Excerpts from Dr. Christopher J. (Chip) Doig's
Speaking Notes for President Installation
Saturday, September 26, 2009
Ladies and gentleman, honored guests, my family, my colleagues and my friends. First and foremost let me extend my personal congratulations to all of the CMA Senior Award winners who have been honored here today. These individuals, their personal commitment to their patients and to our profession are remarkable role models. I hope you will join me once again in recognizing their contributions and congratulating them.
I would also like to take a moment to congratulate Drs. Noel Grisdale and Darryl LaBuick. Dr. LaBuick is completing his 3-year commitment in the presidential cycle. It has been a privilege and a pleasure to work with him. Our membership has been fortunate to have his leadership during the past 3 years.
Of course, I also need to recognize Dr. Noel Grisdale. He has demonstrated many characteristics that will serve as a role model for me; and some maybe not (he is a serious crackberry addict-I bought an iPhone). Noel, thank you for all that you have done on behalf of the profession over the past year. It has been an eventful and extremely challenging year ... but with your leadership and energy ... the AMA has steered the right course. On behalf of all AMA members ... I thank you for your dedication and tireless efforts. I look forward to your support and wisdom as past president in the coming year.
I am honored to stand before you today as your 2009 president. It is a privilege to have been selected by my colleagues, peers and mentors ... to represent Alberta physicians.
For those who don't know me ... perhaps a short description of whom I am. I am an extremely fortunate man. I am a product of my parents. For the OBGYN's and family physicians ... I'm sure you're impressed with my clinical acumen. But what I mean is I received my brains from my mum, and everything else from my dad.
I grew up in a comfortable and safe home, with parents and siblings who love me, and who taught me the value of hard work. I had a chance to attend the University of Saskatchewan ... a small medical school where students work closely with physicians in clinical practice. One of my favorite preceptors was a family friend, Dr. Ed Somerville, a retired Canadian Forces physician who was an internist at Saskatoon's City Hospital. Dr. Somerville had a habit of always having a special sentence about each of his patients: for example, "This cantankerous 60-year-old widower was a pilot flying Lancasters during WWII and was shot down on his 23rd mission."
Now since Dr. Somerville-I still won't call him Ed-was pretty hard on the interns, there were a lot of unkind comments about why he wrote these notes. I asked him once, and he said they were simply a memory aid, but whether it was the lesson or not, I learned that he spent at least a few minutes to learn something personal about each of his patients. Another physician was a family doc in La Ronge, Dr. Betty Spooner, that I worked with for a month ... sorry to say Dad, that I almost did go into family medicine, but it wasn't going to be in Saskatoon.
I interned in Vancouver at St. Paul's Hospital during the start of the HIV epidemic. At St. Pauls-very much an intern's hospital, and if you're old enough, you know what I mean-I saw 2 populations of marginalized individuals. One group, predominantly gay men with an infection at the time that was viewed as the 20th century equivalent of the plague, and those of lower SES often either members of one of the proud First Nation's communities, or suffering and marginalized often because of psychiatric illness or the ravages of alcohol or drug addiction. Admitting 12-16 patients a night with complications of HIV-4, 5, 6 patients on each medical floor on non-rebreathers and tusks with oxygen saturations of 85% and as long as they were mentating, they didn't go to ICU, because the ICU would run out of beds. If they did ... they wouldn't come out. My training in BBF precautions was a senior nurse during orientation saying "and whatever you do, don't poke yourself." During that time, I saw SPH-the sisters, the nurses, the doctors, all together-as a beacon of care for these individuals otherwise marginalized in their community. Too few beds, an epidemic threatening to collapse this system, an emergency room where our goal on medicine was to clear out admitted patients before the next night we were on call. This was not care provided by a system, a region, or a provincial department, it was care provided one patient at a time in an overcrowded system, with a bulging emergency department, and too few beds, by doctors and nurses that cared about each and every patient.
I am extremely lucky that in the year I interned, my beautiful wife, then girlfriend, was in Calgary, and I followed her here. I will pause to say that I am lucky in having met and married my soul mate, my confidant, and my barometer. I am also so lucky to share my life with her and my 4 wonderful happy and healthy children.
I met and worked with some outstanding physicians. Some are here and are recipients of national awards such as Dr. Atkinson ... some are past recipients such as Dr. Andre Ferland. One of the physicians-who ultimately became my boss, a physician who grew up in Pincher Creek, trained in Edmonton, practiced in Red Deer, trained as a specialist, started ICU in Calgary-he taught me to first and foremost, always put the patient first.
I found my area of medicine in the ICU. Since then, I have had the privilege of caring for patients and their families that are truly the sickest in our system. I have the privilege of seeing patients diligently cared for by physicians in rural settings without the resources that I have that literally save the life of a patient, and give them a chance by stabilizing them to get them to our centre. I see outstanding specialists performing surgery on patients that even when I started my career we'd never operate on. Family physicians, chased from the hospitals in the ‘90s who now accept some of the sickest patients from the ICU. And of course, finally, the chance to work with many residents - past presidents included - who teach me as much as I teach them.
Despite working and growing up in the profession mainly in community based hospitals, I now find myself somewhere I never expected as I was going through med school and the rest of my training. I am a full-time faculty member at the University of Calgary. I am an educator. I am a researcher. But first and foremost, I am a bedside clinician. My professional identity is as a bedside doctor, and I am extremely proud to be a member of the most noble of the health care professions.
I've been involved with the AMA and CMA since 2001. It is a privilege to work and have worked with so many talented individuals, from staff to past presidents, many who are in this room today. I have learned much from all of you, and I hope to follow in your footsteps.
Looking forward, our association and profession are facing a number of issues.
First ... the need for unity. I have had the chance to work with physicians in private practice and physicians in academic settings. With specialists and with family physicians. With those who treat acute illness, and those who treat chronic illness. What I am impressed by is that as a professional body, there is no other group with the confidence and trust of patients, family, and the public as a whole. There is no other group with the breadth and depth of expertise and practical experience on how to deliver care. There is no other group that are the natural leaders in delivering care, in recognizing shortcomings in the system, and who are the only ones who can truly maintain the accessibility to quality health care in our province. Therefore, we must not be afraid to speak out for necessary change to our system, and also speak out against change which will not be in the best interests of our patients. We must help represent other health care providers in our system whose contributions may be minimized and not celebrated. In a speech earlier this week, the Minister of Health stated that patients need to be put at the top (first) in our system. This is exactly what our profession has called for, and we appreciate the minister recognizing again the leadership in our profession in calling for putting Patients First.
Second ... I have spoken of some of the physicians who have been my role models. But I have neglected the 2 most important. They sit before me today and they are my dad, and my much, much, much older sister (just in case she thought I was going to leave that out). One of the most telling moments is sitting in a family room in the ICU with a family... 2 of the women watched me very closely...at the end they simply asked me..."is your father Noel?" When I replied yes (with my usual, that he's the Model T, I'm the GT 500) they did what many people have. They spoke warmly and fondly of the care provided by my dad, and my sister. The backbone, nervous system, and the heart of our profession lies with physicians, like them, who provide such primary care. Today there are many changes being proposed for primary care ... so many voices ... so many players. We need to keep the focus on providing physicians with the resources they need to deliver the primary care services that are the core of our health care system.
Finally ... negotiations and the trilateral agreement. Our master agreement has been in place since 2003 ... and last year we signed the final, three-year financial agreement. But the overall trilateral relationship is about far more than money. It is unique ... and Alberta Health and Wellness and Alberta Health Services must recognize and commit to the principles behind the agreement. They must fully engage the profession and our voice ...through the AMA, the board, sections and the Representative Forum ... in decision making and shaping the health care system.
In Dr. Phil Hebert's book Doing Right, he suggests there are 3 measures to determine the propriety of your conduct:
- can you look in the mirror
- can you stand having your face with your actions subject to publication in the media
- can you stand before members of your profession.
I agree with Dr. Hebert that these will be the measures by which I will judge my own conduct ... with one exception that I hope I will not have to stand before you, nor stand in front of you, but rather that I will be able to stand with you by my side.
Thank you again.