Province’s physicians favour accountable, team-based health system

A Saskatchewan Medical Association survey shows most physicians in the province believe they have the ability to help lead and redesign a health system that is accountable, provides better care for patients and better value for the public.

It also found most doctors are outward-looking — they want to influence the system beyond their own practices. Physicians also support a team-based approach to care, with decisionmaking that is shared among other health-care professionals, the SMA survey shows.

“Over the last year our members told us very clearly that a fragmented health system was diminishing patient care and wasting resources,” said Dr. Intheran Pillay, SMA president. “Our survey confirms for us that these views are more widely shared among the province’s physicians. We are keen to continue talking with our colleagues about these issues, and are looking to work with the Ministry of Health, and other key health-care stakeholders, on how we can build a better, more integrated health system for the people of Saskatchewan.”

Almost 650 doctors completed the SMA survey, which asked physicians questions about their views on team-based care, data and accountability, compensation and physician participation in health system redesign. Respondents were mainly split between specialists (45%), family doctors (43%) and students/residents (12%). The survey took place from Jan. 16 to Feb. 5, 2017. Results of the survey include:

87% think Saskatchewan doctors should be responsible for using health-care resources wisely.

68% believe Saskatchewan doctors have the skills to help lead and redesign the health system.

89% think doctors have an obligation to influence care beyond their own practices.

98% think care is improved when delivered by teams working to maximum scope of practice.

74% think the compensation method for Saskatchewan doctors enables them to practise high-quality medicine.

to promote public reporting on health system performance. Other findings are:

On the issue of accountability, the vast majority (88%) of respondents think the profession needs to promote public reporting on health system performance. Other findings are:

86% want to know how their practice compares to that of their peers.

76% of Saskatchewan doctors use data from their practices to improve their own performance.

Dr. Pillay said the survey also indicated that a large number of doctors are reporting that they are at risk of burnout, a statistic he finds troubling. One in two specialists identify as being at risk of burnout, as do two out of three general practitioners.

“Burnout is a very real concern for physicians,” Dr. Pillay said. “The data we gathered here would seem to confirm that we have a large number of physicians who are managing, but are signalling a very high level of stress. Many physicians recognize this problem and are ready to work on solutions that will lessen the rate of burnout within their profession.”

The SMA says it will now engage the membership in further discussions about the survey results, and about how physicians want to go forward on specific issues identified in the survey.

The SMA survey results come at a time when physician leadership is being affirmed. The Saskatchewan Advisory Panel on Health System Structure Report, issued in early January, includes as one of its recommendations: “Ensure physicians play an active role in the planning, management and governance of the health system to achieve shared responsibility and accountability for health system performance.”

The Saskatchewan Medical Association (www. sma.sk.ca) is a voluntary, member-based, professional association for physicians, medical students and residents in the province and it is the provincial chapter of the Canadian Medical Association. As the trusted voice of Saskatchewan’s 2,300 practicing physicians, the SMA negotiates for and on behalf of our doctors; supports the educational, professional, economic and personal well-being of physicians; and advocates for a high-quality and patient-centred health care system.