Colleagues in both medicine and medical politics for more than 35 years, Dr Brian Day pays tribute to recently retired BCMA CEO Dr Mark Schonfeld.
I first met Dr Mark Schonfeld in July 1973. I had just arrived from London, England, to begin my orthopaedic residency, and he was about to embark on what was to become a very successful 22-year period in the practice of family medicine.
Those early days were, to many, the “golden era” of modern medical practice in BC. Vancouver General Hospital was a complex institution and incorporated all specialties, including obstetrics and pediatrics. The entire organization was run in a remarkably efficient manner by the medical director, Dr Lawrence Ranta, who acted as a “benevolent dictator,” always putting patients first.
Mark and I were probably both impressed by the fact that a physician was both the leader and manager of such a large and very complex facility. In those days, whether the crisis was an issue with the ICU, a leaking pipe in the underground tunnel, a shortage of B negative blood, or a complaint that there was no bread left in the house staff living quarters, a call to Dr Ranta’s office led to an immediate solution to the problem. Now, almost 40 years later, international studies show that the best performing hospitals are run by physicians.
Early in Mark’s career he recognized that while a clinician’s focus must be on patient care, it was important not to neglect the administrative and political roles that doctors had traditionally held. He realized that if we abrogated such roles to others, both we and our patients would suffer.
Not only did Mark immerse himself in clinical practice in those early years, including leadership roles at VGH and BC Children’s Hospital, but he also became actively involved in multiple medical, academic, and nonprofit organizations. His patients were unhappy when he retired from active practice, but understood his reasons. BCMA President Nasir Jetha recently wrote about Mark’s achievements during his terms as president of the VMA and BCMA, and specifically recognized his contributions as CEO of the BCMA.
Mark understood the difference between his role as BCMA president and that of CEO. He achieved success and longevity in a role that many other accomplished individuals had found very difficult. He understood the difference between political leadership and top-level management. He proved able to make that transition.
During my 3 years as a BCMA Board member I was able to observe his masterful handling of the CEO role. Few can deny that he is likely the most successful CEO in the organization’s history. His knowledge and experience were a great resource for the Board but, unless asked, he never volunteered or tried to impose his views on issues under discussion.
On the other hand, his counsel was often actively sought, especially if there were important historical or procedural questions. That is perhaps the reason he excelled in his role through the tenure of 13 consecutive BCMA boards and executives.
To simply describe Mark’s achievements as a leader and a manager is interesting, but I believe it will be a little more instructive to others if I summarize the difficult realities faced by him, and others, in similar positions.
We physicians are a difficult group to lead. We are equally difficult to manage (good leaders do not always make good managers). I hope nonphysicians will not consider us arrogant if I opine that, as a group, we are fairly intelligent, moderately well educated, and generally confident and opinionated on most subjects—especially those that relate to the practice of medicine.
Some have documented that we listen to a patient for an average of 26 seconds before we interrupt them. From my experience on boards and committees, some of us apply a similar formula to our colleagues. The challenges created by rapid advances in medicine and technology in the 21st century—especially the resulting economic pressures—have created a “divide and rule” opportunity for governments in negotiating with doctors. Thanks to our leaders and managers, we have remained united under our professional associations.
It is perhaps a gross understatement to say that during Mark’s tenure as CEO, there were many periods when the BCMA faced difficulties and even crises. On more than one occasion I have personally witnessed Mark’s talent as an arbitrator of conflict and his ability to manage critical incidents. While most physicians acquire some of these abilities through their clinical training and practice, I know of none who can match Mark’s tolerance and skill in this area.
Mark’s activities outside of the BCMA are perhaps less well known. His volunteer involvement and leadership with the BC Variety Club, BC Jockey Club, Justice Institute of BC, Hamber Foundation, Sauder School of Business, and the Vancouver Board of Trade are a tribute to his sought-after talents.
Those of us who have known Mark both professionally and personally are aware of his tremendous commitment to his family. He is a devoted husband to Tracey, and a proud father and grandfather. I am sure they will all soon enjoy a little more time together.
In a recent book chapter on leadership I wrote, “If you succeed in climbing Mount Everest, remember not to stay at the summit too long. That will be fatal.” Mark did not wait too long at the top, and has chosen to descend from the summit at a time when the BCMA is the envy of every other provincial medical association. He can, and should, look back with great satisfaction and pride. I know Mark has a lot more “fuel in the tank,” and I look forward to following him as he moves on to other innovative and exciting challenges.
Dr Brian Day currently practises orthopaedic surgery and is an associate professor in the Department of Orthopaedics at the University of British Columbia (VGH). He has been a member of the BCMJ Editorial Board since 2002.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org