When Sandy Buchman was a teenager, back in the ’70s, he was so bored with high school that he dropped out.
Then, along with a group of like-minded, eager-to-learn dropouts, he started his own school, Nohant West, in Toronto’s Jane-Finch neighbourhood.
Inspired by the artistic retreat of French author George Sand, it was a free-spirited institution where students biked to Stratford to study King Lear, and university professors donated their time to teach calculus in the local library.
That kind of problem-solving and self-directed learning impressed the leadership of the fledgling McMaster University medical school, which was doing its part to reinvent medical education. Soon enough, he graduated as Dr. Buchman.
On Sunday, the young rebel, with almost 40 years of experience under his belt, was installed as the 152nd president of the Canadian Medical Association.
Ever the outlier, Dr. Buchman is a family physician at the head of a group dominated by specialists. He works full-time in palliative care, doing home visits and working with the homeless, another anomaly. He is also one of the few palliative-care doctors who will provide patients with medically assisted death.
Dr. Buchman said he is guided by a straightforward principle, “You don’t abandon your patients.”
It was a lesson he learned as a young doctor when one of his patients developed AIDS at a time when the virus had not even yet been identified.
He learned as much as he could about the new disease and that brought him to volunteer in Africa and South America, and then to focus increasingly on working with low-income communities in Toronto.
“Being a doctor is privileged work. But your patients teach you, and they got me thinking: What is my moral obligation to give back?” he said.
Dr. Buchman speaks passionately about the need for social accountability and compassionate leadership.
“We at the CMA must keep walking the talk. We’re an organization that represents a caring and compassionate profession, and so our work should be guided by these values, too,” he told delegates at the general council meeting in his inaugural address.
He also said that at a time when rates of burnout, depression and suicide are at record levels in the profession, physicians have to start taking better care of themselves.
Dr. Buchman said there has been a lot of attention to treating the symptoms, by promoting work-life balance, more sleep, better diet and regular exercise but it’s now time to tackle the root causes of burnout, “to focus on the environment in which we train and work … [and] create a culture of psychological safety that leads to creativity and innovation in addressing the challenges of the medical workplace.”
With a massive nest egg (the CMA sold its investment arm, MD Financial Management, for $2.6-billion last year) and a federal election on the horizon in October, physicians have a “unique opportunity to lead a conversation about the changes needed in this country − whether it’s a national approach to health human resource planning, a plan to mitigate the risks of climate change, or actions to address the inequities faced by our marginalized and vulnerable populations, including seniors,” he said.
The departing president of the CMA, Gigi Osler, picked up on that theme in her valedictory address, saying physicians have to use their power and influence to work toward “a future where the millions of Canadians without a family doctor will have access to one, a future of closing Indigenous health disparities and improving health outcomes and a future where physicians are healthy and thriving.”
Some delegates expressed unhappiness that the organization was placing so much emphasis on social issues, saying it should concentrate on the well-being of physicians.
In particular, there were calls for the CMA to use its financial windfall to create a pension plan for physicians. (Most Canadian doctors are self-employed private contractors and do not have pensions and benefits.)
But board chair Brian Brodie said that issue had been studied and a consultant concluded the “CMA does not have an employer-employee relationship with its members and therefore cannot legally create or contribute to a pension plan for physicians.”
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