Looking back, and to the future

It is hard to imagine that my year as president of the BCMA is fast drawing to a close and I will soon put behind me the everyday dealings of health care politics.

The year started off with a bang with the release of the BCMA’s document Specialty Care in BC—A System in Distress, which gave government a failing grade across all health regions in its ability to provide for patients needing specialty care. Since then my presidency has been akin to a game of hopscotch—which has made for a very interesting year. One month later the association concluded a new 3-year Working Agreement, which was ratified by members, that provided no direct fee increase for the first 2 years and a reopener for fee compensation negotiations for the 2006–2007 fiscal year, set to begin this October.

The crisis in full-service family practice has been front and centre for the past 8 months. I have found the Professional Quality Improvement Days (PQIDs) a stimulating and illuminating dialogue with well over 1000 general practitioners throughout our province. Once the recommendations of the General Practitioners Service Committee (GPSC) are debated by the BCMA Board and the Society of General Practitioners Board, they will be sent out to referendum for approval or rejection by all BC family physicians.

I have attended the conferences sponsored by the BC Physician Health Program and I’m pleased that the number of physicians who are accessing or revisiting this excellent program is increasing. More and more doctors are experiencing job dissatisfaction manifested by burnout, depression, substance abuse, marital problems, professional boundary violations, and suicide. Job dissatisfaction threatens our long-term existence as a caring and nurturing profession.

I have had many interesting and stimulating media interviews concerning the sustainability of our publicly funded health care system in light of the increasingly obvious access-to-care problems experienced by our patients. Waiting times, emergency room chaos, lack of sufficient acute care hospital beds, physician and nurse shortages, and the inadequacy of our community-based health care resources have been front-page stories all year.

Internally, the BCMA is taking a close look at how we govern ourselves and ensure adequate and sufficient representation for all BC doctors. An ad hoc Committee on Governance and Restructuring is deliberating these big issues in a methodical and careful way. We need to closely examine what’s already in existence before we embark on any consideration of change.

I attempted to improve our image with the public and the media as well as converse with government in an attempt to rebuild trust in our relationship. Time will tell whether our collective efforts at the BCMA will yield a more cooperative and collaborative working relationship with our health authorities and our provincial government—but I am hopeful. It is axiomatic that little or no successful system change will occur without the full input of, and cooperation and collaboration with, BC’s doctors.

Other important issues are in the works and require ongoing effort and eventual resolution including fee disparity, the introduction and uptake of information technology, and the evolution of computerized medical offices with electronic connectivity to hospitals, PharmaNet, laboratories, and other physicians’ offices.

There are many individuals and organizations that I would like to thank for making my year an exciting, stimulating, and rewarding one. I owe a huge debt of gratitude to the BCMA Board and my fellow directors for their wisdom, strategic thinking and planning, attention to their fiduciary duties, and for their due diligence on behalf of all members. The BCMA is, and must always remain, a member-driven organization.

I must salute both the Society of Specialist Physicians and Surgeons and the Society of General Practitioners for demonstrating how they, in conjunction with the BCMA Board, can form a mature, cooperative, and collaborative partnership that is beneficial to all BC doctors.

I owe a huge thank you to the exceptional and talented BCMA senior staff and to all the 65-plus BCMA staff who make our organization what it is today: effective, representative, and a leader in health care delivery in BC. No elected officer can begin to be fully conversant with all the details surrounding health care policy and economics, health care prevention and promotion, education, and the myriad professional relationship issues that arise daily. The BCMA staff are both the vision and the glue that has kept me on course this year.

I look forward to working with the Board and Executive, under the leadership of our incoming president, Dr Michael Golbey. I know that Michael will soon come to know what a tremendous support system is always at his fingertips. I know that he will be able to count on every BC physician with the challenges of negotiating the new Working Agreements and the renewal of the Master Agreement, together with the ongoing threats of essential services legislation and the need for local dispute resolution mechanisms to prevent service disruptions to our patients.

I am convinced that we are and will remain a noble and honorable profession that puts the health of our patients as our number one priority at all times. I am extremely proud and humbled to have served you during the past 12 months.

—Jack Burak, MD
BCMA President