'We have to improve patient care. Period.'

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For the past two years, the successive presidents of the powerful Canadian Medical Association have hailed from private enterprise, physicians who operated lucrative private medical clinics and openly espoused the need for more private care in the country's publicly funded health-care system.

But Brian Day is back working as an orthopedic surgeon at Cambie Medical Surgery Centre in Vancouver and, on Wednesday, Robert Ouellet will return full time to running five private imaging clinics in suburban Montreal.

Stepping into the role of CMA president will be someone from a very different background: Anne Doig is a family physician in Saskatoon who has operated solely in the public system for more than three decades.

The assumption, therefore, is that Dr. Doig's views will be diametrically opposed to those of her outspoken predecessors, but she refuses to be pigeon-holed.

"If I say my views are not markedly different from my predecessors that will be the headline. If I say my views are markedly different, that will be the headline.

"Here's the headline I want to see: Let's stop looking at the private/public care issue as an either/or question. We have to improve patient care. Period."

Dr. Doig says she sees the position of president of the Canadian Medical Association - which represents Canada's 67,000 physicians, residents and medical students - as that of an advocate, not solely for physicians but for patients.

Hailing from Saskatchewan, the birthplace of medicare, she is conscious of the symbolism, but says: "I am not the saviour of medicare."

That being said, Dr. Doig says patients, politicians and policy makers need to understand the fundamental commitment that physicians have in ensuring that care is available and accessible to all.

"Canada's doctors are not opposed to medicare, [and neither of my predecessors was opposed to medicare by the way.]We don't want a health system where people can be beggared, crippled and bankrupted by medical expenses. That is anathema to Canadian physicians.

"But we can't just sit back and smugly say we have the best health system in the world while our system is crumbling around us," Dr. Doig said.

In looking for ways to improve patient care, she said, everything should be on the table.

"I want Canadians to have the freedom to talk about this openly, and I think we're ready for that discussion."

In fact, Dr. Doig said that the U.S. debate on health reform, where Canada's medicare system has become a lightning rod, "should encourage Canadians to be a little more introspective."

The CMA president said that she is not so naive as to believe that there is a single change that will result in a perfect health-care system.

Rather, the focus must return to patients, and on two specific areas: outcomes and quality of care.

"We went through a period of throwing more money at the system, we went through another period of pulling people out of the system to save money. Now, we have to get back to basics: We have to focus on quality," she said.

Beyond the larger public-policy discussions, Dr. Doig also has internal issues to deal with, chief among them, she said, improving the health of physicians.

On that front, she leads by example. Dr. Doig is super-fit, and a competitive speed swimmer. She sings in the church choir, an important part of her work/life balance. She and her husband, engineer Robert Cowan, until recently, operated a grain farm on the family homestead.

Not to mention that they have six children and a grandchild.

Dr. Doig said her involvement in the politics of medicine has been driven by the increasing gaps she sees in care in her everyday practice.

"I love practising medicine but seeing problems in the system up close led me to be political," she said.

Dr. Doig also has an important familial link to medicine and the CMA.

Her father, Noel Doig, opened his Hawarden, Saskatchewan practice in the winter of 1958, before moving to a larger group practice in Saskatoon three years later. He also became a fixture in the Canadian Medical Association, as the long time chair of the ethics committee.

Daughter Anne joined the practice, now known as City Centre Family Physicians PC Inc., in 1978 and has remained since.

Brother Christopher (Chip) Doig is also keeping the family franchise alive: He is head of intensive care at Foothills Hospital in Calgary and president-elect of the Alberta Medical Association.

Anne Doig said that health-care reform should be driven by one thing and one thing only - the needs of patients.

"I see my patients not getting as good of care as they could and should and I don't find that acceptable. But I can't just sit in my office and grouse so I decided to act."