Q & A with two of the most powerful people in Canadian health care
Hamilton MDs lead two of the country's most powerful doctor's groups
Two of Canada's most powerful medical organizations are led by Hamiltonians, putting two local doctors in the centre of the key debates affecting health care for Canadians.
Dr. Anna Reid is the President of the CMA and moved from Kenya to Dundas when she was six. Dr. Reid has a degree in wildlife biology, and a medical degree. She has also completed critical care and trauma training. Dr. Reid has served as Chief of Staff of Kootenay Lake Hospital, and President and Chair of the Medical Advisory Committee. She currently practices in Yellowknife, and has been President of the CMA since 2011.
Dr. Scott Wooder is the president of the OMA, and was sworn in on May 4, 2013. Practicing as a family physician in Stoney Creek for 27 years, Dr. Wooder is 132nd President of the OMA.
Both doctors agree that a healthy population equals a healthy economy but there are some issues facing healthcare provincially and nationally.
What are some issues facing healthcare?
Dr. Wooder: "Getting good quality care to our patients, making sure that they have access to the care they need."
Dr. Reid: "Traditionally in medicine, in the medical care system, we are very poor at measuring anything. We're actually far behind other industries. We're way behind the aviation industry in things such as safety and measurements, and those sorts of things. It's an unbelievably complex system to measure as you can probably imagine, so it's very hard to assess what you do in the system unless you actually measure outcomes. A lot of our work is trying to look at ways to put into place accountability measures. I don't mean that in a negative sense, but how do we find a way to measure the outcomes of what we do, and if they're not working figure out how to improve on them."
"We need to make the system work around the needs of the patient, and not so much around the needs of the institutions that run the system."
How does Hamilton compare to the rest of Ontario?
Dr. Wooder: "I think Hamilton has some really big advantages. We have a very good hospital system, there's a lot of co-operation between the two hospitals. The university is a huge asset, so there's lots of learners, lots of very high quality teaching, some world-class research and I think it leads to excellence in clinical care, too. In the community there is a very progressive primary care system, family doctors working with other providers."
Dr. Reid: "I think Hamilton, in some ways, has been a bit of a leader with the town council trying to address some of these [healthcare] problems, that maybe don't happen as well in other cities."
Dr. Wooder: "We want to take a leadership role. We want to work with other providers, other stakeholders like hospitals, nurses, CCAC [Community Care Access Centre] patients... and we think we need a province wide plan on developing a comprehensive end of life plan."
150 physicians in Hamilton make the city the largest family health care team in Ontario.
Where can Hamilton improve?
Dr. Wooder: "The whole social determinant of health issue. Where people in the city core have worse health outcomes than people in the affluent suburbs. They have higher smoking rates, higher rates of obesity, less education, more illiteracy — it leads to worse health outcomes."
What is palliative care and why is it important?
Dr. Wooder: "It's part of end of life care, when the goal shifts from extending the person's life to relieving symptoms."
"Hamilton has some strong advantages; there's a regional palliative care team who will go out to people's houses to provide care, and also do consultations. I'm a family physician and I do palliative care in my patient's homes."
What about childhood obesity and early education?
Dr. Wooder: "It has such an effect on people's health throughout their lives, and there's some real positive things we can do to prevent illness. It's much better to prevent illness than to treat it. Things like exercise programs, physical education in schools, calorie labeling in chain restaurants, general education about proper eating and food guides"
Dr. Reid: "If you invest in early childhood development and education your return on your investment is anywhere from 1:6 to 1:8 times"
Dr. Reid: "Things such as understanding early stimulation of kids in a way that's interactive … getting them interested in books and in reading from an early age, and interested in learning. Exposing kids to various experiences where their imagination and interests are peaked."
What kind of social programs do we need to put into place to help create a healthier city?
Dr. Wooder: "Smoking is a huge thing."
"I think we especially need to focus on young women and children, and keep people from starting to smoke."
Dr. Reid: "We need to find venues and programs to actually get kids out, and get them socialized with other kids and other adults, and get them curious about the world and learning how to play."
What are some social determinants that affect health?
Dr. Reid: "The number one social determinant which affects your health and your longevity is your income level. The second most important social determinant that leads to your health is actually your early childhood development and education."
"We know it's key that we have to start getting governments at all levels, federal, provincial, and municipal, as well as community leaders, businesses, schools, police, everyone involved in addressing these issues of severe poverty, and these other socioeconomic determinates of health."