It is essential that the health care system be transformed to put the needs of patients and their families ahead of those of providers, the new president of the Canadian Medical Association says.
"I have seen our health care system through the lens of a patient's family and experienced both the best and worst of family-centred care," Anna Reid said in an emotional inaugural address.
She related deeply personal stories about the care of her elderly parents, beginning with her father's hospitalization in Ontario when "my family experienced the antithesis of patient-centred care." Dr. Reid's father, Ian, who has Alzheimer's disease, fell and broke his hip. During his long hospital stay, she was at his bedside daily but was able to speak to a physician only twice, and could not even relay his end-of-life care directives.
In that same time period, Dr. Reid's mother, Barbara, was diagnosed with leukemia, contracted pneumonia and died.
"Her care was exemplary. … Her precious last days were spent with her loved ones at her side, and our burden of grief was lightened immeasurably not just by the care and compassion of the hospital staff, but also by their capacity to communicate," Dr. Reid told a hushed room of CMA delegates, who are gathered this week in Yellowknife.
The most astounding aspect of those vastly different experiences – one provider-centred and the other patient-centred – is that they occurred in the same Toronto hospital, two floors apart.
Dr. Reid said that the health-care system has become so big and complex that "we sometimes stray from what it is to be a healer."
The health-care system has traditionally focused on treating acute illnesses and being risk adverse, Sholom Glouberman, president of the Patients' Association of Canada and philosopher in residence at Baycrest Centre for Geriatric Care, said in an interview on Wednesday. But he added that with a rise in chronic conditions, there's a need to allow patients to participate in their care more.
"If you're going to improve the patient experience, you have to look at things from the patient's point of view," Dr. Glouberman said. "Very often things aren't thought about from the patient's perspective."
It comes down to some basic changes, he said, like emergency room patients being told why they have to wait, patients being able to correct errors in their records, and continuous care for chronic conditions that involves a physician who knows the patient.
There's been an "enormous shift" in the past few years, in terms of discussing and moving towards involving patients in their care, he said. "At the same time, the patient voice and the patient experience and the patient perspective has been so far from people's minds for such a long time that it will take time for things to change," he said.
Dr. Reid acknowledged that physicians face big challenges, including crushing workloads, scarce resources and loss of autonomy, but they cannot allow themselves to lose their identity as physicians and their primordial duty to patients.
"Patient-centred culture does not cost a penny more," Dr. Reid said.
The new CMA president, who works as as emergency physician at Stanton Territorial Hospital in Yellowknife, also addressed health care for native people. "I witness every day how far behind our country lags when it comes to the health and health care of aboriginal peoples," she said.
As a result, she wants to make tackling inequalities the focus of her term. Dr. Reid said physicians, and Canadians more generally, "must speak out against the persistent and pernicious inequities."
Dr. Reid said Canada's doctors must lead by example in another important way, by taking care of their own health.
"We need to make the health of physicians and their families a priority," she said, praising the creation of the New Canadian Physician Health Institute.