On June 8, more than 350 people took part in the final session of the CMA’s 2022 Health Summit Series – a discussion about the crisis facing Canada’s health workforce.
CMA President Dr. Katharine Smart moderated the two-hour event, which featured a keynote address from Dr. Verna Yiu, former president and CEO of Alberta Health Services.
Panellists included registered nurse Amie Archibald-Varley, first-year medical resident Dr. Dax Bourcier, family physician Dr. Lynette Powell and Jake Starratt-Farr, a social worker and patient advocate.
Five key take-aways from the session are to:
“We can overcome the workforce shortage and we’ll do what we do best – focus and find solutions so Canadians can have quality health care and better outcomes.” – Dr. Verna Yiu, Keynote speaker
You can watch the conversation here:
KATHARINE SMART: Welcome, everyone, to the CMA's fourth and final Health Summit session for the year. I'm CMA president, Dr. Katherine Smart, and I'll be your host and moderator for this event.
Thank you for being here today and for contributing to this important conversation on solving the health workforce crisis. Before we get started, I'd like to acknowledge that I'm coming to you from the traditional territories of the Kwanlin Dün First nation and the Ta'an Kwach'an Council in Whitehorse Yukon. And since we have people joining from all across Canada, I'd like to acknowledge that we are on many treaty lands and unceded territories. I make this land acknowledgment with the recognition it must come with action towards real change that honors Indigenous peoples as the caretakers of this land we now call Canada.
The 2022 CMA Health Summit series has been a virtual forum for bold conversations about how to do health differently in Canada during COVID and beyond. Our first Health Summit session in March explored ways to reform primary care, reduce wait times, and develop new models of care. In May, our second and third sessions, held in English and French respectively, focused on transforming the health system to a thriving and responsive one given the societal and economic consequences of the status quo.
We are bearing witness today to a collapsing health workforce, patients left without care, and the economic fallout of prolonged closures to protect capacity in our health care system. Change is needed. Today's session is about Canada's health workforce crisis heightened by 2 plus years of the pandemic. Burnout, increased workload, staff shortages, and harassment are just a few of the issues health workers now face.
Results from the CMA's 2021 national physician health survey were quite disturbing. They showed that 53% of physicians and medical learners are reporting high levels of burnout, up 30% from 2017. The survey also found that 46% of respondents were considering reducing their clinical hours in the coming months. Another recent survey conducted by the Canadian Federation of nurses unions found that severe burnout in the profession had jumped from 45% compared to 29% just two years ago.
As more health care professionals retire or leave their profession due to exhaustion, burnout, or dissatisfaction, the foundation of our health care system is at risk of collapse. So the question becomes, where do we go from here? This event is all about exchanging ideas, and we have several experts here with us tonight to help in that conversation.
But there are also several ways that you can take part in the discussion. The chat is there for you to share your thoughts and to connect with other participants. We'll have a question and answer period where you'll be able to submit and upvote questions for our panelists.
And we'll be hosting Zoom breakout sessions, safe spaces for you to unmute, share your stories about the health workforce shortage and crisis, and work together to come up with some potential solutions. As with any online forum, we ask you to please be polite and professional. Any appropriate conduct or language will not be tolerated. Finally, if you encounter any technical difficulties at any time, please click the tech support button on the lower left corner of the screen.
With that, I'd like to now introduce you to our keynote speaker, Dr. Verna Yiu, someone who certainly understands the magnitude and the urgency of the situation facing our health workforce. For more than six years, Dr. Yiu was president and CEO of Alberta Health Services, or AHS, Canada's largest province-wide fully integrated health system.
Under her guidance, AHS saw improved efficiencies in patient care, and launched a province-wide clinical information system. Verna also led AHS and its more than 100,000 employees through the pandemic response. She is here to share her insights. Welcome, Verna.
VERNA YIU: Thanks very much, Katharine, and thanks to the CMA for this invitation to speak really on one of the biggest challenges that we are all facing in health care as we continue to combat COVID-19. The health workforce shortage is not just a Canadian issue, it's a global issue.
There were notable challenges even before the pandemic, but COVID has really highlighted the growing gap of the most important health care resource, which is health human resource, or lack thereof. According to stats, Canada between the third quarter of 2019 and 2021, job vacancies in health care and social assistance increased by 80%, or more than 52,000 spots.
With the exception of Nova Scotia, all provinces saw an increase in vacancies, with Quebec, BC, and Saskatchewan leading the pack. Occupations with the largest two year increases in job vacancies were nursing aides, orderlies, patient service associates, RNs, and registered psychiatric nurses.
On an international level-- because this is a global issue-- the WHO says that by 2030, the world would need an additional nine million nurses and midwives to reach a sustainable state. For physicians in Canada, although there have been some moderate growth in the number of doctors from 2016 to 2020, there remains a maldistribution of where they're practice. And you've just heard from Dr. Smart the burnout stats that's going to further impact on physicians and workload.
About 8% of physicians working and only 2% of specialists work in a rural setting compared to 19% of Canadians who live in rural areas. For those that are in training, there are about 3,000 medical students enrolled in first year, with another comparable number in medical schools outside of Canada.
How many do we need to train each year? What about IMGs who are Canadian but not working as physicians? These are really, really difficult questions to answer since there's never been a physician workforce strategy at either the provincial level or the federal level.
Regardless of what or where the shortages there, are some common principles that must be applied when looking at health human workforce strategies. The first is that any strategy developed must be integrated and go beyond the silos of individual professions.
Health care is a team sport. And working in health care has moved from individual practitioners to team-based care. Understanding how one influences the other and how each compliments holistic care for the patient is absolutely critical in determining the future demands on the workforce.
COVID proved the value of team-based care. And in fact, without augmenting team functions and ensuring that everyone worked to their maximum scope of practice, we would not have fared as well in caring for Canadians. Second, solutions have to be multi-pronged, involve multiple stakeholders, and address the entire pipeline and career continuum of a health care professional. Partnerships are absolutely critical to create to creative solutions, especially between regulatory colleges, educational institutions, local municipalities, and governments to list a few.
Third, we have to think outside the box. Traditional solutions have been tried and will continue to be tried, but do we have the time to wait? Can we afford to wait? Going forward, we need to consider solutions we would have never thought of before.
For example, outside of Canada in one remote rural jurisdiction, retired teachers are the first point of patient contact. Armed with very simple point of care tools, they screen local residents, and if required, they then refer them onto further care. Are we ready to consider these atypical solutions?
So whatever strategies we consider, they need to be integrated, partnered, and innovative. In terms of developing solutions going forward, we need to consider how to not only increase the supply of health care workers, how to improve and maintain retention, how to optimize scopes of practice and models of care, and last, but not least, how to improve the wellness of health professionals. They serve the basis for the integrated workforce plan that AHS has developed back in 2021.
And I just want to share with you some examples of the work that AHS has done in each of these areas. In terms of increasing supply, at least for the short-term, AHS actually started hiring fourth year nursing students in partnership with regulatory colleges and 9 post-secondary institutions.
This enables students to get paid work experiences, receive academic credit while filling critical positions within the health care system, and then allow for seamless transition to the workplace upon graduation when they were hired as full-time employees. Another short-term strategy is for AHS to grow its own workforce through the creation of an in-house health care aide or a health care aide training program to support acute care and long-term care areas.
Many uncertified health care areas were unable to fully fund their additional requirements, so AHS created a bursary program to support an additional 600 health care aides per year. For retention, one of the really critical determinants of whether people stayed in the health workforce was that the amount of support that they received. Supports can be financial, they can be educational, and social.
So for example, enhancing education. Specialty orientation training and student nursing graduate engagement were amongst the top reasons that people stayed practicing in rural areas. Local communities and municipalities are also essential partners in supporting recruits and making them feel welcomed and part of the community. And without that local support, even though you may get young health professionals through the door, they will leave shortly thereafter for more urban areas.
For optimization, one needs to consider what job is being done and is it being done by the right person? Optimizing scopes of practice not only improves efficiencies, but also improves work satisfaction and builds a team-based model of care. COVID has shown us how essential team-based care was in dealing with the pandemic. Going forward, we cannot lose sight of this important enabler to ensure that we have the right people doing the right type of job at the right time.
And finally, wellness. Wellness is critical to supporting a tired and burnt out workforce. We need to invest in programs that support both physical and psychological well-being through multi-pronged approaches. And the use of additional resources, tools, and training.
Examples would include peer-to-peer local support, 24/7 support lines, online texting tools and resiliency building programs, as well as supports to ensure a safe, quality work environment. We know that the health human resource challenge facing us. What we need to do now is to find common solutions.
It doesn't matter where you live in Canada. This is a borderless problem, so we need to find borderless solutions, like national licensure. COVID has brought a level of nimbleness, creativity, and innovation to our health systems. Let's not lose sight of what we've been able to achieve over the past two plus years of the pandemic.
Let's learn from it. We can overcome the workforce shortage. And we'll do what we do best-- focus and find solutions so that Canadians can have quality health care and better outcomes. And Katherine, back over to you.
KATHARINE SMART: Thank you, Verna, for your optimistic outlook and for sharing some unique workforce strategies from Alberta. I have a few questions for you now. I often notice that we hear authorities reassuring the public that the health care system is OK or that people will still get care when they need it when we know that's not always the case. How can we work with policymakers, health care providers, patients, and all stakeholders so that we can encourage people to take the actual action that is needed to transform the system to make those statements true?
VERNA YIU: Yeah, I totally get where you're coming from, Katherine, with that question. But I think even before I get to answering the question, I think we actually need to define what we mean by transformation. Because everybody talks about transformation, but the definition is different for each group of stakeholders.
From the health care system perspective, transformation is a word that actually scares many of us because we're very cautious. What exactly does it mean? Are you speaking about financial transformation, are you speaking about clinical transformation, workforce transformation?
So first, I think we need to define what we mean by transformation. And until we do that with public and key stakeholders in a very clear and transparent way, we're going to continue to run around circles avoiding the conversation. So it's a very, very important discussion to have, because as I said before, the system belongs to all of us.
From my perspective, as you can tell from my initial five minutes, I'm an optimist. And I think that any of us who lead in health care, we have to be optimists. Otherwise, it'd be very depressing because it is very stressful.
And there seems to be a disconnect, for sure, from the front line struggles to what I would say others are trying to say in the public. But after saying that, at least within Alberta and Alberta Health Services, there are a lot of difficult things that have been happening recently-- long wait times, EMS struggles. But when you think about the whole province and the whole system, the bulk of people are actually getting good care, and I think we can't lose sight of that.
From my perspective, I'm actually really proud of all that we've done over the past two-plus years. The pandemic is still with us. It's really stretched us all. I think we've found ways to work together to ensure that Canadians get the best health care possible. And I think we've come a long way since the Canada Health Act, but we have a ways to go.
And we know what we need to do. I mean, there are no magic bullets. Anything that's been easy has been done. I think that's the first comment I would make.
The second thing I think is really important is that I think health care providers have to really feel valued, and they're not being valued right now. The type of, I would say, difficult situations they've had to encounter-- I think some difficult interactions with patients and the public has really been demoralizing. And it's been very, very difficult, especially for the frontline clinicians.
But when we think about our health system in Canada, we know what we need to do, Katharine. You can list it all off. It's about really trying to find a strong primary care system. That is the foundation of any health care system.
We need better integration between our different sectors. We need better support-- we need to better support Canadians in their home setting. We need data to help inform our decision making.
We need social prescribing, because so many aspects of health care are really social care. But we really need Canadians to support the notion of a publicly funded health care system. We need the health care system-- because we in the health care system what we need to do.
We just need to have the time, the support, and the will, and we will get there. And we need to support our teams. And at the end of the day, we need to tell our story, we need to make sure that the public knows what's happening, because we're experienced today. If you're not on the front lines and you haven't experienced it, I don't know what you can really say. So I think the personal experience is really, really important.
KATHARINE SMART: So much of what you said, Verna, really resonates with me. First of all, I'm reassured that your list of things that you would like to see for transformation are the same as mine, so that's good news.
But I also totally agree with you-- it's incredible what health care workers have been able to do for their communities over the last two years. It's really absolutely incredible how people have pulled together. And I agree-- we have to maintain optimism that we can make things better.
So that links kind of into my next question. I think when we look at what's happened over the last two years, and the system in general, we know that medicine and other aspects of the system have really relied on the altruism of health care providers for a long time to keep the system going.
And whether that's working 36 hours shifts as physicians-- and this is really true in rural settings where, often, resources are limited. And even some of our bigger hospitals where there are small numbers of specialists and they do huge amounts of call. Or expectations for family doctors to be available 24/7 to patients.
But I think what we're learning is that these expectations on our workforce are not sustainable. And frankly, they can be unfair and really prevent work-life integration. How do we account for are these changes in terms of what we expect from professionals in the health workforce in our workforce planning?
VERNA YIU: Yeah. So I think all of us, health care, as a career choice, is a calling and not a job. And I think one of the benefits for myself and leading-- before Alberta Health Services was that there fundamentally, at the forefront, is a level of altruism that you don't see in any other business or in any other organizations.
So right off the bat, when you lead this type of organization, you know the types of people that are going to be in there are the ones that are going to put themselves out beyond the call of duty. They're going to care for others before they care for themselves, and that's just what has incented them to go into health care.
So that's not a criticism by any means. That's, if anything, inspiring and admirable, but it leads to burnout. And so let me just start a bit by saying that unless we understand that we need to care for ourselves first, we can't really care for others.
And so we need to build our own resiliency. We need to-- what does that mean? It means that all of the health care organizations, each of us as individuals, we need to actually look at how we look after ourselves.
And we know resiliency encompasses four dimensions. It's not just the mental resiliency. It's physical, spiritual, and emotional. And we need to work on all of those aspects to ensure that we can remain strong to keep on going.
And if any of those areas are neglected, then we're more likely to succumb to burnout and fatigue. But no question, the system is pushing everyone. I know many people who won't answer their phones anymore because they don't want to be called in for a shift.
Or if you're working in the hospital, you can't get out when you're supposed to because there are so many other patients waiting. So it is a really stressful time. And all I can say is that we have to share the burden together, which is why some of the workforce strategies around really ensuring that team-based model of care is so important. Because it's not just on one individual. This is on all of us to be able to share and use our skill sets to be able to complement each other going forward.
And in terms of what we need to do in terms of workforce planning going forward, well, Katharine, I bet you that it's not going to be just one person that's going to be replacing you. If anything, it's going to be maybe two or even three. In my generation, the role models that I saw worked 24/7 in the hospital, had no life outside of the hospital.
Those are the people that we saw. They were incredible clinicians. Everybody wanted to emulate them, but there was a price to be paid. And we're now seeing a generation of medical students and residents where they're saying, you know what, I'm not going to be doing that. And they're so right.
And we need to learn from that. So it's not going to be a straightforward 1-to-1 ratio. And going forward, when we look at workforce planning, we will always underestimate the number of people required if we don't consider some of these changes in demographics and changes within society.
KATHARINE SMART: I totally agree. Thank you so much, Verna. We'll reconnect with you in about 30 minutes after our panel discussion to take part in the Q&A.
So for those of you listening, if you have a question for Verna or for any of our upcoming speakers, you can add them to the Q&A tab at the main menu. To enter your question, you just go there, enter it, and then click Send. It'll come through to you, and then people can upvote their favorites.
So before I introduce our panel, I'm proud to let you all know that this Health Summit session is a patient-included event, which means people with lived experience participated in the design and the planning of the session, including the selection of themes, topics, and speakers.
As we all know, patients have a very essential perspective to bring to health human resources as the quality and timeliness of their care depends on a robust workforce. We extend a warm welcome tonight to Jake Starratt-Farr a member of CMA's patient voice committee and one of today's panelists as well to all patients and caregivers in the audience.
So now, let's move on to getting to know our prestigious panel. First, we have Amie Archibald-Varley who is a registered nurse and a quality and patient safety specialist for Niagara Health. She's a graduate of the master's of nursing program at the University of Toronto.
Amy is a thought leader in advancing health equity and political health activism, including anti-black racism. She also co-hosts the Gritty Nurse Podcast. Dr. Dax Bourcier is a first year pediatrics resident at Dalhousie University. Yay, pediatrics-- I'm also a pediatrician.
As a board member at the Canadian Federation of Medical Students, he founded and chaired their health human resources task force. Dax is currently a co-investigator on a project to develop a minimum data standard for health workforce data in Canada funded by the Canadian Institutes of Health Research.
Doctor Lynette Powell has been practicing family medicine in Grand Falls Windsor Newfoundland Labrador since 2004. She's a passionate advocate for strong primary care, and recently closed her practice to tackle the family doctor shortage in the province's central region.
Lynette is past president of the Newfoundland and Labrador Medical Association. And last, but certainly not least, is Jake Starratt-Farr. He's a social worker and a counselor who works with an interprofessional primary care team in Durham Ontario.
As a trans person, he's dedicated to supporting trans and gender expansive individuals, and is passionate about helping health care providers better understand the unique health needs of the 2SLGBTQI community. So welcome to all of you. Lynette, I'm going to get started with you. We've all been hearing about how the shortage of family doctors is reaching a crisis level across the country, but particularly in rural communities across Canada. Can you describe the impact it's having on patient care where you work?
LYNETTE POWELL: Sure, Katharine. Thanks for having me this evening, and it's a real pleasure to be able to talk about this. It's a very heavy topic.
I wanted to maybe tell a little bit of story about where I work and where I live. So I'm in the middle of Newfoundland and Labrador, and I work on what we call a hub site. So it's a community that services a lot of our rural communities.
We have an emergency room in my community, but it supports about nine small rural emergency rooms. And there's about 177 communities in Central Health that are all kind of within the umbrella of our hub sites. So over the past few years, our hub sites have hollowed out.
There's no there's no positions in a lot of these rural emergency rooms. Of the nine, I think there's two that are still fully staffed. And interestingly enough, those are actually rural teaching sites for our family medicine program. So it's an interesting kind of thought about how we work on keeping people in rural areas.
But through the course of the pandemic, with the hollowing out of these sites, what's happened is primary care has really been fragile on these sites for a long time. As physicians come and go-- and long before the pandemic, that was happening-- emergency care would often take precedence to family medicine and primary care.
So a lot of these patients have had a long legacy of not really having great primary care. Now, they have no primary care, and they also have lost their access to emergency services. So through the pandemic, I'm very proud of what we have been able to do.
We've been able to implement virtual emergency rooms in our hub site. And that's actually taken a lot of our physicians away from their family practices. We've also been able to implement a health hub that provides both virtual and in-person care to the orphan patients from across the region. So you know it's quite an innovative and rapidly implemented step that happened at the beginning of the pandemic, which is probably something that should have happened long before.
But I think what we're seeing now is our hub sites are now very affected by this primary care shortage as well, because physicians are now providing urgent and emergent care, and taking care of a lot of orphan patients. And what's happening now, of course, is people are just leaving their family practices because the demands elsewhere in the system are so robust.
So it's been a little bit tragic to see that patient care and longitudinal family medicine has really taken a beating in the last couple of years. And that has a tremendous impact on patient care. We're seeing more late stage cancers, more complications from diabetes. Newfoundland and Labrador has some of the highest rates of diabetes in the country, and you can imagine, if they have no primary care, the kind of complications we're seeing.
So that's been very heartbreaking for sure. It's something a lot of us take home at night when we work when we see these patients. So it's certainly contributed to burnout in a lot of the physicians who are trying to step up and support this kind of failing peripheral system.
KATHARINE SMART: Thanks for sharing those experiences. It really resonates with what I'm seeing where I work as well. I know that things became so dire in the central region of Newfoundland that after nearly 20 years, you recently closed your own family practice to help with these critical staffing shortages. Can you tell me a bit about that decision?
LYNETTE POWELL: Ah. So that's still very raw, and it's a bit disingenuous to say that I did it to help. I think it's-- I think the picture really of what's happened to primary care across the country-- as other parts of the system fail, family doctors who have a broad scope of practice and a lot of skills, are often getting pulled in 100 different directions.
So you end up in a situation where you really can't maintain your practice. You really want to help in all the different places that the system needs you, but at the end of the day, community family medicine, I think, is an example really of failure of policy around primary care.
Community-based family physicians really don't have the support or the infrastructure to really be able to continue in the system in the way they need to the way it is currently. So I think for me, I struggle with this decision. I had tremendous guilt about it. I still do.
These are people I've taken care of for 16, 17 years. They need me. And what the best place for me as a family doctor and where I do the best work is sitting in front of patients in my family practice. So being pulled into other parts of the system to kind of help lift things up and support the other areas is necessary right now, but at the same time, it's not where we need to be focusing our efforts, I think, across the country.
We need to be figuring out how to keep family physicians in their longitudinal practices, supporting them with teams, and helping with their infrastructure. I think that's going to really be-- in the future, if we can do that, and if we can build our primary care infrastructure around our family physicians and our nurse practitioners, then we're going to succeed in providing better care. But we have to move out of this urgent/emergent quadrant of management. We need to start looking at what's really important, but maybe not absolutely urgent right now. Because if we don't focus on that, there's going to be lots more in the urgent and emergent category.
KATHARINE SMART: Thanks for sharing your story, Lynette. I can only imagine how tough this has been when you're, just as you said, pulled in so many directions. So thank you for what you're doing.
Amie, I'm going to move to you. During the pandemic, I think we have all heard so much, and so importantly, about how nurses have been under incredible pressure, faced with increased workload, staff shortages, and a lack of resources. What effect is that having on their mental health?
AMIE ARCHIBALD-VARLEY: Yeah, Thank you so much for that question. I mean, in terms of how nurses are feeling-- and I think it can speak broadly for nurses across Canada-- is that we are suffering the ill effects of moral injury as well, which is that distressing psychological, behavioral, and social-- sometimes, almost spiritual-- aftermath of the exposure of the various events that we've been dealing with over the pandemic.
And this is actually kind of a long-standing problem. Nurses have been working short for several years now. This is actually something that I learned about when I was in nursing school over 10 plus years ago, and the problem hasn't changed. It's actually been really exacerbated by COVID-19 and the pandemic.
And really, a lot of us are feeling overwhelmed, overburdened. Again, nurses are expected to do more and more with less and less. And the strained system-- we're seeing this ripple effect trickling down to patients, and that's where that moral injury and moral stress is really coming from from our standpoint.
So we understand that patient safety is an integral part of nursing. And many nurses are looking actively to leave the profession and move away from bedside nursing because of this moral injury and this moral strain. Because at the end of the day, what we want to do is care for our patients and families. We want to see best health care outcomes.
But one of the things that we're concerned about is we're not seeing that quality of care that we would like to see. And I've been hearing this countless times, that we're just not being listened to. So that stress, and that moral injury, and that strain, it's beyond burnout at this stage. And it's sad to hear that there are many nurses looking at leaving the profession and then moving into non-traditional nursing types of roles.
KATHARINE SMART: Thank you for sharing that, Amie. It is so heartbreaking. I so value the relationship I have with the nurses and the skills that they bring. And to hear those people that are in this work to care for others aren't being cared for by the system to the point it's breaking them is really heartbreaking, and I think a testament to just how challenging our environments are right now.
AMIE ARCHIBALD-VARLEY: Absolutely.
KATHARINE SMART: Jake, I'm going to move to you now. I know it's really challenging for transgendered people to get the health care they need, to find people skilled in delivering the care and having access to the care. So how is that being impacted right now by the shortage of health professionals, and what are you hearing from your communities?
JAKE STARRATT-FARR: Oh, yeah. Thank you very much for asking me that question. As a person of lived experience and also a professional that does provide services for the trans community, I think the things that we notice nowadays is that we are seeing a vast increase in folks who are becoming who they are and identifying under the trans umbrella.
And so the services that were already short in gaps-- and have large gaps have increased, especially during this shortage. But even before this pandemic and this shortage, affirming care for trans folks has been really referred to specialists. And we kind of need to bring this forward-- that trans care is not something that always has to go to a specialist.
This is something that a general practitioner or nurse practitioner can absolutely care for trans people. And I think it's around us taking a look at how do we make those changes that can help sustain our physicians, our nurse practitioners in supporting the community away from going to specialists, which then makes long lineups, it puts harder care on the mental health system because people aren't accessing care equitably.
And so when we look at it currently, it takes someone to diagnose a trans person with gender dysphoria to access care. It's the same DSM book that we're also accessing information about if someone is depressed or someone has anxiety, and then we could offer them treatment.
And again, we've come away from that sort of like referring people to psychiatrists. Many general practitioners are doing this work now. And it just seems that there's still this kind of space around trans health care that we look at it like it's much bigger than what it is.
And there's a fear of do no harm, and what if I'm wrong, and misunderstandings around the effects of cross hormones, those type of things. And I think-- how do we fix that and how do we make that sustainable? I think there's a space in there that, one, we really have to go back to reinventing our education a little bit around trans health care in all medical academics.
I heard earlier someone speaking about we can't just keep doing the same thing over and over again. And I think that's the real key here, is that we need to take a step back and be like, hey, let's get folks the information, let's get these providers the information in their education so when they have a patient that comes to them, they can support them.
It's not something like, oh, my gosh, what am I going to do here? In a trans pulse survey, they had 1 in 3 non-binary people said their doctors or nurse practitioner had no idea anything about trans health care. So I think that's something where we're-- I think we have a big gap in is education.
I think it's really great to start seeking out how do we promote specialists that can be mentors, or like mentorship phone calls like rainbow health Ontario offers. For practitioners to call in and say like, I have a patient-- this is what I need help with.
I think we need to look at funding around supporting the expansions of interprofessional care teams. So including like a cross-country team. So it doesn't have to be just this town or that province, but where practitioners can help providers-- can call in and be like, so I've got a trans person-- I need some support and helping them move along in their journey if they choose to.
And I think that's the things that we can really look at. When we look at our statistics around this, most trans people actually report through Trans PULSE Canada again that they have about the same amount of primary care space as general population. Around 80% have primary care.
However, when we look at their unmet needs in health care, it's 45% versus 4% for the general population. So I think that that's what the difference is. And we look at an IPC team to help-- one out here in Durham, quickly, they had 153 patients in one year since its inception.
And out of that, like 32, or 20%, have already returned back to their primary care providers with support of this team. And during this time, they have supported 60 different individual practitioners to keep patients in place. So that's how we're going to stop the-- we're talking about shortage of care.
By really developing these teams, but developing them for those practitioners who are on their own so they don't have to be on their own. And I think debunking the myth that trans health care is just complicated and breaking down those systemic barriers. And understanding that when a provider refuses to care for a patient because they don't know about trans care, or they choose not to maybe learn about it or look it up, it really has a long-lasting and negative effect.
And as a patient who has had that happen to them-- as a person with lived experience-- that I had a practitioner that I had I worked with for 20 years. And when I was finally able to get up the-- ha, I guess the courage to tell them who I was and what I needed, I mean, they looked at me and they said, oh, I'm sorry I don't do that sort of work.
And they just had me walk away. So I think that's stayed with me for a very long time, and I think that we can do better. And I think it also puts less pressure when we start looking at teams approach for the practitioners to help with trans health care.
KATHARINE SMART: Thank you so much, Jake, for sharing your experience, and challenging all of us to do better. And I love your vision and just the call to action that we can do better, and we can collaborate, and learn, and that certainly resonates with me.
As a pediatrician, this is an area of health care for my patients I've been actively learning about. And I couldn't agree with you more with your vision of what that experience should look like for people when they're in our offices and in our care. So thank you for that work, and that advocacy, and also for challenging all of us to do better.
Dax, I'm going to move to you. You are at the very beginning of this journey as a first-year medical resident. Well, I guess you're part way through. You completed medical school, so that's one hurdle.
So you must be really looking at what's happening in the health workforce and wondering what that means for your future. How do you think this shortage and this challenge with burnout amongst health care professionals affecting the future generation of doctors?
DAX BOURCIER: Yeah. Thank you for having me on this panel. And really, the answer probably depends on who you talk to. And in general, medical trainees are probably either scared or in hopeful denial that this won't affect them.
And so scared are the ones who have lived experiences. Dr. Powell talked about rural students in Newfoundland going to emerge there and seeing firsthand what the shortage feels like. And disproportionately so, this is affecting primary care.
And so people or students-- trainees who have worked with primary care physicians and have seen them burn out and even perhaps retire during their time working under them is having a big impact on these future trainees. And what happens is once they live these experiences, they're scared, and they either want to choose a different discipline, they either want to move to bigger urban areas, they might look to work in teams, or they might even leave home and look for different provinces and try to look for work elsewhere.
And then you have another group who's in hopeful denial. This is never going to affect me, or I hope it doesn't. And it's really important to note that the majority of trainees in Canada are being taught in big urban cities and fully staffed academic centers, and so there's little vacancies there. And this probably skews their perspective as to what medicine really looks like across Canada.
And it skews their perspective, but also it affects their desire to-- what they want to become in the future is. What they see and what they breathe every day is what they're going to develop an interest in wanting to do that in the future. And so with everything else that's unknown, why would they want to risk going there? What's the incentive of going out to do that work afterwards?
And so overall, we have trainees who are either scared or in hopeful denial-- this isn't going to happen to me. And really, this kind of leads a relentless drive to want to find a job that's desirable and one that's sustainable in the long run for them and also for their families. And so currently, one could argue that most of these jobs are in urban cities in large academic centers. And so this sort of creates this bottleneck around big cities and big academic centers, leaving huge gaps in rural Canada. And ultimately, it really is the patients who suffer the most, because this perpetuates poor access to health care.
KATHARINE SMART: Thank you, Dax, for sharing that perspective. I totally agree, and that's why I'm a big proponent of electives outside of big centers. And I welcome you to come to an elective with us here in Whitehorse so you can see what rural pediatrics is like.
So now we're going to bring everyone back to the stage together to share some ideas. So we've heard a bit about different strategies for addressing these concerns, and I'm curious if each of you might want to share what you see as some short-term solutions.
So Lynette, I'm going to start with you. We've talked a bit about expanding the idea of team-based care. How do you think that would help solve the workforce shortage, especially in primary care?
LYNETTE POWELL: So I guess I really had some lived experience with this through the pandemic. I told you earlier about the fact that our local hub had-- or a local community had really kind of-- position group had banded together to establish an orphan patient clinic, which serviced the entire orphan patients from across the region.
And our health authority had the foresight to put a nurse in that clinic and give us an LPN as well. And we've grown as a team over the pandemic. And the work I can do in that clinic now far surpasses the work I'm able to do by myself in my family practice.
I think we'd all agree through the pandemic, the system's gotten very sluggish. It's very hard to navigate for patients, but it's also very hard to navigate for providers now. I spent a good deal of my day triaging people who've been waiting for things, figuring out why they got lost or where they are in waitlists.
It's been invaluable to have a team around me in the orphan patient clinic. And I mean, I think we've serviced three to four times the number of patients with like two doctors a day that it would've taken five family physicians in their own clinics without a team around them.
So it's-- we really-- we've been very far behind in Newfoundland and Labrador on team-based care. Very few primary care practitioners have nurses, our allied health professionals in their practices. I can only imagine the value that would come with having other people-- therapy, social work.
It just excites me because I've seen how well it can work. And I just think if we can move towards that more quickly, and particularly focus it on longitudinal family medicine so we can support the practitioners who are doing that very important work. The most important work in the system is the longitudinal care. So we need to support those people to keep doing it, and help them to continue to navigate the system that's kind of not really supporting them at present.
KATHARINE SMART: Thank you so much, Lynette. Jake, I'm going to go to you. You're a social worker. You work on an interprofessional professional team. What do you see are the benefits for your patients and for the other team members?
JAKE STARRATT-FARR: Sorry about that. Yeah, you know what? I see a great advantage on these. I've been on many interprofessional teams. And what we see is that it takes that weight off, or that heaviness off of the practitioner to be everything.
And I think oftentimes, as whatever the practitioner is doing, they often get sidelined and are in need to help with those secondary supports. That really could be done by folks like me who are a social worker, or maybe a counselor. And so when we have those interprofessional teams within maybe even a health care setting itself, then we can really take care of the patient.
The patient gets involved, they have a voice. And as we discussed in our patient voice meetings, that yeah, oftentimes, the providers end up doing secondary supports that could be well-managed by others, and which takes away from their time then to see other patients, or to have time to research or how to get things done.
So I think by having those interprofessional teams, they are very important. And they're very important to I think the patients as well, because it helps them be a full part of the process, because when there's things going on that a medical provider sometimes is supporting them in one area. But where do they go to get that blood work done?
In my case, for around folks who are under the trans umbrella, where's a safe place to go get your lab work done, where do we go get an ultrasound that's safe? And if we're looking to our health care provider to tell us those things and they're trying to find resources, it really takes away from their time. So I think these interprofessional teams really adds to and fulsomely takes care of clients much better than when we just do everything on our own.
KATHARINE SMART: I think that's so true, Jake. Absolutely. We're going to move on now to take questions from the audience. And I want to invite back Dr. Verna Yiu to join our panel for the question and answer session.
So welcome back, Verna. And if you haven't posted a question already in English or French, now is the time. Click on Q&A in the main menu, enter your question, and then click Send. And then you can also upvote your favorites.
For the next 15 minutes, our speakers are going to try to answer as many of your questions as is possible. So that's just great. We already have our first question. How much of our health human resources problem can be attributed to the federal provincial territorial system?
How can we overcome this rather than using it as an excuse for inaction? Great question. Any takers?
DAX BOURCIER: Sure, I'm happy to tackle this one. This is a great question, Maggie. And I think there's one thing that, in Canada, is missing, and that's a national health human resource governance.
So in many countries, this exists where there's a national body that is in charge of health human resource planning and strategy, and we don't have this in Canada. And so creating such a body would help for accountability.
So it would help four provinces and it would help for local problems to-- so Dr. Smart, do you still hear me? I have a message--
KATHARINE SMART: I do.
DAX BOURCIER: --that says that they've lost sound? Good.
KATHARINE SMART: I'm hearing you.
DAX BOURCIER: Great. And so this would ensure that there's accountability in reporting [? box ?] specific indicators as to performance not only at the provincial level or territorial level, but also in health jurisdictions. And so again, having a national governance health human resource committee or body would be a very important step into answering this question.
KATHARINE SMART: Yeah, absolutely. In the interest of answering the most questions possible, let's move to the next one. I think this is-- that first question, we could all talk about for a long time.
So the next question is from Diane. How do we involve young emerging physicians at the problem-solving table, and encourage thinking outside the box, breaking the old guard hierarchical rigid structures? How do we make it psychologically safe for young doctors and residents to make health system change suggestions? Great question. Anyone want to weigh in on that?
VERNA YIU: Katharine, maybe--
KATHARINE SMART: Verna-- perfect.
VERNA YIU: --I'll try to help with this one. I think one of our big challenges in health care in Canada is that-- at least within Alberta, but I'm assuming in every single province-- physicians don't necessarily see themselves as being part of the system.
They're funded outside of the system. If you think about it, the majority of their work is outside of health care system, and they're small business models, small business practices. And so it's a very different, I would say, environment for physicians.
And in fact, that was one of the reasons why I actually joined Alberta Health Services, was that as a physician, I actually wanted to have-- or to make some changes-- impact the health system, but I could not do that actually from a University setting. I could not do that as a private practitioner.
I actually had to be within the health system to be actually able to help provide some input into how we can make our system better. So I would say that one of the most important things for physicians who are listening to this session is that you can do more by being part of the solution than being outside of the box.
And when I first started-- I joined AHS in 2012-- I can tell you that everybody was saying to me, Verna, what the heck? Why are you going into the health system? It's like going into the Death Star.
You know what I mean? The negativity that I heard was unbelievable. And I'm sure, Katherine, you've heard that from a lot of physicians who decide to go into medical leadership. It's actually very hard for them to actually get that.
But I see I see a shift in the trend in how physicians see themselves as leaders within the system. And it's very important for physicians to actually be heard in the system as medical leaders. And it's through that process that we can actually bring the younger generation to the table to actually have all of the diverse voices heard.
KATHARINE SMART: Absolutely. Amie, I'm curious if you have any insights to share from the lens of a nurse? How do we do this for young nurses that are so important as well?
AMIE ARCHIBALD-VARLEY: Yeah, I was actually going to add on. Thank you so much for calling on me, because one of the things that I pride myself on is actually advocacy.
I think if there's one thing that we can all-- and we have all learned is health care is political. Like, I think COVID-19 has shown how political health care can be. And I think one of the biggest things that we all have to involve ourselves in is understanding health care politics.
And I am not a physician, but I think all of us as health care providers have that field of advocacy within our role. So like, I know CanMEDS there's a pillar of advocacy. And as well as in nursing, there's also a pillar of advocacy.
And we have to think about how can we use our voices, how can we use our platforms, how can we use our tables, or whatever shared power mechanisms that we have to continue to encourage these dialogues, especially when it comes to politics? Because we can see that huge intersection in terms of who might be voted in politically, who might not be, how health care is discussed, or the financial aspects, or these various different elements.
And I think it's super important for all of us to be involved in some way, shape, or form, whether that's advocating for at the bedside or advocating at a decision-making table in politics, whatever. And I think that that is one of the most important things that we all need to do-- is who are our MPs, who are our [? MBPs, ?] who are our political leaders?
Making sure that we know them, making sure that we know what the agendas are, what they're running on in terms of their platforms in health care, and actually be involved in those different channels and aspects as well. I think it's a very powerful place for us all to be in. And I think we definitely should be involved in that political aspect in health care.
KATHARINE SMART: Thanks for sharing that, Amie. And certainly, I know for myself, I think the general approach to advocacy and working in that space is absolutely one of the things I enjoy most in my own work.
So we're going to move to the next questions. And I think we'll direct this one at Lynette. Lynette, do you have sound? Can you hear again?
OK, perfect. Why are IMGs not included in the plan to face this health crisis? IMGs are well-prepared and already assessed. IMGs are a fast and reliable solution.
So Lynette, you're in a rural part of the country. What do you think? Why aren't we doing better on that front?
LYNETTE POWELL: Oh, absolutely. I mean, it's a great question. I don't know that I know the answer. I would like to shout out to all the wonderful IMGs that have for many years been the backbone of the health care system in rural Newfoundland and Labrador.
I think there's been some things over the years that I have seen since I've been in practice that have been a little bit upsetting and possibly we need to change going forward. We need to make sure that IMGs coming into our system are empowered in the system and they feel like they have a voice.
I felt often that that was not the case, and some of our IMGs were sometimes put in places where they might not have had the comfort level to maybe work. And that really led to them probably not being there as long-term as they might have been. We need to look at just making sure that they are integrated into our communities.
I think one of the big things in Newfoundland and Labrador that happened recently was a change in licensure, which made it harder as an International Medical Graduate to get a license. So that's actually been a large driving force why a lot of our rural sites now are in such desperate shape. So I agree with Teresa's question. I think it's a question we do need to be asking across the board, across all provinces and territories.
KATHARINE SMART: And Verna, you've been a leader in a health system. What do you think is happening here?
VERNA YIU: Yeah, we actually absolutely do include IMGs in the plan, but it's not actually a fast solution contrary to popular belief. There are many different types of IMGs.
They come from different parts of the world. The training is different. And so it's actually not a quick solution. But one of the things I would really strongly advocate for is that I actually think we should be opening [? Harms-- ?] the first round [? Harms ?] to all IMGs.
I think it's been a limitation. I think that we need more positions in residency training programs. And I think going forward, this is something that government definitely can support and fund. And I think that IMGs should be eligible for first-round [? Harms. ?]
KATHARINE SMART: Thanks for sharing that, Verna. And, again, I think it links to that problem where we don't have a pan-Canadian workforce strategy. If we did, we could then be thinking about the numbers we need at medical school, the CaRMS entry-level, and then the output.
So I agree. We need to start thinking more broadly and eliminating these silos. The next question is from Suzanne. We've been talking about integration for at least a decade, but we don't even have the basic IT infrastructure available to allow for this in most provinces.
How can we have any meaningful integration without dealing with this up front? I might throw that back to you Verna since you are part of an organization that did actually implement a province-wide EMR-- is in the process of doing so.
Tell us, what is holding us back there? This always fascinates me as well-- how Instagram is better than EMRs. What's happening?
VERNA YIU: You know what, Suzanne? It was very difficult to actually get the support from government to embark on a provincial EMR.
People are very scared of any EMR rollout. There's been some notable rollouts that have been less than optimal, I would say, in Canada. But the way we actually sold it to the Alberta government back in 2016 was really talk about what the 10-year vision is for health care.
And I think one of the challenges that we have in Canada is that we actually don't think of health care in the long enough time frame. It's two years, four years at the most. We really need to think about it 10 years out.
What do we need as a sustainable health care system? We need data. We need data to connect the clinical with the financial, with the outcomes piece. We need to be able to know what we're doing. We need clinical decision support tools, appropriateness of care, reduced variation of care.
All of that is better for Canadians. Ultimately, it's better for financial budgets, for health systems if you do that. So it really requires this conversation with the government to actually say we need this-- this is a long-term strategy. This is something that we need to be prepared for, and you can do it.
Alberta is well on its way-- Connect Care is about 50% rolled out. We're on time, on budget, if not for COVID. And it's working really, really well, and there have been significant demonstrations of improved outcomes as a result of that.
KATHARINE SMART: Absolutely couldn't agree more. We've got to have a data-driven system for accountability and quality. There's just no other way to do it. Dax, I know you work in this area as well. What are some of your thoughts?
DAX BOURCIER: Yeah, thank you. Doctor Yiu, I totally agree with what you've brought up. And there's two things I'd like to bring up in terms of data in Canada, and that are kind of missing right now, and that could really at the core, help fix this issue of interconnectivity in terms of data infrastructure.
So one is the fact that we have old data. So we use old data to base our current workforce planning. So we need either real-time or near real time data processing to be able to power, a system where data can be useful for planning and health human resources strategy.
And the second is that we need a minimum data standard. What this means-- and this is actually-- Dr. Smart mentioned that we're working on a project with the Canadian Institute of Health Research. And we are currently developing this minimum data standard, not only for physician data, but for all allied health professionals in terms of what and how should we be recording data in terms of very specific criteria so that it can all be interconnectable.
And so what this brings forward afterwards is that you can have machine learning and automated processes into using this data, and processing it and reporting it in near real-time so that it can be used right away to make decisions.
KATHARINE SMART: Fantastic. Thank you for sharing that. So one final question. I'm going to send this to Jake, and I think it's a really critical question coming from Maya. How can we incorporate the patient voice to be part of the discussion to help transform and innovate the health care system?
JAKE STARRATT-FARR: Yeah, that is a fabulous question, and I appreciate that. So yes, as someone who is on the patient voice with CMA, one is I know accessing that diversity of that team within-- when we're making policies or standards. Or we're looking for how do we connect to the community, because each one of us on there comes from a different community.
And then again looking-- I heard in here we're using old data. So when I think of old data that's around research, when we're using research from 10 years ago and we're saying that's the voice of the patient or that's what needs to be done, we're really missing that space.
And so we need to start to look at current data and also data from the appropriate places. So Statistics Canada is not really a great place to get some information. We really need to go to the people that are doing the right research for the right communities.
And I think that's part of it. And then also to really develop this team approach to health care. That the health care providers are not the only ones who are in charge of the health care. That it is an absolute responsibility and right for the patient to have part of that care, and to not just be looking at their providers as fix me-- that they're part of the solution.
And they're part of also being able to say, yeah, I'm not sure if I agree with that. And being able to start to help-- and I think what I've heard is breaking down the barriers-- maybe that systemic hierarchy that's been put in place over the years so that patients can feel they can come forward and say things. And also start doing the, I guess, funding of proper and good research to be able to bring forth patients with lived experience voices.
KATHARINE SMART: Thank you so much, Jake, for sharing that perspective. And totally agree, and that's why I love this idea of patient partner that you people at the CMA voice have come up with.
It really, I think, is that right lens of we're partners in the care, and patients need to be partners at the table and not an afterthought. So thank you for that. We're now going to take a break. It was going to be a 10 minute health break, but now it's going to be a 7-minute health break before we transition to our breakout rooms.
So before we do that, I just want to thank you, Dr. Verna, for kicking off our conversation today, and for her incredible leadership in health care and being a mentor to so many of us in this very difficult time. For the rest of our panelists, they are going to be sticking around to join the breakout sessions, so you'll get a chance to speak to them a bit more in-depth. So let's all come back at 10 minutes past the hour, and we will go into our breakout rooms and continue the conversation.
Welcome back, everybody. I hope that you enjoyed your breakout rooms. And while everyone's getting back, I'm going to encourage our panelists to share some key takeaways from in the chat.
So all of you, please jump in. Say what you thought-- panelists as well. And we're also welcoming back our panelists now. Each of them also attended a breakout session, tackling four of the main questions related to the health workforce challenges.
So I'm going to go around and ask each person to give us a 2-minute summary of what they heard. Lynette, I'm going to start with you. Your session focused on team-based care.
Is it an effective model for health professionals and patients? And if, so how do we scale it? What did you hear?
LYNETTE POWELL: So it was a very interesting session, actually. The diversity of opinion there, hearing about some of the lived experiences is actually quite relevant when we're looking at team-based care and how we move forward with it.
I think the prevailing thought is that patients have to be part of that team, and we have to make sure that happens at every junction along the way. I think there's a general consensus amongst our group that team-based care should be our future, and it is probably likely effective.
Patient navigation, seamless transitions through care. That's important when you're a patient, and that's important to care providers as well. There was a-- a lot of people talked about team based experiences that had worked for them.
You'll be happy to hear, Dr. Smart, that pediatrics seems to be one of everybody's favorites. The pediatrics teams tend to be very effective at being patient-centered and wrapping around patients and families. And it's been noted that that often gets lost as people age out of that system. Mental health care in particular was identified as a need for better wraparound team-based care.
In terms of scaling, I think there were ideas that came from across the country. There's been things in Alberta, for an example, of pre-emergency care by advanced care paramedics, and how that's enhance the team in the emergency department.
We, again, talked about Tee models that had worked. And looked at the fact that we haven't really invested those resources into primary care teams. And primary care providers work in every community, but have not been effectively integrated into any team-based models.
But we've done it for other specialty services that have been short like cardiology, things like that. They often have team-based approaches within larger centers. So we just need to start looking at models from across the country that work. And those are going to be our blueprint for moving forward, particularly with primary care based teams as primary care gets more and more stretched.
KATHARINE SMART: Excellent. Thank you so much, Lynette. Dax, I'm going to move to you. Your group explored the huge gaps in patient care left by the workforce shortage. How do we ensure an adequate supply of health workers in the future? What were some of the suggestions?
DAX BOURCIER: Yeah, so there's some great talk about different suggestions as to how to tackle the future supply. And the conversation started in the fact that there's supply that's there, but then there's a comment that having more people will cost more money, and that this is not effective.
Whereas really, if we have more people in there, it will save money in the future just by the system being more effective. And so from that standpoint, we then went on to talk about how the way that the system is set up currently doesn't focus as much on the needs of the population, but more so on the supply and how to fill the gaps.
And so to look at what the actual needs are of our population, and then to design the system following that. And then the two other parts of the design the system that were brought up were pay models being one, whereas fee for service in some regions of the country don't seem to be effective in doing their intended purpose.
And so looking at alternative pay models might be a way to entice people to go into where the need is. And the other part is that we lack data. We lack the data to tell us what the needs are, and where needs are in the country.
And if we have a better visualization of what health care looks like in Canada, what the needs are not only now, but in the future, this will help retain and it will help attract the future workforce to fulfill these needs in the society.
KATHARINE SMART: Fantastic. Thank you, Dax. Amie, I'm going to move to you. Your breakout room tackled retention, especially in rural communities. What strategies are needed to better support health workers as well as attract new ones?
AMIE ARCHIBALD-VARLEY: Yeah, it was a great session, and there was a lot of really great pearls that came from that. And one of the things that was talked about a lot was about culture. So creating a culture that was really important that-- making people feel welcome in the space, and supporting that collaboration, and cross-practices to support how other people who might be coming into these rural areas can feel comfortable and stay within the communities.
It also dovetailed into not feeling isolated, and how do we support individuals who are out there working in these areas as well. There was also some discussions about medical school. So for example, like the northern school of Ontario, and how do we attract people who want to stay in these communities to continue to practice medicine within that region.
And thinking about recruiting campaigns for rural areas for medicine, health care just in general as well. So not even just physicians, but how do we retain nurses, social workers, and other people in those areas, and making it more attractive for them to stay.
And also talking about the way that people think about rural communities. There's this sense that urban centers are better centers to work in, but how do we change the conversation from talking about whether it's better or not? I think there was a lot in terms of talking about how we can talk about the importance of the care that's needed in these rural areas.
There was also discussion about advocating for the importance of teams and that team model. So that was definitely a theme that has run through all of the different questions that were discussed tonight. And also the importance of knowing how to reach out to other community and other team organizations.
There was a lot of conversations on concerns around perpetual understaffing. And then really challenges surrounding obstetrical and maternal care. How do we support these particular areas in these rural communities?
And then also looking at various different other models of care. So places like in Australia, and looking at how can those care models be integrated here? And then just also making sure that we address these concerns adequately and effectively, because we have to have that important focus on rural care as well.
KATHARINE SMART: Thank you so much, Amie. And finally, you Jake. Your group looked at how to shift more care from hospitals to community-based care. What would need to change to support patients and their caregivers, particularly those living in under-resourced marginalized communities before they need acute or complex care?
JAKE STARRATT-FARR: Yeah. So thank you. Our group-- was a very fulsome conversation. So some of the things that came out of that was definitely establishing what outcomes are valued for the area, and then connect funding to those, and don't keep refunding things that aren't working.
Develop comprehensive plans. Provide team-based preventative care. So working to align that population needs with the workforce service capacity not only just now, But. As we've talked in this whole thing tonight about it's about the future as well.
When we keep just looking at one or two years out, we're going to kind of miss that long-term care. About fun preventative care activities, which would include mental health care. And then how do we bridge the gaps from youth into adulthood? Because sometimes, that's a big part of what happens in the community.
We have a lot of youth programs, and then once they hit a certain age, there isn't anything else. So more trauma-informed care, and have community partners more engaged with the community before they arrive into the health care system.
And then also recognizing that sometimes, some of our systemic places like around policing and all that-- that sometimes, we have to make sure that we are listening to those engaged with those types of services. And that as people are getting formed into mental health and things like that, that we are really listening to what's happening for them and not just taking that one authority to another authority is the right answer.
And that health care is not and cannot be a singular person process. That this has to be a community thing in order for us to continue to engage in promoting and moving forward from where we know it isn't working into what can work. So accessing that team-based care is going to be essential.
But part of that in the group-- we were talking about is that everybody has to know what's being offered and what they can actually have available to them. Sometimes, we have these team-based approaches, but kind of nobody knows what's there and who's doing what. And so to really promote that sort of space.
KATHARINE SMART: Excellent. Thank you so much, Jake, and to all our panelists, and again, to Dr. Verna Yiu for taking part in this Health Summit session, and for sharing your passion and commitment to building a stronger workforce. Thank you also to all our participants tonight for taking this time from your evening and your busy schedules to engage with us, and to share your ideas about how we can do health care differently.
The insights shared tonight are extremely valuable, and will help inform the CMA's advocacy work on health human resource strategies and planning, and our overall work to build a better future of health for everyone in Canada. Thank you again for helping to lead that change.
Katharine has worked in pediatrics for more than 20 years. She moved to Whitehorse (Yukon) to implement a new collaborative model of pediatric care to serve marginalized children. She works primarily with children who have experienced trauma and adverse childhood events. Prior to moving to Canada’s North, Katharine was a pediatric emergency medicine physician at the Alberta Children’s Hospital in Calgary and the Royal Children’s Hospital in Melbourne, Australia. She currently serves as CMA president, the 10th woman to assume the role in 154 years.
Verna is one of Canada’s most respected health care leaders. For more than six years, she led Alberta Health Services (AHS) through a period of considerable change that included better integration of care within the province, improved efficiencies in patient care and the launch of a province-wide clinical information system. In addition, Verna successfully led AHS and its 100,000+ staff in their pandemic response. She was the first female dean (interim) of the faculty of medicine and dentistry at the University of Alberta, where she is professor of pediatrics in the division of pediatric nephrology. Verna continues to provide care at the Stollery Children’s Hospital in Edmonton.
Amie is a registered nurse and a quality and patient safety specialist for Niagara Health. She is a graduate of the Master of Nursing program at the University of Toronto. Amie is a thought leader in advancing health equity and political health activism, including anti-Black racism. She is co-host of The Gritty Nurse, a podcast that gives nurses a platform to speak out and explore issues facing the profession.
Dax is a first-year pediatrics resident at Dalhousie University, having previously completed his MD/MSc at Sherbrooke University. As a board member at the Canadian Federation of Medical Students, he founded and chaired their Health Human Resources (HHR) Task Force, creating a first-of-its-kind interactive online HHR platform. Dax is currently a co-investigator on a project to develop a minimum data standard for health workforce data in Canada funded by the Canadian Institutes of Health Research. His work aims to empower the future health workforce to make career choices based on both personal interest and social accountability.
Lynette has been practising family medicine in Grand Falls-Windsor, Newfoundland and Labrador, since 2004. She is a passionate advocate for strong primary care and made the difficult decision recently to close her practice to tackle the family doctor shortage in the province’s Central Region. Lynette is past president of the Newfoundland and Labrador Medical Association and has served on its board since 2016. She enjoys teaching and has been actively involved in Memorial University of Newfoundland’s Family Medicine Residency Program.
Jake is a social worker and counsellor who works with an interprofessional primary care team in Durham, Ontario. As a trans person, he is dedicated to supporting trans and gender-expansive individuals and is passionate about helping health care providers better understand the unique health needs of the 2SLGBTQI community. As a member of the CMA’s Patient Voice, Jake advocates for timely and equitable access in transgender care. As a parent, he is navigating the health system with a child on the autism spectrum and supports his own aging parents in accessing health care.