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Issues in medicine

We are just a few weeks away from the election, and it is time for the assessments and declarations of intent. As physicians, we are sure to be directly affected by what our elected officials will do related to health. However, I also think that this is an ideal time to stop for a moment and reflect on the issues in medicine.

As QMA president, I take part in many panels and conferences, which gives me an opportunity to engage in discussion with various stakeholders in the health network and to hear many different thoughts on the future of the health care system. I have also been invited to several provinces in Canada to discuss issues with my peers in the medical associations and their members. This has allowed me to learn how physicians get involved to reduce the growth in health costs or to improve the appropriateness of care in Canada’s different provinces. I have also had the opportunity to meet with many of you, namely during the QMA’s Professionalism Tour. Not to mention everyone who writes to me personally or as president to share their opinion on the QMA’s positions or outcomes or what they are experiencing every day in their respective environments.

But every time, I am surprised to note that it is always related to the same issue: the breach of our social contract with the population, its impact on the health care system and our profession in a context characterized by growing stress on public finances. Not to mention doctor bashing, which is clearly more vicious than ever during an election period. Fortunately, the QMA is proposing solid responses that have proven themselves, both locally and more broadly either province-wide or country-wide. By concentrating on leadership, professionalism and appropriateness, we hold the keys to innovate and ensure the sustainability of the public health care system.

Leadership allows us to reclaim our collective role and to influence population health and the organization of services. Those who do not feel the calling to be a manager or leader can support the physicians who take on these tasks by freeing up time for them or by joining an association like ours. Through its training, the QMA continues to ensure that the next generation can benefit from the tools needed to get involved.

Professionalism allows us to have an impact every day in our practice. At our level, as small or local as it may be, our commitment makes a difference, in our face-to-face relationships with each of our patients and in our physician-society relationship. Together, we have a collective responsibility to facilitate access around care teams. It is also up to us to self-regulate when we see abuse or excesses. That is how we guarantee our autonomy of practice and retain patient trust.

The appropriateness of care makes it possible to free up time slots for patients who truly need the care, encourage a work-life balance and reduce costs. Physicians, patients, organizations and policy-makers must work together to tackle overdiagnosis and overtreatment, because it concerns all of them. And physicians can also help to reduce the number of preventable incidents and readmissions at every level of in health care system by getting involved in a better co-ordination of care.

The issues facing our profession are significant and have an impact on the health care system. The way we address them will shape our future for much longer than four years. It is important for physicians to be able to participate in the organization of care, which involves a collaborative, productive relationship with the next government.

Dr. Hugo Viens, B.Sc., M.D., FRCSC 
President of the Québec Medical Association