 2020

Pushed to the fringes

As COVID-19 swept the country over the past 19 months, an already marginalized group of people experienced even greater challenges than most in Saskatchewan. Those experiencing addictions and homelessness saw many community supports end abruptly, leaving some people, quite literally, out in the cold. Three physicians in Saskatchewan are acutely aware of the heightened impact of the pandemic on individuals who live on the fringes of society and they share their experiences, here.

CONTENTS

MEDICINE: ONE CAREER, MANY PATHS 4 6 9 13 15 19 22 24 26 28 32 38 40 43 44 47 48 50

President’s message Rural roots: Dr. Eben Strydom The year that felt like a decade Wrestling with pandemic fatigue Resilience and recovery: How La Loche beat back COVID-19 Challenges, rewards of leadership during a pandemic Sask. doctors take to social media to dispel misinformation Patience and humour: Tools for dealing with vaccine hesitancy Two takes on COVID Highs and lows of rural practice in the midst of COVID-19 How do you stay whole? Voice from the ICU All in the family: Dr. Biswa Datta, 2020 Physician of the Year Do’s and don’t’s of virtual care Pushed to the fringes Expectation vs. reality SMA EMR Program launches Enhanced Use Program Celebrating our staff

57 CLASSIFIEDS 58 IN MEMORIAM

Resilience and recovery

The first case of COVID-19 in La Loche appeared in early April 2020. A public health investigation determined the infection was linked to travel from northern Alberta. By mid-April, an outbreak of COVID-19 was declared at the local long-term care facility. Subsequent community transmission resulted in more than 250 people being confirmed positive, dozens hospitalized, and several deaths by the end of May 2020. Health resources at local and provincial levels were mobilized to deal with what at the time was the largest outbreak in Saskatchewan and the first in a remote Indigenous community in Canada. SMA DIGEST | FALL 2020

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Traditionally, physicians in need of care feel guilty about accepting care and shame for needing it.

Let’s start

the conversation

Many physicians struggle with undiagnosed, untreated or self-treated mental health issues. Many others struggle with relationship and family issues, and substance abuse. If you or a colleague is struggling, please contact the Physician Health Program for confidential support.

Brenda Senger

Jessica Richardson

Director, Physician Support Programs

Clinical Coordinator (Regina)

306. 244. 2196 or brenda.senger@sma.sk.ca

306.359.2750 or jessica.richardson@sma.sk.ca

PRESIDENT’S MESSAGE As I write this message Saskatchewan is deep into the fourth wave of the COVID-19 pandemic. This is a troubling development, but I am confident the physicians of the province and the Saskatchewan Medical Association (SMA) will meet this challenge with the same resolve and determination as they did in previous phases of this unfortunate historic event. The pandemic is not even close to being over, and we need to become used to the idea of living with COVID as a fact of life. Nevertheless, it is often instructive to reflect on where we have been, and this issue of SMA Digest reflects back on the pandemic, and our responses to it, thus far. There are lessons to be learned, and we can draw support and strength from hearing from the front lines. As a rural physician I know that the pandemic presented a different set of challenges in rural areas. On page 15 you can read about how the town of La Loche, far removed from the buzz of urban medical centres, faced the pandemic head on. The story evokes sadness, but is also inspiring, and one which speaks to the dedication of rural physicians.

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Similarly, Highs and lows of practicing in rural, remote areas during the pandemic (on page 28) carries this theme further and explores some of the challenges physicians faced in La Ronge. While these stories offer narratives about the pandemic, they also illustrate some deeper truths about rural medicine. Wellness is never far from the pages of SMA Digest and it makes sense to reflect on how the pandemic has affected physicians. On page 47 a medical learner shares her experience. During the last 19 months physician voices – all of them -- have helped in the battle against COVID. The SMA, as an organization, has weighed in many times to speak out for physicians, and to advocate for patients. The pandemic has pushed and pulled and stretched the health-care system, and the wider community, in many difficult ways. The physician voice has been amplified by social media as many doctors took to social platforms to talk about the need for masks, physical distancing and to encourage (and implore) citizens to get vaccinated. I want to thank

the physicians profiled in the story on page 22. Their efforts clearly show the importance of these media channels in the time of a pandemic. I hope you enjoy this issue of SMA Digest. I think it is a great look at the past, while we move steadily and carefully toward a more optimistic future.

Dr. Eben Strydom President Saskatchewan Medical Association

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DURING THE LAST 19 MONTHS, PHYSICIAN VOICES – ALL OF THEM – HAVE HELPED IN THE BATTLE AGAINST COVID.

SMA DIGEST | FALL 2020

RURAL ROOTS SMA president Dr. Eben Strydom has been influenced by his small-town background

SMA DIGEST | FALL 2020

By Girard Hengen

Saskatchewan Medical Association (SMA) president Dr. Eben Strydom’s “five-year plan” is approaching its 20th anniversary.

neighbours’ yards who had small kids and dogs. We decided we should look at other options. Luckily, we did find a perfect spot and moved to an acreage where they can play, have space, not hurt anybody and I could make loud noises doing carpentry without waking anybody. “We have a good life here. I am able to do the things I love at work. It has been good for us as a family.”

Dr. Strydom was working at a hospital in South Africa when he came to Redvers, Sask., for a two-month locum Making a difference for rural doctors in December 2000 during the dead of winter. It was a Rural Saskatchewan is familiar to Dr. Strydom. Born in the scouting mission of sorts. town of Otjiwarongo in rural Namibia, his mother was a “I worked with a friend when I was an intern at Paarl Hospital. He immigrated to Saskatchewan and worked in Redvers,” Dr. Strydom recalls. “He was looking for a locum as he wanted to go on holidays to see his family. That’s part of living in small-town Canada – and continues to be a problem – to have enough time to go away. When you go to Africa you can’t really go for two weeks. “I said I could do a locum in December-January 2000-01, first of all to see how bad the winters are, and also to experience the health system a little bit before I think about bringing my family here and making any decisions about the future. I ended up having a great time in Redvers.” Trained as a GP anesthetist and surgeon, Dr. Strydom was looking for an opportunity to use his skills in Canada. It came down to Dawson Creek, B.C., and Melfort. Dr. Pierre Hanekom, a Melfort physician originally from South Africa, happened to be vacationing in his home country and paid a visit to Dr. Strydom. “He came around and introduced himself and we had a good chat about Melfort, so I was excited to come,” Dr. Strydom said. Two GP anesthetists had just left the community. When Dr. Strydom arrived in June 2003, he fell into a full practice involving obstetrics, anesthesia, and surgery. He came on what he calls a “five-year plan.” “We were close to our families, so it wasn’t a simple decision to permanently immigrate,” he said. “Our plan was to come and pay down debt, tour a little bit and see the world, and then go back because our parents were getting older. Family support is a massive thing.” But as the years passed, his family – wife Marianthè, and children Ockert and Lian – made Melfort their home. When it was time for a family discussion on their future, the choice was made to stay, but they needed more room. “I bought the kids bows and arrows, and they didn’t have enough space,” Dr. Strydom said. “The arrows ended up in

nurse and his father was a teacher. He was raised in Gobabis, a town of about 15,000 near the Botswana border that bills itself as the “heart of cattle country.” Like rural Saskatchewan, hundreds of kilometres separate major communities. He graduated from the University of Stellenbosch in South Africa with a BSc honours degree in 1992, and a medical degree in 1997. He worked for five years in Paarl Hospital, training as a generalist and obtaining post graduate diplomas in anesthesiology and obstetrics.

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WE HAVE A GOOD LIFE HERE. I AM ABLE TO DO THE THINGS I LOVE AT WORK. IT HAS BEEN GOOD FOR US AS A FAMILY.

Early on in his career in Saskatchewan, Dr. Strydom was introduced to the SMA by local colleagues and strong advocates for rural medicine such as Drs. Lionel Lavoie, Bev Karras, and Larry Sandomirsky. He points to the enhancements in access to the GP anesthetist training program at the College of Medicine as an example where he and others could help make a difference for rural medicine. “This showed me we actually could effect change through support from our RMAs and through SMA structures,” he said. “The ability to make things better drew me in. I was active in the SMA through working groups, I became part of the Committee on Rural and Regional Practice (CORRP), and from CORRP was elected to be on the SMA Board of Directors, and then the rest is history. I never saw it coming.”

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He served on the Kelsey Trail Regional Medical Association for 16 years, the SMA Board of Directors, the Section of Family Practice, and the Intersectional Council. He was elected president of the SMA on Friday, May 7, during the 2021 Spring Representative Assembly, which was held virtually. He is the 55th president of the SMA, succeeding Dr. Barb Konstantynowicz, a Regina family physician. Rural medicine and the COVID-19 pandemic will be priorities during his one-year term. He believes communities require a sufficient cohort of physicians to cover clinical work, maintain an ER, and have a reasonable call schedule in order to retain their doctors. “Access to a family physician is a huge concern for residents throughout Saskatchewan but especially in rural Saskatchewan,” he added, saying the concept of the Patient’s Medical Home is fundamental to health care. “I feel that integrated care is really important for all patients throughout the health system. Hopefully over time the technology will improve so that things like the duplication of services and wasteful repeated entry of the same data will be minimized and the flow of, and access to, information improved. I hope that improvements in EMR and other data server integration will make it easier and safer to help care for people throughout the province. We need to provide access for every citizen in the province to a family physician.” The pandemic has put much of the normal routine of health care on hold as knowledge of COVID-19 continues to evolve. Physicians and staff at all levels had to adjust to ever-changing circumstances and issues. He hopes the health system is in a much better position when his term as president concludes in the spring – that people will have taken much-needed time off to rest and recharge – but at

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IT DOESN’T MATTER WHO YOU ARE OR WHERE YOU COME FROM, IF YOU HAVE A PROBLEM WE CAN HELP YOU. WE HAVE THAT RESPONSIBILITY TO MAKE AND KEEP OUR SYSTEM ACCESSIBLE. WHERE THERE ARE BARRIERS, WE NEED TO BREAK THEM DOWN. 8

SMA DIGEST | FALL 2020

that point other issues will be priorities. These include access to care, ensuring resources are in place to address wait times for surgical procedures, changes in the way medicine is practised including virtual care, and how facilities and clinics function with in-person visits. The lingering effects of COVID-19 are unknown at this point. “The information that we learn on a daily basis will help us understand the dynamic better and how we deal with COVID-19,” Dr. Strydom said. “Everybody is just looking forward to getting to some sense of normalcy.”

‘Where there are barriers, we need to break them down’ Another crucial issue during his term is addressing issues of systemic racism within the medical community and health care. The SMA Board of Directors has created an Equity, Diversity, and Inclusion Committee with a mandate to begin work in this area. Dr. Strydom said as leaders in communities, physicians have to learn about the issues and what they can do to help bring about change. He remembers working in South Africa, where significant public-sector resources were spent addressing interpersonal violence and trauma, leaving little left over for routine procedures for many patients. “We have to care for each and every person in this province equally,” he said. “In Saskatchewan, when I arrived here, it was nice to see that here I could help everybody equally. It doesn’t matter who you are or where you come from, if you have a problem we can help you. We have that responsibility to make and keep our system accessible. Where there are barriers, we need to break them down. We need to ensure that we do everything we can to make people feel valued and for them to feel they can trust doctors and the healthcare system.” ◆

THE YEAR THAT FELT LIKE A DECADE By Girard Hengen Reflecting on her 2020-21 term as “virtual” president of the Saskatchewan Medical Association (SMA), Dr. Barb Konstantynowicz recalls the words of a fellow physician. “During a virtual meeting, a colleague in B.C. said it well: ‘The year that felt like a decade,’ ” Dr. Konstantynowicz said. “Despite this, I marvel at the strength, scientific knowledge, and abilities of so many physicians. I am incredibly proud of my colleagues who have stepped up in these difficult circumstances.”

Dr. Konstantynowicz became SMA president at the 2020 Spring Representative Assembly (RA). The spring RA, usually held in person in early May, was delayed to June due to the COVID-19 pandemic and conducted virtually. It was just one instance of many in which the SMA adapted to the demands and constraints brought on by the pandemic. When Dr. Konstantynowicz became president, the pandemic was three months old. Masking was not widely accepted and obtaining personal protective equipment (PPE) was difficult for most community-based physicians’ offices, which SMA DIGEST | FALL 2020

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THERE WAS A SIGNIFICANT STRAIN IN THE HEALTH-CARE SYSTEM AND THE NEED TO ADVOCATE AND COMMUNICATE WITH OUR MEMBERS WAS VITAL.

were a mix of open, partially open, or virtual only. “There had been 11 deaths, and COVID-19 was still fairly new to all of us,” she said. “We had 626 recovered cases, 21 active cases.” The beginning of the pandemic coincided with the final months of Dr. Allan Woo’s 2019-20 term as SMA president. Early on, physicians were looking for guidance on how to stay open or maintain their practices while safeguarding themselves, their staff, and their patients. By mid-March, temporary fee codes had been negotiated by the SMA, with the Ministry of Health covering virtual telephone and video-conferencing consultations. “The SMA is pleased with this development because it provides patients with remote access to physicians,” Dr. Woo said in a March 13, 2020, news release. “This kind of access also provides a safer work environment for doctors and their staff during this pandemic. We need a healthy physician workforce to tackle the challenges presented by the outbreak of COVID-19.”

contract. The previous agreement expired on March 31, 2017. A tentative five-year retroactive agreement was struck in the summer, which physicians ratified in August 2020. Virtual care fee codes were incorporated in the new contract as a pilot project. On behalf of the SMA Board of Directors, Dr. Konstantynowicz thanked the SMA’s Negotiating Committee. “This will continue to benefit the practice of medicine and the province’s health system for years to come,” she said in an Aug. 12, 2020, news release. “I would like to thank the Negotiating Committee of the SMA, and Ministry of Health representatives, who put in countless hours of work on behalf of Saskatchewan’s physicians to reach this deal. With the agreement now in place, physicians can work with a degree of certainty during these uncertain times created by the COVID-19 pandemic.”

The SMA also negotiated free, 12-month licensing for clinical video conferencing for health-care providers. This agreement has been extended to January 2022, with subscriptions now available to physicians.

Meanwhile, SMA staff continued to negotiate benefits for physicians. In January 2021, new virtual care pilot fees were implemented to reflect changes negotiated in the new contract. A COVID-19 PPE Benefit Program was developed with the Ministry of Health that assists eligible physicians with PPE costs. The COVID-19 Illness and Mandatory SelfIsolation Benefit was also made available to physicians in late 2020.

By April the SMA had also negotiated another important agreement with the Ministry of Health and the SHA, the Pandemic Physician Services Agreements for fee-for-service physicians. These agreements, which expired June 30, 2020, stabilized physicians’ income and facilitated redeployment as needed.

In the area of physician wellness, a Physician and Health Worker Wellness group, established in collaboration with the SHA, offered access to mental health support and psychiatry. To promote mental health for physicians, members of the SMA’s Physician Health Program presented “wellness boosts” at virtual town halls hosted weekly by the SHA.

Agreements developed during the initial stages of the pandemic were carried out amid the backdrop of ongoing negotiations with the Ministry of Health on a new physicians’

The SMA also worked with the CMA on several pandemicrelated initiatives. The CMA launched a Wellness Support Line, which provides 24/7 mental health support and coun-

SMA DIGEST | FALL 2020

selling to physicians, residents, medical students, and their immediate families. It augments services offered by the SMA’s Physician Health Program. The CMA also took a lead role in advocating for virtual care, developing recommendations on the national standards, legislation, and policy needed to pave the way for virtual care in Canada. In an ever-changing information and technological environment caused by the pandemic, the SMA embraced new methods of conducting meetings and communicating with physicians. Like the 2020 Spring RA, the 2020 Fall RA and the 2021 Spring RA were held virtually. Dr. Eben Strydom, who was elected to succeed Dr. Konstantynowicz as SMA president at the 2021 Spring RA, noted the third wave of the pandemic threatened to strain a health system already operating at its limits. “The continuing challenges of COVID-19 pandemic are top of mind for myself and for physicians,” he said in a May 7, 2021, news release. “One of my main priorities will be to continue the advocacy work of the SMA for physicians during these unprecedented times.” In addition to the RAs, Board of Directors meetings were conducted via video conferencing, as was the annual President and Vice-President’s Tour. Committee and section meetings were also held virtually. The SMA kept physicians informed through frequent emailed Practice Alerts and President’s Letters, and the public informed through ad campaigns in print, radio, and television and on social media. Public campaigns urged mask wearing when physical distancing was not possible. During the summer of 2020, the SMA unfurled banners across Saskatoon streets advocating

for the need to wear masks. The SMA let the public know physicians remained open and ready to serve their patients, either in person or virtually In later 2020, the SMA and representatives from several health-care organizations in Saskatchewan united in their call for additional measures to be taken to curb the spread of COVID-19. The following month more than two dozen health-care organizations joined forces in an online ad campaign that targeted young adults and asked them to “hang in there” by following public health guidelines. “Saskatchewan’s physicians have heard sobering predictions for the health-care system if we do not get COVID-19 under control,” Dr. Konstantynowicz said in a Dec. 10, 2020, news release. “We are seeing more cases among all age groups, and this campaign encourages young adults to recognize that public health guidelines include them as well. The only way we will return to normal is by reducing the spread of this virus.” Dr. Konstantynowicz became a frequent commentator in the media on behalf of physicians, urging the government to issue clearer directions on mask wearing, exercise caution with school reopenings, revisit changes to the Immunization Delivery Plan, and during the provincial election campaign to tackle challenges in rural health care that were exposed during the pandemic. Despite these efforts, a second wave hit late in 2020 and early 2021. “There was a significant strain in the health-care system and the need to advocate and communicate with our members was vital,” said Dr. Konstantynowicz. “In December we saw the terrible toll COVID took in Saskatchewan – 117 people

SMA DIGEST | FALL 2020

died in December and 121 died in January... There was still confusion knowing who to speak to about concerns, and many calls were made to understand the issues and advocate for what our colleagues needed to provide quality care.” December also saw the arrival of vaccines and a delivery plan unveiled in January that incorporated vaccinations of physicians in early phases. This plan was subsequently changed by the Ministry of Health to an age-based system. The SMA pressed the government to prioritize the vaccination of all essential workers – including physicians not included in the first phase of the vaccine rollout - as identified cases of variants of concern mounted in spring 2021. “COVID-19 is mutating into variants of concern that threaten to overwhelm Saskatchewan’s health system. The virus is adapting. We ask the government to show flexibility and adapt to the rapidly changing circumstances of the pandemic,” Dr. Konstantynowicz said in an April 7, 2021, news release. The advocacy efforts were successful, with government relenting the following week. “While I am pleased with this development, I am disappointed that it took this long,” Dr.

Konstantynowicz wrote in a President’s Letter to physicians. “We have a long way to the end of the pandemic. Vaccinating all physicians is a crucial step needed to secure our health-care system. These vaccinations will keep you safe as you go about your work.” When the time comes, the post-pandemic road to recovery will be a long one, with twists and turns that will continue to challenge the SMA as it guides physicians on a journey without a clear end. While the level of resiliency among physicians is nothing less than inspiring, there will be a toll. It is anticipated that the numbers of physicians needing physician health support will significantly increase once the pandemic is over and people have time to reflect on their experiences and the vicarious trauma. “We will learn to live in a new normal,” Dr. Konstantynowicz said. “It is taking a long time and many of us long to get away, see family and dear friends. We have missed weddings, births, graduations, and funerals. We have all lost something in this turbulent time…. This virus has touched us all in some way.” ◆

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SMA DIGEST | FALL 2020

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Wrestling with

Pandemic Fatigue By Greg Basky In the early days of COVID-19, many Saskatchewan physicians were feeling anxious.

ability of the system to keep up with the changes has become the greatest challenge or frustration for physicians. The pandemic is a chronic situation and chronicity is very wearing on people.”

“They were waiting for the huge spike in cases that was predicted,” said Brenda Senger, the SMA’s Director of Physician Support Programs. “They were worried about protective gear to avoid bringing the virus home to their families. They wondered if they had the skills they’d need if they were redeployed.”

Many of the calls to the Physician Health Program (PHP) are from physicians who are recognizing this fatigue and looking for tools to take care of themselves. “Self-care is often the first thing physicians will let go of, but now they’re finding that if they don’t attend to those things, the chronicity of it (COVID) is having a greater impact on them”.

Over a year and a half into the pandemic, it’s fatigue that Senger and her counterpart, Clinical Coordinator Jessica Richardson, are increasingly seeing in the physicians and medical learners reaching out for help. The ongoing uncertainty is wearing, she said, because physicians like to be in control.

Physician Health Program sees increased demand

“Every week, there’s some evolution to battling this pandemic, some change that has to be made,” said Senger. “The

Senger and Richardson are the first point of contact for physicians who reach out to the PHP, Senger in Saskatoon and Richardson in Regina. The pair do an initial triage to determine what type of support doctors and learners need. While they provide a lot of counselling themselves, they also refer physicians to the program’s consultant psychiatrists. SMA DIGEST | FALL 2020

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ASK YOURSELF AT THE END OF THE DAY: ‘WHAT WAS ONE THING I DID TODAY THAT MADE A POSITIVE DIFFERENCE? WHAT IS ONE THING THAT FEELS REWARDING AND MEANINGFUL IN MY WORK TODAY?

Saskatchewan’s physicians and medical learners are demonstrating the “help seeking behavior” promoted by Senger and Richardson. So far this year, 210 new people have accessed the Physician Health Program, bringing the total number of participants since the start of the pandemic to 369. Of these, nearly a third (31.2%) reported they were experiencing stress or burnout at work, 42% were wrestling with mental health problems, 24% were experiencing occupational challenges, and close to 16% flagged struggles in their personal relationships at home. Many PHP participants reported that they’d contracted COVID while providing care to others. While more physicians are reaching out for support, that’s actually a positive, according to Dr. Alana Holt, one of the consulting psychiatrists who works with physicians and medical students referred through the Physician Health Program. “We feel it is very positive that physicians are paying attention to their own mental health and wellness at this time. It is vitally important that physicians and our healthcare teams remain well so they can provide sustained, quality care to the community during the pandemic.” Senger agrees. “There’s been a change in the culture as far as giving themselves permission to seek help. People are calling earlier and they’re not in crisis. They’re saying, ‘I need some more tools in my toolkit,’ or ‘I am really struggling more than I thought I would and I need some help.’ ” For many physicians, normal coping strategies such as socializing with friends and family were taken off the table by the pandemic. A big focus for the PHP team has been helping physicians better manage uncertainty and stress. This often involves coaching doctors to reframe their perspective, says Dr. Holt, so that rather than feeling a lack of confidence because of all the uncertainty, they can instead focus on their strengths and how to use these to help patients.

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What physicians can do to take care of themselves Physicians need to be vigilant, said Dr. Holt, not to fall into old negative coping habits and instead practice strategies that will benefit their physical and mental health. It’s only by taking care of themselves that doctors will have the endurance to carry on providing top quality care to their patients through to the end of the pandemic. With the increased workload from the pandemic and outof-province travel curtailed, Dr. Holt said many physicians have continued to work week after week, month after month, without a break because they find it hard to stop and thus continue to work if they can’t get away. “It’s important that doctors take vacation time for restoration to reset and recharge, to prevent burnout and illness themselves.” For many physicians, “making the conscious effort to take care also of themselves does not come easy,” said Dr. Holt, given their “sense of responsibility, commitment, and compassion for the patients they serve.” She encourages physicians to reflect on what brings purpose and meaning in their practice. She says staying mindful of the value of one’s work and the parts that are rewarding helps manage stress, prevent burnout, maintain wellness and even grow during this challenging time: “Ask yourself at the end of the day: ‘What was one thing I did today that made a positive difference (for a patient, a colleague, or team)? What is one thing that feels rewarding and meaningful in my work today?” While some doctors have wrestled with burnout or feelings of loneliness from lack of social contact, the profession as a whole is holding up well, Senger said. When we emerge on the other side of this pandemic, there will be greater appreciation for how resilient people actually are, she said. “We don’t know how resilient we are until we’re faced with a challenge,” she said. “Doctors get up every day, they go to work. They do what they have to do because it’s about taking care of patients and their colleagues. They’re coping. They’re adapting. And they’re adjusting...that’s what resilient people do.” ◆

Resilience Recovery and

How a community-led mobilization of local and provincial health services helped La Loche beat back COVID-19

By Girard Hengen | Photo credit Hilary Aadland When the remote northern village of La Loche overcame an outbreak of COVID-19 early in 2020, the massive effort to squelch the virus was lauded as a success. But for physicians looking back more than a year later, that success is hard to define. “It is a success story in terms of how the outbreak was managed, how everything came together and the ultimate outcome – because it could have been worse – but the fact that people still lost their lives was still pretty difficult to deal with,” said Dr. Moliehi Khaketla, Medical Health Officer with the Northern Saskatchewan Population Health Unit based in La Ronge. “The fear and anxiety that people had was understandable, particularly when northern communities including La Loche started losing residents as a result of COVID-19,” she said. “Communities had to adjust to grieving and paying re-

spects to loved ones in a different way – that presented an additional layer of complexity to a very challenging situation.” The first case of COVID-19 in La Loche appeared in early April 2020. A public health investigation determined the infection was linked to travel from northern Alberta. By mid-April, an outbreak of COVID-19 was declared at the local long-term care facility. Subsequent community transmission resulted in more than 250 people being confirmed positive, dozens hospitalized, and several deaths by the end of May 2020. Health resources at local and provincial levels were mobilized to deal with what at the time was the largest outbreak in Saskatchewan and the first in a remote Indigenous community in Canada. This, in combination with travel restrictions and door-to-door testing, ultimately helped disrupt the spread of disease within the communities of La Loche and neighbouring Clearwater River Dene Nation.

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“We received so much energy and inspiration from a community that continued to shine in terms of their strength, their resilience, their capacity for hope, their capacity for generosity and hospitality,” she said. “We were so profoundly touched, humbled, and amazed by this beloved community, and that seemed to help us stay strong and committed.” ***

Dr. Moliehi Khaketla, Medical Health Officer with the Northern Saskatchewan Population Health Unit

Dr. Khaketla had just returned from maternity leave when the World Health Organization declared COVID-19 a pandemic on March 11, 2020. Shortly thereafter, she and her northern public health team were faced with an unprecedented pandemic crisis that significantly increased their workload. Fortunately, her mother was able to assist her and her husband with much needed child care. “The experience did take its toll because there was so much uncertainty around how things would evolve. Evidence was changing rapidly, and there were various demands for information, in addition to case investigation, contact tracing, data analysis and reporting, monitoring of cases, and dealing with issues related to enforcement.” On the ground working in La Loche, Dr. Laura Remarck was energized by a community that amazed and inspired her.

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Dr. Remarck had spent her career in community health and was practising in the United States before coming to La Loche. When the first cases of COVID-19 appeared, “we took it by the horns, essentially,” she said. An emergency operations centre was established with village and reserve leadership, while the Saskatchewan Health Authority and the Northern Inter-Tribal Health Authority (NITHA) provided support. Nurses and staff were brought in from the south. With help from community residents, they knocked on every door to test for the virus, diagnose and self-isolate cases, and gain the trust of a population whose wariness of the health-care system was rooted in generations of trauma and an inherent mistrust of anything public health or health related. “It was extremely important that our effort be very culturally humble, very culturally sensitive, and very engaging with the community.” The door-to-door campaign screened 813 houses in La Loche and the nearby communities of Garson Lake, Black Point, and Descharme Lake, as well as 220 houses on the Clearwater River Dene Nation. Test swabs were shipped to

WE RECEIVED SO MUCH ENERGY AND INSPIRATION FROM A COMMUNITY THAT CONTINUED TO SHINE IN TERMS OF THEIR STRENGTH, THEIR RESILIENCE, THEIR CAPACITY FOR HOPE.

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the provincial lab in the south, delaying results until the community secured a portable GeneXpert machine for onsite testing. A COVID assessment centre was opened in one wing of the La Loche Community Health Centre, while another wing became a treatment centre. Camper trailers were used to house COVID-positive patients who could not isolate at home, while high-acuity cases were transferred out. A shelter was created with camper trailers for about 32 chronically ill people who needed addictions and alcohol support through a managed alcohol program. “We were able to do quite a bit to help communities at different levels and with different levels of need,” said Dr. Remarck, “but we couldn’t have done it without our community leaders, the elders, who championed the effort. They led the effort, so we humbly walked behind them as they helped open the doors of trust and allowed for as much coopting as possible.” *** Before specializing in public health and preventive medicine at the University of British Columbia, Dr. Khaketla started her career as a family physician. Having practised in South Africa, New Zealand, and Canada, she is passionate about the intersection of health policy and politics, prevention and control of communicable diseases, and efforts to address structural inequities and racism globally in health care. She was drawn to population and public health, and as part of her post-graduate training completed an internship at the World Health Organization in Geneva. She found the

experience and exposure to that level of coordination and expertise helped put the local pandemic response in a context beyond what was happening in Canada in the spring of 2020. “For public health and preventative medicine specialists, this once-in-a-lifetime event is what we were trained for,” she said. “Community leaders collaborated effectively with the health authorities, with other stakeholders like the Public Safety Agency, local physicians, other community stake holders and organizations to achieve a common goal. That is what public health is about.” She emphasized that communication was key to managing the outbreak. People waited for daily radio broadcasts that were translated into Dene. “Sometimes we take the value of communication for granted. Early on there was this need for a coordinated and effective communications process. It was important because so many people were involved in this outbreak. It was quite challenging in the early phase, but definitely improved over time.” She said thankfully, crucial working relationships had been established through years of work in the community with local leaders, the Northern Saskatchewan Population Health Unit, and NITHA. “I am very grateful to work with a remarkable team of public health nurses, community outreach and education workers, public health inspectors, an epidemiologist, administrative support staff, and many others who do not always get recognition. I couldn’t have picked a more rewarding specialty and area of practice as a physician; it is an incredible honor and privilege to be able to make a difference at a population level.”

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*** More than a year later, long after the outbreak in La Loche was declared over in late summer of 2020, physicians remain vigilant, watching the spread of COVID-19 and its variants of concern. For Dr. Remarck, spring of 2021 in La Loche brought the return of a warming sun, the chirping of birds, and a people once again reborn after tragedy. “The community is amazing. It went through yet another trauma and here it is thriving…. The community has also been coming back from a year of isolation. That was very difficult for a community that is very family oriented, very hospitable and warm toward each other.’ Dr. Khaketla, too, finds the resilience of the community remarkable, considering its people have endured tragedies and despair. “The pandemic, including the outbreak in La

Loche, really highlighted things we already knew existed in the north in terms of inequities,” she said. “This is part of the work that physicians like myself and medical health officer colleagues across Canada do in trying to address these inequities and advocate for adequate investments and resources in public health. “Lower income, higher unemployment rates, houses that are not in the best shape, overcrowding, food insecurity – all these things have been highlighted and amplified in the context of the pandemic,” she said. “I’m hopeful that some of the work that’s being done around COVID-19 and the pandemic response can help to find longer-term solutions for challenges that people in the north have been living with for decades. “I’m hopeful that the pandemic presents an opportunity for improvement of the health of northern people.” ◆

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CLARITY

Challenges, rewards of leadership during a pandemic By Greg Basky Pictured left: Dr. Satchan Takaya Pictured below: Dr. John Froh

Since the pandemic was officially declared in Saskatchewan on March 18, 2020, physicians around the province have given tirelessly of themselves to keep patients safe and healthy. Meet four of your colleagues who have stepped out of their regular roles to help lead the province’s medical response to COVID-19.

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Dr. Mark Fenton

Dr. Jasmine Hasselback

n the months since COVID-19 hit Saskatchewan, Dr. Satchan Takaya has served as pandemic physician lead for infectious diseases, chair of the provincial screening working group, Saskatoon pandemic area chief of staff, and most recently immunization physician co-lead for Saskatoon. She’s found it challenging at times, switching hats, trying to remember whether she’s supposed to be bringing a provincial perspective to the table or a local one. When first asked to step up, Dr. Takaya – whose regular job is as a clinical infectious diseases doctor – said she was more of a follower than a leader. “I guess I’ve proven myself wrong. I’m hoping I can take that (new skills) forward and use it in future roles.” Dr. Takaya says two images will stick with her long after the pandemic is over. She remembers the first COVID-19 patient she saw on a ventilator in the ICU late in spring 2020. “I walked in and there were plastic walls up and everyone was in full PPE. I can remember thinking to myself: Oh boy, we’re in trouble. This is real.” That image, though, is offset by the joy she felt walking into a personal care home and seeing the residents lined up outside the dining area waiting their turn to be vaccinated. “When we came in, they were all clapping. That was a huge moment.” *** For Dr. Mark Fenton, the pandemic has shown just how nimble the health care system can actually be, with people identifying a problem, thinking of a solution, and then implementing it, all on very short timelines. “We’ve repeat-

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edly looked at each other and said, ‘Holy moly! Before the pandemic it would have taken us 10 years to get this done. And we just finished it in a week.’ ” Dr. Fenton, who is division head of respirology, critical care and sleep medicine at the University of Saskatchewan, was in the early days of the pandemic heavily involved in the province’s PPE task force; he’s since also taken on the role of pandemic chief of staff for Saskatoon. Another big positive to come from the pandemic, Dr. Fenton says, is that it has required physicians and the operational side of the Saskatchewan Health Authority to closely align their thinking and to consider the other’s perspective in decision making. “I’ve gained a real appreciation for how the operations side thinks, and I think they’ve gained an ap-

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EVERYONE IS JUST SO COMMITTED AND WILLING TO INVEST THEMSELVES IN THIS EFFORT. HONESTLY, IT’S JUST BEEN REALLY INSPIRING.

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ONE OF THE THINGS WE TELL PEOPLE DURING THE PANDEMIC IS BE KIND. I WANT THAT AWARENESS TO CONTINUE.

preciation as to how we (physicians) think as well. The two (perspectives) are very complementary and help us get to even better decisions.” Dr. Fenton says he’s also encouraged by the level of engagement among his physician colleagues and among professionals and administrators across the health system. “Everyone is just so committed and willing to invest themselves in this effort,” he says. “Honestly, it’s just been really inspiring.” *** Dr. John Froh says the pandemic has shone a spotlight on the power of teamwork. “If you try to approach this as a bunch of individuals, you won’t succeed,” says Dr. Froh, who stepped out of his role as emergency room physician and medical director of STARS (Shock Trauma Air Rescue Service) to serve as deputy chief medical officer. “What we’re seeing is that you really do need to bring the team to bear upon the problems we’re trying to solve. That team stretches from the person who’s helping you with parking (at the hospital) to the intensive care physician.” Dr. Froh believes the work he’s done in the months since the beginning of the pandemic has affected more people’s lives in a positive way than anything he’s done in the past 20 years of working in emergency, being part of STARS, or caring for patients at mass casualty events. “When you look at the potential number of patients who can become sick or die during the pandemic, helping to respond to that in a way that minimizes death and disability is very rewarding,” he said.

While he will be glad to put much of the pandemic in the rearview mirror, Dr. Froh hopes we can all carry forward the patience and empathy we’ve learned to extend to one another. “One of the things we tell people during the pandemic is be kind. I want that awareness to continue.” *** Since her “battlefield promotion” to the lead Medical Health Officer for Saskatoon in April 2020, Dr. Jasmine Hasselback has been a jack of all trades, dropping in where she’s needed, then pivoting to a new role, always focused on preventing spread of the virus. Early on, she provided public health clinical support and guidance to the Saskatoon Interagency Response to COVID-19, a collective of community-based organizations focused on helping already marginalized groups and individuals deal with new challenges posed by COVID-19. “I spent a lot of time at the beginning helping bridge and providing clinical support to that group, until they became experts themselves. I’m very proud of what was built by Saskatoon.” Dr. Hasselback says it’s been tough in her role, always asking people to sacrifice – from individuals to self-isolate to businesses to change the way they operate. “I know that I am doing this because the virus, an inert and unbiased little bug, requires it be done to save lives – but it is still very, very hard.” Still, she’s found it encouraging to see a renewed appreciation for the value of upstream and preventive thinking in the way health care is delivered. “To see it play out everywhere, from funding, to allotment of resources, to regularly talking about how to prevent cases, that’s what’s been most gratifying.” ◆ SMA DIGEST | FALL 2020

Sask. doctors take to social media to dispel misinformation, promote public health measures Dr. Emily Sullivan

By Greg Basky Saskatoon family physician Dr. Emily Sullivan started posting COVID-related memes and infographics to Instagram early on in the pandemic because she saw an information gap facing people in their 20s and 30s. Dr. Sullivan, whose handle is @yxe.md, figured while people 40 and older were already well served on Facebook and Twitter by the Saskatchewan Health Authority (SHA) and the provincial government, people in her own and younger demographics were at risk of missing out. Prior to that, she hadn’t used social media as part of her work. “But I was following influencers in Saskatoon so I understood how the platform (Instagram) worked,” says Dr. Sullivan, who now has more than 13,000 followers on the image-based social media platform. “I started sharing some of my own scientific evidence-based content, along with content from the SHA, so that people who didn’t have Facebook or Twitter would see it.” For ICU physician Dr. Hassan Masri, it was a video his mother shared on social media, touting garlic and olive oil as a cure for COVID, that sparked him to start talking about the

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pandemic on Facebook. After receiving overwhelming response to his first video – done in his mother tongue, Arabic – he posted another, this time in English. Dr, Masri has been active on the platform ever since, at times sharing written and video posts several times each week. “There was a void and either you fill it up and answer (people’s questions) and help them, or they will turn to other people who may not be qualified to answer those questions,” says Dr. Masri. “It was very clear to me from the beginning that there was a real battle that was about to happen between misinformation and real scientific facts.”

Advocacy part of a physician’s job Both Dr. Masri and Dr. Sullivan consider advocacy to be part of their job as a physician. “Everyone does that in different ways,” said Dr. Sullivan, who has her master’s in public health “I felt that it (using social media) would be a fast and easy way for me to connect with the public and get information out, and help people navigate public health measures.”

Dr. Masri would like to see more of his physician colleagues get active on social media. “You cannot underestimate the power of words and images and video,” he said. “Physicians are supposed to be leaders in the community. People really respect us. They trust us.” Physicians wield considerable influence and they’re not using it nearly enough to create positive change, and not just around COVID-19, he said. “We’re missing so many opportunities to address issues like obesity, poverty, homelessness, drug addiction, mental health, access to care.” He’d like to see more guidance and support from national physician organizations to help doctors engage effectively on social media, and to avoid any potential missteps.

Physicians develop unique social styles When Dr. Sullivan launched her account, she was still on maternity leave, so she had more time to create original content – memes and infographics. Busier now, she says many of her posts are screen shots of information shared by the SHA, for example, or a particularly good tweet from an epidemiologist. She characterizes her posts as a mix of dispelling misinformation and advocating for adherence to public health measures. Later in the pandemic she shared more information around vaccinations. There’s been an evolution in his Facebook posts, says Dr. Masri. “In the beginning, in the first few months, it was more just busting myths and spreading real, factual scientificbased information,” he said. From there, he shifted his focus to why it is important to follow public health orders, to get vaccinated. “Then it was more educational.” And throughout there’s always been a thread of advocating for government to take steps that are in the best interests of patients.

Haters gonna hate Dr. Sullivan’s skin has grown considerably thicker since March 2020. She doesn’t take the trolls as seriously now. And she puts down her phone when she’s tempted to engage with someone who’s posted something inflammatory. “You can’t take them (attacks) to heart,” said Dr. Sullivan. “It’s just part of the game, and you have to be able to go with the flow.” It’s important to recognize that physicians are unlikely to sway the deeply entrenched opinions of COVID deniers and non-believers, says Dr. Sullivan. “The true anti-vaxxers are really hard to reach. But the vaccine hesitant are the kinds of people we can have a positive influence on.” Both physicians note that their followers quickly come to their defence when someone posts a negative comment in response to something they’ve shared. Dr. Masri puts a lot of time into the wording of his posts, so they cannot be misunderstood, or provide something for his critics to latch on to. “If I think a person is a real account or posing a genuine question, I usually engage with some education,” he said. But if a person is using foul language or making baseless accusations, he simply ignores the comment and moves on to the next one. “Those few bad apples don’t bother me much anymore.” Dr. Sullivan is definitely going to take a break from her professional use of Instagram once the pandemic is over. But she’s already looking ahead to what public health issues she can tackle down the road. While she’s tried to stay “on brand” by focusing her social posts on COVID-19, Dr. Sullivan’s followers reacted positively – with lots of likes and shares – to a post she did reminding people that we’re also in the midst of a syphilis outbreak. “I know there is interest out there for general public health advocacy.” ◆ Dr. Hassan Masri

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THERE WAS A VOID AND EITHER YOU FILL IT UP AND ANSWER (PEOPLE’S QUESTIONS) AND HELP THEM, OR THEY WILL TURN TO OTHER PEOPLE WHO MAY NOT BE QUALIFIED TO ANSWER THOSE QUESTIONS. SMA DIGEST | FALL 2020

Patience & Humor Useful tools for dealing with misinformation, vaccine hesitancy

By Greg Basky In hindsight, Dr. John Dosman wishes he’d handled differently a patient who showed up at the Saskatoon Community Clinic in the early days of the pandemic refusing to wear a mask. Things escalated to the point where the man became aggressive toward Dr. Dosman and his staff, and finally had to be asked to leave the building. “I must say, I didn’t deal with that very well,” says Dr. Dosman, who chalks up his uncharacteristic reaction to a fuse shortened by lack of sleep from a busy on-call rotation. However, hard-core anti-maskers and anti-vaxxers have been the exception, not the rule, in Dr. Dosman’s practice. Far more common, he says, are the patients who are simply

a bit hesitant or unsure about getting vaccinated, sometimes based on misinformation. Like the woman Melfort family physician Dr. Michael Stoll spoke with on the phone, whose husband was convinced he couldn’t get his shot for COVID-19 because he’d had a shingles vaccine several months earlier. “I asked her where he’d heard that. As it turns out, it was just some random person he didn’t even really know who told him he’d have an aneurysm rupture.” During the past year, based on hundreds of interactions with patients, Drs. Stoll and Dosman have identified a handful of strategies they’ve found effective when communicating with those who are on the fence when it comes to vaccinations.

Vaccination is the default

Humor helps

Dr. Dosman, who completed training made available for physicians who wanted to deliver vaccines, says he starts virtually all patient interactions with: “Have you had your shot yet?” If the answer is no, he follows up by asking if they’ve made an appointment to be vaccinated. “It’s almost that the default position is, well of course you’re going to get vaccinated,” says Dr. Dosman. “I think maybe the psychology behind this is that if your doctor is making the assumption that you’re getting it, then you probably should.”

Dr. Stoll says he pulls out humor when it’s the right fit for a patient he knows well. He cites the example of patients who pointed out during the first phase of the vaccination rollout that 30 per cent of Saskatchewan health-care professionals initially opted not to receive their first shot. “They’d say, ‘What does that tell you?’ And I’m like, ‘It tells me they’re making a bad decision, that’s what it tells me.’ ” Dr. Stoll says humor does work and it’s part of who he is as a doctor. The key is its judicious application. Know your audience, and know what’s going to resonate with them.

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vacation family family

Get personal For some people, knowing that their doctor has rolled up his or her sleeve is all the nudge they need. Dr. Stoll says he’s had conversations with patients who thought they couldn’t get vaccinated because they already had COVID-19. He explains that he had the virus – and that he went ahead and got vaccinated too. “You can talk through their concerns from your own personal perspective. I tell them what side-effects I had. You go through that with them and explain what to expect. When you’ve chosen to do something, that shows you’re comfortable with the safety.” Dr. Dosman agrees. “I tell my patients that I’m super excited that I’ve gotten my vaccination, because this is our way out of these annoying restrictions and inconveniences.” At the end of the day though, patients who are deeply entrenched in their “anti” views are unlikely to be swayed by facts and data, according to Dr. Stoll. “Absolutely, it’s important to do your due diligence and make an attempt. But you need to pick your battles. Those patients probably aren’t the ones you’re going to win over.”

Focus on facts One of the most common concerns patients raise with Dr. Dosman is the speed at which the various vaccines were developed. He patiently talks them through the factors that made this possible: It was a global, collective scientific effort; the MRNA technology already existed so scientists could hit the ground running; all of the necessary regulatory checks and balances were followed; and millions of people have been immunized with no serious side-effects. “More often than not, that short discussion is enough to ease any concerns those people have, and then they’re for it.”

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Two takes on COVID-19 Dr. Steven Goluboff retired during the pandemic; Dr. Jared Diederichs is one of the physicians who took over his practice By Girard Hengen Longtime Saskatoon family physician Dr. Steven Goluboff admits to some regret about retiring while his colleagues continue to grapple with a resilient COVID-19 pandemic. “I feel that by retiring, I’m abandoning the ship,” he told the SMA. “I’m feeling a little bit guilty. Everyone says I’ve gone beyond the call of duty. How many guys in their 70s are still working in Saskatchewan? Probably not a lot, but I kind of feel like I shouldn’t quit now.” Dr. Goluboff, who joined the forerunner to the City Centre Family Physicians (CCFP) practice in 1981, retired from CCFP on July 31, 2021 – but not totally from medicine. “I’m still having too much fun being a doctor. I’m not tired of seeing patients,” he said. “I’ve said to my group, any time you need help or advice, just call me. I’ll give you a bit of guidance, because I want them to take good care of my patients.” He could be providing advice to Dr. Jared Diederichs, who along with another physician, Dr. Patrick McMahon, joined CCFP in 2018 to begin taking over from Dr. Goluboff as he tapered his workload. When the pandemic hit last spring, Dr. Goluboff was preparing for retirement while Dr. Diederichs, who graduated from the University of Saskatchewan College of Medicine in 2016, was just getting established. “Nobody expected a global pandemic,” said Dr. Diederichs. “In the first five years of practice, every day is a learning opportunity, and I am still asking my colleagues and mentors for advice. I felt like my career was going as planned. I was building my practice, getting involved with undergraduate medical teaching, and exploring other areas of interest like obstetrics.”

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I THINK THE PANDEMIC HAS ALSO SHOWN THE NEED TO STEP OUTSIDE OUR DEFINED ROLES TO ADDRESS NEEDS IN OTHER AREAS. I THINK FAMILY PHYSICIANS ARE UNIQUELY QUALIFIED AND ABLE TO DO JUST THAT WHEN THE NEED ARISES.

That changed in March 2020. He said it has been hard to keep up with so much uncertainty and new information to digest. “It’s odd to think some people have gone their whole medical careers without experiencing something of this magnitude, yet it comes about so soon for myself and others,” Dr. Diederichs said. “Unfortunately, it may not be the last time, but my hope is that we will be better prepared both medically and politically in the future.” Both physicians adapted quickly and easily to virtual care. They are grateful the Saskatchewan Medical Association and the Ministry of Health rapidly developed virtual care fee codes, which have been maintained as a pilot in the latest contract with the government. While it has benefits, the physicians agree virtual care is not appropriate in all situations and cannot fully replace face-to-face visits with patients. However, they hope and expect virtual care to continue in some form into the future. “It’s an advantage to our patients and to the health system,” said Dr. Goluboff. “The costs? The government will figure that out, but at the end of the day patients won’t have to travel long distances for a simple 10-minute appointment... I think it is a revolution in the care of patients, not just here but all over the world. This is the future.” Dr. Diederichs said another adaptation he has had to make is addressing the amount of misinformation that has circulated by providing clarity to patients. This includes motivating patients to take public health guidelines seriously and dealing with vaccine hesitancy. As he continues his medical career, pandemic-related issues will be paramount.

“We will have to continue to be vigilant and cautious, at least for now, regarding people with infectious symptoms or exposures to ensure the safety of others, while also providing quality care,” he said. “Motivating patients to continue to adhere to infection prevention and control measures while continuing to promote vaccination, will also be important even when the pandemic is ‘over.’ Lastly, I think the pandemic has also shown the need to step outside our defined roles to address needs in other areas. I think family physicians are uniquely qualified and able to do just that when the need arises.” For Dr. Goluboff, the future will revolve around family, grandchildren, some work when needed – and golf. Photos and mementos adorn the walls of his home office, a reminder of a lifetime of service to his profession – including the College of Medicine and Saskatchewan Chapter of the College of Family Physicians of Canada – and to Congregation Agudas Israel in Saskatoon. He was honoured in 2007 as Family Physician of Year and in 2004 received the B’nai Brith We’re Proud of you Award for community service. “I’m a little nervous about retirement. I’m not really going cold turkey,” he said. “When I am done, I know I will be asked – could you be available? I could be a roving locum. I am retiring as a family doctor at CCFP, but I will continue if I am needed to support my group and my former patients, as I am loyal to both.” ◆

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HIGHS &LOWS of rural practice in the midst of COVID-19 By Greg Basky, Photo by Laura Miller Two images will stick with La Ronge family physician Dr. Michael Bayda after the pandemic subsides. One is from spring 2020, when a number of surrounding communities saw major spikes in case numbers. “When those patients first presented through our emergency department, it was a really steep learning curve, because a lot of the protocols were still being developed or rolled out,” recalls Dr. Bayda. “That stands out as a time when everyone had to come together and work as a team and make sure that everyone felt comfortable and safe, and understood the different considerations for COVID.”

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AS A RURAL PHYSICIAN, YOU’RE WEARING ALL OF THOSE HATS AND YOU’RE SPREAD VERY THIN ALREADY. THAT’S PART OF THE NATURE OF THE PRACTICE THAT EVERYONE LIKES. THAT’S WHY YOU DO IT. BUT ALL OF THOSE THINGS WERE MAGNIFIED (BY THE PANDEMIC) AND YOU’RE SPREAD EVEN THINNER.

The other lasting impression, he says, is of the impact the pandemic has had on patients and families – in particular people who had to be transferred to a hospital in a different community or to an assisted isolation site. “It’s scary for people to find out that they’ve tested positive, and then you follow up that news by telling them, ‘You have to leave, and you don’t get any visitors, and it could be a couple of days, or it could be a couple of weeks,’ ” says Dr. Bayda. “That’s a difficult conversation to have, and I think it’s really hard for patients. They’re trying to notify their family. They’re concerned about themselves. And they have to leave town. It was really hard, trying to help people navigate all of that.”

time trying to stay on top of ongoing regular health checks and clinic follow-up that needs to happen for people’s wellbeing. “As a rural physician, you’re wearing all of those hats and you’re spread very thin already,” he said. “That’s part of the nature of the practice that everyone likes. That’s why you do it. But all of those things were magnified (by the pandemic) and you’re spread even thinner.” Dr. Michael Bayda, family physician, La Ronge

Challenges of rural, remote practice during pandemic According to Dr. Bayda, COVID-19 brought some unique challenges for physicians working in rural and remote locations. While having a smaller health-care team made it easier to keep everyone informed of the latest updates from the Saskatchewan Health Authority, being short by even just one member would throw a wrench into staffing. “If there’s any dip into that pool – people needing to isolate, people not being able to work for whatever reason – then it instantly affects your numbers quickly.” Dr. Bayda says their physician group has had to be flexible in how they do their scheduling. With their limited bench strength, Dr. Bayda says it was often tough finding time to provide support to patients who were in assisted isolation. While numbers in La Ronge were lower than in many other centres, this additional service added to an already overflowing plate. Dr. Bayda and his colleagues were still doing deliveries, taking shifts in emergency, and supporting the outpost communities – while at the same

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Saskatchewan Air Ambulance, STARS transport critical patients to tertiary centres While the La Ronge area did not see as many critical cases come through emergency as neighboring regions to the east and west, Dr. Bayda says there were times – particularly during peaks in case numbers – when they relied heavily on ground EMS, Saskatchewan Air Ambulance (SAA), and STARS (Shock Trauma Air Rescue Service) to transport patients to the province’s larger centres. Over the past 19 months, Saskatchewan’s fixed wing and rotary wing air ambulances have transported intubated COVID-19 patients who were some of the most fragile and difficult patients to ventilate that either organization has ever transported.

from smaller centres such as La Ronge, while Rise Air (previously Transwest Air) – which serves the province’s Northern Medivac Program – flew another 48. To put those figures in perspective, SAA’s “flying ICU” averages around 110-120 patient transports per month or around 1,350 per year. Mandzuk and his team saw peaks in requests for transports correspond with COVID-19’s first wave in fall 2020 and second wave in spring 2021. While most transports come out of the north, the SAA serves the four corners of the province. The transport physicians with STARS provide online medical consultation to local doctors for every critical call – whether it ultimately results in a SAA or STARS mission. During the pandemic, they have coordinated care with sending and receiving physicians, first responders, and ground EMS.

It was in fact a resident of northern Saskatchewan that presented the SAA team with its first chance to put into practice newly developed COVID processes and protocols – just two weeks into the pandemic. David Mandzuk, manager of SAA, says transporting that first COVID-19 positive patient set the tone for all that followed.

Although STARS has not collected figures on confirmed or suspected COVID patients specifically for Saskatchewan, the fact that their numbers doubled for critical care and transport of patients with influenza-like illness illustrate the significant uptick in demand they’ve seen through the pandemic.

“What struck me most was that it was really just a normal, everyday transport that we do hundreds of times a year,” says Mandzuk. “We did our job, just like every other day. We approach each trip so that we minimize risk to the patient and to our staff. We’re here to transport patients safely and efficiently to where they need to go.”

Many of the patients coming from rural areas and the north had comorbid illnesses such as diabetes and high blood pressure, so they’re more fragile and they require extra care. During peak times, the STARS team was caring for confirmed or suspected COVID-positive patients on virtually every shift. When called upon – often on short notice – STARS staff also supported ground transport teams in rural and regional sites.

Between March 2020 and March 2021, SAA’s King Air 200 fixed wing airplane transported 93 COVID-positive patients

David Mandzuk, manager, Sask. Air Ambulance

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Dr. Jon Witt, a transport physician with STARS, says a silver lining is the way health-care professionals across the system continue to pull together as a team under adverse conditions. “We see people working hard to support patients in their home community, and support the urban centres by managing sicker patients,” says Dr. Witt. “Then STARS and Air Ambulance (SAA), and all the other providers across the province in turn supporting them, and everybody just working together and collaborating through really the most challenging health-care crisis the world has seen in over a hundred years. That’s what makes this such a great place to live and work.”

Submit your application

*** While the past 19 months have been challenging, La Ronge’s Dr. Bayda says the positives of practising in a remote location outweigh the struggles he and his colleagues have faced during the pandemic. “It did just really highlight the flexibility and the variety that comes with rural medicine,” says Dr. Bayda. “That’s something that everyone (who practises in rural and remote areas) embraces – being part of a community and flexing and adapting to whatever the community needs are. The pandemic really highlighted what’s special about that.” ◆

Deadlines are approaching for SMA programs and bursaries. Visit sma.sk.ca to learn more and apply by the deadline. •

Rural & Regional Physician Enhancement Training Program Application deadline Dec. 31, 2021

Medical Benevolent Society The Medical Benevolent Society is there to support physicians and their families in need. Through the generosity of Saskatchewan physicians and in partnership with the College of Physicians and Surgeons the society provides financial support as well as educational scholarships, bursaries or fellowships for those who qualify.

To request financial assistance, or to make a donation to the Medical Benevolent Society, please contact: brenda.senger@sma.sk.ca.

Dr. Jon Witt, STARS transport physician

SMA DIGEST | FALL 2020

How do you stay whole?

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Dr. Marlys Misfeldt | Family physician, Saskatoon I have been a practising family physician in Saskatoon for nearly 40 years. Until recently I practised obstetrics and specialized in sports medicine. The pandemic has impacted my family, travel, work, and volunteering. To help balance the impacts, I have reinvested in my hobbies and exercise, and shifted how I engage with family.

What have you done with your leisure time during the pandemic? It is important for me to get out and walk my dog every morning. It helps me to feel calmer when I start work, and better able to put on my mask with a few less deep breaths. As an amateur photographer of small things, stepping into the shapes of blossoms on plants, or the patterns of frost on the window, allows me to step out of the stresses of living in this pandemic. Snowflakes were elusive but tempting subjects, and a continuing project for next winter. I welcome the spiders and bees that visit in the warm months and pose in my garden. Feeding and watching the many varieties of birds has become a wonderful addition to spending time outside and I am excited to see if the family of crows I helped “raise” last year come back to visit. They got quite familiar with me feeding them every day and even let me cover a fledgling in a blanket once when he fell from his nest in the rain. Our daughter and her children in Australia are experts at Facetime with grandma and grandpa. To keep in touch with my siblings, nieces, and nephews, we have a scheduled weekly Zoom call, sometimes with more than a dozen visitors. Enjoying my camera or just the quiet of the backyard has taken priority over the endless housework or jobs I “should” be doing. And I continue to try to be gentle with my expectations.

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Dr. Nnamdi Ndubuka | Medical health officer, Northern Inter-Tribal Health Authority, Prince Albert

I am a medical health officer with the Northern Inter-Tribal Health Authority and assistant professor with Community Health and Epidemiology, College of Medicine, University of Saskatchewan. I am continuing to provide public health expertise to northern Saskatchewan First Nation communities in responding to the COVID-19 pandemic.

How do you stay whole? The COVID-19 pandemic has presented an additional layer of stress to all of us. As a physician, juggling multiple roles as a spouse, parent, friend, volunteer, and caregiver has been challenging and unprecedented. Staying whole and attempting to achieve a work-life balance has become a priority now more than ever before. I stay whole by eating healthy (I love homemade food) and engaging in physical activity, including walking and biking. Most times, my wife and I use the Prince Albert Rotary Trail. In addition, I keep in touch with loved ones as much as possible.

What have you done with your leisure time during the pandemic? Coaching soccer: As a licensed soccer coach, I enjoy coaching youth soccer. I love to spend time on the soccer field, fostering positive youth development through sports. Spending time with family: My family is the most important support system at my disposal. My wife often reminds me when it’s time to pause, take a break, and go for a walk. We started a family fitness routine every morning. I try to participate as much as I can, and also catch up with my kids during this moment. Family movie times have also helped me to unwind.

Why do you do these things? These activities enable me to stay whole. Some of the activities act as a coping mechanism for me. The exercise habits are helpful in terms of maintaining physical and mental well-being.

Why do you think it is important for physicians to have outside pursuits, especially during these challenging times? I think physicians having outside pursuits is important to socialize, learn more about their community, and strike a work-life balance. This has the potential to improve the quality of patient care.

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Dr. Emmett Harrison | Family medicine resident I am completing my residency in Swift Current, and plan to continue practising here when I’m finished my training. I will be completing an additional year of training in the Enhanced FMEM program locally, then hope to enter full scope family practice including clinic, emergency medicine, and obstetrics. Swift Current is conveniently located close to Moose Jaw, where I grew up, and my girlfriend Amanda’s family farm in Kyle.

What have you done with your leisure time during the pandemic? Amanda and I were in the same running group with the University of Saskatchewan Huskies track and field team. We still run a 5-10K circuit together on a weekly basis to rekindle something we had previously and continue to enjoy doing together. This has not changed during the pandemic. I also don’t want her to get faster than me, so she keeps me accountable. When I’m not running with Amanda, I have found a local running crew to train for the Beaver Flat 50K race at Saskatchewan Landing. During the pandemic we have transitioned our runs together to virtually challenging each other’s “racing segments” on the app Strava and posting encouraging comments and the occasional smack talk. Sometimes I pretend I’m not a city slicker and help with either seeding or harvest on Amanda’s family farm. It still brings me joy to be a part of the operation, mostly because of how much joy it brings Amanda. Amanda will even take many of her holidays from being a local accountant to assist with harvest. If I want to spend time with her, I better join her on the combine.

Why do you do these things? My leisure activities, such as running and farming, bring me great satisfaction and are a reprieve from my busy clinical days and studying. However, they are also a great excuse to spend time with Amanda, my family, and friends. In addition, my running pursuits provide a source of stress relief and exercise. I have made great use of this outlet after purchasing my “pandemic treadmill” early in 2020.

Why do you think it is important for physicians to have outside pursuits, especially during these challenging times? Pursuits outside of medicine help us maintain balance in our lives by providing a yearning to fill our free time with diverse and enjoyable experiences on a regular basis. This is especially important in a career that is easy to commit all of our free time to – when the work is endless and the requests to join committees and initiatives are constant.

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Dr. Geeta Achyuthan | Family physician, Regina What have you done with your leisure time during the pandemic? To say this past year has been challenging would be an understatement. For me, my stress relief has been my Pilates classes. I started Pilates more than 15 years ago and really enjoyed it. I have done it off and on since then, but very consistently since 2014. It is not only great as a form of exercise, but the focus on breathing and proper body positioning also gives it a meditative quality. I go to Core Connection Pilates Studio three to four times a week, so when COVID shut the studio down it was quite difficult. However, the owner of the studio, Corinne Harle, put a lot of work into creating online classes and videos – so that was very helpful.

Why do you think it is important for physicians to have outside pursuits, especially during these challenging times? It’s important for everyone to have interests outside of the workplace. Physicians, in particular, are constantly looking after everyone else and often forget to look after themselves. We are not immune to the diseases we treat. I had a major illness four years ago and Pilates helped significantly with getting through the chemo, surgery, and radiation. I was able to continue with classes during treatment and Corinne was amazing to work with. Although there are residual side-effects, I think it would have been much worse physically and mentally if I hadn’t been active. For me, it was the illness that was pivotal in driving home the message that I need to look after my health. A year ago, none of us could have imagined the events of the past year with COVID. Hopefully with the vaccines, we will be able to have some semblance of normal in the near future.

Dr. Megan Lyons | Plastic and reconstructive surgeon, Regina What have you done with your leisure time during the pandemic? I am a busy mom of three young boys and wife to another busy physician. The COVID-19 pandemic has been an unbelievably stressful time for our family, as it has been for all Saskatchewan families. There have been many worries over the past year, including my husband on the front lines in the ER department, my kids attending school, and our family and friends in the community. During this stressful time, I have found exercise to be an essential tool in helping to relieve stress and stay healthy both physically and mentally. One of my favourite types of exercise is Pilates. I have been doing Pilates since medical school more than 15 years ago. When I moved to Regina, I was so glad to find a great local Pilates studio. When the pandemic hit, Corinne Harle, owner of Core Connection Pilates Studio, quickly turned to virtual classes. Having the ability to continue Pilates classes in our home gym space was so important to keeping some normalcy in my life and connecting with the instructors and class participants virtually.

Why do you think it is important for physicians to have outside pursuits, especially during these challenging times?

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I believe that having this outlet allowed me to keep active while in lockdown, which helped to keep me strong physically and mentally. Physicians have had an enormous number of challenges this past year. Having ways to relieve stress in a positive manner is crucial to surviving this pandemic.

Dr. Amanda Kleisinger | Physiatrist, Regina

Why do you think it is important for physicians to have outside purI am a physiatrist in Regina and I work in a group inpatient and suits, especially during these challenging times? outpatient practice at Wascana Rehabilitation Centre with wonderful colleagues including nurses, therapists, administrators, and physicians. I try to structure the chaos in my life while balancing time with my young daughter, Maeve, and husband Konrad, who is a local surgeon.

How do you stay whole? Staying mentally and physically healthy is always a challenge but I try to carve out one or two exercise sessions for myself, mostly virtual during the pandemic. In the past this also included ballet, but for now includes Pilates in my home or the physically distanced studio. As a family we are looking forward to more walks and playground visits.

What have you done with your leisure time during the pandemic? Leisure time is a funny term as a working doctor mom. In my leisure time I generally sleep, and I make bedtime a priority for everyone in our house. But honestly, if I have real leisure time I will take a bath and read. I find this quiet time helps me refocus for the day and helps with quality sleep. I also try to exercise at home and indulge in my favourite show online.

Our energy and focus have been so concentrated on the workings of our clinics, hospitals, and health systems, and many of us have nothing left in the tank, especially after we give the remaining energy to our children and family. Learning to save some of that focus for ourselves is a very challenging skill. I hear many stories that resonate with me as a mom of small children: that many of my parent colleagues are very empty now. Taking time away from work in one-week intervals is helping me recharge and enjoy my family life. The extra effort I used to plan and take trips is now being focused on our home, including cooking, playing games, and exploring outside. The more I practise this skill of protecting time away, the easier it becomes, and the more fulfilled I feel at home, the more productive I am at work.

Photo below and photo group above left: Dr. Amanda Kleisinger (left), Dr. Geeta Achyuthan (right)

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Voice from the ICU Dr. Jeffrey Betcher writes about his experiences during the third wave in Regina’s ICUs, where he is critical care department head and area lead. He compares a typical day prior to COVID-19, to the preparations taken at the outset as cases began to mount. He traces the ebbs and flows of the pandemic, how events affected him personally and what he has done to cope with the challenges of his job. By Dr. Jeffrey Betcher, Critical care department head and area lead, Regina. A typical day in ICU in Regina varies with the units for which I am on service. There are three ICUs in Regina covered by two intensivists and supported by critical-care associates. There may also be a resident on rotation, but this is variable. Typically, the day begins with a brief walk through the unit to decide on potential transfers and to deal with anything that cannot be deferred to the ward round later in the day. The ward round that occurs midmorning in the surgical ICU and Pasqua ICU, and in the early afternoon in the medical ICU, is multidisciplinary involving nursing, physicians, respiratory therapists, a pharmacist, a dietician, and a social worker. Family presence during these rounds is also encouraged to enhance communication. Much of the time outside rounds is spent speaking with consultants and meeting with families for intense discussions about such things as goals of treatment and advance care planning. At first the pandemic didn’t change the daily routine other than the precautions that needed to be taken with personal protective equipment (PPE) and the isolation of patients. The donning and doffing of PPE required more time when going into patient rooms, most of which occurs outside the time for multidisciplinary rounds. There were times, however, when discussions with family had to take place over the phone or virtually due to restrictions with isolation and visitation. I found it taxing and stressful to have goals of treatment discussions with families over the phone rather than face to face. The most significant change early in the pandemic was the number of meetings and huddles that occurred daily, in-

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cluding weekends, and the challenge of planning to meet the demand of the initial predicted numbers of patients expected to require critical care. The planning happened on many levels and included nurses and health-care support staff. There was a significant amount of angst over how to provide sufficient coverage by intensivists and critical-care associates to meet the expected patient demand. Open discussion and contemplation resulted in the plan we now have in place. As the summer progressed without seeing the large number of predicted cases, there was a sense of relief. Things changed significantly with the third wave and the rise of variants of concern (VOC). Regina was spared when other areas, including Saskatoon, saw a rise in cases late in 2020. The third wave with VOCs impacted the Regina ICUs hard with a large influx of patients that required the opening of multiple surge areas and the deployment of extra staff. On a personal level, the third wave was harder as the age demographic was much younger. Some of the patients had young children and, in some cases, had expectant wives. Sometimes, the entire family was in isolation and life-changing decisions had to be made over the phone. It affected me in a profound way as it did not allow for the usual face-to-face meetings where I could get to know more about the patients and their loved ones as I talked with them. Multidisciplinary rounds took most of the day with little time left for other tasks. Decisions about opening new surge areas needed to be made. The decision was made to stand up a third intensivist so each ICU had an attending intensivist. Decisions of when to stand up, how long to stand up, and when to stand down extra physicians in the face of the ebb

and flow of patients was difficult yet needed to be made. Fortunately, decisions like these are not made in isolation and there is support on many levels. It would not have been possible without the support of colleagues in many roles at many levels. Support for each other has been very important throughout this time of uncertainty. The most stressful and anxietyprovoking aspects of the pandemic have been not knowing exactly how it will play out and how to best plan for and anticipate how to handle the surges as they come. Everyone is in the same predicament; many teams have pulled together to work cooperatively to overcome this pandemic. It has brought about the building of relationships throughout the Saskatchewan Health Authority. I suppose you could say it has been the SHA’s “coming of age.” On a personal level, my faith has been especially important to me in this time of uncertainty, and God has been faithful in guiding me in my leadership role. Another important outlet for me has been my hobby of scale model building. Retiring to my workshop to work on a project has given me a retreat from the pressures of the day where I can contem-

plate issues that have arisen or simply turn my attention away for a time of respite. I find it to be a creative outlet that is rejuvenating. The public can be confident in the work that has been done to meet the surges. I would say to them that we have done this to be there for them when they need us, and I would ask that they continue to do their part in fighting the pandemic by obeying the public health orders, wearing masks, getting tested if symptomatic, and getting vaccinated at the first opportunity. Dr. Betcher was raised in rural Manitoba and attended the University of Manitoba for his undergraduate medical degree. He completed a rotating internship at the Regina General Hospital and joined the medical staff in the Department of Anesthesiology in 1995. He completed an anesthesiology residency and critical-care training at McMaster University before settling into practice in Regina, where he has been for 26 years practising anesthesiology and critical-care medicine. The focus of his practice has shifted to critical care, where he has been the department head and area lead since 2014. ◆

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SUPPORT FOR EACH OTHER HAS BEEN VERY IMPORTANT THROUGHOUT THIS TIME OF UNCERTAINTY.

SMA DIGEST | FALL 2020

2020 SMA Physician of the Year Dr. Biswa Datta learned medicine from his physician father. His children also became doctors, and he hopes his grandchildren join the profession, too

ALL IN THE

FAMILY

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By Girard Hengen Growing up in Dacca, Bangladesh, Dr. Biswa Datta learned about medicine at the knee of his physician father. Much later in life and half a world removed from his childhood, Dr. Datta – by then a pediatrician in Yorkton, Saskatchewan – passed along his love of medicine to a new generation, his daughter and son who are physicians, too. “My father was my role model, and I followed in his footsteps,” said Dr. Datta, who is now based in Regina and is the recipient of the Saskatchewan Medical Association’s 2020 Physician of the Year Award. “When I was a little boy I used to be with my dad at his medical clinic,” he continued. “I would accompany him from time to time on his house calls. That was my initiation into my love for a career in medicine. From my father I learned a lot, and marvel now at the fact that he had no antibiotics, insulin, or any vaccines available then to help him treat his patients.” Educated at Dacca Medical College in Bangladesh and in England, Dr. Datta came to Saskatoon’s Royal University Hospital in 1973 as chief resident and teaching fellow in the department of pediatrics. He met Indra, who was working on a PhD in political science, while visiting his sister in Kolkata, India. The two were married and moved to Yorkton in 1976, where Dr. Datta became the only pediatrician in the region. “Instead of a career in political science, Indra concentrated on the well-being of the Datta family,” Dr. Datta said. Their children Anita and Samir, born and raised in Yorkton, attended the University of Saskatchewan and graduated from medicine. Anita is a pediatric neurologist/epileptologist at Vancouver Children’s Hospital and Samir is a family physician in London, Ont. Family matters for the Dattas – from one generation to the next and possibly the next, medicine has been a constant. “It gives me great joy that both my children are in the medical profession,” said Dr. Datta. “In my family, we have been physicians for four generations. I hope my grandchildren will follow the family tradition and study medicine.” *** The 2020 Physician of the Year Award was presented Oct. 30, 2020, as part of the SMA’s virtual 2020 Fall Representative Assembly. Dr. Datta was surprised to receive the annual award, but he shouldn’t have been. In letters supporting his nomination, patients describe him as an “angel” and a “saint.”

“I have shared with many that Dr. Datta is like an angel that came into my son’s life to save him,” one patient’s parent wrote. “In our eyes Dr. Datta is a true role model of excellence, diligence, and kindness. He is also a hero to my son and I truly don’t know where we would be today without Dr. Datta’s excellent care for us.” “To his patients he is a miracle worker, to his peers a mentor, and to us a blessing,” one patient wrote. “On behalf of our family, we would like to thank him for the extraordinary care and service that he has provided not only to our children, but to the countless others he has had under his care. Dr. Datta is without question the best at what he does and truly one of a kind. An award of this magnitude is truly deserving and long overdue.”

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THE CHILDREN THAT I TOOK CARE OF AND THEIR FAMILIES WERE LIKE ONE BIG FAMILY FOR ME.

One of his co-nominators wrote: “Dr. Datta greets each patient with a smile and joy in his eyes. He is passionate about being a doctor to the core of his being. This love for his profession radiates out to his patients every single day … Dr. Datta helps to support the caregivers of these sick children in so many ways. He is so much more than just a doctor. He is a saint in many eyes. He gives hope to the hopeless. He gives joy to the joyless. He loves all who he meets and aims to bring joy to the children. He sees the good in everyone and believes for the best.” Dr. Datta said he was honoured to receive the award. “I never expected it. I will cherish it and it’s just a blessing for me. I don’t know how to express my feelings to be recognized by the SMA as Physician of the Year. I’m really very surprised and very honoured.” During his fellowship in the early 1970s at RUH, Dr. Datta travelled to Yorkton by air ambulance to pick up sick babies and transfer them to Saskatoon. He got to know the obste-

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trician in Yorkton, who asked him to set up a pediatric department in the east-central city. “I was impressed by the kindness and dedication of the staff at the (then) Yorkton Union Hospital,” he said. “That was the sole reason for choosing Yorkton. I never regretted the decision. Initially I had thought I would stay one or two years in Yorkton, but the wonderful community and the staff at the hospital was a big factor in our staying longer. Yorkton became our home.” It became a home with challenges. He was on call 24 hours a day. The work was demanding. With no backup in a rural setting, he had to stabilize sick babies with support from hospital staff before sending them by ambulance to larger centres. His own family sacrificed so he could pursue his career in medicine. “The children that I took care of and their families were like one big family for me. I felt a very special kinship with the children and the families,” he said. “It is very kind of the families who supported my nomination to remember me fondly even after so many years. I also feel very honoured that I get to see the children of the children I had taken care of.” *** Dr. Datta left Yorkton after 25 years to establish his practice in 2001 at the Regina General Hospital. In addition to his

regular work, he teaches medical students and residents, which he sees as an opportunity to share his experience and knowledge and leave a legacy with the next generation of physicians. Like all physicians, he has had to make adjustments to his practice due to the pandemic, seeing patients one at a time in his office. He has consoled worried parents and advised them on what to do when the virus hits close to home within their family. At work, he wears a face shield and gown, a look that can be intimidating for his tiny patients. “They’re scared of the white coat. Children don’t like the white coat,” he said. “I used to put on my ordinary jacket but now children see me with the mask on, the plastic cover on and the white coat. They really get scared.” Pandemic or not, Dr. Datta has been on a remarkable journey, from following his father while on rounds in Dacca to setting out for a new life on the Canadian Prairies almost 50 years ago. “I came to Saskatchewan in 1973. Since then, I have lived and worked in Saskatchewan. The bitterly cold winters force us to build tenacity against all odds. I always say I matured and became stronger because of my living in Saskatchewan.” ◆

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HE GIVES HOPE TO THE HOPELESS. HE GIVES JOY TO THE JOYLESS. HE LOVES ALL WHO HE MEETS AND AIMS TO BRING JOY TO THE CHILDREN. HE SEES THE GOOD IN EVERYONE AND BELIEVES FOR THE BEST. - patient

SMA DIGEST | FALL 2020

DO listen carefully

Do’s & Don’ts of virtual care There’s a lot to like about virtual care – for patients and providers. For minor conditions, patients can check in with their physician without having to leave home. No more headaches trying to find a parking spot, no need to find a babysitter for the kids. And during the pandemic, it has enabled patients, physicians, and clinic staff to stay safe. But there are challenges to delivering high-quality care over the phone or by video chat. Dr. Susan Hayton, former Director of Physician Advocacy & Leadership for the Saskatchewan Medical Association, offered a handful of tips that can help physicians make the most of their virtual visits.

There are a lot of cues that physicians – particularly family doctors – can pick up on just by looking at a patient. Do they seem upset? Are they behaving in the way they normally do? Do they look thinner? Are they pale? You can’t do that same visual assessment over the phone. “You need to be listening carefully, to ensure that what you’re hearing is not something that needs to be seen in person,” says Dr. Hayton. Patients may not realize that a symptom they’re experiencing is significant. “I do think it takes a bit of practice and heightened acuity or heightened cautiousness to be very sure that you’re not missing something when you talk to people (over the phone).” It’s better, she says, to err on the side of caution by having a patient come in for an inperson appointment if you have any doubts about what you’re hearing.

DON’T rush virtual visits

While many people thought virtual care would be faster than in-person visits, many doctors have found the opposite. That’s probably a good thing, says Dr. Hayton. “Maybe it’s partly because some of the cues you would get in an in-person visit you might not be picking up on, so you need to ask a few more questions.” And during the pandemic, some people have been lonely and just need to talk.

DO adjust your approach to chronic disease management

Chronic disease management has suffered due to COVID. For example, some physicians may have delayed regular appointments with their patients with diabetes, assuming that the pandemic would be over by now. Dr. Hayton says physicians need to think about how best to use virtual visits to ensure they are continuing to deliver optimal care. “Maybe I need to see them a little less frequently. Maybe I still schedule them for the same amount of blood tests, but we can discuss the results on the phone.” Be sure to communicate these changes to your patients as well. “Patients need to know what your plan is and why and how you are going to manage their care.”

DON’T assume all patients prefer virtual

If you’re trying to replace some of your routine visits with virtual care, be sure that’s what the patient wants and that it’s meeting their physical – and emotional – needs. “Offer people the option, particularly once it’s safer to do so after the pandemic is over,” says Dr. Hayton. “Despite the potential convenience of virtual care, some people will still want to see you in person because they feel that they get more from that.” Based on her own clinical experience, Dr. Hayton says many elderly people like getting out -- even if it is to visit the doctor. “It’s a social outing for them.” Similarly, patients struggling with depression or anxiety may not get the same benefits over the phone as they would from being with you face to face. “You have to figure out what the best type of visit is for the individual and the particular type of problem they have.”

Virtual care is a mechanism of ongoing care, says Dr. Hayton, but not a replacement for in-person care. “I think it’s becoming more and more clear that it’s a modality, but it shouldn’t replace other things that you do. There are some real benefits, but it just needs to be advanced cautiously.” ◆

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PUSHED TO THE FRINGES Three physicians who support those living with substance use disorders and homelessness discuss the added impact of COVID-19

Dr. Sean Groves

By Maria Ryhorski As COVID-19 swept the country over the past 19 months, an already marginalized group of people experienced even greater challenges than most in Saskatchewan. Those experiencing addictions and homelessness saw many community supports end abruptly, leaving some people, quite literally, out in the cold. Three physicians in Saskatchewan are acutely aware of the heightened impact of the pandemic on individuals who live on the fringes of society. From the perspective of Dr. Sean Groves, family physician in La Ronge and head of the Opioid Agonist Therapy Program, COVID-19 has exposed cracks in a system where those living with addictions and homelessness were already underserved.

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As COVID-19 hit Saskatchewan full force, detox programs – where many of the patients Dr. Groves serves get a chance to stop, reflect, and take the first steps toward recovery – were one of many community supports to be shut down. As a result, he says, “We saw a lot of revolving door addictions medicine happening, where people were just consistently in and out with addictions issues. And that exacerbated mental health issues that a lot of marginalized populations deal with.” In an effort to curb the spread of COVID-19, care moved to a largely virtual model and this lack of face-to-face contact has further inhibited treatment and recovery of those with mental health issues.

“That face-to-face connection, in person, can be really important to developing trust, particularly for people who’ve dealt with lots of trauma in their lives,” noted Dr. Groves. “And so, the ability for a mental health care provider to provide trauma-informed care over the telephone in an unstably housed population is really challenging.” Dr. Morris Markentin provides care at the Saskatoon Community Clinic where he serves an urban population who face similar challenges. He observed that some of his patients had difficulty accessing care at all because they did not have access to a cellphone for virtual appointments. “Everything moved to virtual,” Dr. Markentin said. “If you don’t have access to wifi, you’re not connecting. You can’t access the services. So a lot of our clients were left out of a lot of the services they used to have. And so there were a fair amount of relapses and a fair amount of other issues related to, not just mental health, but addictions as well.” Dr. Peter Butt, addictions medicine consultant with the Saskatchewan Health Authority, points out that the costs of this pandemic are high.

Dr. Butt highlights positive work by the Saskatchewan Health Authority in response to the need for people with substance use disorders to be supported when they are required to self-isolate. “We have these assistance-for-self-isolation shelters,” he said. “These shelters have protocols where nurses, primarily, and physicians, are able to provide either detox or a substitution approach to their substance, provide some level of monitoring and harm reduction interventions – they’ll certainly escalate it toward treatment if that’s what the individual wants, but the primary goal is isolation for two weeks. So they’re really supporting them in hotels with food and accommodation and mitigating some of the difficulties that they have because of their health problems.” In La Ronge, Dr. Groves and the local health care team worked hard to provide addictions management and detox in an acute setting where patients could at least be kept safe, in the absence of better options. They also supported the local assisted self-isolation sites.

“The real challenge here is that the people who are pushed to the margins of society don’t have access to the secure housing, don’t have access to the community-based organizations, don’t have the same access to the health-care services that they had pre-pandemic,” he said. “And that’s certainly contributing to the increased fatality rate in addition to no disruption in the supply.” Despite border and public health restrictions, there was not an interruption to the availability of illicit substances, according to Butt. “Frequently we’re dealing with people that are socially isolated, they’re more anxious, they’re feeling insecure, they’re worried. And all of these things combined drive the chemical coping. So they may not have had a significant problem pre-pandemic, but what we saw was a significant escalation during the pandemic.” All three physicians are solution focused and have worked with their teams to support those in their care to the best of their ability while still keeping their staff safe. At Dr. Markentin’s clinic, if patients needed care in the clinic but didn’t pass the COVID-19 screening, care providers put on PPE and went outside to speak with them, and help find a way for them to access the care they needed. Additionally, they allowed clinic phones to be used by those without a phone or a computer, so they could access other virtual care services such as specialist appointments.

Dr. Peter Butt

SMA DIGEST | FALL 2020

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COVID IS JUST ONE AMONG THE MANY THINGS THAT CREATE BARRIERS FOR PEOPLE WHO DEAL WITH POVERTY AND ADDICTIONS, AND MENTAL HEALTH ISSUES AND UNSTABLE HOUSING.

Dr. Groves emphasized the critical impact of local leadership when it came to managing the COVID-19 crisis successfully within the community. For community leadership to step up and promote the importance of public health measures was invaluable because they already had the trust of the community. “Right now in society we have a bit of a mistrust of government in general,” Dr. Groves noted. “And I think the best way to overcome that is through relationships with people in positions of power … It’s not good enough to put out the science and to put out the educational information. It also has to be done in a way that’s respectful and built on relationships. And I think that’s been one of the strengths of smaller communities and, in particular, communities on reserve.”

“COVID is just one among the many things that create barriers for people who deal with poverty and addictions and mental health issues and unstable housing,” he said. “It’s always impressive to me to see how well people who are in those situations can band together. It’s a real inspiration actually. It’s one of the reasons I like working in that area of medicine. It reminds me how lucky I am some days and also reminds me how I could maybe shift my own perspectives and my own ways of living to maybe a simpler, more person-focused way of life.” ◆

Still, Dr. Groves is frustrated with the inadequacy of system resources for the most vulnerable in his community. “The fact that we’re still seeing patients in Saskatchewan die regularly as a direct consequence of addictions-related overdose, trauma, infectious diseases, and suicide is a clear signal that addictions care is not considered a priority in our health system, despite the massive acute care costs as well as the chronic disease, mental health and societal cost that it generates,” said Dr. Groves. “I would love to see people in positions of power with the SHA, as well as the Ministry of Health and government, recognize that addiction is not a choice or a lifestyle, but a devastating coping response to what is often severe trauma experienced during early childhood - and begin prioritizing addictions care as an essential component of a good health-care system, rather than just being a nice add-on.” Still, he admires the resilience of the population that he serves and how they continue to hold each other up even in the most difficult circumstances.

SMA DIGEST | FALL 2020

Dr. Morris Markentin

EXPECTATION VS. REALITY USask medical student, Amy Zhou, reflects on the complicated experience of beginning medical school in the middle of a pandemic.

As medical students, we have overcome our biggest obstacle to date – acceptance into medical school. As for those in the classes before ours, this came with countless hours of studying and a significantly compromised social life. We were all so preoccupied with the anticipation of receiving the letter that would determine our career that none of us were prepared for the global crisis that would overshadow the moment we found out whether our hard work had paid off.

Despite the challenges and disappointments of the past year, there have been small but significant silver linings. The class of 2024 has worked harder than any other class to maintain and recognize the importance of mental health. The class of 2024 has optimized self-care techniques and checking in with friends virtually. The class of 2024 has remained determined to socialize and connect with the rest of the College of Medicine via safe means. The class of 2024 has grit.

Shortly after COVID-19 hit, headlines proclaimed “Shortage of health-care workers” and “Health-care systems being stretched thin.” The education we were embarking on was now about so much more than a career – it symbolized the responsibility and service that being a member of the medical community represents to our currently understaffed health-care system. Getting into medical school wasn’t simply the fulfillment of our dreams anymore, it was a deep commitment to our health-care system, country, and global efforts against COVID-19.

One thing I noticed as a recent BSc psychology major is the shift in our class from extrinsic to intrinsic motivation. A study done by Lepper et al. in 1973, demonstrated the impact of the free choice paradigm and our ability to become intrinsically motivated. This year has allowed the class of 2024 to slow down and pursue subjects that are motivated by our own volition. The lack of interaction has led us to individually explore our preferences and priorities.

The months leading up to the first day of orientation were filled with anxiety, excitement, and anticipation of what was to come. I think many of us were eager to step up and serve our health-care system in any way that we could. The reality was more mundane with hours spent in virtual anatomy classes, while subject to class-wide quarantines. There were strict prohibitions against shadowing, learning practical skills, and face-to-face interaction with patients. While necessary and understandable, these restrictions made our reality a far cry from our idealized aspirations of helping our country and loved ones in the battle against the pandemic. It felt discouraging – as if we worked so hard to be part of a team, only to watch the action unfold from the sidelines.

Physicians – you stand with endless hours stretching out before you and a never-ending cue of patients and their worried loved ones. I want you to know that the class of 2024 supports you from a distance. We are saddened that we cannot stand beside you physically but please know that we admire your resilience and the way you have continued to provide your patients with the best possible care under these extreme circumstances. You should be proud of the lives you make better by your service. Although many of you have never met us, we hope you know that we look up to you and see you as our role models. We hope to see you in the halls someday and to shake your hand when all of this is behind us. ◆

SMA DIGEST | FALL 2020

The SMA EMR Program launches

Enhanced Use Program January 2021 saw the launch of the SMA EMR Program’s Enhanced Use Program. The EMR team is excited that their vision – to help physicians make optimal use of their EMR – has come to fruition. Physician response and participation have been tremendous! With more than 80% of Saskatchewan physicians utilizing an EMR, the SMA EMR Program determined that its focus must shift from supporting the adoption of an EMR to working with physicians on optimizing their EMR use. In speaking with physicians, the program’s Practice Advisors (PAs) found that many were frustrated and saw the EMR as more of a hindrance than a help in their practice. As well, many physician groups have identified the EMR as one of the leading causes of physician burnout. As a result, the Enhanced Use Program was born. To take part in the Enhanced Use program, you will first need to complete an EMR Progress Assessment (EPA). This online self-assessment will help determine your current and desired levels of EMR use. The tool will ask you to assess your current usage based on 10 key measures, spanning three functional areas of the EMR. Based on the results of your self-assessment, the team will work with you to create an action plan using a template developed by Practice Advisors using information from interviews with physicians. This action plan will outlines your goals, training needs, supports, and actions required to achieve the desired outcomes. Once consensus is achieved on the proposed plan, the PA will support you throughout your enhanced use journey.

SMA DIGEST | FALL 2020

You are eligible to be reimbursed up to $3,000 per physician (please refer to the details of the criteria on the EMR program website) for the time and effort required to complete an EPA and a follow-up action plan. The Enhanced Use Program includes a portfolio of services designed to help you and your team make optimal use of the EMR. Fluency Direct, a self-editing dictation software, is one such service. It includes everything you need: hardware, software, first-year licensing costs, training, and support. Feedback has been positive and Fluency Direct is proving to be an optimal solution for many physicians. To date, we have deployed Fluency Direct to more than 500 physicians and counting. The Enhanced Use Program also includes a Peer Program. This provides you with ready, no-cost access to a network of physicians and office staff who can provide training and workflow suggestions. Peers host a regular webinar series on a range of topics. These webinars have been recorded and are available on our program’s website. The EMR team is excited to work with you to determine which of the Enhanced Use initiatives is the best fit for you. Please reach out to us at emr@sma.sk.ca to get started on your optimization journey. Your journey, your way!

“

Testimonials

Dr. Mandi Nel

“

All these tips and tricks increased my productivity significantly. Every time we had an evaluation, I would state the problem that I am facing and then we would work together in developing practical and easy-to-use solutions. The support staff are extremely knowledgeable and very eager to help. Examples of improvements that I have made: • Adjusting my personal dashboard: I have easily accessible icons that make frequently used forms/documents accessible with one click, without the need to scroll down a list of documents; • Optimizing billing capture with minor changes to appointment booking templates • Improving macros within the system • Understanding and utilizing the tracking function • Understanding the cohort list function • Able to better build queries and get usable information from the EMR to build on quality improvement

Dr. Lane Rathgeber With my limited experience, I implemented several easy ways to improve efficiency: • Saving ‘favorite’ prescriptions and naming them in a way that makes them easily accessible for future use. • Creating macros for frequently used phrases in documentation. • Setting a default recipient for those forms or requisitions that have only one possible recipient.

Advance your skills... The Specialist Physician Enhancement Training Program now includes the option to apply for funding for part-time advanced education. The program can support further training in areas that promote an applicant’s ability, like medical research, teaching and others!

The details: • • •

Grants of up to $25,000/year toward administration costs are available to specialists practicing in Saskatchewan. Funding is available for six-month training to a maximum of to two years per applicant depending upon the length of training. All recipients will be required to fulfill a return-in-service commitment. One year of service will be required for each year of funding received. Length of return-ofservice will be prorated according to the number of months funding was received.

Learn more and apply on our website or by email.

sma.sk.ca or rsprograms@sma.sk.ca SMA DIGEST | FALL 2020

Celebrat ing

our staff

From programs, funds and events that support your health, education, and professional life, to the EMR system in your office, to the communications that keep you abreast of health-care developments and celebrate your medical community – dedicated SMA staff are at the heart of it all, working to support you. In this special feature, we recognize the achievements and milestones that our staff have reached in 2021, and give you the opportunity to get to know them a little better.

SMA DIGEST | FALL 2020

Celebrat ing

years of service

Ed Hobday

related to their specific practice, or involved with others in negotiating on behalf of either a group of physicians or the entire membership.”

At 51 years with the SMA and counting, Ed Hobday knows the organization and its physicians better than anyone else. From the time the SMA staff was just five people including himself working in a small four-room house on 25th Street, to its current staff complement over 50, Ed has spent the last five decades listening attentively to the needs and concerns of physicians and advocating on their behalf.

During his many years with the organization, Ed has seen a great deal of change, such as an increased shift away from fee-for-service practice, and increased administration of the health-care system resulting from the creation of health authorities. He notes one thing that remains constant however, is “physicians’ singular focus on their patients’ well-being” – something Ed has long admired. A positive change he has seen in more recent years that he considers equally important is “physicians’ recognition of the need to make time for themselves” and look after their own well-being too.

Administrative Director

When he came to the SMA in March 1970, Ed was welcomed by Dr. Ernie Baergen, the SMA’s Executive Secretary at the time and its first CEO as his partner – a working relationship that Ed viewed more as an apprenticeship. Under Ernie’s tutelage he was able to become knowledgeable on the full range of issues and activities that the SMA was engaged in and grew into the person that physicians across Saskatchewan would come to rely on as their most ardent supporter and trusted advisor. Ed says, “The core of my role (as administrative director) is to provide advice and advocate on behalf of physicians. This might be assisting an individual physician with an issue

Ed is known around the office for the ever-present spring in his step, ready smile, and the energy that powers him to be persistent in advocating for the physicians of Saskatchewan – all the while viewing his work with the SMA as a privilege. This energy doesn’t let up when Ed leaves for the day, though. When he is not in the office you can likely find him at a local rink playing hockey – a passion that has stayed with him since his university days playing for the U of S Huskies. He also enjoys spending time with his wife, Colleen, on their acreage where there is always plenty to do to keep him busy.

SMA DIGEST | FALL 2020

Wendy Boucher

Jane Hickson

Celebrating 15 years of service

Celebrating 11 years of service

After 14 years working as an executive assistant at the British Columbia Medical Association in Vancouver Wendy Boucher was facing a cancer diagnosis. She wanted to be closer to family during this time so decided to move to Saskatoon where she transitioned smoothly into the same role at the SMA, working for Martin Vogel, who was then the CEO.

Upon starting work at the SMA in 2008, Jane Hickson quickly realized she had found what she’d been looking for. Over her 11 years at the SMA Jane has seen many changes, both to her role and to the organization.

Executive Assistant to Board & Executive Office Process Improvement Specialist

Over the past 15 years at the SMA Wendy has worked for three different CEOs and one interim CEO – in addition to supporting the board, Representative Assembly, and human resources at various times. At present she is the executive assistant to the board and the current CEO, Bonnie Brossart who is not just her mentor but someone who has become a lifelong friend. Her exceptional organizational skills have not only kept a generation of CEO’s on track but also made SMA staff operations more efficient through her design of SMA workspaces. Wendy deeply appreciates the physicians and staff she works with, and the friendships that have grown over time. “Over the years I have gotten to know many physicians and staff that have become an important part of my life. The work is always changing and is always interesting.” When she isn’t working, Wendy’s life is consumed by being a mom to her busy and active son. Together they fill their time with biking, playing sports, watching movies, and feeding their mutual popcorn addiction. With any time left over Wendy shares her talent for organization with friends and takes on projects to help organize their homes.

SMA DIGEST | FALL 2020

“I’ve seen the staff numbers increase, technology used to perform our duties improve, and improved relationships with medical learners and physicians. And, of course, the new building we work in.” Jane began as an administrative assistant supporting the Committee on Rural and Regional Practice and the Specialist Recruitment and Retention Committee. After several progressively more senior roles, she became Process Improvement Specialist, where she is currently leading the transition of SMA document management to SharePoint Online. Jane derives a great deal of satisfaction from her work, and especially appreciates the opportunity to support and get to know Saskatchewan’s physicians. She has made many friends over her time at the SMA and values these relationships. She recently experienced a personal health crisis and is deeply grateful for the support she received from the physicians she has come to know over the years, and from the SMA. In her downtime Jane, a self-described homebody, enjoys working with her hands creating jewelry, sewing, and crocheting elaborate and intricate projects. Jane and her husband also love to travel – anywhere warm usually fits the bill, or anywhere their four wheels and an open stretch of highway can take them.

Delilah Dueck

Bonnie Brossart

Celebrating 10 years of service

Celebrating 6 years of service

Delilah Dueck joined the SMA 10 years ago after taking extended time away from working outside the home to raise her two children. Her youngest was starting school and the part-time receptionist position provided the opportunity to get to know the organization, its members, and to ease back into the workforce.

Since January 2015, CEO, Bonnie Brossart has spurred the SMA on to ever higher standards of excellence. Not one to sit still, Bonnie’s positive and supportive leadership, and passion for continuous improvement, are consistently reinforced with her persistent urging to imagine “even better if” of every project and situation.

Coordinator, Community Engagement

Ten years later, her role has evolved greatly. After transitioning through a couple of progressively more senior roles in other departments, Delilah is now the go-to person for the medical students and residents across Saskatchewan as they train and explore practice options in the province. As Coordinator of Community Engagement in the Communications & Community Engagement department, Delilah supports the medical learner community and helps them build lasting relationships and explore practice opportunities through the SMA’s Roadmap Program. In addition, she coordinates the SMA’s in-house CMA Physician Leadership Institute courses, sponsorship requests, and plays a supportive role in the SMA’s Acknowledgement and Random Acts of Recognition programs. Delilah brims over with enthusiasm when she speaks about her students and residents, and judging from all the thank-you cards and smiling student faces that beam out from photos on her office walls, the feeling is mutual. “The SMA is very much my second family,” Delilah said. “Some of my closest friends are my co-workers and members that I have met through the SMA over the past 10 years. The laughter and camaraderie among us bring so much joy to my life and work. I value all the relationships that I have built and will continue to build going forward.” When Delilah isn’t focusing on engaging with members, she loves spending time laughing, sharing a good meal, and having great conversations with “her people” – many of whom are also part of her SMA family. Her interests are diverse and include “anything in life that makes me smile” from her love of animals to lake life, travel, farming, and meeting new people.

Chief Executive Officer

Bonnie was attracted to the role because of her experiences working with physicians in her previous position as CEO of Saskatchewan’s Health Quality Council and, prior to that, as lead of the Chronic Disease Management Collaborative. Bonnie was inspired as she worked alongside close to 30% of the family physician workforce during this initiative and she hoped that her extensive health system relationships and experience would allow her to work with the SMA to “create a future where physicians across the province are meaningfully involved, integrally designing, and leading health system strategy and improvements” – a goal which she has inarguably met and continues to improve upon every day. In her role as CEO she takes great joy from the team she works with and the opportunity to work closely with the board to “make a day in the life of a physician better.” She does this by building and supporting a strong and vibrant complement of SMA staff, fostering relationships with members and health system stakeholders, and by advancing the strategic direction of the board. She emphasizes that, “physicians must play a central role in designing and continuously improving the health care system.” She can’t believe that she’s nearing seven years with the SMA. “I continue to learn so much in this role. I’ve always said it’s a privilege to work on behalf of Saskatchewan physicians.” When she is not at the SMA office, you can find her spending quality time with out at the lake with her husband, three adult sons and the family’s two yellow labs, Cooper and Maisie. SMA DIGEST | FALL 2020

Priscilla Bam Administrative Assistant, Physician Support Programs

Celebrating 5 years of service After completing a temporary work placement as receptionist at the SMA, Priscilla Bam told herself, “I will one day return to work here as a permanent staff member should the opportunity present itself.” The culture at the SMA had made an impression. Two months later, it became reality as Priscilla joined the Physician Health Program team as administrative assistant. Priscilla values being part of a program that offers encouragement and support to the medical community and their families during some of their most challenging times. She has thrived in the role, and in addition to administrative duties she has gained a great deal of understanding around diagnoses and ailments, basic triage assessments, tracking and understanding screening results. During her time at the SMA she has seen the program grow to increase support for physicians in the southern half of the province with the addition of a Regina-based clinical coordinator, and has watched the number of members supported through the program increase steadily. Being a part of this work means a great deal to Priscilla and she values being a part of an organization that cares so much about its team as well as its members. Outside of her work at the SMA, Priscilla enjoys spending time with her family – her husband, and two young children – as well as reading, cooking, baking and traveling.

SMA DIGEST | FALL 2020

Jason Loseth Accounting Technician

Celebrating 5 years of service Fresh out of business college and challenged to find a career in his field, Jason Loseth took work with a temp agency as he continued to search for something more permanent. This agency became the stepping stone to his five-year career (and counting) at the SMA when they offered him a placement in the Accounting department. The organization quickly recognized his value and welcomed him to a permanent position a few short weeks later. He has been a proud member of the SMA team ever since. In his role as accounting technician he provides accounting services for the SMA’s key member funds including the Rural & Regional Incentives Fund, Specialist Recruitment & Retention Fund, Insurance Fund, and the Electronic Medical Records Fund, in addition to providing accounting support for SMA corporate and payroll. He appreciates the variety in his work and the “big things” he has been able to be a part of as a member of the Accounting team, including the new CRM system currently underway. “As someone who is always thinking of ways to improve workflows and processes, I really appreciate the opportunities I’ve had at the SMA to innovate and contribute to various initiatives, and I look forward to many more in future,” he said. As the father of two young children, Jason doesn’t have a lot of time just for himself, but when he finds some, he enjoys tearing down and rebuilding vintage motorcycles and restoring them to their former glory. He’s recently completed his first project – an old Suzuki – and hopes to begin another one soon. He also has a passion for woodworking and has built a number of custom furniture pieces for the family’s home. He particularly enjoys spending time with his family, and is looking forward taking his outdoorsy three-year-old daughter fishing, camping and hiking.

Charlene Koch

Practice advisor, Saskatchewan EMR Program

Celebrating 5 years of service When Charlene Koch joined the SMA in fall of 2015 it felt like a natural fit. She’d worked closely with physicians and clinics in her previous roles with the Ministry of Health and eHealth Saskatchewan and looked forward to doing so again. As a Practice Advisor (PA) with the SMA EMR Program, Charlene enjoys working closely with physicians and their support staff to help them get more out of their EMR. Charlene does so by focusing on ways to increase efficiency in their EMR workflows within their practice. Since Charlene started with the SMA, the EMR Program has shifted from its original goal of 80% clinic adoption of EMRs – a target it has met and exceeded – to EMR optimization and enhanced use. The SMA EMR Program’s Enhanced Use Program was developed in response to concerns voiced by physicians – concerns that they were spending too much time navigating the EMR, time that physicians would rather spend with patients. Charlene and the EMR team are dedicated to the support of physicians in making changes that allow the EMR to work for them. On personal time, Charlene enjoys being with her family, especially her four grandchildren. Like most people, Charlene has found navigating the pandemic and its restrictions hard. None of Charlene’s grandchildren live in Regina. Now that the restrictions have been lifted and vaccines have become available, most of Charlene’s free time will be spent travelling to see her grandchildren. Charlene’s favorite ways to relax include fishing, putzing in the yard, and getting creative in the kitchen where she frequently tries out new recipes on her family and friends.

Ivan Muzychka Director, Communications & Community Engagement

Celebrating 5 years of service After spending most of his decades-long Communications career at large post-secondary institutions like Memorial University in Newfoundland and, more recently, the University of Saskatchewan, Ivan Muzychka was ready for a change. He wanted a smaller atmosphere and more relaxed pace. He got one of two when he joined the SMA in 2016 to lead what was then a two-person Communications department. Five year later, his role has grown to Director of Communications & Community Engagement and his team has tripled in size. Under his creative, enthusiastic, and appreciative brand of leadership, he leads his team in fulfilling the SMA’s communications, marketing and community engagement needs. Through the organization’s web presence, media efforts, publications, and marketing campaigns, Ivan ensures physicians’ voices are heard and amplified where they can have the greatest impact. On the community engagement side, the team orchestrates events that provide physicians with the opportunity to engage with each other and the SMA, and administers a myriad of programs to support physician practice and wellbeing. Ivan particularly values the “absolutely great group of people” on his team and loves the variety of opportunities that they take on together to help meet the needs of Saskatchewan physicians. “It is very rewarding to work for the physicians of this province. They are such a dedicated group of professionals and work so hard for their patients. They inspire me to work hard to support them in their amazing, often life-saving work!” In his life outside of the SMA Ivan is an avid reader, with a passion for books that has transformed the basement of his home into his own personal library. When he isn’t reading one of the two or three books he typically has on the go, Ivan enjoys spending time with his wife and two grown daughters. SMA DIGEST | FALL 2020

Marcel Nobert Executive Director

Celebrating 5 years of service After 12 years in health care leadership with various organizations, Marcel Nobert saw the working at the SMA as an opportunity to put his knowledge and experience in medical administration, finance and contract negotiations to good use for the benefit of Saskatchewan’s physicians. This role – with both broad responsibilities and a small family business-like atmosphere – was the best of both worlds. In his role as executive director at the SMA he works with a dedicated team to deliver top-tier member benefits, insurance protection, support programs, and contract negotiation support. In addition he oversees the accounting and IT teams to ensure the SMA’s financial and informatics needs are well supported. “I love the people, the small office atmosphere, and the diversity of work that cross my desk daily.” Marcel said. “It truly is a small organization with a very large mandate – never a dull moment.” He is particularly energized about the redesigned, integrated IT platform and various member service portals, which will reimagine the way the SMA supports its members. This two-year project is nearing fruition with a planned launch in fall 2021. Another landmark moment during his time at the SMA was the growth of the SMA to include an office in Regina which would house the local EMR contingent, as well as the expanded Physician Health Program. With a Regina base, the program can now provide more easily accessible clinical support for physicians in the southern half of the province. Marcel’s interests are equally diverse outside of his professional life. In his down-time he enjoys playing live music with his band at venues around Saskatchewan, taking random Saskatchewan road trips, and watching his kids realize their goals through their various activities.

SMA DIGEST | FALL 2020

Strong physician leadership has never been more important. Gain the tools to lead in a CMA-SMA in-house PLI course.

PHYSICIAN LEADERSHIP

INSTITUTE 2021 LEADING HIGH-PERFORMANCE CULTURE

Nov. 19, 27, 2021 Virtual

DEVELOPING AND LEADING SYSTEM IMPROVEMENT

Nov. 25, Dec. 2 & 9, 2021 Virtual

Watch sma.sk.ca/pli for more information or contact Delilah Dueck at delilah.dueck@sma.sk.ca.

CLASSIFIEDS ANNOUNCEMENTS PRACTICE OPPORTUNITY PRINCE OF WALES MEDICAL CLINIC

PRACTICE OPPORTUNITY QUANCE EAST MEDICAL CLINIC

Regina, Sask.

We are searching for a family physician or a specialist to join our well-established and friendly team of physicians.

We are searching for a family physician or a specialist to join our well established and friendly team of physicians.

Prince of Wales Medical Clinic is located inside Superstore, the busy shopping destination in the east part of the city. East Regina is considered to be the most desirable area to live, shop and work in our city. The clinic is located next to Superstore pharmacy. We provide both regular family practice and walk-in services. We currently have 3 physicians working with us on fee-for-service basis. Our doctors working full time have consistently very good income, which is more than enough to support exceptionally high standard of living. The advantages of practising with our group also include:

Quance East Medical Clinic is located inside Victoria Square Mall, the vivid shopping and recreational destination in the east part of the city. East Regina is considered to be the most desirable area to live, shop and work in our city. The clinic is located next to Shoppers Drug Mart and its pharmacy. We provide both regular family practice and walk-in services. We currently have 3 physicians working with us on fee-for-service basis. Our doctors working full time have consistently very good income, which is more than enough to support exceptionally high standard of living. The advantages of practising with our group also include:

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Competitive overhead split resulting in excellent earnings (details are negotiable, depending on the level of involvement, full time, part-time or locum );

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Competitive overhead split resulting in excellent earnings (details are negotiable, depending on the level of involvement, full time, part-time or locum );

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ou can practise on a full-time basis, provide walk-in Y shift coverage, or do a mix of both;

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ou can practise on a full-time basis, provide walk-in Y shift coverage, or do a mix of both;

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fully implemented Accuro EMR with remote internetA based access provides the efficiency and convenience of paperless charting;

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fully implemented Accuro EMR with remote internetA based access provides the efficiency and convenience of paperless charting;

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The option to manually chart your notes is available;

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The option to manually chart your notes is available;

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IT support is provided;

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IT support is provided;

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S cheduling flexibility is provided with no associated overhead costs during your vacations, CME time, or other periods of absence from practice;

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S cheduling flexibility is provided with no associated overhead costs during your vacations, CME time, or other periods of absence from practice;

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T here is a possibility for any new doctor joining our clinic for full time engagement to receive financial support to help with the relocation costs.

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T here is a possibility for any new doctor joining our clinic for full time engagement to receive financial support to help with the relocation costs.

Any inquiry regarding this opportunity will be held in strict confidence. Please contact us at 306 591 5122 or email us at quanceclinic@yahoo.ca

Any inquiry regarding this opportunity will be held in the strict confidence. Please contact us at 306 591 5122 or email us at quanceclinic@yahoo.ca

SMA DIGEST | FALL 2020

IN MEMORIAM DR.QURESHI ISHTIYAQ AHMED

DR. LEANNE DAHLGREN-SCOTT

1939-2020

1972-2020

It is with great sadness that his wife, Nasim, and his children, Irma, Ayesha, and Rabia, announce the passing of their husband and father Dr. Qureshi Ishtiyaq Ahmed which occurred at St. Paul’s Hospital, Saskatoon on Saturday, December 26, 2020. Special thanks to Dr. Rob Basi and everyone in the ICU for their incredible care and compassion. We also want to acknowledge the kindness and support of Dr. Ahmed Shoker for his help during this difficult time. Memorial donations may be made to the St. Paul’s Hospital Foundation ICU in memory of Dr. Ahmed.

Leanne Dahlgren Scott, loving wife of Paul and devoted mother to Ronan age 14 and Elin age 9, passed away at her home in West Vancouver on Monday Dec 21, 2020.

DR. AMJAD ALI

1950-2021

Celebration and thanksgiving for the life of Dr. Amjad Ali born on April 2,1950. Passed away on February 8, 2021. Dr. Amjad Ali will be lovingly remembered as the son of Bibi Halima Badal (mother-living) and Inshan Ali (father-deceased). He is survived by four children, Jehan Ali, Yasmin Ali, Alia Ali, and Amir Ali; three grandchildren; five sisters; and one brother. He will be dearly missed by his family, friends, and colleagues. The family of the late Dr. Amjad Ali wishes to extend our sincere appreciation to all those who were a source of comfort and help to us at this time. Barakallah fik

SMA DIGEST | FALL 2020

Leanne was born August 2nd, 1972. She grew up in Saskatchewan and always stayed true to her humble, friendly, and honest prairie roots. After medical school and an Obstetrics and Gynecology residency at the University of Saskatchewan, she moved to BC in 2001 to complete her Maternal Fetal Medicine fellowship and a Masters of Health Sciences in Epidemiology at the University of British Columbia. She joined the Division of MFM at UBC and BC Women’s Hospital in 2004 where she pursued her passions in teaching, research, and quality assurance while delivering firstclass care to her high-risk patients. Her Bouvier des Flandres dog Jasper was a source of great delight and endless funny stories to Leanne and greeted her with love and affection after a long day of work. She lived her life by her pillars of honesty, integrity, loyalty, and truth. Her love and pride for her children and husband were evident every day when she was at her work. Her humour, infectious laugh and sunny disposition will be sorely missed by all those fortunate enough to have had her pass through their lives. She loved living on the North Shore and coming home to her family across the bridge to be surrounded by the mountains and ocean. She will be dearly missed by all but never forgotten.

In lieu of flowers an Educational Trust Fund for her children and a Medical Student teaching Award will be established in her name. Due to Covid restrictions a private service is being held. Please contact Mckenzie Funeral Services by email at info@mckenziefuneralservices.com, if you would like further information regarding the Trust Fund.

DR. RAMACHANDRAN DEVARAJALU

1941-2021

DR. C. STUART HOUSTON

1927-2021

Dr. Stuart Houston achieved a degree of success in each of three distinct fields, that most people would have been happy to achieve in one. Stuart was born in North Dakota where his parents, Dr. Sigga Christianson Houston and Dr. Clarence Joseph Houston practised briefly before relocating to Yorkton, Saskatchewan. Stuart’s interest in ornithology began as a boy in Yorkton, fostered by an amateur naturalist, Isabel Priestly and subsequently by his work for Ducks Unlimited. Stuart completed his medical degree at the University of Manitoba and spent eight years in General Practice in Yorkton. Stuart then specialized in Radiology (now Medical Imaging) at the University of Saskatchewan with one year

in Boston, pursuing a particular interest in pediatric radiology. He returned to a faculty position at the University of Saskatchewan where he stayed for his professional career. He served a term as chair of the department but particularly enjoyed his term as editor of the Journal of the Canadian Association of Radiologists. He served on the Council of the Royal College of Physicians and Surgeons and was the only professor in the College of Medicine to have been named honourary president of the Student Medical Society three times. He maintained a lifelong commitment to ornithology, mainly expressed through banding birds. To 2014 he had banded 150,283 individual birds of 211 species, with 3,945 recoveries of 84 species (the highest number of species and 4 subspecies recovered of any Canadian bander). Over decades he cultivated an extraordinary network of people, mostly farmers, who notified him, for example, when they found an owl nest on their land. Equally remarkable was the army of both young and old who volunteered to climb trees to bird nests or chase down smelly young pelicans to band. He was also an active member of the Saskatoon and provincial Natural History societies and participated extensively in their activities. His work in ornithology included four books on Saskatchewan natural history and 311 articles in ornithology and natural history journals, and culminated in 2020 with the publication with Frank Roy and Alan Smith of the definitive book, Birds of Saskatchewan. He remained keenly involved in his most recent project, banding and wing-tagging turkey vultures, until his last year.

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His third concurrent career was as a historian and his 13 other books all had historical subjects. Four described the observations of early Canadian explorer naturalists with the Franklin expedition, two were biographies of pioneer Saskatchewan doctors and three, starting with Steps on the Road to Medicare, described Saskatchewan’s early achievements in health care. In large part he was able to do all this with the help of his wife, Mary Isabel neé Belcher. Stuart married Mary in Dilke, SK on 12/08/1951 and was devoted to and inseparable from her for the next 68 years. Mary kept the household running as well as making a major contribution to the banding efforts and contributing to the research for many of his publications. Looking back, however, we kids were blissfully unaware of his many commitments since he was always home for meals and available to drive us to hockey games or canoe trips. He received many honours including D. Litt and D CnL degrees, Saskatchewan Order of Merit, Officer of the Order of Canada, and innumerable other awards, local, national and international, in all three spheres of his activities. Stuart was predeceased by Mary in 2019. He is survived by children Stan (Venta Kabzems), Margaret (Richard Ehman), David (Kate Bell) and Donald (Marty Helgerson), nine grandchildren and two great grandchildren. Given COVID restrictions, a small family service was held 31/08/2021 at Emmanuel Anglican Church. A larger in person celebration is planned for next year. If you wish to be notified of the details when they become available, please e-mail shouston@ualberta.ca. Donations can be made to Nature Saskatchewan at info@naturesask.ca or Luther Care at foundation@luthercare.com

DR. ROGER GRAHAM KEITH M.D., FRCSC, FRCS, FACS

1940-2021

ADr. Roger Graham Keith M.D, FRCSC, FRCS, FACS, Professor Emeritus, in his 80th year, on December 15th, 2020, died peacefully with family at his side. Beloved husband and best friend of Nancy, loving father and father-in-law of Janet and Ed Mahony, Donna (deceased) and Jim Gresham, son Brian, and devoted grandfather of Emily and Andrew, all of British Columbia and Kayleigh of Alberta. Brother and brother-inlaw of Nancy and Terry Wilson, Uncle to Kenneth Chapton and his wife Betsy and Leah Secrest and her husband Rob, all of Denver (CO). Brother-in-law of Barb and Sandy Hampson of Regina, Ann and Dave Trick of Rideau Ferry (Ont), Jim and

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Kathy Lynch of Airdrie (Alta), Joy and Mike Vervoot, Ameliasburg (Ont), and Garry and Maggie Lynch of Port Hope (Ont). Great Uncle to many nieces and nephews in Saskatchewan, Alberta, Ontario, and Denver. Special thanks to Dr. Veronica Marcoux for her expertise and gentle care throughout Roger’s illness and final days. Special thanks to the nurses and staff of 5th Medicine at St. Paul’s Hospital, Saskatoon. Special thanks to Dr. Paul Hayes for his friendship and updates when we were unable to visit during COVID. Special thanks to Shoshi, Kim, and Alex of Medigas for their support at home. Roger was born in Calgary on August 14, 1940, son of Wilson and Evelyn Keith of Calgary (Alberta). After completing his medical degree at the University of Alberta and general surgery residency at the University of Toronto, Roger went to Toulouse (Professor Jean Escat), London (Sir Rodney Smith), Los Angeles (Dr. William Longmire) and Seattle (Dr. Thomas T. White) to gain the best training in liver and pancreatic surgery. He is known for his many contributions to the surgical expertise in hepatopancreaticobiliary surgery, including endoscopic retrograde cholangiopancreatography, which became Roger’s specialty. He led its development in Canada over the next 40 years. He produced numerous books, chapters in books, and articles over his career. In 1990 he moved west to become the professor and head of surgery at the University of Saskatchewan. He contributed to the rapid development of surgical education through leadership roles, as president of the Canadian Association of General Surgeons, Chairman of the Examinations Committee in General Surgery for the Royal College of Physicians and Surgeons of Canada. Roger served as Councillor, Program Committee Chair and President of the Central Surgical Association; was a Governor of the American College of Surgeons; an Executive Committee member of the International Federation of Societies for Endoscopic Surgery; an International Director of the James IV Association of Surgery; and served as a Committee member of numerous academic surgical societies including the Society for Surgery of the Alimentary Tract, American Surgical Association, and the American HPB Association. He was a member of the Surgeons Travel Club through which he and Nancy enjoyed many warm friendships. Roger was editor-in-chief of the Canadian Journal of Surgery from 1992 to 1998. Roger was active in sports throughout his life, playing both football and basketball at the University of Alberta, curling at the Thornhill Club in Toronto, and leading the hosting committee of the Toronto Silver Broom World Curling 1986. Roger and Nancy had a love for travel from safaris in Africa to mingling with the penguins in Antarctica and many

places in between, including annual spectators at the British Open and regular spectators at the Canadian Open in recent years. Roger was an active skier, hiker and canoeist with his family, and remained an active golfer throughout his time in Saskatoon as a member of the Riverside Country Club. Roger had a wonderful sense of humour, loved to share a good story, loved a good competition, and he will be remembered as a loving husband, father, proud grandfather, brother/brother-in-law, respected colleague, caring friend, and dedicated doctor. He spent over 56 years of academic surgical care of patients in Alberta, Ontario and Saskatchewan. He was truly loved by his patients, and always took time for each and every one of them. He was much loved and will be sorely missed by all that knew him. Roger and Nancy were regular contributors to charities. As an expression of sympathy, donations may be made to Interstitial Lung Disease Research at the Canadian Lung Association (https://www.lung.ca/research/interstitial-lung-disease/), Canadian Pulmonary Fibrosis Foundation (https://cpff.ca/), or a charity of your choice. The family are planning a Celebration of Life at a later date. To share memories and condolences, visit www.parkfuneral. ca “Obituaries-Guestbook”. Arrangements entrusted to Greg Lalach, Park Funeral Home 306.244.2103.

DR. MICHAEL BORIS KROCHAK

1931-2021

It is with great sorrow we announce the peaceful passing of Dr. Michael Krochak of Saskatoon on Thursday, March 11, 2021, just a few weeks shy of his 90th birthday. His fulfilling, impactful and beautiful life began on April 7, 1931, in Stornoway, Saskatchewan. He attended school in Otthon, Wroxton, and St. Joseph’s College in Yorkton. Michael earned a Bachelor of Arts Degree (1953) and Doctor of Medicine (1957) from the University of Saskatchewan prior to completing his medical internship at the Regina Grey Nun’s Hospital. Dr. Krochak established his general family practice in Saskatoon in 1958, and dedicated nearly 60 years to his patients, and the art and science of medicine. He humbly cared for more than three generations and was adored, loved, and respected by so many patients and families whose lives he touched. Over the span of his medical career, Dr. Krochak was on staff at all three Saskatoon hospitals and most long-

term care facilities in the city including St. Joseph’s Nursing Home, a home to so many people and staff near and dear to his heart. Michael’s commitment to the profession steered him to serve in many leadership roles in medical organizations locally and beyond. He held senior positions with the Saskatoon Medical Association, the College of Physicians & Surgeons of Saskatchewan, College of Family Physicians of Canada, Saskatoon & District Medical Society, and the Ukrainian Medical Association of North America. He served as Chief of the Department of General Practice at St. Paul’s Hospital for nine years and shared his medical skills and expertise with generations of medical students at the University of Saskatchewan. Michael made it a practice to combine his love of travel with his commitment to medicine. Meetings and conferences with the many organizations he was involved in allowed him to see the world with his family and maintain many friendships while working for and on behalf of his profession. Michael’s dedication and expertise were recognized by many prestigious awards and honors, including Saskatchewan’s 2001 Family Physician of the Year, St. Thomas More College Distinguished Alumnus Award, and the esteemed Nation Builder Award by the Ukrainian Canadian Congress. He was humbled to have been named one of Canada’s Family Physicians of the Year in 2002, and when the Saskatchewan College of Family Physician’s in 2007 established the annual ‘Dr. Michael Krochak Award for Contributions to Family Medicine’ in his honor. Michael was a faithful member of Sts. Peter and Paul Ukrainian Catholic Parish, and an active and engaged supporter of countless church and community groups. He also selflessly gave to his community and served as a trustee to the Saskatoon Separate School Board for more than seven years, the Board of Regents for St. Vladimir’s Minor Seminary, the executives of the Fides Club and Sheptytsky Institute, and as a 4th degree Knights of Columbus. Michael shared 61 years of marriage with the love of his life, Marie (nee Luzney), whom he married in 1959. He cherished family time and was blessed with two children and six grandchildren whom he supported wholeheartedly, never missing a graduation, tournament, birthday, or recital. He was a caring and present pillar of strength and inspiration to his family, who always cherished his wisdom, love and kindness, and valued the time spent with and lessons learned from him. He found joy in gardening, fixing everything in the house and yard, boating and fishing at the family cottage at Blackstrap Lake, travelling with friends and family,

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reading spy novels, catching up with old friends, baking and cooking, and watching reruns of old-time TV shows. Michael treated everyone he met with the utmost respect and as an equal, and brightened the room with his kind soul, smart wit, and wisdom. His life was one well-lived and his legacy will survive through those privileged enough to have known him. Michael was predeceased by his parents Wasyl and Anna; brother Nick and his wife Mary; sister Stephanie Edward and her husband Harold; brother Joe; sister Elsie Tataryn and her husband Andrew; brother-in-law Joseph Luzney; brother-in-law Msgr. Rudolph Luzney; brother-in-law Wally Moldenhauer; and grand-daughter Sarah Marciniuk. He is survived by his loving wife Marie, daughter Carla (Darcy) Marciniuk and their children Tanya and Jeffrey (Samantha), son Michael (Brenda) and their children Natasha, Alexander, Andrew and Nicholas, sisters-in-law Nancy Krochak, Anne Moldenhauer and Michaeline Luzney and many nieces, nephews and cousins.

DR. E. JERRY RUDNISKY

1944-2021

In the early minutes of January 14, 2021, E. Jerry Rudnisky passed away, after a difficult three-month struggle with cancer. His wife was at his side. Jerry was devoted to his family; his wife, Judith Dutton; his son, Steven and his daughter, Vanessa; his son, Christopher and his wife, Michelle Breault and their children, Poppy and Charles; and his aunt, Pat Senych. He very quickly adopted all of Judith’s family into his family circle and was a warm and joyful addition to all the Dutton family occasions. Jerry was predeceased by his parents, Annie and Joseph. He was a dedicated ophthalmologist, practising until late November of 2020, never retiring. His office was always welcoming, efficient, and friendly. He will be sadly missed by his staff and his patients. Recently retired from the Eye Institute of Alberta at the Royal Alexandra Hospital, he will be fondly remembered by his colleagues and students there. Jerry was a patron of all forms of art and sport. He and Judith met through a mutual love of opera. He contributed to the Stratford Festival, and attended yearly, but Jerry also attended the rodeo, university and professional sports, museums, folk, rock, and country concerts. He loved his summer cottage at Itaska Beach on Pigeon Lake and served on the Itaska Beach Council for several years.

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DR. KOMALURU RADHAKRISHNA VISVANATHAN

1929 – 2021

Dr. K. R. (Vishy) Visvanathan passed away in Calgary on September 16. Born September 3, 1929 in Salem, Tamil Nadu, India, he was the second of eight children. He graduated from medical school in Madras in 1954. He immigrated to the United Kingdom to pursue further surgical training. Vishy was proud to have attained Fellowship in the College of Physicians and Surgeons of Glasgow and the Royal College of Surgeons of England, both in 1966. Vishy and Margaret met in Burnley, Lancashire in 1955. He told the story of seeing a young nurse in the operating room and being smitten by “a pair of beautiful blue eyes above a surgical mask.” They were married on November 20, 1959. His medical training took them to several cities in England and Scotland. Their three sons were born in England. After immigrating to Canada in 1967, he established a medical practice in Estevan, Saskatchewan. Soon after that, he achieved his Fellowship in the College of Physicians and Surgeons of Canada. He had a busy general practice and surgical practice until retirement in 1994. He was proud to be a Canadian citizen and often said “Canada has been very good to me.” His dedication to his patients made him much loved and respected in the community. Many patients became close friends. A much-sought-after invitation for those friends was to attend one of Vishy’s basement slideshows. In a time before the internet, digital cameras, and commonplace international travel, a narrated travelogue of adventures in India was fascinating and exotic. While he enjoyed sharing the culture of his homeland, he wholeheartedly embraced the customs of his adopted home. He and a group of close friends enjoyed an annual fly-in fishing trip at Wollaston Lake in northern Saskatchewan. He purchased a motorhome and took his family on many trips exploring North America. Vishy lived the Rotary motto “Service Above Self.” He served as President of Estevan Rotary Club and DDGM of the Masonic Lodge. He was particularly proud to serve as President of the College of Physicians and Surgeons of Saskatchewan in 1980. Vishy and Margaret moved to Calgary in 1995. This allowed him to further pursue his interests in photography, gardening, golf, and Indian classical music. While in Estevan, his photography hobby led him to build his own darkroom, where he developed and printed his own pictures. During retirement, he became interested in digital photography.

Ever curious and eager to learn new things, he embraced the new technology and edited his photographs digitally. Vishy and Margaret enjoyed travel, including bus tours and cruises to many continents. He was proud to introduce his family, including grandchildren, to his homeland with several family trips to India. The Canadian branch of the Visvanathan family enjoyed getting to know many uncles, aunts and cousins on these trips. Very important to both of them was the community they joined at the Calgary Crowfoot YMCA. Far beyond the fitness activities they enjoyed, their gregarious nature led to lasting friendships with many at the Y. In retirement, Vishy and Margaret spent many happy winters in Citrus Gardens, Mesa, Arizona. As was their custom wherever they were, they formed a circle of close friends in the snowbird community. His face lit up whenever he was with or spoke about his grandchildren. Vishy kept close track of each one’s pursuits and progress. He embraced their partners whole-heartedly into our family. This kind and generous man will be remembered for his ready smile, warm heart, wisdom and love for his family. He is survived by his loving wife of 62 years, Margaret, sons, Kishore (Janice), Raman, and Nandha (Shari); and grandchildren, Derek (Athanasia), Ashley, Nisha (Mitchell), Hannah, Brittney, Kyle (Felicity), Dean (Terava), Neil, and Noah. He is also survived by brothers, Ramanujan, Anandha and Babu; sister Shyamala; and their families. He was predeceased by his parents K.V. Radhakrishna and Mahalakshmi; brothers Pandurangan and Sarathy; and sister Prema. A private family service will be held. Condolences, memories and photos can also be shared and viewed here. Special thanks to the wonderful staff on Ward 43, Peter Lougheed Centre, and particular gratitude to Dr. Stephen Field. If friends so desire, in lieu of flowers, please consider making a donation to Doctors without Borders (donate.msf. ca). In living memory of Vishy Visvanathan, a tree will be planted in the Ann & Sandy Cross Conservation Area.

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Photo by Dr. Jessica Winter, resident

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