Carrying the torch: Inaugural thoughts from the new AMA president

October 7, 2020

Dr. Paul Boucher, AMA President

Dear Members: 

On Monday of this week, during our Association’s 115th Annual General Meeting, I was honored to officially assume my position as AMA president for the 2020-21 year. Before touching on anything else, I would like to recognize the amazing work and dedication of our Immediate Past President, Dr. Christine Molnar. Her leadership this past year has been beyond exemplary. In these dark times she held the torch high and, as a profession, we were behind her every step of the way. Throughout her presidency I received many unsolicited comments about her strong presence and appreciation for her frequent and clear communication to members. I begin my term with a determined membership, a unified membership, and I know that I have Christine to thank for that. Metaphorically speaking, I have big shoes to fill.

For the long nights, the early mornings, the endless Zoom meetings, the constant phone calls: thank you. For never wavering, for keeping the profession focused on what matters, for showing the public that physicians have their best interests at heart: thank you.

Of course, behind most successful people in this world are the loved ones who support them and keep them going. For this, I want to thank Christine’s husband, Dr. John MacGregor, family and friends. What she has achieved for our Association would not have been possible without you by her side.

As I look to the challenges we will face in the year ahead and I know I will continue to benefit from Christine’s wisdom and guidance. With the Board and the membership behind us, we will keep fighting the good fight.

Chris, on behalf of every physician, resident physician and medical student across the province: Thank you.

I would like to start off by recognizing all the challenges the current environment has placed on the Association and our staff. The loss of programs, the funding associated with them and the uncertainty in our membership numbers for the upcoming year have required changes to the business plan and uncertainty for our staff. Thank you all for all you do. This year has asked a lot from senior staff, our CEO Mike Gormley and the Board. Thank you all for your dedication, the long hours and for consistently going above and beyond.

I grew up in a medical family. My father was a family physician in northern Ontario with a full scope practice. At one point he had a roster with upwards of 5,000 patients, and one year attended close to 300 deliveries. I grew up seeing the challenges a busy practice brought to his personal life and to our family. Long days, weekends, the calls in the middle of the night. Sometimes when I think about it, I wonder why I chose this career path having been exposed to the more negative side of it early on. Perhaps it’s because he didn’t resent it. Sure, at times he was tired but didn’t spend much time complaining.

It wasn’t until I began my own journey in medicine that I really understood all the pieces that balance the challenging aspects of a medical career. These are the things that drive us to do what we do and make the sacrifices we make. It’s the trust our patients and families place in us, the awesome responsibility of life and death decisions, the challenge of sorting through complex problems and the collegiality of working in teams.

In the words of Sir William Osler, “The practice of medicine is an art, not a trade; a calling … a calling in which your heart will be exercised equally with your head.” In the end it is more than a job, it is part of our fabric. Your hearts are in all you do.

We put a lot of ourselves into our work. We often give of ourselves to our patients. We also give to the system, working hard to ensure that patients get the care we know they need. We advocate, sometimes at a personal cost. We take extra time. We give at times at the expense of our own well-being, but we give knowing that our patients are better for it and that it is the right thing to do. This makes you leaders. Leaders in your practice, your clinic, your care teams and in your communities.

Much like me when I was growing up, it is sometimes difficult for people outside of medicine to appreciate these points and understand who we really are; and this is what the government has failed to comprehend. When they tore up our agreement and came forward with the so-called Physician Funding Framework, it led to a backlash that they were not expecting. They believe, and continue to believe, that it is a discussion about income. Yes, finances are important. A significant portion of Albertan’s health care is delivered by small businesses: your practices. The viability of these enterprises is critical. But it strikes so much deeper than that. This fight is about your voice as leaders in the system and as champions for patient care. It’s about the way we are regulated and our ability to advocate. Government is attempting to diminish all that we do beyond making a diagnosis and writing a prescription or booking a surgery. Ultimately, this is an attack on our most fundamental values and the core of the physician patient relationship.

We have pushed back. You have pushed back. Communities and our patients have pushed back. We have all waged this fight while dealing with the most important public health crisis we have faced in our lifetimes. We need to continue to advocate and maintain our resolve. Achieving a negotiated agreement with government that is fair for physicians and brings value to patients is not only in the best interest of Alberta’s doctors, but also that of our patients.

We must find a way to move forward. From a strictly financial standpoint, the loss of our programs: Medical Liability Reimbursement, Continuing Medical Education, our Locum Program and the Alternative Relationship Plan Physician Support Service may have altered the value proposition of the AMA. Now more than ever, we need to ensure that we provide value to you as your representative body and your voice.

We need to ensure we are aligned and engaged with you to achieve this. The AMA is refocusing our business plan and directing resources to the greatest priorities of representation, advocacy, unity and of course the supports and services you need. Your Representative Forum has also directed us to address ongoing work that contributes to our needs and our leadership as a profession, such as income equity, healthy work environments, inclusion and diversity. These are important issues.

In these chaotic times, organizations and individuals across the globe have had to do what has become known as the “Pandemic Pivot.” Essentially learning to do what has to be done in a different way.

If you will indulge me, I would ask you for a moment to conjure a mental image of what a pivot looks like to you. Maybe it’s a quarterback pivoting to pass, or a warrior pivoting to face a new threat. What strikes me with those images is how the back leg stays firmly planted on the ground. That back leg is the strong one, it holds the position. It keeps the warrior steadfast, allows her to hold the ground. Yes, the AMA has had to pivot. Pivot as a result of changing and threatening landscape. You are that back leg, planted firmly: it is the doctors of Alberta, it is the staff at the AMA. You are our strength that keeps us steadfast and unwavering. We need this strength as we move forward.

As I begin this year, my message to government is this: There is a proverb that states, “If you want to go quickly, go alone. If you want to go far, go together.” If our hearts are truly in the right place, then we want the same thing: A sustainable health care system that delivers the best care for Albertans. We understand the fiscal reality the province is facing and the toll it has taken on Albertans. We see it all around us, in our communities, our practices, emergency departments and intensive care units. We want to see our society through this pandemic, protect the vulnerable, care for the sick and provide the most compassionate care we can to those that can’t be made well. Indeed, we need to go far. We must go together.

And I would say this to those that would see us falter and to those that seek to actively dismantle the Association: We are not an association of surgeons, anesthetists or intensivists. We are not an association of emergency physicians, laboratory physicians or radiologists. We are not an association of family physicians or ophthalmologists. We are the Association of the doctors of Alberta. Yes, we are all different, we are diverse, and we must listen to one another and recognize these differences. For it is only by acknowledging them and understanding them that we will stay united.

We are better together. We are stronger because of each other. We are the AMA.

Your comments are welcome in the following ways:

  • Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org
  • Comment publicly on this President's Letter on the AMA website (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member).

Sincerely,

Paul E. Boucher, MD, FRCPC

President, Alberta Medical Association

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