SMA Digest - Summer 2015 v. 55 | i. 2

A publication of the Saskatchewan Medical Association Volume 55 | Issue 2

DIGEST

SUMMER 2015

ENTERING A NEW ERA IN CONVERSATION WITH

DR. MARK BROWN New SMA president talks practice & priorities

MAKING CONNECTIONS saskdocs connects physicians and residents online

INSIDE THE RED ZONE SMA locum fights Ebola in Sierra Leone

In conversation with Dr. Mark Brown Summer 2015 | VOLUME 55 ISSUE 2 SMA Digest is the official member magazine of the Saskatchewan Medical Association. It is published twice per year and is distributed to nearly 90 per cent of practising physicians in Saskatchewan.

New SMA president Mark Brown speaks with the SMA about his love of practising in Moose Jaw, and shares his thoughts on a national seniors strategy, end-of-life care and the unique value of physicians.

Upcoming issues The next issue of SMA Digest will be distributed in winter 2016.

Bylines Where bylines are not given, articles were written or solicited by SMA communications staff.

Advertising The deadline for booking and submitting advertising for the winter issue is Tuesday, December 1, 2015. 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 Communications Coordinator Saskatchewan Medical Association 201-2174 Airport Drive Saskatoon, SK S7L 6M6 (306) 244-2196 maria@sma.sk.ca SMA mission The SMA is a member based organization that promotes the honour and integrity of the profession.

We: • Provide a common voice for physicians • Support the educational, professional, economic and personal wellbeing of physicians • Advocate for a high quality, patient centred health care system

Inside the red zone

SMA locum physician Dr. Paul Dhillon describes his experience fighting Ebola as part of an international team of volunteers in Sierra Leone.

CONTENTS

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2 4 6 8 11 12 14 16 18 20 22 24 28 29 30 32

YOUR SMA President’s note: Entering a new era Spring 2015 Representative Assembly highlights Representative Assembly resolutions In conversation with Dr. Mark Brown Congratulations 2015 CCPE recipients Dr. Jenny Basran: Leading innovations in geriatric care SMA Insurance: Made by physicians, for physicians Burnout: Understanding it. Finding support.

HEALTH CARE Our doctors pledge Inside the red zone Privileges and ensuring continuity of care Learning from the best to make SK health care better Achieving better referrals, quicker consults PIP - EMR integration project

STUDENTS & RESIDENTS Making connections Synergy mentoring program living up to its name

34 UPCOMING COURSES & CONFERENCES 36 CLASSIFIEDS 39 IN MEMORIAM

Making connections

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A new process by saskdocs makes direct contact between recruiting physicians and residents as easy as logging on.

PRESIDENT’S NOTE

entering a

NEW ERA A

t our recent retreat, the SMA Board of Directors discussed the future of Saskatchewan’s health care system and what the role will be of both physicians and the SMA within it.

We are entering a time of growing pressure on health care and those who provide the care, with an aging population that is demanding more of increasingly scarce resources. The changes that have occurred over the past decade have brought a new era where access, accountability and efficiency are top priorities for both governments and patients.

Knowing that we are entering a time of changing expectations and uncertain financial resources, it is time for us to consider some tough questions.

First, how do we, as physicians, remain influential in leading a patientcentred health care system? And second, how can the SMA improve to support physicians and provide you with the resources you need to thrive in your practice?

The overriding theme that kept coming up during the retreat is the im-

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portance of communication. Be it communication between the SMA and our members, communication between physicians and other health care providers, or communications within the profession, it is clear this is important and will require more time and greater focus.

I and other leaders at the SMA have committed to better, more frequent communication in an effort to be more transparent to our members and clear to other health care organizations about the challenges physicians face.

Another theme that was discussed at length was system transformation.

System transformation and quality improvement have never been more important and I believe physician involvement is essential to ensure the transformation efforts remain focused on improving patient outcomes.

Improving physician participation and leadership in health care design is one of the four strategic priorities of the SMA. We believe a strong, physician-led health care system is

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PRESIDENT’S NOTE

We believe a strong, physician-led health care system is essential to improve access to care, achieve wait-time targets, improve seniors care, and to realize system transformation that will benefit all of our patients. essential to improve access to care, achieve wait-time targets, improve seniors care, and to realize system transformation that will benefit all of our patients.

The Board of Directors also discussed physician engagement and what the SMA needs to do to better engage our members. In addition to better communications and offering more opportunities to enhance leadership skills, the Board discussed how to build and nurture long-term relationships with members, from students to retired physicians.

Engaging younger members, particularly those in “Generation Y”, which encompasses students, residents and physicians in their late 20s and early 30s, will be a particular focus of the SMA over the next few years.

We will be looking at communicating better with this generation, particularly over social media, while providing more networking and mentoring opportunities for young people.

needs. Please contact me at president@sma.sk.ca and follow me on Twitter: @drmtbrown. I look forward to hearing from you and to meeting as many of you as possible during Fall Tour stops this September and October.

Sincerely,

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Dr. Mark Brown SMA President president@sma.sk.ca

I want to hear from all members about how the SMA is doing and what we can do to better meet your

SMA DIGEST | SUMMER 2015

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YOUR SMA

COLLEGIALITY & QUALITY IMPROVEMENT Spring 2015 RA highlights Saskatchewan’s physicians discussed the barriers preventing better intra-professional collegiality and what the Saskatchewan Medical Association (SMA) can do to bring down those barriers at the 2015 Spring Representative Assembly (RA), held May 8 and 9 in Saskatoon.

President’s address Dr. Dalibor Slavik concluded his year as President of the SMA, noting it was a year filled with change and growth for the organization. In addition to the new building for the SMA and CPSS, the SMA created a new strategic plan and appointed Bonnie Brossart as the new CEO. In his final speech as President, Dr. Slavik reiterated his call for better physician involvement in health system changes that will impact patients. “It is crucial to our members and ultimately our patients that we are present at provincial tables, and proactive in these discussions,” he said.

“Who better than we physicians to advocate on behalf of our patients and their family members? As physicians, we owe it to them to ensure that their voices are heard. During my term as SMA president, I did my very best to make our collective voice heard where it mattered.”

Minister of Health’s address The RA included the semi-annual address and question and answer session with Minister of Health, the Honourable Dustin Duncan, and his officials from the Ministry of Health.

Among the topics discussed was the newly introduced legislation that will allow for private MRI scans in the province, generating several concerns from radiologists and other physicians.

Keynote address: Dr. Bill Cavers The keynote speaker was Dr. Bill Cavers, 2014-15 President of Doctors of BC. He showed the experience of British Columbia physicians and their struggles in turning around a fractured relationship between family physicians and specialists in the early and mid 2000s.

While Dr. Cavers outlined several initiatives that contributed to improving the relationship, one of the most successful of

In the spirit of collegiality, SMA members come together after lunch for our biannual Walk the Doc

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YOUR SMA

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Who better than we physicians to advocate on behalf of our patients and their family members? As physicians, we owe it to them to ensure that their voices are heard.

- Dr. Dalibor Slavik

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those was the creation of the Shared Care Committee. The mandate of this committee is to provide funding and project support to family physicians and specialist physicians to improve the flow of patient care from primary to specialist services.

As Dr. Cavers explained, the primary focus of this committee has been on the patient, but both patients and physicians have benefitted from the committee’s work. “The focus of the initiative is on clinical care. Improving clinical care, reducing gaps in care, improving the physician’s sense of self worth and putting physicians from different disciplines in the same room to talk about these clinical issues.”

Following Dr. Cavers’ presentation, physicians broke into groups to discuss the barriers to physician collegiality in Saskatchewan and what steps physicians feel the SMA can take to dissolve those barriers.

Learnings from Intermountain Health In addition to collegiality, the RA focused on quality improvement, learning from the first five Saskatchewan physicians to complete Intermountain Health’s mini-Advanced Training Program (mini-ATP). Drs. Gary Groot, Paul Babyn, Phillip Fourie, Guruswamy Sridhar and Jenny Basran spoke about their experiences with Intermountain’s clinical quality improvement program and how the mini-ATP principles are applicable to their practices.

Following the panel discussion, the room again split into discussion groups, contemplating the questions of what resonated for them from the panel discussion and their thoughts on the collection and use of data to inform practice.

The Fall 2015 Representative Assembly will be on November 13-14 in Saskatoon.

Check www.sma.sk.ca for more information as it becomes available.

SMA DIGEST | SUMMER 2015

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YOUR SMA

RESOLUTIONS

SPRING 2015 RA SASKATOON

The spring meeting of the SMA Representative Assembly was held May 8-9, 2015 in Saskatoon. These are the resolutions that were carried or referred to the board during the meeting.

Resolution 1 That the following member has been nominated as a delegate to the Representative Assembly: Dr. Saliu Oloko – Sunrise Health Region Pfeifer/Oleksinski - Carried Resolution 2 That the Representative Assembly appoint Drs. Stan Oleksinski, Clare Kozroski and Shayne Burwell to the Resolutions Committee.

Malholtra/Abdulla - Carried Resolution 3 That the narrative portion of the reports be received for information.

Slavik/Brown - Carried Resolution 4 That the minutes of the November 2014 meeting of the Representative Assembly be approved.

Sridhar/Pillay - Carried Resolution 5 That the Representative Assembly approve the actions of the Board of Directors as reported.

Slavik/Bayly - Motion Resolution 6 That the Representative Assembly approve the SMA financial statements for the year ending December 31, 2014.

Shannon/Sridhar - Motion

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Resolution 7 That the accounting firm of KPMG be appointed as auditors for the SMA for the year ending December 31, 2015.

Kozroski/Bayly - Motion Resolution 8 The SMA and its members support and advocate for an appropriately resourced Integrated Provincial Medical Laboratory Services initiative.

Magee/Pfeifer - Carried Resolution 9 That the SMA communicate to the Minister of Health and RHAs strong objection regarding mandatory participation in pooled referrals. Â Bayly/Oleksinski - Carried

YOUR SMA

Resolution 10 That the SMA call on the Minister of Health to demonstrate his support for family physicians providing obstetrical care in the Cypress Health Region by limiting any further expansion of the midwifery program.

Tumbach/Kozroski - Carried

Resolution 17 That the SMA urge the Ministry of Health and RHAs to provide adequate compensation for physicians participating in improvement processes initiated by the Ministry and RHAs. Sridhar/Shannon - Carried

Resolution 11 That the SMA call on the Minister of Health to require current midwifery programs to fulfill their initial mandate of providing care to underserviced populations.

Tumbach/Kozroski - Carried

Resolution 18 That the SMA request the Ministry of Health resurrect the tripartite process involving the SMA, Ministry of Health and RHAs to review or modernize medical staff bylaws.

Sridhar/Oleksinski - Carried

Resolution 12 That a provincial strategic plan be spearheaded by the SMA to address issues of senior care and, in particular, the issues of dementia.

Konstantynowicz/Achyuthan - Carried

Resolution 19 That the SMA investigate premiums on fees for physicians who work in rural and regional centres; similar to the 4.2 per cent rural retention premium in British Columbia.

Arsiridam/Malholtra- Carried

Resolution 13 The SMA call on the Minister of Health to reconsider the expanding role of pharmacists in the province, including assessing and prescribing for minor ailments and interpreting lab results. The SMA calls on the Minister to halt any further expansion of pharmacists’ scope of practice.

Kassett/Tumbach - Carried Resolution 14 That the SMA request the government to keep the hyperbaric oxygen chamber in Moose Jaw at the Hospital.

Thorpe/Sanderson – Referred to the Board Moved by Oleksinski/Abdulla Resolution 15 That the SMA work with the section of radiology and the Ministry of Health to establish standard, comprehensive MSB billing codes for all radiological services.

Oduntan/Goyal - Carried

CONGRATULATIONS TO OUR AWARD AND HONOURARY MEMBERSHIP RECIPIENTS

AWARD OF MERIT: Dr. Dalibor Slavik PHYSICIAN OF THE YEAR: Dr. Jenny Basran CMA HONOURARY MEMBERSHIP RECIPIENTS: •

Dr. Jerry Danielson

•

Dr. Stewart McMillan

•

Dr. Larry Sandomirsky

•

Dr. Betty Spooner

Resolution 16 That the SMA consider the need for a publicity drive to engage the people of Saskatchewan about the roles played by the physicians of Saskatchewan.

Prasad/Kassett - Carried

SMA DIGEST | SUMMER 2015

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IN CONVERSATION WITH

DR. MARK BROWN

By Dallas Carpenter

A

s he navigated the streets of downtown Moose Jaw, the gusting prairie wind of late April, kicking up winter’s remaining dust and sand, did little to affect the mood of Dr. Mark Brown.

“I’ll take this over snow,” joked the good-natured physician, a veteran of 16 Saskatchewan winters.

In his adopted home town, the “Friendly City” lives up to its name, as several people offer a friendly smile and say “Hi, Mark!” as he passes by. It seems this southern city, with its unique architectural beauty and undeniable charm, is as smitten with Dr. Brown as he is with it.

“It’s a great community and you really feel appreciated here,” said the native of South Africa. “It’s small enough that when you go to the grocery store, you’re probably going to bump into six or seven people that you are going to chat with. It’s going to take you a little longer to get your groceries, but you’ll get home quicker than you would in a bigger city.

“For me personally, what made Moose Jaw such a great fit, was that as a family physician, I was able to practise at my full scope of practice. I really enjoy doing stuff with my hands; I enjoy doing lumps and bumps, I enjoy doing procedures, I enjoy delivering babies, I enjoy assisting in the OR, and stuff like that. So practising here allows me to do all of this stuff in addition to my office practice.”

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Serving as the President of the SMA in 2015-2016 will mean Dr. Brown will spend less time in Moose Jaw as duties will take him around the province. For him, the time he spends travelling across Saskatchewan this year is both an opportunity to communicate with his physician colleagues and an opportunity to learn more about the province’s health care system and the people who rely on it.

“It’s one of those things that is understated in Saskatchewan,” explains Dr. Brown. “People often say to me, ‘Hey, everyone who comes to Saskatchewan moves to Alberta or BC. Why did you stay?’ It’s the people.”

Among the various health care issues currently on the minds of both physicians and patients, Dr. Brown is eager to delve into seniors care. With the number of people over 65 expected to rise to over 20 per cent of Saskatchewan’s total population by 2026, Dr. Brown believes it is critical to prepare for the “grey wave” now while also addressing current shortfalls in seniors care.

“There is a clear need for a national seniors strategy and I totally agree with the CMA’s push for that,” he said. “If you look at the demographics and how the population is aging, the need is becoming huge. We will need as many physicians to become geriatricians, palliative care physicians and seniors care doctors as we can possibly get.”

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YOUR SMA

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If I can contribute to something that improves things for the people of the province of Saskatchewan, I see that as time well spent.

In addition to increasing the number of physicians, Dr. Brown feels bringing back some traditional medicine practices may also allow the system to better meet patient needs. “We need to make it possible for not only a doctor to go see a patient at home but for that patient’s personal doctor to see them at home. I feel there should be incentives for family doctors to do more things like make house calls.

That’s the traditional way.”

Providing proper end-of-life care is another topic that Dr. Brown is passionate about. When it comes to medical care for terminal patients, he is clear that proper palliative and hospice care should be the priority of our health care system. “(CMA President) Dr. Simpson said this clearly: You should have good palliative care for all before you go to physician assisted dying,” explained Dr. Brown, referring to the Supreme Court of Canada’s decision on the Carter V. Canada, which struck down the law forbidding doctor assisted death. “You should have that in place first. We know there are many places in Canada that don’t have any form of palliative care. So you have to have that in place first or you are putting the cart before the horse.”

Ensuring patients have access to the care they need is a major issue facing the health care system. Having access to a family physician throughout a patient’s life will not only keep them healthier and delay or eliminate the need for nursing and palliative care, but, according to Dr. Brown, will create more satisfaction within the health care system.

“There was research done by the Canadian College of Family Physicians in the last decade in Ontario which looked at who was happy with the health care system and who wasn’t and why,” he said. “At the end of the day, what it boiled down to was that if you had a personal family doctor, you were happy with the health care system. And if you didn’t you weren’t happy with the health care system.

- Dr. Mark Brown

“So for me it’s about access. For me, if you could get enough family physicians in the province so every Saskatchewan person had a personal family physician and then you had a system like Advanced Access where you could get in on your day of choice to see your doctor, it would bring major improvements to the system.”

Embracing quality improvement and adopting the Advanced Access program was pivotal for Dr. Brown’s career. “I was going to leave the province in 2006 because my practice got so big. I was too busy and I had two options: One option was to leave, walk away from it, and start somewhere else. The second option was to change the way I was doing business.

“I learned about a concept called Advanced Access. It is a specific way to run your office where you do today’s work today and offer same-day appointments. What it really does is make sure you don’t book your schedule up so heavily that you aren’t able to do the important stuff. The ideal breakdown is 60-40; 40 per cent of your schedule is prebooked and 60 per cent is left open.”

Dr. Brown says that Advanced Access has been proven to reduce emergency room visits, specialist consultations, lab tests and the number of hospital admissions. While he admits it does not solve all the access problems, it is a proven quality improvement tool that can solve many day-to-day issues for physicians while contributing to better access to care.

“Why are the nurse practitioners doing more and their numbers are increasing?” asked Dr. Brown. “Why are the pharmacists being allowed to prescribe more? Why are naturopaths getting expanded powers? It’s because of access. It’s because people can’t get in to see their doctor when they’re sick. So they need to look for another option.”

Dr. Brown believes that working collaboratively with other health care providers, rather than competing with them, is important to improve both access and the quality of patient

SMA DIGEST | SUMMER 2015

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YOUR SMA

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If we, as doctors, think that by becoming part of a health care team it will dilute our ability and what we bring to the table, I disagree. I think it will set us apart and make doctors even more appreciated.

care. In addition, providing primary care as part of a team may also lead to greater career satisfaction for physicians, who would be able to practise to the full scope of their abilities.

“I’m pretty big on the unique value proposition of physicians,” he said. “At (the 2015 CMA General Council), Dr. Brian Goldman said that the problem is that many physicians function at the base of our abilities and we need to aim as high as possible. That’s how we are going to become and stay unique.”

“The unique value of physicians will be appreciated in a team setting. If we, as doctors, think that by becoming part of a health care team it will dilute our ability and what we bring to the table, I disagree. I think it will set us apart and make doctors even more appreciated. You will spend more time doing only what you can do and less time doing what other care providers can also do.”

After coming to Canada in 1999, Dr. Brown quickly found a practice and a mentor in Dr. Volker Rininsland. As a young physician, finding a mentor to guide him as he was starting his practice was invaluable and he sees a need to provide better mentorship opportunities to medical students, resident physicians and new physicians. However, the new generation of physicians may influence the older generation to change while learning from their mentors, a relationship Dr. Brown feels will be beneficial for the entire profession.

“I’m excited about the next generation because I think they are helping us reset our priorities,” he said. “My behaviour tends to mirror my older partners who are mentors to me,

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where you are always working. I’m the first one to admit that’s the wrong way to go. In terms of that work/life balance, I think that next generation has it spot on.

“I think that what we at the SMA need to do is find a way of convincing the people who provide the resources for us to work in the province to have the right physician numbers in places so people can have the right work/life balance.”

Dr. Brown is not one to shy away from challenging the status quo and calling for changes when he believes they are needed. In addition to serving his fellow physicians in various capacities, he has been a vocal proponent of health initiatives such as banning smoking in public spaces, chairing Citizens for a Smoke Free Moose Jaw. In 2003, the group forced Moose Jaw city council to pass the first smoking ban in public places in Saskatchewan, winning an award from the Canadian Cancer Society for their efforts.

“I still remember the night that election went down and we won, I remember saying to a friend of mine that ‘You can be in the office and seeing patients until you’re blue in the face.

But you will probably save more people by passing a bylaw than by writing 100,000 prescriptions.’

“That’s how I see my time at the SMA. If I can contribute to something that improves things for the people of the province of Saskatchewan, I see that as time well spent.”

Follow Dr. Mark Brown on Twitter

@drmtbrown

your SMA

YOUR SMA

CONGRATULATIONS CCPE RECIPIENTS

2015

Congratulations to the 2015 recipients of the Canadian Certified Physician Executive (CCPE) designation, which recognizes Canadian physicians for their performance as exemplary leaders. This year four physician leaders from Saskatchewan received this designation.

DR. KAREN SHAW

DR. DAVID STOLL

Registrar, College of Physicians

Family Physician, Emergency

and Surgeons of Saskatchewan

Department, Penticton Regional

/ Vice-president Medical Coun-

Hospital, Penticton, BC / Immedi-

cil of Canada

ate Past Senior Medical Officer

Saskatoon, SK

(Chief of Staff ), Mamawetan Churchill River Health Region

DR. DAVID TORR

DR. ROBERT WEILER

Consulting Medical Health Officer,

Vice-President, Practitioner Staff

Cypress & Heartland HRs / Clinical

Affairs, Saskatoon Health Region

Assistant Professor, College of

/ Interim Senior Medical Health

Medicine, Department of Com-

Officer, SHR / Clinical Professor,

munity Health and Epidemiology,

Department of Anesthesiology,

University of Saskatchewan / Chair,

University of Saskatchewan

Medical Health Officers Council of

Saskatoon, SK

Saskatchewan Regina, SK

Developed by the Canadian Medical Association (CMA) and the Canadian Society of Physician Leaders (CSPL), the CCPE credential is designed to recognize and advance physician leadership and excellence through a national, peer-generated, standards-based assessment process. Those who earn the CCPE have demonstrated that they have the leadership capabilities, knowledge and skills needed to succeed and to direct, influence and orchestrate change in Canada’s complex health care system.

TO LEARN MORE ABOUT BECOMING A CANADIAN CERTIFIED PHYSICIAN EXECUTIVE PLEASE VISIT WWW.CMA.CA/CCPE SMA DIGEST | SUMMER 2015

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DR. JENNY BASRAN

LEADING INNOVATIONS in geriatric care

By Maria Ryhorski

dition to being a practising clinician, associate professor at the College of Medicine and an internationally sought-after hile the Canadian Medical Association works to raise speaker. awareness of the need for a national seniors strategy, Dr. Jenny Basran already knows better than most, how geri- Dr. Basran’s determination to create a health care environatric care will need to evolve to meet the needs of Saskatch- ment that is supportive of the complex health needs of older ewan’s growing population of older adults. As the only geri- adults has driven her expansion from direct patient care into atrician in the province, Dr. Basran has tackled the front line education, health system transformation and technology. challenges of ensuring this province’s seniors receive the support they need to age well.

“I was really focused at the beginning on trying to recruit more geriatricians,” says Dr. Basran. She realized early on, This work has earned her the heartfelt appreciation of her however, that recruiting enough to fill the need might not patients and families, the admiration of her students and be realistic, so she shifted her thinking. colleagues and the 2015 SMA Physician of the Year Award, presented at the Spring Representative Assembly on May 8. “Everybody pretty much is going to end up having geriatric patients in their practice except for paediatricians and ob“Dr. Basran is an incredible systems thinker and visionary stetricians,” she says, “so I thought, ‘how do I make sure that leader,” said Mr. Graham Fast, project lead for the ED Waits & everybody who is involved in the care of an older adult actuPatient Flow Initiative, of which Dr. Basran is clinical co-lead. ally has some knowledge of geriatrics?’”

“She has developed and articulates a clear vision for transformative change to the way that health care is delivered to Education was the answer. In addition to teaching at the Colseniors and other complex patients in Saskatchewan.” lege of Medicine, Dr. Basran worked with a team to develop the Geriatric Skills Day program that ensures all new phyThrough her work ranging from the front lines of medicine, sicians have the knowledge and skills to manage geriatric to education, to health system transformation, to research, patients and those with complex health needs.

Dr. Basran has grown to identify gaps and barriers to quality geriatric care in the current system, and help engineer In addition to skills training, Dr. Basran feels that educating solutions. Among her current roles, she is a core member health care providers to see the whole person and not just of the Health Technology Expert Review Panel, and head of their ailments is crucial to providing good care.

Geriatric Medicine at the University of Saskatchewan, in ad-

W

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YOUR SMA

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We’re going to have to use technology in a way that is respectful, that empowers the older adult, but can also provide us information to help them be safe and age well.

Growing up in small town Saskatchewan with her grandmother living in their home, and the family restaurant playing host to coffee row, Dr. Basran always had close relationships with older adults – something she partially credits with her becoming a geriatrician. It is this familiarity she feels is lacking for many medical students and residents.

Dr. Basran is currently working with a team to develop a Single Care Plan, something she believes will have a great impact on this. A Single Care Plan would house records from all the patient’s care providers in one electronic record thereby optimizing communication and data flow and fostering whole person care.

“Many of them have not had an exposure to an older adult growing up … and so their first exposure is often the older adult that they see in hospital who is often at their worst, their most frail,” says Dr. Basran.

“I firmly believe, if done right, … that it will make huge, significant changes to how we care for older adults,” she says.

“It changes the way we think about patients with complex issues.”

This can be detrimental because, as a result, ageist views, like not expecting a patient to recover, can develop. To counteract this Dr. Basran developed the Longitudinal Elderly Person Shadowing program (LEPS) which creates opportunities for medical professional students to spend time with and get to know a relatively independent senior in their home. This fosters the understanding that the frailty and vulnerability that they see in the hospital is not representative of the patient’s normal level of function.

As the population ages, Dr. Basran believes that care will move more and more into the community and as it does, technology will play an increasing role in supporting seniors living at home and their caregivers.

Dr. Basran’s passion for education has seen tremendous results. Her students find her enthusiasm contagious, many considering subspecializing in geriatrics following her lectures. The LEPS program has been recognized as a best practice by Accreditation Canada, Geriatric Skills Day was adopted by medical schools across the country, and pivotal changes have been made to the medical curriculum to include core competencies in geriatrics. But she has found that once health care providers have the knowledge, they are impaired by a system that is not built to facilitate good geriatric care.

“My belief is that our health care system is really based on a traditional model of care that is focused on – what is your chief complaint? Let’s fix it. Then off you go – and unfortunately that doesn’t reflect the current needs of our patients.”

“Many of our older adults have five or more chronic conditions and so that system where you have to treat just one thing and go, doesn’t work.”

One idea in development is the possibility of using non-invasive sensors around the home to establish a custom baseline of normal activity and functionality for the individual being monitored by tracking every day activities such as the opening and closing of fridge doors etc. If there are disruptions to this baseline, they act as a signal to the caregiver that something may be wrong. Such a system would allow individuals to maintain their independence but at the same time provide safeguards.

“We’re going to have to use technology in a way that is respectful, that empowers the older adult, but can also provide us information to help them be safe and age well,” she says.

Despite her advancements in systems work and technology, Dr. Basran always feels the pull back to working one on one with her patients.

“I think for me the impact of the direct clinical care, and the impact that I can have on … both the patient and their family - I think that’s what’s most rewarding for me,” she says.

“I always have to go back to that to feed my soul and say, ‘Ok, this is why I love this. This is what I’m doing it for.’”

SMA DIGEST | SUMMER 2015

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YOUR SMA

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We’re not just selling the insurance; we’ they have appropriate cove

SMA Insurance

MADE BY PHYSICIANS, FOR PHYSICIANS

SMA Communications Coordinator Maria Ryhorski speaks with Mr. Ed Hobday, Administrative Director at the SMA and veteran employee of 45 years, about one of our staple programs: Insurance. The guidance and feedback of SMA Insurance’s Cindy Anderson was much appreciated in the development of this feature.

The insurance program at the SMA has been around since 1969. Can you tell me why the SMA branched into the insurance business?

Hobday: It was in recognition that insurance was important for physicians and that there was the opportunity, if the SMA was to become involved, to work with insurance companies and put together plans that were tailored to the specific needs of physicians.

At that time the three key products that they identified as being important for physicians were life insurance, disability insurance and office overhead insurance, the latter being insurance that would help pay your ongoing business expenses in the event that you’re unable to practise.

Why is it important for every physician to have the right insurance?

Hobday: Insurance is part of a larger financial planning strategy, and there is a need to recognize that so much of your time, energy and resources has been invested in your career that it only makes sense that, if one has a valuable asset like yourself, you should attempt to insure that asset. There are many variations and types of insurance out there and they are not necessarily focused or targeted to the uniqueness of physicians. A comprehensive insurance plan would ensure that a physician has made the appropriate arrangements to look after self, family and the business in the event of his/ her unforeseen and premature disability or death.

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How does the SMA ensure that their plans reflect the current needs of their members?

Hobday: Our Insurance Committee comprised of practising physicians serves as our direct link or “eyes and ears” of the members regarding what their colleagues’ continuing or changing insurance needs might be. Based on this feedback, the SMA, with the assistance of our consulting actuary, negotiates with the insurance companies that underwrite our products to make changes and additions to these products so that they continue to be aligned with those needs. It is important to be aware that our insurance plans are dynamic and that all improvements are automatically “retrofitted” into all existing coverages. Simply put, the SMA insurance plans are made by physicians, for physicians.

What is the advantage to physicians to come to the SMA for their insurance needs?

Hobday: As previously mentioned, physicians would want to take a close look at our offerings, because they’re structured with the input and advice of an oversight committee of practising physicians. Our life and disability insurance plans are set up on what is known as a “retention basis” which means that participants share in the good experience of the plans. Premiums not needed to meet the expenses of the plans are returned to participants in the form of premium rebates. Our very knowledgable staff who are involved in administering our insurance plans are neither commission incentivized or driven. Rather, their focus is on service and not profit or revenue. From the Association’s perspective, this is one of a number of services or products that are unique in terms of identifying a need and filling that need.

We would hope that we are seen as a trusted provider of these types of products. We’re not just pushing or selling the insurance; we’re working with our members to ensure that they have appropriate coverage that makes sense to their circumstance.

re working with our members to ensure that rage that makes sense to their circumstance.

” ‘‘

- Ed Hobday

YOUR TEAM We like to think that the biggest SMA insurance advantage is our people...

We have good products and great people!

’’

- Ed Hobday

You mentioned insurance as part of a larger financial plan. Can you tell me about the SMA’s relationship with MD Financial Management Limited?

CINDY ANDERSON

has been helping physicians find the right insurance for the last 12 years. She is licensed with the Insurance Councils of Saskatchewan and is a member of Advocis, the Financial Advisors Association of Canada.

Hobday: We have in place a Memorandum of Understanding that we refer to as an “Insurance Alliance” where MD Financial Management and a number of provincial medical associations have entered into that recognizes the unique products and services that each partner can bring to that Alliance – MD Financial Management on the wealth management side, and the SMA on the insurance side.

GISELE DEAULT

has been with the SMA for four and a half years, with an additional 13 years in the financial industry and is fluent in both French and English.

The products that the SMA sponsors are not the only insurance offerings that physicians can access through the Alliance. MD Financial Management has the ability to access a product shelf of individual products to complement the SMA’s insurance offerings. That results in a full-service package. Since the Alliance has been in place, it’s proved to be very impressive. It really is one-stop shopping.

YOUR PLANS DISABILITY • • •

•

available to practising members, residents and students definition of disability specific to physicians, including specialty choice of plans ranging from zero-day elimination period to lifetime benefit continuation of coverage if practising outside of Saskatchewan

LIFE •

• •

OFFICE OVERHEAD

Available to practising members, residents, students and spouses Standard, preferred and elite rates available Maximum available - $5 million

•

• •

available to practising members to cover business expenses in the event of disability maximum coverage $15,000 per month up to 18 months payable in addition to disability insurance benefits

. . . AND MORE To explore your insurance options with the SMA please contact Cindy Anderson at cindy@sma.sk.ca / 306.244.2196 SMA DIGEST | SUMMER 2015

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YOUR SMA

BURNOUT UNDERSTANDING IT FINDING SUPPORT

By Dallas Carpenter

M

uch of the focus within the health care system over the past decade has been on quality improvement, including finding efficiencies and making informed choices that improve patient outcomes. Improving the health and well-being of the health care providers, however, has not received the same level of attention. Thanks to the Saskatchewan Medical Association’s Physician Health Program, awareness of serious problems such as physician burnout, and the help available to physicians and their families, are now coming to the forefront.

It is becoming increasingly clear that the pressure being felt by physicians is having a negative impact on the satisfaction many have in their professional lives and in the care they deliver to their patients. A recent survey by the Canadian Medical Association indicates that 46 per cent of Canadian physicians are feeling burned out. In addition, 23 per cent of Canadian physicians are reporting that they are feeling depressed while the rate of suicide is twice as high for physicians as it is for the general population.

The factors that are causing physician burnout are likely to continue or increase in the near and long-terms, necessitating a greater focus on the health and well-being of physicians. More importantly, it will require better awareness by physicians about the consequences of becoming burned out and a willingness to ask for help to build the skills they need to better cope with workplace stress.

Saskatoon psychiatrist Dr. Alana Holt, who sits on the SMA’s Physician Health Program committee, sees the problems burnout can bring to the lives of her patients. These problems can have serious consequences for physicians and their patients if the signs of burnout are not recognized or are ignored.

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“Burnout creeps in,” explains Dr. Holt. “It does not happen suddenly and it does not give you warning unless you are paying attention on purpose.”

Burnout happens in three phases. The first is typically exhaustion, which is often not helped with rest or time away from work.

The second phase is depersonalization. “Physicians tend to create space between themselves and their patients,” says Dr. Holt. “This is actually a dysfunctional coping mechanism for exhaustion. You create distance between you and your patients in an attempt to minimize the drain on you. This presents itself as cynicism, sarcasm, and what’s called ‘compassion fatigue.’”

46% of physicians in Canada are feeling burned out

The third phase is a reduced sense of personal accomplishment or a lack of efficacy. It is a feeling of not making a difference or having an impact in what you are doing.

YOUR SMA

‘‘

Sometimes people think they can outsmart these things...

’’

Burnout is not about being intelligent or unintelligent. It’s about the impact of the distress of our work over a long period of time.

“I have seen this,” says Dr. Holt. “I have seen physicians having no purpose or meaning and thinking about leaving the profession. These are treatable conditions and physicians will come back and say ‘I feel so fulfilled again. I feel able to practise and no longer want to leave my practice.’ So the key is asking for some help.”

It is important to identify the signs of burnout early and take action before it starts to cause severe problems. This is easier said than done, as it may not be apparent to a physician that they are in the early stages of burnout. Many are also reluctant to seek help until they are experiencing problems that are affecting their practice and patients.

Fortunately, the stigma of appearing vulnerable and asking for help is slowly dissipating, with younger generations leading the way by seeking help more often. “Asking for help is really difficult,” says Brenda Senger, Director of the SMA’s Physician Support Programs. “I must say though, that generationally, there appears to be much less stigma for our current medical students and residents. They are much more proactive and reach out long before they crash and burn.

“Older physicians will often say, they have worked for 30, 40 or 50 years, and now they have earned the right to take some time to take care of themselves, to spend some time with their families. Most say they wish they would have done this sooner.”

Developing resiliency and having strategies that enable a physician to be more resilient is important as it is difficult to deal with workplace stress without these tools.

“Sometimes people think they can outsmart these things,” says Ms. Senger. “Burnout is not about being intelligent or unintelligent. It’s about the impact of the distress of our

- Brenda Senger

work over a long period of time. Burnout doesn’t happen as one incident, it happens over a long period of time.”

To move past burnout, Dr. Holt concurs that it is important for physicians to find strategies to take mental control of their lives and improve their resiliency. “Resiliency is the ability to bounce back from psychological, physical and any kind of profound stress,” she explains. “It’s the ability to adapt to adversity.”

A resilient person, says Dr. Holt, has a number of key traits that allow them to adapt to stress. “A resilient person has a sense of autonomy. They have a general sense of self-like and self-acceptance. They have a sense of mastery, and an ability to problem solve and make decisions. They have a sense of purpose and set goals. They have a vision and they see themselves in their life and in their practice working at that optimal level.”

For more information and self-reflection tools, please log in to the member’s side of the website and click on “News and Resources” and “Resources and Guidance”. Remember that help for physicians and their families is only a phone call away: Please call Brenda Senger at (306) 244-2196 or 1-800-6673781.

PHYSICIAN HEALTH PROGRAM The Physician Health Program provides assistance to colleagues, students, residents and their families who may be struggling with a variety of issues including mental health, substance abuse, physical health or marital and family concerns.

For assistance please call Brenda Senger, Director of Physician Support Programs at (306) 2442196 or 1-800-667-3781.

SMA DIGEST | SUMMER 2015

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HEALTH CARE

OUR DOCTORS PLEDGE

By Shannon Boklaschuk

D

r. Susan Shaw has decided to make a positive change: She will sit down and be at eye level when talking with all of her patients and their family members.

It may seem like a small action, but it’s one that she hopes will make a big difference.

“This is a small but significant change in how most doctors talk with their patient in a hospital. It helps create a better sense of people being equal partners and participants within the conversation,” said Shaw, who practices critical care and anesthesiology in the Saskatoon Health Region.

“I really hope my patients will feel more at ease when speaking with me and know that I actually do want to hear from them. But I also hope that I will model a best practice to my colleagues and medical students, and then others will build this best practice into their work.”

Shaw’s pledge was made for the second annual Saskatchewan Change Day, a province-wide campaign organized by the Health Quality Council (HQC) that aims to improve health and health care. The theme of Saskatchewan Change Day 2015 is “Make Health Better Together.” Participants can pledge to do something to improve their own health, the

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health of their workplace, or the health of the patients, residents or clients they serve. People are also encouraged to share their pledges on Twitter to inspire others, using the hashtag #skchangeday.

“Saskatchewan Change Day is about the power within each of us to make a difference. Anyone who provides health care, receives health care or who cares about health care is encouraged to pledge to make a change for the better,” said Shaw, HQC’s board chair.

“Everybody has the ability to make a small positive change in their work or in their lives. You don’t need to wait for permission to test something out.”

Saskatchewan Change Day 2015 will be celebrated on November 5, 2015. From now until November 5, people are encouraged to make a pledge on the Change Day website: www.skchangeday.com. The goal is to receive 2,015 pledges from across the province for Saskatchewan Change Day 2015 – more than double the goal of 1,000 pledges in 2014, when 1,397 pledges were received.

Dr. Werner Oberholzer has made a Change Day pledge that he hopes will improve the quality of care he provides to his patients. Oberholzer, who has a family practice at the Radville Marian Health Centre, has pledged to incorporate the

HEALTH CARE Choosing Wisely campaign into his daily care delivery. The aim of Choosing Wisely Canada is to help doctors and their patients have conversations about unnecessary tests, treatments and procedures.

Oberholzer, who is an HQC board member, hopes his Change Day pledge results in his patients being more informed about evidence-based medical care delivery.

“Continuous quality improvement is a concept that needs to be part of our daily thinking and the cornerstone of how we deliver care. We need to practice evidence-based medicine, and the quality and quantity of the care delivery model should be based on best evidence. The guidelines should of course be implemented within the clinical context, and what best suits the patient and their circumstances,” he said.

“By having a Change Day initiative, we can question our current practice and work towards a better system of sustainable health care.”

Oberholzer is enthusiastic about the Change Day social movement, as he believes one small change made by each health care provider can lead to large improvements in care delivery.

“It is not always the big idea that leads to better care; small changes can affect a big system.”

“It is not always the big idea that leads to better care; small changes can affect a big system,” he said.

Dr. Dennis Kendel also believes that small changes can make a big difference. Kendel, who is the CEO of the Physician Recruitment Agency of Saskatchewan (saskdocs) and an HQC board member, wants to ensure medical students and residents “think boldly” about the things they can do to improve care for the patients they encounter in their clinical training. His Change Day pledge is to ensure that all University of Saskatchewan medical students and residents know about Change Day 2015 and are encouraged to make a pledge.

“I made this pledge because I recognize that the current medical students and residents will soon succeed me and other colleagues in the medical profession and I want to instill in them a sense of social activism that is focused on making things better than they currently are,” said Kendel.

“There is inherent in the culture of medicine a strong attachment to tradition and the way we have always done things.

Students and residents have not yet been fully captured by that culture, so they are well positioned to bring forward fresh ideas for making things better at many levels.”

Kendel said he likes the Change Day concept for two reasons.

“It challenges us to realize that every one of us has the power to be a change agent and that we need to model the changes we would like to see all around us. It also showcases the power of new ideas and the power of social movements to translate ideas into pragmatic action,” he said.

The Change Day social movement originated in the U.K.’s National Health Service, which held its first Change Day in 2013. The Change Day concept has since spread around the world, including to Australia, the U.S., Sweden, the Netherlands, Jordan, South Africa, New Zealand and Finland. HQC organized Canada’s first Change Day campaign in 2014.

“For the first Saskatchewan Change Day in 2014, nearly 1,400 people from across the province entered a pledge on the website at www.skchangeday.com. It was exciting to see this enthusiasm for positive change. We want to build on that energy this year,” said Gary Teare, HQC’s CEO. “Change Day complements HQC’s mission of accelerating improvement in health care to make care better and safer for the people of Saskatchewan. We hope people across the province will join us in supporting Saskatchewan Change Day 2015. Let’s show the world what we can achieve together.”

(Shannon Boklaschuk is a communications consultant at the Health Quality Council.)

SMA PLEDGES

The SMA is an enthusiastic supporter of Saskatchewan Change Day and the power to improve health care one pledge at a time. Take a look at these pledges from SMA members and staff.

I pledge to try to personally call specialists on call for all in patient or urgent consult requests.

Dr. Mark Brown, SMA President

I pledge to complete all patient related calls, forms and other tasks before the end of each workday.

Dr. Dalibor Slavik, SMA Past-President

I pledge to express gratitude to a SMA co-worker every day.

Ms. Bonnie Brossart, SMA CEO

SMA DIGEST | SUMMER 2015

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HEALTH CARE

‘ INSIDE THE RED ZONE

By Maria Ryhorski SMA locum physician Dr. Paul Dhillon, already known for his travels not just throughout the province but around the world, jetted off this past January on his most high risk endeavor yet, to join an international task force of volunteers for six weeks in Ebola stricken Sierra Leone.

While many would shy away from a country being devastated by one of the worst epidemics in history, Dr. Dhillon leaped at the opportunity to help - and to put his knowledge and training in disaster medicine to use.

“I have been working towards training myself up so that I would be able to work in humanitarian environments,” he says, “and I have just reached the stage where I am comfortable doing so.”

Since the beginning of the outbreak in March 2014, Ebola has claimed over 11,000 lives. Its progress has been dramatically slowed by tenacious local staff and international volunteers who work in Ebola treatment centres across west Africa, providing care for the sick while keeping them quarantined from the rest of the population.

“It is a very unique environment that I don’t believe has existed before in the world,” says Dr. Dhillon. The treatment centre he worked in is comprised of long, windowless patient wards, known as the “red zone”, with openings func-

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tioning as doorways on either end. Anyone entering the red zone must first suit up in protective gear that includes a full body suit as well as goggles, double mask and double gloves, a process that takes 20 to 30 minutes. Upon exiting they undergo a thorough decontamination before they can leave.

“I think there is a healthy respect for the virus for all those that work in the environment,” he notes. Despite the risks, he adds that, “There is a phase where the fear slowly diminishes and your work becomes normal.”

But it is anything but normal. The heat is sweltering, and the protective gear workers wear compounds this. In addition, simple procedures like starting an IV, are rendered difficult by cumbersome gear and stifling temperatures.

During their six-hour day shifts and 12-hour night shifts, workers use the buddy system when going into the red zone. Operating in pairs, they provide personal hygiene care, administer IV fluids, dispense pain and anti-bleeding medications as well as treat other conditions as they come up. They can only stay in the red zone 20 minutes at a time, to a maximum of one hour. Staying any longer is too dangerous. The risk of passing out from heat and exhaustion is high and, should it happen, would be disastrous. Still, they strive to maintain a constant presence for the patients, especially the children, for whom being hospitalized is a particularly frightening and isolating experience.

HEALTH CARE

‘‘

’’

I have a huge amount of respect, not only for those who have children and families who went over, but for the families who supported them from abroad.

“There is an incredible amount of trust that you must place in your colleagues, not only those working with you in the red zone but those that do the decontamination as you exit,” Dr. Dhillon says. He adds that he has nothing but pride for his colleagues in Sierra Leone, particularly his colleagues from Cuba who were there much longer than he was and who lost one of their own to malaria while they were there.

had to leave his own girlfriend at home, something he describes as one of the most difficult parts of this experience for him.

“I feel that we were part of a much larger humanitarian machine,” he says – a machine that collectively helped save thousands of lives and brought the Ebola mortality rate down from 80-90 per cent to 30-40 per cent, each volunteer sacrificing time with their own family to help.

“She was dropped off out of a car, literally, and walked up to the hospital on her own,” he recalls. “Everyone was worried that it would end badly.”

“I have a huge amount of respect, not only for those who have children and families who went over, but for the families who supported them from abroad,” says Dr. Dhillon, who

Now safely back in Saskatchewan and newly engaged, Dr. Dhillon reflects on his time away. There is one moment that sticks in his mind, of a little girl, only five years old.

Thankfully this story has a happy ending. The little girl recovered completely and was able to be reunited with her father, a reunion that Dr. Dhillon witnessed.

“Those moments made it worthwhile.”

‘‘

There is an incredible amount of trust that you must place in your colleagues, not only those working with you in the red zone but those that do the decontamination as you exit.

’’ SMA DIGEST | SUMMER 2015

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HEALTH CARE

PRIVILEGES and ensuring

CONTINUITY OF CARE

By Dallas Carpenter

P

ractising medicine requires skills and knowledge that takes the better part of a decade to acquire. However, the rigorous study and practical experience gained in medical school or in continuing medical education activities rarely include review of the ethics, bylaws and regulations that govern the practice of medicine, prompting concerns over the ability of some physicians to provide adequate, continuous care for their patients.

Being aware of and regularly reviewing bylaws, regulations and the Canadian Medical Association (CMA) Code of Ethics is important for all practising physicians, as it reinforces important principles and requirements that impact patient care. Family physicians, in particular, must be aware of the practitioner staff bylaws of their region and the regulations of the College of Physicians and Surgeons of Saskatchewan (CPSS), as those bylaws and regulations outline what is expected of physicians in providing continuity of care.

The SMA Representative Assembly and Board of Directors continue to encourage all physicians in the province to seek privileges in the regions they practise in, privileges which allow for access to region resources such as labs and diagnostic imaging. The privileging process requires physicians to have an awareness of practitioner staff bylaws and, just as importantly, creates a relationship between a physician and their region which leads to practice and patient benefits.

Fewer physicians are seeking privileges and familiarizing themselves with the bylaws in their region of practice, a concerning trend for the SMA and other health care organizations. As Dr. Ulla Nielsen, Chair of the SMA’s Legislation and Policy Committee explains, the changes made to the health care system in Saskatchewan over the last two decades, which were done largely without the input of doctors, played a major part in contributing to the trends we see today.

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“Over the past 15 or 20 years, there have been increasing changes within the practice of medicine, changing the whole structure of medicine,” she said. “The regional health authorities have changed a lot over that time. Much of that has happened without a lot of attention being paid to doctors and having doctors being part of the process. These changes have happened around them and to them. Doctors are not interested in bylaws because they see them as things that were created by somebody else and they are being done to them.”

Much could be done to encourage physicians to seek privileges within health regions, by approaching privileges as truly a privilege with services and incentives associated with obtaining and retaining them. Nevertheless, a fair portion of the responsibility for not seeking privileges rests with physicians.

There are clear advantages for physicians to be privileged in a region and be aware of practitioner staff bylaws. Not only will it improve their practice and the care they deliver to their patients, but becoming aware of the bylaws and knowing that they are living documents is also empowering for physicians, believes Dr. Nielsen.

“You need to know there are rules, where the rules are, and what they are, and what to do if you don’t agree with them,” she said. “These are the rules we’re living by and if you don’t like them, get them changed. There are ways built into the bylaws to make the changes. They are not, in fact, written in stone.”

The impact privileges can have on continuity of care is an issue the CPSS and other licencing bodies across Canada are acutely aware of. “There is discussion at a broad number of levels, including at the most recent FMRAC (Federation of Medical Regulatory Authorities of Canada) meeting, wheth-

HEALTH CARE

er it is acceptable for physicians to practise without some degree of privileges,” says CPSS Associate Registrar and Legal Counsel Bryan Salte.

“Do you need to know every word that is in these documents? No, you don’t. But you need to know they exist and understand the broad strokes of what is in there.”

“Should there be some requirement of connection with the regional health authority as a requirement to practise, and access labs and access all of those other things? Frankly, it would be a most unusual practice where a physician can engage in a meaningful practice with no access to labs and no access to diagnostic imaging and no access to things which are offered through the health region.”

There is one document every physician must read and review throughout their career says Dr. Nielsen. “You need to read the CMA Code of Ethics. It underlies all of the rest of these acts, bylaws and regulations. It is the foundation on which all of your learning and all of your practice is laid. It’s not going to steer you wrong.”

While the CPSS does not require holding privileges to be considered for licensure, Mr. Salte says that the possibility exists that the CPSS Council may decide to create a policy around privileges in the future. If concerns come forward over non-privileged physicians and the impact they are having on the continuity of patient care, the CPSS or a regional health authority may feel compelled to create additional regulations or agreements outside of the practitioner staff bylaws.

“It’s pretty clear, in continuity of care issues, that one of the big challenges is what I like to call the lone wolf out there,” said Mr. Salte. “They’re the person who really doesn’t practise in collaboration with other physicians. It’s a big warning sign for lack of confidence if you’re not involved with other people in the range of services you provide. There are a lot of reasons why there is some real concern about physicians practising completely independently without that involvement of colleagues.

“Continuity of care is a much bigger issue than what happens if my doctor prescribes me a drug and I recognize I’m having a side effect at 10 o’clock at night. It’s also about how my care is handed off to another physician, how is it that if my care is handed off, that the information comes back to my regular physician, so somebody knows something about whatever the issue happens to be. It’s about the consistency of the information across the spectrum.”

The message coming from several organizations is that there is an onus upon physicians to be part of the privileging process and to take appropriate steps to ensure continuity of care for their patients. Both Dr. Nielsen and Mr. Salte agree that while it is unrealistic for a physician to know every bylaw and rule that affects their practice, physicians need to know the basics of the key documents of the organizations they will be accountable to.

“When somebody is going to start a practice in Saskatchewan, it is their responsibility to find the rules, legislation and guidelines that will govern their practice,” says Dr. Nielsen.

KEY RESOURCES FOR PHYSICIANS Canadian Medical Association Code of Ethics https://www.cma.ca/En/Pages/code-of-ethics.aspx College of Physicians and Surgeons of Saskatchewan Regulatory Bylaws http://www.cps.sk.ca/Documents/Legislation/Legislation/RegulatoryBylaws.pdf The Medical Professional Act, 1981 http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/M10-1.pdf The Health Information Protection Act http://www.qp.gov.sk.ca/documents/english/Statutes/Statutes/H0-021.pdf College of Family Physicians of Canada (accreditation and education maintenance for family physicians) http://www.cfpc.ca/Bylaws/ Royal College of Physicians and Surgeons of Canada (accreditation and education maintenance for specialists) http://www.royalcollege.ca/portal/page/portal/rc/ about Canadian Medical Protective Association Good Practices Guide https://www.cmpa-acpm.ca/serve/docs/ela/goodpracticesguide/pages/index/index-e.html Links to practitioner staff bylaws for each region and links to other resources will be posted on the SMA website.

SMA DIGEST | SUMMER 2015

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HEALTH CARE

LEARNING FROM THE BEST TO MAKE SK HEALTH CARE

By Greg Basky

A

small cadre of Saskatchewan physicians is learning the science of quality improvement, from a health system widely regarded as the world leader in delivering high-quality, lower cost care.

In April, Drs. Gary Groot, Paul Babyn, Jenny Basran, and Philip Fourie – all of whom are involved in priority provincial improvement efforts – completed the four-month miniAdvanced Training Program (mini-ATP) at Intermountain Healthcare, based in Salt Lake City, Utah. The program is an immersion into Intermountain’s unique approach, which combines continual rigorous analysis of the results of bedside care, and efforts to improve those results.

The Saskatchewan doctors who took part this spring were selected based on their roles as physician leaders and participation in provincial health care quality initiatives. Current plans are to have another four Saskatchewan doctors take part in the nine-day course between January and April of 2016. The aim is to develop sufficient capacity within the province’s physician community to help HQC integrate key

BETTER

features from the Intermountain program into a Saskatchewan training and learning system that complements and builds on the current Lean-based programs.

For surgical oncologist Gary Groot, the Intermountain approach goes to the heart of physicians’ professionalism.

“I think my biggest ‘aha’ was coming to understand that clinical quality improvement is not something ‘they’ (administration) do to us (physicians) to save money so much as a way of working as a profession to optimize our ability to provide our patients with the best care possible in a complex environment,” says Groot, “where evidence is ever changing the timely integration of that evidence into practice is next to impossible for individual clinicians working in isolation.”

The cornerstone of the Intermountain model is “standards of care,” developed by teams of local doctors, nurses, and administrators, which explicitly spell out what they have agreed is the best way to treat specific clinical conditions – diabetes care, for example, or heart failure. These protocols – which set out such things as how much of a drug to pre-

‘‘

I DEEPLY BELIEVE THAT IT IS OUR COLLECTIVE PROFESSIONAL RESPONSIBILITY TO CREATE NEW KNOWLEDGE AND IMPLEMENT THAT KNOWLEDGE, A RESPONSIBILITY THAT IS MET THROUGH OUR COLLECTIVE RESEARCH EFFORTS AND I AM CONVINCED THAT THIS IS AN AREA OF RESEARCH THAT WE CAN EXCEL AT NATIONALLY AND INTERNATIONALLY.

’’

- DR. GARY GROOT

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‘‘

HEALTH CARE

’’

THE INTERMOUNTAIN SYSTEM IS A LEARNING SYSTEM THAT LEARNS FROM EVERY SINGLE ENCOUNTER WITH THE PATIENT WITH A SOLE AIM TO IMPROVE CARE FOR THE NEXT PATIENT.

scribe -- become the default option for doctors and nurses.

The standards are built right into Intermountain’s computer system. Providers can deviate from the norm, but they’re required to document why they did so. Key to this, their detailed electronic records enable individual doctors and the teams who developed the different protocols to look at outcomes – for patients who received standard care, and for those whose care fell outside the protocol.

Dr. Guruswamy Sridhar, a consultant physician in Regina Qu’Appelle Health Region and a past president of the SMA, did the training on his own time, in spring 2014. His Intermountain experience left a lasting impression on him.

“The Intermountain system is a learning system that learns from every single encounter with the patient with a sole aim to improve care for the next patient,” says Sridhar. “If errors are noted, all efforts are focused on preventing further recurrence of the error.” Intermountain’s use of care maps has improved care for patients, and increased empowerment and satisfaction for clinicians, he says.

- DR. GURUSWAMY SRIDHAR

“I deeply believe that it is our collective professional responsibility to create new knowledge and implement that knowledge, a responsibility that is met through our collective research efforts,” says Groot. “And I am convinced that this is an area of research that we can excel at nationally and internationally.”

The Health Quality Council, in partnership with the SMA, sponsored the participation of the physicians who attended the Intermountain course this year in order to expose Saskatchewan physicians directly to the world-leading health care quality improvement approach used there. Intermountain combines elements of Lean process improvement with evidence-informed care design. The hope is that HQC and SMA will be able to partner to send another four physicians to the course next year. Then there will be at least nine physicians in the province with exposure to the Intermountain course – an important critical mass to inform ongoing development of leadership and improvement training in this province that incorporates Lean along with elements of evidence-informed care design.

Sridhar and Groot are putting their new learnings into practice here at home, for the benefit of their own patients and the broader health system. Sridhar dug into the data to identify clusters of patients presenting to Emergency who could be triaged and managed differently. He has also brought the data-driven improvement mindset to his involvement in activities led by the Ministry of Health, the Medical Association, and Regina Qu’Appelle. “It is my hope that, by integrating the learnings from Intermountain along with our learnings about Lean as a tool, we will have the ability to make quality care the fundamental focus of our system.”

Groot has brought together a group of surgeons, pathologists, radiologists and radiation oncologists to look at how they determine which patients with thyroid cancer should have biopsies and how best to follow these patients. He’s also clinician co-lead on a provincial QI program, and is helping create a new clinical QI research program for the University of Saskatchewan’s College of Medicine.

SMA DIGEST | SUMMER 2015

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HEALTH CARE

At the recent SMA Spring Representative Assembly, the cohort of Saskatchewan doctors who completed the Intermountain course this spring talked about their experience and shared lessons learned. RA delegates had the opportunity to discuss what they heard from their colleagues and suggest future directions for their profession around physicians’ participation in and leadership of quality improvement in this province.

design of care – in other words, what care is best for each patient population -- with process improvement -- which looks at how care should be delivered,” says Teare. “We are looking to build upon the Lean-based process improvement foundation that has been laid in Saskatchewan over the last few years so that health care providers in this province have a system that supports continuous learning and improvement of patient-and family-centred care.”

“It’s encouraging to hear about the excellent experiences these physicians had with the Intermountain program,” said SMA President Dr. Mark Brown. “These physicians will be able to pass on their knowledge and be the frontline leaders our health care system really needs to enhance quality and access and bring real benefits to all of our patients.

(Greg Basky is the Director of Communications at Saskatchewan’s Health Quality Council.)

“The SMA has a strategic priority devoted to improving physician leadership in health care design, and having physicians implement standards and initiatives that were inspired by what they learned at the Intermountain program will be a key part of achieving our goals in this area.”

Gary Teare, CEO of the province’s Health Quality Council, says Intermountain is really the “complete package.” “More than any other health system, they have integrated the

ADDITIONAL READING

Intermountain’s miniAdvanced Training Program http://intermountainhealthcare.org/qualityandresearch/ institute/courses/miniatp/Pages/home.aspx Making Health Care Better, New York Times, November 3, 2009 http://www.nytimes.com/2009/11/08/ magazine/08Healthcare-t.html

OPPORTUNITY FOR TRAINING AT INTERMOUNTAIN HEALTHCARE

COMING SOON! The SMA and the Health Quality Council are partnering to fund up to four physicians to attend the Advanced Training Program in Health Care Delivery Improvement at Intermountain Healthcare in Utah from January - April 2016.

WATCH THE SMA E-NEWSLETTERS FOR DETAILS ON THE NOMINATION PROCESS.

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SMA DIGEST | SUMMER 2015

CMA PHYSICIAN MANAGEMENT INSTITUTE (PMI)

SEPT. 18-19 | REGINA

OCT. 16-17 | SASKATOON

LEADERSHIP FOR MEDICAL WOMEN

LEADERSHIP STRATEGIES FOR SUSTAINABLE PHYSICIAN ENGAGEMENT

Registration deadline: Aug. 28 Venue: Delta Regina CME credits: 13 Cost: $650

Registration deadline: Sept. 25 Venue: SMA Boardroom CME credits: 13.25 Cost: $650

Given busy work environments and family schedules, there are few opportunities for women physicians to slow down and examine their life’s purpose as it relates to present or future leadership roles. This course focuses on deepening self-awareness and self-knowledge in today’s medical leadership and societal context and will help women physicians leverage their natural strengths to exercise leadership skills in a variety of venues.

Physician engagement is vital to the success of Canadian health reform. This program provides physicians with the knowledge, skills and abilities, and the opportunity to use those attributes to construct an action plan. Participants can become active leaders, bringing about effective physician engagement wherever they work, whether as clinicians in primary or hospital care, or as system administrators.

FOR MORE INFORMATION OR TO REGISTER please visit www.sma.sk.ca or contact Delilah Dueck at delilah@sma.sk.ca or 306.244.2196

SMA DIGEST | SUMMER 2015

27

HEALTH CARE

patient wait times to see a specialist

ACHIEVING BETTER REFERRALS QUICKER CONSULTS

When the health system began the daunting task of improving safety and reducing surgical wait times in 2010, it was already clear that an equally important challenge lay ahead: reducing the length of time patients wait from their referral until they see an appropriate specialist (Wait 1).

The billing code for partial assessments (Code 5B) was the most frequently used billing code that involved referrals to a specialist. But if a patient had several partial assessment visits, there was no simple way to confirm which one resulted in a referral.

Specialists, GPs and patient/family advisors are helping develop a more effective way to handle referrals, with the goal of cutting Wait 1 in half by March 2019.

The new 55B billing code was created for partial assessments that result in a specialist referral. Use of the 55B code indicates the start date for the patient’s wait among the stream of partial assessments, which can be compared with the billing date for the specialist visit.

“Some referrals are processed flawlessly,” La Ronge family physician Sean Groves says. “But too often, patients aren’t sure the paperwork got to the specialist until they get a phone call months later. When they finally arrive at the office, they may find out more tests are needed, or that they should be referred to a different kind of specialist. Working together, we can do better than that.”

Their long distance from urban centres makes the experience all the more frustrating for Groves’ patients. If they suddenly find out a diagnostic test is needed, they must scramble to get it done immediately, or delay the consult until the next time they can make a trip south.

Along with Saskatoon urologist Kishore Visvanathan, Groves is a physician lead on the Improving Access to Diagnostics and Specialists Initiative. Some of the efforts underway will: • Streamline and standardize (where possible) referral processes; • Improve communication among health providers and with patients; • Make better use of billing processes, referral forms and Electronic Medical Records; and • Expand the online Specialist Directory to include medical specialists.

“Tools are needed to close the loop, so all partners are informed of key information and decisions,” Groves says.

Billing code 55B helps measure patient wait times Unlike surgery wait times, no simple method existed to estimate with confidence how long patients were waiting before a specialist appointment (Wait 1).

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SMA DIGEST | SUMMER 2015

Once a critical mass of physicians are using the 55B code, provincial billing data can be used to produce a valid sample to estimate wait times for a visit to any specialist. Once the results have been validated, they will be posted to the online Specialist Directory, helping patients and referring physicians discuss specialist referral options.

Researchers at the University of Western Ontario’s Department of Statistics and Actuarial Sciences confirmed that measuring samples of specialists’ wait times using the 55B billing code provides an accurate estimate of their wait times, even though some referrals are made using other codes.

NOTE: The 55B code is for use by general practitioners and family physicians only.

For more information, please contact Mr. Bhooman Bodani at the Strategic Priorities Branch in the Ministry of Health (email: bbodani@health.gov.sk.ca, phone: (306) 787-8936 or fax: (306) 798-0023) Find the Specialist Directory at www.sasksurgery.ca.

PIP-EMR INTEGRATION PROJECT

O

ver 300 Saskatchewan physicians and clinic staff can now view patients’ Pharmaceutical Information Program (PIP) profiles within their EMR, thanks to a joint project of the Saskatchewan Medical Association and eHealth Saskatchewan. This important initiative is providing clinicians with easier access to the vital information they need to deliver the best possible care for their patients.

The PIP-EMR Integration Project offers QHR Technologies Accuro EMR users seamless access to PIP profiles in their EMR, simplifying clinical workflows by eliminating the need to log into PIP separately. Keeping key patient information in one place – the EMR – ensures clinicians have ready access to an up-to-date version of their patients’ medication history. While important for any patient, this is of particular value for those who may have trouble recalling their medications.

PIP profiles can also assist clinicians in discovering compliance issues with patient prescriptions, and are invaluable for identifying potential drug interactions or duplications of therapy. By making this vital information available to physicians and their staff in the same application as the rest of a patient’s chart – their Accuro EMR – the PIP-EMR Integration Project is supporting patient safety and the best possible care for Saskatchewan residents.

As with any new advancement, there have been a few bugs to work out. Some users reported that their patients’ PIP profiles were slow to load, or noted that some features were missing or not yet functional – the ‘Print’ and ‘On Behalf Of’ functions, for example. The project team has been proactive in addressing these trouble spots and has engaged QHR to correct them. The project team has also heard concerns about the complex process to become a PIP approver or delegate and is working with the Ministry of Health to improve the process.

Initial rough patches notwithstanding, the project has been a tremendous success: as of March 31st, 2015, 340 users had access to PIP information within their Accuro EMR. The PIP-EMR Integration Project team continues to work hard at bringing more physicians and clinic staff on board and improving the user experience for those who already have access.

To learn more about obtaining PIP access within your Accuro EMR, please contact your SMA EMR Change Management Advisor (CMA). If you are not certain who your advisor is or do not have an advisor, please email Elizabeth Pease, EMR Program Coordinator, at elizabeth@sma.sk.ca. If you are a TELUS Health MedAccess EMR user, this functionality may be developed in the future. Please notify your

EXTRA CME FUNDING AVAILABLE IN 2015 An extra $1,000 is available for eligible Continuing Medical Education (CME) activities in 2015. The SMA is encouraging physicians to use the extra portion of CME funding for activities related to improving leadership skills and strengthening abilities to lead system transformation.

The Continuing Medical Education Fund assists physicians with the costs associated with continuing medical education courses and materials. If you would like to know what your CME balance is, please log on to the members side of the website (www.sma.sk.ca) by clicking the “My SMA Member’s Area” button.

SMA DIGEST | SUMMER 2015 29

HEALTH CARE

MAKING CONNECTIONS SASKDOCS MAKES DIRECT CONTACT BETWEEN PHYSICIANS AND RESIDENTS AS EASY AS LOGGING ON

By Maria Ryhorski

M

aking direct contact with residents early on in the recruitment process can be challenging for physicians, particularly those who can’t afford to spend hours or days away from their practices traveling to recruitment fairs.

A new process by saskdocs aims to streamline that first step, condensing the first point of contact between physicians and residents into a 15 to 30 minute episode that utilizes already existing infrastructures and completely eliminates unnecessary travel and time away from the office.

How? By matching physicians to residents in a particular training site and facilitating a “face-to-face” meeting using videoconferencing software.

Two sessions have been piloted so far between physicians in Moosomin and residents in two Saskatchewan training sites, both earning positive feedback from the physicians and residents involved. Health region recruiters and saskdocs were also on hand to facilitate.

“It was just a matter of taking half an hour out of my day and clicking on the GoToMeeting app,” says Dr. Ross Kerkhoff, a physician at a Moosomin clinic that is currently operating two physicians short. For him this is a small price to pay to speak one on one with residents so early on in the recruitment process. This direct contact is something that Dr. Kerkhoff feels is valuable and often absent from the early stages of recruitment.

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SMA DIGEST | SUMMER 2015

“Historically it’s always been by way of written advertisements, and perhaps recruitment fairs where you may be speaking to a recruitment agent,” says Dr. Kerkhoff. “Very few times do you get to actually see a physician.”

For Dr. Kerkhoff, talking directly to the residents and giving them an honest representation of what life and practice is like in Moosomin, was important.

“I think it’s important to hear from the actual physicians who you’re going to be working with,” he explains, “and not to hear just the good side of things … but to tell them honest details as far as, this is what you can expect, the good and bad.”

“Then you can formulate your own opinion and ask pertinent questions.”

This opportunity to ask questions and receive honest answers early on, is something that Dr. Ankit Kapur, first year La Ronge based resident and participant in the first GoToMeeting session, appreciated.

“Everyone has some sort of ‘no go’ criteria,” he says, “and if it doesn’t meet those, then what’s the point of even wasting anyone’s time?”

He also appreciated that saskdocs and the regional recruiters were included in the meeting. This allowed him and his colleagues to benefit from the honesty and candidness of the local physician on the ground in Moosomin, but also

to ask the saskdocs representative questions that they may not have been comfortable asking the recruiting physician.

“It adds another whole dimension or another whole value point to the interaction,” he notes.

Dr. Dennis Kendel, CEO of saskdocs, hopes that the convenience of this option will encourage recruitment conversations to begin earlier. Often he says, retiring physicians may not begin the recruitment process until they’re ready to retire.

“What this leads to is what we refer to as ‘recruitment by crisis’,” he says. “You suddenly want someone there immediately and I don’t think that gives both parties optimal time to really explore whether it’s a good match.”

Ever wish you could get away? ...spend more time with your family ...catch up on CME

Ideally those conversations should start over a year preceding the anticipated retirement – preferably between April and November when residents are wrapping up their first year and most haven’t yet locked down a permanent position.

Dr. Kendel believes this videoconferencing option will facilitate earlier first contact thus leaving more time for direct interaction between physicians and residents before decisions are made. This will likely result in better matches and better matches equate to better retention.

Anticipating a need in your practice?

Planning for retirement? saskdocs would be happy to help you connect with interested residents on your schedule, close to home.

Please contact Jennifer Grunert, saskdocs recruitment consultant, at jennifer.grunert@ saskdocs.ca to get more information or set up a meeting.

Our team of family physicians is ready to travel to your community, and step into your practice and call rotation so you can take a well deserved break.

To book your SMA Rural Relief Program locum coverage for September through January, please contact Randall Kehrig at 1-800-667-3781 or randall@sma.sk.ca or apply online at www.sma.sk.ca.

SMA DIGEST | SUMMER 2015

31

‘‘

IT’S A SAFE ENVIR IT’S A PLACE WHE

SYNERGY mentoring program living up to it’s name

By Maria Ryhorski

S

ince its launch two years ago, the Student-Physician Synergy Mentoring Program at the College of Medicine has “exploded” according to its co-founder and liaison Dr. Jasmine Hasselback. Numbers have grown to 100 mentees and 150 mentors from a variety of specialties and practice settings including rural and regional. In addition mentors and mentees alike are reporting overwhelmingly positive benefits – something Hasselback had hoped would happen.

“Just spending time with that kind of energy and enthusiasm – it’s contagious,” he says.

“JUST SPENDING TIME WITH THAT KIND OF ENERGY AND ENTHUSIASM – IT’S CONTAGIOUS.”

Having an ongoing relationship with a physician mentor is something that Drs. Groot and Hasselback both benefitted from throughout their training and want to share with the next generation of physicians.

- DR. GARRY GROOT, MENTOR

“A big hope I had was that the mentors would get just as much out of it as the mentees – and based on testimonials they are almost shocked by how beneficial it was for them too,” she says.

For Dr. Gary Groot, a surgical oncologist in Saskatoon and one of the program’s first mentors, being active in this role helps him regain the enthusiasm and excitement he had for medicine back when he began his training.

“It’s very easy after you’ve been in practice for a long time for that enthusiasm to wane a little bit,” he admits.

He recalls going back to school a number of years ago to do his PhD and spending time with students again and realizing, “You know, yeah, there’s really no reason for it not to be absolutely amazing.”

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SMA DIGEST | SUMMER 2015

Despite his busy schedule, he feels the extra effort is more than worth it.

“You find the time for the things that are important,” he says.

“I see those students as our future colleagues and so it’s embracing them right from the get go.”

Hasselback sees a mentor’s role as a safe person to ask difficult questions of, as one of the most valuable roles a mentor occupies.

“Ideally you build up a sense of real trustworthiness,” she says. “I think it’s that honesty that, as a student, can be very difficult to bring forth in other settings because of how enwrapped most of their life is in their training.”

Second-year medical student and student liaison of the program, Cheyanne Vetter, agrees and considers this access to honest feedback one of the top benefits of having a mentor.

“It is important for every student to have a mentor, to be able to ask those questions that you don’t want to ask the physician who is evaluating you,” she says.

“It’s a safe environment to ask the ‘silly questions’. It’s a place where you’re not criticized or judged.”

STUDENTS & RESIDENTS ONMENT TO ASK THE ‘SILLY QUESTIONS’.

RE YOU’RE NOT CRITICIZED OR JUDGED.

’’

- CHEYANNE VETTER, MENTEE

It’s more than a practice...

it’s a lifestyle!

Family Physician Locums In addition, she feels that having the mentoring relationship within the context of a formalized program is even more beneficial.

“Lots of the value of the program comes from the ‘artificial’ conversations we have with mentors,” she says, “conversations about goal setting, our personal limitations and growth. All of these are important conversations to have between mentee and mentor yet outside of the formalized Synergy program they can be odd to bring up.”

According to Hasselback, the value of a mentor is limitless, and the mentoring relationship can have as many incarnations as there are physician-student pairings. What is important is that there is clear communication to negotiate the needs and expectations of the relationship so that the result is positive and mutually-beneficial.

The Student-Physician Synergy Mentoring Program at the University Of Saskatchewan College of Medicine, launched in 2012 with the support of the SMA. It pairs a current medical student with a practising or retired physician in a formalized mentoring relationship.

The program will be moving into its third year and welcomes and encourages physicians and students from all disciplines to become involved. For more information or to join the program as either a mentor or mentee, please contact Gabriella MezoKricsfalusy, Director of Mentoring Programs at (306)966-6473 or gabriella.mk@usask.ca or Cheyanne Vetter, Student Liaison at (780)806-6862 or c.vetter@usask.ca.

Northern Medical Services is seeking family physicians for locum positions available in northern Saskatchewan. Work with a team of physicians and nurse practitioners who provide a full range of medical services in community-based hospitals and clinics.

A balanced lifestyle and appealing medicine await you in some of the most scenic settings in northern Saskatchewan.

We pay a fixed daily rate of $1300-$1765 per day depending upon location. Transportation costs are covered. Accommodation is provided.

www.northerndocs.com For further information please contact: Kerri Balon, Recruitment Coordinator Northern Medical Services #404, 333 - 25th Street East Saskatoon, SK Canada S7K 0L4 Tel: (306) 665-2898 or 1-866 667-3627 Fax: (306) 665-6077 Email: balon.nms@usask.ca

SMA DIGEST | SUMMER 2015

33

UPCOMING COURSES AND CONFERENCES SEPTEMBER Neonatal Resuscitation Program Instructor Course September 17-18, 2015 - Regina, SK For more information visit www.usask.ca/cme.

PMI: Leadership for Medical Women September 18-19, 2015 - Regina, SK For more information visit www.sma.sk.ca.

Neonatal Resuscitation Program Provider Course September 19, 2015 - Regina, SK For more information visit www.usask.ca/cme.

Saskatchewan Interprofessional Preceptor Conference September 24, 2015 - Regina, SK For more information visit www.sma.sk.ca.

OCTOBER Pediatric Acute-onset Neuropsychiatric Syndromes October 1-2, 2015 - Saskatoon, SK For more information visit www.sma.sk.ca.

Practical Orthopedics October 2-3, 2015 - Saskatoon, SK For more information visit www.usask.ca/cme.

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SMA DIGEST | SUMMER 2015

Saskatchewan Emergency Medicine (SEMAC VII) October 16-17, 2015 - Saskatoon, SK For more information visit www.usask.ca/cme.

PMI: Leadership Strategies for Sustainable Physician Engagement October 16-17, 2015 - Saskatoon, SK For more information visit www.sma.sk.ca.

Saskatchewan Interprofessional Preceptor Conference October 22, 2015 - Saskatoon, SK For more information visit www.sma.sk.ca.

Horizons Medical Career Specialty Conference October 24, 2015 - Saskatoon, SK For more information visit www.sma.sk.ca.

NOVEMBER SMA Fall Representative Assembly November 13-14, 2015 - Saskatoon, SK For more information visit www.sma.sk.ca.

Practical Management of Common Medical Problems November 20-21, 2015 - Saskatoon, SK For more information visit www.usask.ca/cme.

HORIZONS MEDICAL CAREER SPECIALTY CONFERENCE

OCTOBER 24, 2015 - SASKATOON, SASKATCHEWAN Horizons is an event of Student Medical Society of Saskatchewan (SMSS), sponsored by the Saskatchewan Medical Association (SMA), that strives to expose medical students to the various specialties available to them and help them along their path to choosing a career.

This is an excellent opportunity to showcase the benefits of practising in Saskatchewan to our medical students. Get a head start on building relationships with your future colleagues and raise the profile of your practice at Horizons.

SPONSORSHIPS BRONZE

booth at conference organization logo displayed at event on appreciation poster

SILVER

in addition to bronze recognition: organization logo included in promotional emails and advertising for the event

GOLD

in addition to silver recognition: verbal recognition at the event unlimited placement of promotional materials in registration packages

PLATINUM

in addition to gold recognition: lead sponsor of the conference, alongside the SMA 15 minute time slot to present to attendees

CONTACT Brittany Pirlot, SMSS bap890@mail.usask.ca SMA DIGEST | SUMMER 2015

35

CLASSIFIEDS

FAMILY PHYSICIANS

CLASSIFIEDS

Family Physicians are invited to join the busy Quance East Medical located in East Lakeside Medical Clinic opening available While some women know Clinic, right away what they will do in Regina, close to major shopping centers and first class Opening available to take over a medium sized, established the case of housing. an unintended or unwanted pregnancy, others practice at the Lakeside Medical Clinic. The practice could aren’t so sure. Exploring their feelings about their preginclude a mix of booked appointments as basis well as walk-in nancy and options can be helpful to make the choice that - Full-time, part-time or locum shifts during the week. All physicians work a rotation of is best for them. Pregnancy options are discussed in a sup- Two convenient locations daytime weekend shifts averaging one in four. The practice portive, safe and confidential atmosphere, and experienced The clinic isinclude well established 2006,candirecently in newly-constructed does- not currently obstetrics butsince a potential counselors are available forpremises those who need or want this Regular walk-in patients areforaccepted date- could easily and add this.

The clinic qualifies the EMR support. For some, the best choice will be parenting or stipend as well aswork the Family Physician Careasadoption, while others will choose abortion. Medication - Flexible hours, you Comprehensive can be as busy you wish Program stipend.

A start date would be negotiable.

Please and surgical abortions can be provided or arranged.

- Electronic Medical Records (Accuro system) direct inquiries to csbuttinger@lakeside.ca.

- Pleasant and efficient staff Women wishing to book an appointment to further discuss Saskatoon Community Clinic offers self-referral - Excellent potential for income withservice 30/70 split The Saskatoon Community Clinic has a longstanding his- pregnancy options including abortion may call the Saskatory of being supportive of women’s right to reproductive toon Community Clinic directly at (306) 652- 0300. A referral choice. We are pleased to offer a self-referral service for is not required. Bloodwork and ultrasound do not need to women considering their pregnancy options: parenting, be arranged in advance: we will make these arrangements.

After services related to pregnancy options and Dr. Lana Cheshenchuk at suitlana@sasktel.net oraccessing call 306.545.5868. adoption, and abortion. management at the Saskatoon Community Clinic, women 10’- 0”will return to their usual health care provider for ongoing care.

2’ - 0”

Contact:

Saskatoon, SK - Fantastic Opportunity! Beautiful Clinic! Great Location! This bustling East

MANUFACTURE AND INSTALL… EXTERIOR

side family practice is looking for energetic family physicians for winter and long term locums.

TWO SETS Partnership possibilities available. Kenderdine Medical Clinic has moved into a brand FIRST SURFACE VINYL ONalso EXISTING LEXAN newFACE facility with experienced professional staff. One of the trailblazers in Saskatchewan’s EMR INSTALLED ON EXISTING LEXAN FACE OVERALL SIZE: AS SHOWN

program, there is also an X -Ray and pharmacy all on site. There is a significant, large and stable patient population and high volume walk-in traffic. Offering a competitive split including

CONSTRUCTION: VINYL GRAPHICS SUBSTRATE: EXISTING CABINET: EXISTING

70/30 for evening and weekend MEC shifts!

GRAPHICS

KENDERDINE: BLACK MEDICAL CLINIC: WHITE LOGO: WHITE/RED/BLACK BACKGROUND: WHITE

COLOUR DATA

VINYL: BLACK Contact Business Manager Daniel McNeil @ 306 934-6606 ext. 105 or dmcneil.kmc@sasktel.net.

3630-33 RED

36 SMA DIGEST | SUMMER 2015 28 Autumn 2011 SMA News Digest

CLASSIFIEDS Medical Council of Canada seeks examiners We are happy to announce that we will be hosting the fall MCC QE Part II in Saskatoon on October 24 & 25, 2015. We are currently recruiting physicians to be examiners for this session and need your support. The official recruitment information will be mailed to all potential examiners at the end of June. Please watch for this to arrive. For further information please contact Nicole Kopp by email at nicole. kopp@usask.ca or by phone at 306-966-6769.

In order to qualify as a physician examiner you must meet the following criteria: 1. Must have the Licentiate of the Medical Council of Canada (LMCC) and must provide their LMCC registration number to the examination centre (exceptions should be discussed with the Manager of the Evaluation Bureau).

2. Should have at least two years of Canadian independent practice 3. Should be two years post-LMCC. 4. Should not be residents or fellows.

5. Should hold an unrestricted license, should not be under professional investigation and currently be practicing medicine.

6. Should have the ability and stamina for the task – overall health and age can be limiting factors (e.g., hearing loss is a serious handicap).

7. Should not examine in the three years prior to anyone in their immediate family or household’s eligibility to take the Medical Council of Canada’s Qualifying Examination Part II • Do you have any family members in medical school or a residency program (including international schools ie. Poland, Ireland, Caribbean etc.?

• If in residency have they completed MCC QE Part 1 & MCC QE Part 2?

8. Should not examine for a minimum of three years before and a minimum of three years after participating in a preparatory course.

9. Should not have a conflict of interest. For the purposes of this examination, a conflict of interest exists, without limitation, in situations where the examiner or standardized patient is: • Related by blood or marriage to the candidate; • In or has been in a significant business or social relationship with the candidate, or is a professional colleague; or • Where a conflict of interest relating to the candidate and such examiner or standardized patient has been previously identified (e.g., there is an outstanding complaint in another context).

New to Saskatchewan and craving a taste of home?

Safari Market serves the grocery needs of South Africans, West Africans (Ghana, Nigeria etc.), East Africans and people from Caribbean nations living in Saskatoon and the surrounding area

Store Hours:

Monday-Friday 10:00 am - 7:00 pm Saturday 9:30 am - 8:00 pm Sunday 1:00 pm - 6:30 pm

Find us:

Location - Unit #270-2600 8th St. E - Saskatoon Phone - (306) 374 – 0411 Email - info@safarimarket.ca Like us on facebook - Safari Market

We’d love to help you find what you’re looking for so stop by the store or call with your request and we will ship to wherever you are in Saskatchewan. We aim to please!

SMA DIGEST | SUMMER 2015

37

SMA PRESIDENT’S

& VICE-PRESIDENT’S

TOUR

SMA President Dr. Mark Brown and Vice-President Dr. Intheran Pillay will travel throughout the province this fall as part of the annual SMA fall tour. They will visit each health region, giving members the opportunity to ask questions and raise concerns. See the schedule* below to attend a meeting in your region.

September 11 Keewatin Yatthe HR

September 17 Five Hills HR

Ile a la Crosse / La Loche

September 14 Sunrise HR

September 16 Regina Qu’Appelle HR

TBA

Saskatoon

TBA

Melfort

October 6

Regina

Heartland HR Rosetown

September 22 Kelsey Trail HR

Swift Current

Prince Albert Parkland HR Prince Albert

September 21 Saskatoon HR

Yorkton

September 15 Cypress HR

October 7

Moose Jaw

Mamawetan Churchill HR TBA

TBA

Prairie North HR North Battleford

Sun Country HR Estevan

* Schedule may be subject to change. Visit sma.sk.ca for updates as the tour approaches.

Professional Office Building Downtown Medical Office FOR LEASE

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cell 306 380 4812 dir 306 664 1248 lisa.matlock@colliers.com

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Colliers McClocklin Real Estate Corp. | +1 306 664 4433 | www.colliers.com/saskatoon

38

SMA DIGEST | SUMMER 2015

IN MEMORIAM Dr. John Shirley Owen January 19, 1923 - June 12, 2015 It is with deep sadness that the family of Dr. John Owen announces his passing on Friday, June 12, 2015 at Royal University Hospital in Saskatoon.

Dr. Owen served at the University of Saskatchewan for many years as professor in the Department of Community Health and Epidemiology. Dr. Owen was honoured particularly for his extensive contributions to the International Studies Program in the College of Medicine and his work in placing more than 200 medical students in developing countries for their elective course in Community Medicine.

Dr. Owen was the most senior member of the Saskatchewan Coalition for Tobacco Reduction, having joined the Coalition in the mid-eighties when tobacco control was just starting to emerge as an important area. He was part of the ensuing progress in our province – the first smoking bylaw in western Canada passed in Regina in 1980, smoke-free public places and workplaces and, of course, the province’s precedent-setting retail display ban.

In 1967, Dr. Owen and his wife Jacqueline came to Saskatoon. Soon after their arrival, they received a letter from Cheshire, who was a personal friend of theirs, stating he had received inquires about starting a Cheshire Home in Western Canada, and whether it was needed. Cheshire Homes is a non-profit charitable organization that provides specialized services to young adults with disabilities. Dr. Owen held discussions with local health professionals, particularly Dr. A.R. (Peter) Huston and confirmed there was a need for such a Home.

On January 19, 1970, registration for Cheshire Homes of Saskatoon was effected under the Societies Act of Saskatchewan and Cheshire Homes of Saskatoon came into being with Dr. Owen as the first president.

Dr. Owen was an active member of the Saskatchewan Medical Association and was made an honourary member of the CMA in 2009.

He will be lovingly remembered by his wife Jacqueline; sons Philip (Jeane) and Andrew (Sophie); son-in-law Francis Kreiser; and grandchildren Miguel, David, Joshua, Claire, Erica and William. Dr. Owen was predeceased by his daughter Elizabeth Kreiser.

SMA DIGEST | SUMMER 2015

39

North 49 offer a diversity of rehabilitation services for: • Motor Vehicle Injuries.!

• Work Injuries.!

• Sports Injuries.!

• Hand Injuries.!

• Concussion Management.!

• Temporomandibular Disorders (TMD/TMJ). !

• Dizziness & Balance Problems.!

• Fall Risk Assessment.!

• Pre & Post Surgical.

Physical Therapy and Vestibular Therapy Services Provided by:!

KREGG OCHITWA BScPT, CWCE, CredMDT! AMANDA PETRIE MPT, BScPHSI! PETER McLEOD BScPT! ELISE GRAY BScPT, BSPE! NATALIE McVITTIE MPT, BSc (Hons)!

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Hand Therapy Services Provided by:!

CATHY SAJTOS BScPT, CHT, DipManipPT, FCAMT !

Clinic Location:!

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Email:! contactus@north49therapy.ca

Kinesiology (Exercise Therapy) Services Provided by:!

TAMARA KOWAL BScKin, CPT, CEP Locally owned and operated.

Phone: 306-343-SIMS (7467) Email: info@sasksims.ca

Educational Opportunities: • Advanced Cardiac Life Support (ACLS) • Pediatric Advanced Life Support (PALS) • International Trauma Life Support (ITLS) • Basic ECG Interpretation • 12 Lead Interpretation • CPR-­‐Healthcare Provider • Medical Simulation Including: o Trauma Simulation o Code Blue Simulation o Pediatric Simulation o Obstetric Simulation • Custom Course Development • And much, much more!

Website: www.sasksims.ca

Give us a call for more information on any of our courses. We offer

courses throughout the province and will come to you!

“WHERE MD HAS HELPED THE MOST IS WITH GETTING OUR RETIREMENT AND POST-RETIREMENT ORGANIZED.” “From the start, we found MD very trustworthy, supportive and informative.

They created a financial plan that helped make sure we could meet our financial goals—and things have gone exactly as planned. Now that we’re in the latter stages of our careers, it’s nice to know we can retire whenever we’re ready.”

– Dr. Jean-Denis Yelle, Trauma Surgeon – Mrs. Susan Nevitt-Yelle, BN, Administrative Assistant

EVERY PHYSICIAN HAS A STORY. HEAR MORE: MD.CMA.CA/MYSTORY

FOUR TIMES MORE PHYSICIANS TRUST MD.1

Fifty-three per cent of Canadian Medical Association members trusted MD Financial Management as their primary financial services firm, four times more than the next closest individual competitor at twelve per cent.

Survey respondents (MD clients and non-MD clients) were also asked to identify their primary financial institution (MD or Other), then rate their level of trust associated with that institution. MD received the highest trust rating compared with all other firms rated. Source: MD Financial Management Loyalty Survey, June 2014.

1

MD Financial Management provides financial products and services, the MD Family of Funds and investment counselling services through the MD Group of Companies. For a detailed list of these companies, visit md.cma.ca.

Incorporation guidance limited to asset allocation and integrating corporate entities into financial plans and wealth strategies. Professional legal, tax and accounting advice regarding incorporation should be obtained in respect to an individual’s specific circumstances. Banking products and services are offered by National Bank of Canada through a relationship with MD Management Limited.

SMA DIGEST | SUMMER 2015

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Photo by Kristine Kim, Resident

Return undeliverable Canadian addresses to:

SASKATCHEWAN MEDICAL ASSOCIATION 201-2174 Airport Drive Saskatoon, SK Canada S7L 6M6

Mail to:

40007031