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Pro-medicare doc nominated to be CMA president

The candidate for Canadian Medical Association president preferred by the pro-medicare contingent of the medical community has won the Ontario Medical Association's nomination.

Dr Jeffrey Turnbull's election points to what may be a major change to come in the CMA's influential political lobbying, potentially moving away from what has been a voice on behalf of reforming the restrictions on privately funded healthcare delivery embodied by the Canada Health Act. That effort has been particularly strong over the last two years, with outspoken private clinic owners Brian Day and Robert Ouellet holding the CMA's top job.

Dr Turnbull, on the other hand, made it clear in his campaign position statement that his politics differed from those of Day and Ouellet. "Through new partnerships, a clear vision, dedicated advocacy and wisdom we can preserve the rich traditions of medicine within a publicly-funded health care system that serves our patients the way it is supposed to," he wrote.

Dr Turnbull acknowledged the potential policy shift after learning of the election results. "Yes, [my election] would be a movement not in keeping with the direction of leadership we've had," Dr Turnbull told The Globe and Mail. "But I think there are opportunities for that debate to take place."

Barring a last-minute challenge from the floor of the CMA's annual meeting this August in Saskatoon, Dr Turnbull, the chief of staff at the Ottawa Hospital and an internist with extensive experience in treating the homeless, will become the group's president-elect in 2009-2010 and then accede to a one-year term in the presidency in August 2010.

His experience in association politics is somewhat limited. As I wrote in January, Dr Turnbull is "one of the very few candidates for CMA president over the years who has never served on the board of directors of the CMA or a provincial medical association" though he has experience leading the College of Physicians and Surgeons of Ontario and the Medical Council of Canada.

The CMA's news announcement of Dr Turnbull's election notes that his campaign's focus was not only on the public-private balance of the Canadian healthcare system, but also on practical issues affecting physicians across the country. Among the three priorities he laid out on his website, he wrote:

"As CMA president, I will advocate for pensions, changes in tax law, and debt relief. I will also continue the good work CMA has been doing on other aspects of physician wellbeing since financial wellbeing is only one small piece of the puzzle."

He emphasized the need for greater effort on physician wellness in an interview with the Canadian Press yesterday. "If we don't make changes, we're heading into a circumstance where there'll be increasing stress, increasing burnout, increasing difficulties for doctors as they continue to try to do the best for their patients," said Dr Turnbull. "We have to redouble our efforts to supporting them and making meaningful changes. We have to get more physicians, we have to improve their working conditions. And we have to make a healthy health-care system... within which doctors can perform."

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7 comments:

  1. sharon4 March, 2009 9:08 AM

    PASTE

    "If we don't make changes, we're heading into a circumstance where there'll be increasing stress, increasing burnout, increasing difficulties for doctors as they continue to try to do the best for their patients," said Dr Turnbull. "We have to redouble our efforts to supporting them and making meaningful changes. We have to get more physicians, we have to improve their working conditions. And we have to make a healthy health-care system... within which doctors can perform."

    END OF PASTE

    AMEN!

    Delete
  2. Anonymous7 March, 2009 2:44 PM

    "Europeans face short, or no, wait times, yet spend less money on health care than Canada."

    Delete
  3. sharon9 March, 2009 6:55 PM

    Anonymous...

    maybe that is because the patient's family is working the "night shift"

    ...forget these cute little "man at the top" forays over a few days ...go live there for awhile... chat with the locals..

    Delete
  4. Scott10 March, 2009 9:27 PM

    I think that the headline for this article is a clear indication that the author unfortunately has no real understanding of what CMA or its past two presidents have stood for regarding Medicare. I have no doubt that Dr. Turnbull is pro-Medicare and will be an excellent spokesperson for the Canadian medical Association and the medical profession in this country as a whole. However to suggest that either doctors Day or Oullette have been anything other than champions of a strong publicly funded system indicates that the author has focused only on the fact that these positions privately deliver healthcare in a publicly funded system. All fee-for-service physicians in this country in fact do the same, that is deliver privately and publicly funded healthcare service. This author as have many others simply confuses rather than furthers the debate by failing to recognize the difference between privately delivered/ privately funded and privately delivered publicly funded. It is unfortunate when a publication for the medical profession cannot get this fundamental difference right.
    Scott Cameron M.D.

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  5. Sam Solomon11 March, 2009 10:07 AM

    Dr. Cameron,

    The phrase "pro-medicare" is admittedly a somewhat crude shorthand, and -- as you point out correctly -- the subject at hand demands a distinction that's indeed far more subtle than it is often permitted (and journalists are guilty of this in many instances, as are many politicians from all parties, and even some physicians).

    To be clear: what distinguishes Dr. Turnbull's stated position on the question of funding for privately delivered healthcare (i.e. care delivered by private-practice doctors) from the positions of Drs. Day and Ouellet is not so much advocacy for a strengthened and more responsive publicly funded system but rather their opinions on the role that the private sector (e.g. the private insurance industry) should play in healthcare funding. It is a crucial point that both Drs. Day and Ouellet have, to some extent and to varying degrees, called for major reforms to what they see as harmful restrictions on private-sector involvement/innovation imposed by the Canada Health Act, whereas my reading of Dr. Turnbull's position is that he will not advocate the reform of that law.

    You're correct that shorthand phrases like "pro-medicare" are at best inelegant and at worst misleading, and at times serve to obscure or obfuscate some of the real issues that obviously need to be addressed in the Canadian healthcare sector -- issues like wait times, primary-care acces, new drug/technology costs, telemedicine, physician wellness, electronic records, coordinated care, physician extenders, etc., all of which, I hasten to add, have been issues that I think most doctors would agree that have been given warranted and appropriate and even admirable attention and effort during the current and immediately past presidencies.

    My apologies for not having been clearer, Dr. Cameron. And my thanks for your letter.

    Sam Solomon

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  6. sharon11 March, 2009 12:27 PM

    "..... 'twas brillig and the slithytoves did gire and gimble in the wabe"

    let's face it.... medicine and journalism both need to build bridges across the chasm.

    Apart from the confusion of unshared meaning using the same dialogue .....is whether the language used in the "report" ...and the "retort" are " spot on".

    Even Turnbull has demonstrated a "blind eye" to legislation in some of his innovative practice.
    And far deeper than the private/public debate, and variations on that theme ,....is the Canada Health Act and how it tenets are cohesively expressed, fulfilled ...and costed .

    Hopefully medical leaders will get past "straining at a gnat.... while swallowing a camel"

    Delete
  7. Anonymous30 January, 2011 7:35 PM

    Dr. Turnbull sounds like a pragmatic, well-grounded expert in his field and, hopefully, we will not see a push toward Americanized privatized care in Canada that defies the spirit and good sense of Pearson's and Tommy Douglas' vision for a NATIONAL Health care plan. Let's examine all options available to Canada's National Health Care and try to install some good sense and balance into the system without ruining it.

    I sense a dangerous push toward privatized care that will only benefit the Ottawa lobbyists who seem to be all over the place these days counting the blessings of insurers and millionaire clinic owners.

    Canada spends less than 12% of its GDP on healthcare and the Americans 18%+. I met many a small business owner (and a cab driver in California) who had to mortgage their paid-for house to....pay their operation.

    Over 64% of all personal bankruptcies last year in the U.S. were due to not Foreclosures, but "inability to pay medical bills"!

    Guess how many bankruptcies due to med bills in Canada? Please let us know if you know of any.

    If only Dr. Turnbull could innovate and manage the healthcare costs in a constructive, modernized way that will not at the same time diminish the care for seniors and those on low incomes (2 out of 3 Canadians!)....

    Mary

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