From 0 to 60 right out of the gate

Well, after only a few weeks “on the job” I am already realizing that, though demanding, being president of the BCMA has many positive elements—the opportunity to meet many fascinating and stimulating people, to speak publicly on interesting topics, and to lend my knowledge and expertise in different areas.

After the June AGM, and one week of acclimating myself at the BCMA office, my wife and I decided to return home to Terrace via Port McNeill on Vancouver Island, and then take the ferry north to Prince Rupert. A much longer trip, including a 14-hour ferry ride along the Queen of the North route, but the motivation was an invitation to stay at the home of former BCMA president Granger Avery and his wife and attend his famous (or should I say infamous) annual pig roast. The custom-made barbeque provides strong competition as one of the seven wonders of the modern world. Invitees to the event included medical students and residents from northern Vancouver Island who contributed to a CME event during the day, sponsored not by any drug company, but by Dr Avery’s legendary largesse.

It was a great pleasure to meet these young doctors. I was impressed by their enthusiasm, their love of medicine, and their innovative ideas on how to improve their learning experience—especially their desire to become more connected to the community. I left Port McNeill feeling much more optimistic about the future of our health care system being in their hands.

The public persona of the Association has been quite visible since the AGM, largely due to the release of two significant policy papers by the Association.

The first paper, released the week following the AGM, was our submission to the Conversation on Health. Physicians Speak Up answered three key questions posed by the premier that involved the meaning of the principles of the Canada Health Act (CHA), how to sustain our health care system in the long term, and how to improve health care delivery so that it lives up to the CHA principles. This paper generated significant and mostly positive reactions. A Vancouver Sun editorial described the paper as “a breath of fresh air,” a description that was later erroneously used to describe me personally! The paper also led to my first appearance on the Bill Good Show, which thankfully went well. For the record, I found Bill to be a knowledgeable and perceptive host.

The second paper, entitled A Prescription for Quality: Improving Prescription Drug Policy in British Columbia, is a well-written, well-researched position paper for which I would like to give kudos to its author, Mr Jonathan Agnew in our Policy and Planning Department, as well as to the other members of the Council on Health Economics and Policy working group. The release of this paper led to an exclusive cover story in the Vancouver Sun, and my second appearance on the Bill Good Show. So far, so good.

The paper lists 24 recommendations in six areas of importance to physicians in BC: prescription drug expenditures, Pharmacare program, drug promotion (to both patients and physicians), information technology, pharmacist prescribing issues, and the National Pharmaceutical Strategy. Included in the recommendations on BC’s Pharmacare program is the Reference Drug Program (RDP), a contentious issue for many physicians. This issue was heatedly discussed at two separate Board meetings, with support for the program contingent on the following conditions:

• Implementation of a transparent process for careful evaluation of the therapeutic equivalence of drugs in current and future reference drug categories.

• An assessment of the impact on health outcomes of reference drug pricing for all drug classes in the BC Reference Drug Program, both current and future, on a short- and long-term basis.

• Creation of a working group, which includes practising physicians, to examine additional categories of reference drugs.

• Appropriate reimbursement for physicians for the completion of special authority forms.

I highly recommend that you read both of these policy papers. They can be found here on the BCMA web site.

All told, it has been an interesting few weeks. By the time you read this, the CMA will have held its AGM here in Vancouver, with the inauguration of Dr Brian Day as president. I expect I’ll have something of interest to say on that topic next month.

—Geoff Appleton, MB
BCMA President