Setting the stage for the next several years

Issue: BCMJ, vol. 52, No. 10, December 2010, Page 498 President's Comment

Portrait of Ian Gillespie

The Board of Directors recently held a very successful strategic planning workshop in which we discussed five themes: prevention services, improved access to care, im­proved IT solutions, quality enhancement for both patients and physicians, and relationship with government. 

Although the Board saw fit to not pursue further governance proposals, choosing instead to make incremental changes, we did endorse a proposal for several forums. Already held was the surgical forum—the next three will be the medical, the diagnostic, and then the GP forum.

Each of the four forums will be repeated in the months ahead, likely including health authority and Ministry of Health Services representation.
We find that using a forum is a very useful format to discuss better approaches to delivering health care, integrating services, and improving collaboration. 

For instance, at the surgical forum about 20 physicians representing GPs, emergency physicians, hospitalists, anesthesiologists, and a spectrum of surgical specialists were engaged in discussions on advances in IT and PSP training modules. The discussions allowed for plenty of ingenuity in problem-solving and highlighted current sticking points.

At the strategic planning workshop we debated a number of ideas and concepts falling within the five themes that will affect all physicians at some point:

• Reforming health care. Our Ministry of Health Services, the BCMA, and CMA have plans to ensure the health care system is efficient and sustainable in the long term. We are all moving quickly—probably no­where faster than here in BC. All physicians remain very busy and face complex issues, but with a sense of greater optimism. How do we adapt to these changes?

• Solo practice. Many physicians prefer an individual practice; however, they may be left in the dust unless they also engage in a “virtual group practice.” 

• Information technology. Electronic information systems such as EMRs, CHARD (the Community Health and Resource Directory), and applications for our PDAs and office com­puters are continually picking up momentum for both GPs and specialists. Although true interoperability is likely a couple of years away, incentives are available for early adoption, so don’t wait too long!

• Preparing for retirement. Given that approximately 50% of our profession is over the age of 50, preparation for retirement is a concern, not just for us, but for our patients as well. Information technology can help by providing a smooth exit strategy in the form of an electronic summary pass­ed on to the patient or to the next physician. On the social side, we need to cultivate more opportunities for physicians who may be thinking of retirement, but who are not ready to fully retire, to continue to contribute meaningful involvement in the health care system and to use their considerable wisdom and experience.

• The I word. Integration frequently comes up as a topic of discussion in visioning exercises. In this case we focused on a seamless flow between acute care and community care and better service to high-needs populations, including those with addictions. Building on the lessons from H1N1 influenza last year, we need to better connect primary care with public health and emergency preparedness.

These advances will not occur with the 0100 fee item—new funding methods that are “population based” will expand. As Divisions of Family Practice makes excellent progress, specialists are keen to explore how they can best be involved in these community-focused solutions. 

Successful ventures will favor simplicity and keeping score of health outcomes and satisfaction. With increasing collaboration among health care professionals, community service groups and other health care providers, those who don’t participate may feel more and more isolated and less involved at the collaborative care roundtable. 

It is truly a pleasure working on your behalf with the excellent staff at the BCMA. This is an exciting time in strategic planning. Hanging on the wall in my BCMA office is Robert Bateman’s print Sheer Drop—Mountain Goats, which reminds me of the unpredictable challenges we all can face in many areas of life—yet there is so much reason for appreciation and optimism.

As the end of 2010 approaches, however you celebrate the holiday season, I send you wishes for good times with family and friends, peace and reflection on the wonders of love and nature, and blessings for whatever spiritual belief enriches your life. For those of you on call, may it also be a time of satisfaction while you serve the needs of others. Best wishes for a happy and healthy 2011.
—Ian Gillespie, MD 
BCMA president

Ian Gillespie, MD. Setting the stage for the next several years. BCMJ, Vol. 52, No. 10, December, 2010, Page(s) 498 - President's Comment.

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