Amid healthcare doom and gloom, CMA's outgoing president finds hope

When I became president of the Canadian Medical Association (CMA) only a year ago, the headlines routinely warned of emergency department closures, oppressive wait times, and a primary care crisis where 6.5 million Canadians were routinely struggling to access care.

If you do a quick scan of your news feed today, you might think that little has changed. As I scrolled the headlines prior to writing this final commentary as CMA president, I spotted news from the Prairies to the Maritimes that warned of lengthy emergency department wait times, a lack of timely primary care options and the need for “urgent action” to stabilize the health system.

Some days it’s hard to believe things can or will get better. As a physician for more than three decades, I have felt that hopelessness at times. But I have spent this past year as CMA president, meeting with physicians, patients and policymakers and advocating for health system improvements across the country. It has provided me with hope that change is possible, and I’d like to pass some of that cautious optimism on to you.

Over the past year, all provinces and territories signed historic funding agreements with the federal government with money targeted for systemic reform: creating team-based care solutions, reducing administrative burden on physicians and much more. Importantly, all premiers committed to transparency and accountability to make sure the money will achieve the positive impact it’s intended to have.

After months of criss-crossing the country talking to health care providers, patients and policy makers, the CMA now has a comprehensive draft of a modern policy to address the mix of private and public health care providers in Canada. The CMA's draft policy recommendations aim to ensure that any expansion of private health care does not compromise the accessibility, equity or quality of care that Canadians expect from their public system.

More than 40 health-care organizations representing all levels of health-care delivery met last Fall to discuss the health system’s long-term human resources needs. Gaining consensus on the services we will need in the coming decades was no small feat, but it left us inspired that meaningful change is within reach if we work together and break down traditional silos.

The establishment of Health Workforce Canada is another step in better understanding the country’s health workforce challenges and creating solutions for the future. The Atlantic Physician Registry was launched to enable doctor mobility in the eastern provinces, allowing physicians across the region to better support one another and hopefully improve access to care. While it’s too early to know the true impact, it is widely acknowledged that this is a step in the right direction and a model that can potentially be expanded or mirrored in other provinces and territories.

I found reason for optimism at the 2023 United Nations Climate Change Conference in Dubai where 124 countries signed the Declaration on Climate and Health that underscores the urgent need to confront the connections between climate change and health. The launch this year of the World Health Organization's Toolkit for Health Professionals Communicating About Climate Change is also a big leap forward on the climate front, empowering doctors with the information and strategies they need to educate their patients and advocate for climate-related health care reform. While there is still an incredible amount of work needed to combat the climate crisis, the medical community and Canadians in general are increasingly aware of the impact 
that climate change has on human health.

As we work toward a better health system for all, the CMA has continued its journey toward reconciliation in health care by learning about our past and listening to advice from Indigenous elders, physicians and advisors about how to move forward together. I am grateful for their time and willingness to work together for a better future of health care that leaves no one behind.

The CMA was also active in conversations about improving digital health-care services and the interoperability of health data, both of which are key to improving patient care and closing existing gaps. Secure data sharing will enable patients to access to their own health data, allowing them to become true partners in their journey to wellness.

We have many challenges ahead. But if we maintain a focus on improving access to care — with a close eye on equity, accountability, and quality — we can build a health care system that meets Canadians’ needs and supports care providers, a health care system that we can be proud to call our own. Together, we can build a health care system that is resilient, inclusive, and prepared to meet the challenges of the future. I still have that hope.

Dr. Kathleen Ross is a family physician in Coquitlam and New Westminster, B.C. and past president of the Canadian Medical Association.