A prescription for better health care
Island MD, the new head of Canadian Medical Association, says groups must get together to hash out issues
A physician whose career was spent on northern Vancouver Island uses a fish analogy to explain his plan to improve health care as the new head of the Canadian Medical Association.
The problem, says Port McNeill doctor Granger Avery, is a lack of communication, co-ordination and collaboration between different groups. For inspiration, he looks to the Fraser Basin Council, which brought together several groups to tackle pollution affecting salmon stocks in the Fraser River.
“And we now have the Fraser as it is … substantially clean,” he said. “It took that collaboration in order to put this into effect.”
Avery will lead the medical organization into its 150th year, taking the reins on Wednesday, the final day of the association’s annual meeting.
“I’m really excited about this opportunity,” he said.
With 13 provinces and territories, each with a different system, and health authorities and hospital systems with their own ways of doing things, it’s not surprising that valuable information can be lost in translation, Avery said.
One has only to look at the implementation of the ihealth electronic health record in Nanaimo — it is under review after physician complaints about it cancelling or doubling up on prescription orders — to know there was a disconnect between the system’s users and its designers, he said.
“The electronic health record should be the glue that holds our health system together, but it’s not there and it’s a shame.” But Avery is thinking bigger. “To be honest with you, I want to spread the discussion even wider than that,” he said. “I’ve described Canadian health care as the land of 100,000 health-care silos, and I think we need to do something to address that.”
The answer lies not in another report or commission, he said. “They don’t get adopted. So what’s the problem? I think the problem is we haven’t sat down to talk to all the health-care partners.”
Avery foresees five levels of health care coming together to hash out the issues: governments; health-care managers such as health ministries, health authorities and hospitals; universities; people who use the system, and doctors and nurses.
The upcoming Canada Health Accord talks could be a vehicle to start the process, Avery said.
“We need to sit down and thrash out first a vision so we can agree this is what we’d like,” he said.
After decades as a physician, Avery said he has learned “again and again the value of sitting down and not talking and listening.”
Avery served patients at about eight outreach clinics — meeting people in their homes — and said First Nations patients best taught him the value in listening.
“The ability to do that is what I have really taken away from Port McNeill,” he said.
A graduate of the University of London in England and the University of Auckland, Avery came to B.C. in the 1970s for a residency in anesthesia at Vancouver General Hospital. He settled in Port McNeill, starting a general practice offering obstetrics, surgery, anesthesia and emergency medicine, and teaching at the University of B.C. He and his wife of 38 years, Winnie, have three children and seven grandchildren.
Avery, a past president of the Doctors of B.C., has held leadership positions with the Ministry of Health and the B.C. Medical Services Commission and has been awarded several distinctions for his work in rural medicine.
He also put in place several initiatives, including a provincial system to track wait times for surgeries and diagnostic testing, and founded the Rural Co-ordination Centre of B.C., which seeks to improve rural health.
Avery, 69, retired in January 2015 to prepare for his role as CMA president.
“I want to put some significant time into this,” he said. “I spent 40 years in general practice and 30 of those years teaching and in medical politics, so that’s a widespread footprint.”
It will be a busy year for the new president, given the implications of the proposed legalization of marijuana, medical aid in dying, and the upcoming health accord talks between the federal, provincial and territorial governments.
Avery said there is concern the physician-assisted dying law does not satisfy either of the extreme positions on the issue, but the fact that federal government has “sensibly allowed for a review in two years” offers some reassurance.
On the legalization of marijuana, Avery is concerned about addiction and the affect the legalization of marijuana could have on youth, citing a report in the August issue of the American Journal of Psychiatry saying adolescent boys who regularly use marijuana are at increased risk of paranoia and hallucinations, even a year after stopping.
Other issues include the need for a national Pharmacare agreement and increased resiliency as more doctors burn out.
The 150th year gives everyone at the CMA reason to pause and reflect where health care has been and where it’s going, Avery said.
“We need something that will be robust enough to stand the next 150 years.”