CSPL white paper calls for changes to increase physician involvement
Effective reform of the Canadian health care system cannot occur without the involvement and leadership of physicians.
That's the main conclusion of "Accepting our responsibility: a blueprint for physician leadership in transforming Canada's health care system", a white paper prepared by the Canadian Society of Physician Leaders (CSPL).
The document outlines actions that must be undertaken by individual physicians, the medical profession as a whole, health care organizations, and governments to bolster the role of physicians as leaders to help change the system.
"The current framework for creating and supporting physician leaders in Canada today is disorganized, episodic, and limited in scope," said CSPL past-president and study co-author, Dr. Johny Van Aerde.
"While there are examples of physicians being meaningfully involved in helping shape health care transformation and innovation in Canada, these examples are limited," said Dr. Van Aerde, who is also clinical professor of pediatrics at the universities of British Columbia and Alberta.
Findings in the paper are based in part on the first-ever survey of physician leaders in Canada conducted by the CSPL, in partnership with the Canadian Medical Association (CMA) and the Centre for Health Innovation at the University of Manitoba.
Among the findings from the survey of 689 physician leaders:
- Many physicians take on a leadership role with no compensation or only a minimal stipend
- Only 54% of physicians in formal leadership roles are compensated for pursuing leadership training or education
- Only 39% said they were involved in innovative projects in their organization
"Organizational policies often exclude physicians from meaningful leadership roles, but the culture of medicine must change to acknowledge the responsibility of physicians to the system as a whole," said Dr. Van Aerde.
The white paper contains a number of recommendations to enhance physician leadership and improve physician participation in health care reforms, including the following:
What physicians should do
- Explore and challenge their personal mental models and the world views that restrict them from engaging in the health care system and realizing their potential as leaders.
- Be willing personally to participate in and champion efforts by colleagues to understand the reform agenda within their provincial health care system and the implications for their own area of responsibility.
- Take steps to negotiate appropriate working conditions for physicians in a reformed health care system.
What health care service organizations should do
- Make changes in organizational structure and design, jointly advocated by the organization and physician representatives, to alter policies and practices toward involving physicians in informal and formal leadership roles.
- Use informal and formal communications approaches to ensure that physicians are aware of organizational issues and priorities and are able to respond and provide feedback on such issues.
What provinces and medical associations should do
- Initiate negotiations to formalize and support regional and organizational efforts to realize effective physician leadership and engagement.
- Work with universities and health research agencies, both provincially and nationally, to identify best practices; either conduct or gather research on the impact of various models of physician leadership and engagement; and share that knowledge widely with potential partners.
- Provide financial support for physician leadership development and remuneration for physicians in leadership roles.
What Canada should do
- The Government of Canada and Health Canada are encouraged to endorse the recommendations of the Advisory Panel on Healthcare Innovation and, in the spirit of human resource development, instill in the national innovation hub strong support for physician leadership development and engagement.
- The Canadian Medical Association should develop a policy statement that recognizes the importance of physician leadership in health care reform and, through its subsidiary, Joule, reform and expand its existing efforts to increase physician leadership.
- The Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, provincial colleges, and medical schools across the country should expand their efforts to embed leadership development in formal medical education and professional development.
"This paper is the first step toward improved physician engagement and leadership in the Canadian health care system," said Dr. Becky Temple, president-elect of the CSPL. "We are asking all stakeholders to initiate a dialogue and take action to support physician engagement and leadership in the context of their own organization or setting."
"The thoughtful and encompassing white paper from the Canadian Society of Physician Leaders is a valuable document, showing the way to the overdue health care reform urgently required in Canada. The paper acknowledges the essential leadership of physicians in health system design and management at all levels, while also focusing on the required collaborative approach to system improvement. Only by working in partnership with all stakeholders in the health care system may we expect to develop sustainable and high quality care," said Canadian Medical Association president Dr. Granger Avery.
"The document acknowledges the important step taken by the Royal College of Physicians and Surgeons of Canada in changing its basic framework for medical education (CanMEDS 2015) to acknowledge the role of physician as 'leader'," said Dr. Andrew Padmos, president and CEO of the Royal College. "We agree with the CSPL that every physician is a leader and leaders can and should be found at all levels."
"Family physicians can be leaders, both in their local communities and at the national level," said Dr. Francine Lemire, executive director and CEO of the College of Family Physicians of Canada. "This white paper provides the rationale for all family physicians to consider taking leadership roles."
About the Canadian Society of Physician Leaders (CSPL)
The Canadian Society of Physicians Leaders is the "go to" organization for physician leaders. Since 1998, it has been providing support and development opportunities for Canadian physicians to help them succeed in their leadership and management roles in health care. The CSPL, with Joule (a CMA company), hosts the only annual meeting in Canada dedicated specifically to physician leadership.
