WEBVTT

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Good afternoon everyone.

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Would like to welcome and and thank
everyone who's joined us online from

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across the country and also to those in
the room with me here in Toronto.

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Welcome to today's panel.

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My name is Michelle and I have the
pleasure of moderating today's panel.

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And I think one of the the areas that you
know,

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I'd like to do is maybe just set the
stage for the discussion before I welcome

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our panelists.

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So I think I'm assuming if you've joined
the session today,

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everyone understands intimately that the
health system is under a lot of pressure.

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And whether you're working in a large
urban hospital or northern community

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clinic or providing primary care across
regions,

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the strain is real and it continues to
grow.

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I think layered on top of the challenges
we already are quite familiar with in

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terms of the, the workforce shortage,
the burnout, which continues to get worse,

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are the,
I would say that the global economic

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challenges, most notably,
I think that the renewed focus on tariffs

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and protectionisms.

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And,
and while these trade measures may seem

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disconnected from healthcare at first
glance,

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they affect everything from the cost
availability of medical supplies to

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cross-border collaboration and research
and care delivery.

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And I think it's a great reminder for all
of us that resilience is not just about

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the clinical and administrative aspect.

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It is also about how we stay resilient
given the economic and political

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environment.

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So in this context, you know,
and resilience is, as we would see it,

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not just about bouncing back,
it's about reimagining the way we work

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with healthcare professionals that we
train,

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we adapt and we support them through
their journey, in particular,

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in a in a time that is where the
landscape is constantly changing.

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So with that,
I'm excited to introduce our panelists

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for today,
leaders who are not only observing these

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challenges,
but are actively working on the solutions.

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So firstly,
with me here in the room is Doctor

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Dominic Nowak,
family physician health leader and past

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president of the OMA,
the Ontario Medical Association.

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And by past, I mean just a few days,
I think a few days ago.

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Yeah.

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So I'm on summer mode now,
but really happy to be here with all of

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you today.

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Thank you, doctor.

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In the virtual room,
I'd also like to welcome Charlene

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Lafrigneur,
the provincial Lead for Indigenous Health

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at Shared Health Manitoba,
who is also currently leading the

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development of an Indigenous health
operating model for Manitoba Health

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Services.

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And finally, Doctor David Price,
family physician and Dean of the new

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School of Medicine at the Simon Fraser
University.

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So welcome to all three of you.

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So maybe to get us started,
it would be great just to hear from your

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context,
some of the challenges you faced and

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through the work you've done,
what solutions have worked,

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maybe what hasn't worked?

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Any kind of key takeaways you'd like to,
to bring to this audience for and for

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them to, to consider as they,
they move towards their,

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their own initiatives and their own
worlds.

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And maybe Charlene, we can start with you.

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I think we have a set of slides that we
want to share as well.

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Yes,
thank you and thank you for the

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opportunity to be a part of this event in
its virtual form.

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My name is Charlene, as was just shared,
and I'm based in Manitoba,

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Northern Manitoba,
which is on the traditional lands of the

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Nischewasa Cree Nation,
as well as the homeland of the Red River

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Metis and also currently known as the
City of Thompson.

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So I just want to take a moment to
acknowledge the space that I have the

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opportunity to work out of and the land
that I live and raise my family at.

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So you might be wondering like, why?

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Why are we talking about Indigenous
representation and resiliency in the

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workplace?

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And how does this fit with what we've
been thinking about and what we're going

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to be planning and doing in our workplace?

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And so I just want to say like many of us
have likely heard and know the word

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intergenerational trauma and it's often
discussed when we discuss the health

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status or current situation of First
Nation matey and Inuit folks in Canada.

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And I think a term perhaps less known
that needs the same kind of airtime is

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the Indigenous intergenerational
resiliency and when you have a

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representative workforce and you work
towards the calls that have made been

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made to us as Canadians to increase the
number of aboriginal is what it said in

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the calls to action.

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Newer more commonly used term Indigenous
or being distinctions based with First

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Nation matey and Inuit is to when we
invite and have that resiliency in our

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workplaces,
it translates to the types of resiliency

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that we need in these times that have
been shared the economic hard times and

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every generation has its economic
struggles and needs to figure out how to

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adapt and live in a new way.

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And so that is the challenge before us,
I would say in these busy times when

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we're our plates are full,
are we taking the time to pause for

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reflection?

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Days like today are important that we
pause and we ask ourselves some hard

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questions.

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We ask ourselves some simple questions.

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We don't leave it with ourselves.

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We need to ask those of leaders and our
organizations as well.

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Those questions have to be collective.

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And so when you think of your workplace
and you think of the workforce that's a

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part of your organization, your site,
your facility, wherever you may be,

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just bring yourself to that space.

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And does that workplace reflect those you
serve?

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If not, what can be done?

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Do we know the Indigenous nations or the
race or ethnicity of that the workforce

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identifies as?

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Do they have an opportunity to identify
who they are and is it safe?

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And we're just talking about the global
impact and we know what kind of

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conversations are happening around
Indigenous rights, equity, diversity,

ea0861bf-999a-4619-bf8b-313df5547001-2
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inclusion,
and how much Canada needs to do better in

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light of that.

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And so is there other demographic
information that we may know about our

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workplace that will perhaps help us do
things in a better way,

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in a different way?

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Do the teams within the workplace,
do they have an opportunity to have

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discussions around values and shared
values and differences?

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Are we creating those spaces so that we
can excel,

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that we can bring all of us to the room,
all of us,

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all parts of ourselves to the workplace?

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Do they have opportunity to innovate and
to collaborate,

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or is that only for the top tier?

fcb9ea25-c08d-4ab9-8333-ee651e97451b-0
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Or does the whole workplace get to be
involved in that to bring their diverse

fcb9ea25-c08d-4ab9-8333-ee651e97451b-1
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perspectives?

0e79056b-cc5c-4bb3-b10b-500c0e9494e4-0
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Is their education and training available
in your organization to disrupt and

0e79056b-cc5c-4bb3-b10b-500c0e9494e4-1
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dismantle racism?

0d0a10a5-bae9-491c-9643-572ddc4209f1-0
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Because folks in the workplace who are
targets of racism, this is important.

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And so are there policies, practices,
or strategies to address racism or is it

9d748672-e00b-425b-b962-4285293219e1-1
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just a hope strategy?

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Have we reviewed,
responded or addressed the Truth and

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Reconciliation calls to Action?

d0ac1ab2-d73e-462b-8bd7-e7baa8e163be-0
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Those calls?

250588da-5cf7-4d4b-8815-c5c6325c8bcd-0
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That report was released 10 years ago.

a8e44239-0996-41ed-adaf-8ee563e89681-0
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How many of us can reflect back on the
pathway provided to the health system and

a8e44239-0996-41ed-adaf-8ee563e89681-1
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be proud of our response to those actions?

db087b35-0d9f-4c00-b2b8-2df24b4cfb4d-0
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How many of us can point to a few steps
and how many of us are saying we'll do

db087b35-0d9f-4c00-b2b8-2df24b4cfb4d-1
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better in the next 10 years?

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We have to.

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So these are the kinds of moments we need
to pause and reflect on.

aee64f2d-a0f9-4e53-89e7-97f0e72f7ced-0
00:08:50.240 --> 00:08:52.880
And do we monitor or track any of this
work?

adbe22e5-1bfb-4466-bd5a-728215c758b5-0
00:08:54.000 --> 00:08:58.200
Because we all know what measure,
what gets measured right, matters.

d49ad751-c5e7-44d9-bfb0-7acbb5f88568-0
00:08:58.920 --> 00:09:00.640
And so are we measuring this work?

a2c688be-0772-474b-8489-687e5ec3edc1-0
00:09:02.400 --> 00:09:03.720
Are we thinking about that?

400b2b4d-defc-4b45-aeda-38a7008eaaa1-0
00:09:04.440 --> 00:09:09.615
And just one more thing from an
Indigenous perspective,

400b2b4d-defc-4b45-aeda-38a7008eaaa1-1
00:09:09.615 --> 00:09:15.900
while I have a an audience,
just try to avoid putting every racial,

400b2b4d-defc-4b45-aeda-38a7008eaaa1-2
00:09:15.900 --> 00:09:19.320
ethnic and Indigenous group together.

884e9344-a0c8-456d-a718-2adffa3ea145-0
00:09:19.920 --> 00:09:26.160
Indigenous racism and the Indigenous
experience in Canada is not like that of

884e9344-a0c8-456d-a718-2adffa3ea145-1
00:09:26.160 --> 00:09:30.880
those who have immigrated and experienced
racism that way.

93376e29-86d9-4f11-94af-96dc8ce4e89f-0
00:09:31.400 --> 00:09:35.254
I'm not saying that that racism doesn't
exist, it does,

93376e29-86d9-4f11-94af-96dc8ce4e89f-1
00:09:35.254 --> 00:09:40.898
but we need to think about how we address
things As for Indigenous people only as

93376e29-86d9-4f11-94af-96dc8ce4e89f-2
00:09:40.898 --> 00:09:45.578
our responsibility as Canadians,
as written in the calls to action,

93376e29-86d9-4f11-94af-96dc8ce4e89f-3
00:09:45.578 --> 00:09:49.432
calls to justice,
the United Nations Declaration of the

93376e29-86d9-4f11-94af-96dc8ce4e89f-4
00:09:49.432 --> 00:09:51.360
Rights of Indigenous People.

ebce46a5-9be2-41a9-a793-f85dbcd8e234-0
00:09:52.680 --> 00:09:56.614
And so if I've overwhelmed you just now,
which is quite simple,

ebce46a5-9be2-41a9-a793-f85dbcd8e234-1
00:09:56.614 --> 00:10:01.040
we'll go to the next slide because those
are like, what are some ideas?

9b2b0b3f-f432-4d1a-a869-5ec7c6d5e2c4-0
00:10:01.040 --> 00:10:03.000
So OK, there's all this going on.

05d3d633-c9e3-4e5e-89fa-c5fbae4a8f15-0
00:10:03.000 --> 00:10:04.640
It's heavy, it's hard work.

92777c03-5500-40a6-bd49-4c2c4178b55c-0
00:10:05.080 --> 00:10:06.560
Our workplace is diverse.

6432c968-9ea3-4574-ba26-85e73df28e27-0
00:10:06.560 --> 00:10:08.000
We're finding out they're not diverse.

ff69f695-f800-4258-9f12-bc32357a6ab5-0
00:10:08.000 --> 00:10:09.400
How do we bring people in?

20d6dbe1-1080-4378-a48f-2a9174e2bc94-0
00:10:09.840 --> 00:10:12.760
And I'll tell you this,
there's not a just a one check mark way.

5d99b673-4dd6-43c1-bb24-8bc35eb92e70-0
00:10:12.760 --> 00:10:14.840
So we need to take a multi layered
approach.

732e1da6-e033-418f-8ed3-b284c571ce52-0
00:10:15.080 --> 00:10:17.780
We need to think of the interpersonal
level,

732e1da6-e033-418f-8ed3-b284c571ce52-1
00:10:17.780 --> 00:10:21.980
then we need to think of our
organizational and structural levels and

732e1da6-e033-418f-8ed3-b284c571ce52-2
00:10:21.980 --> 00:10:23.480
then our systemic levels.

dc2148a0-8398-4043-ba62-affad2118dbd-0
00:10:23.680 --> 00:10:26.680
And we need actions happening at all of
those levels.

fedc7fab-7888-403c-936d-bdbff1229f40-0
00:10:26.840 --> 00:10:30.960
And if you rely only on one,
the progress will be slow.

35285976-8294-433e-aaba-d963c3f4076f-0
00:10:30.960 --> 00:10:32.560
So we need to move at all levels.

70f78617-6532-49b7-a74c-cab897b27960-0
00:10:32.560 --> 00:10:36.177
Collectively,
we can do truth and reconciliation,

70f78617-6532-49b7-a74c-cab897b27960-1
00:10:36.177 --> 00:10:39.795
action planning,
There's a health system section,

70f78617-6532-49b7-a74c-cab897b27960-2
00:10:39.795 --> 00:10:43.051
focus on that,
think about what can be done,

70f78617-6532-49b7-a74c-cab897b27960-3
00:10:43.051 --> 00:10:47.320
implement Indigenous recruitment and
retention strategies.

19372322-6782-414b-be43-bd2a26dcd0ab-0
00:10:47.680 --> 00:10:52.748
The whole, this is probably an old word,
but like a whole pipeline of people who

19372322-6782-414b-be43-bd2a26dcd0ab-1
00:10:52.748 --> 00:10:55.814
are helpers,
who have Wellness and health in the

19372322-6782-414b-be43-bd2a26dcd0ab-2
00:10:55.814 --> 00:10:59.881
forefront of their mind,
who want to be a part of a workforce in

19372322-6782-414b-be43-bd2a26dcd0ab-3
00:10:59.881 --> 00:11:00.320
health.

91bdffa3-cd3e-4e2d-bc65-672f95079230-0
00:11:00.600 --> 00:11:03.766
So how are we,
how are we aligning and targeting those

91bdffa3-cd3e-4e2d-bc65-672f95079230-1
00:11:03.766 --> 00:11:04.400
strategies?

8d8ad7ce-22fa-40a9-a7ed-025f5dbe358e-0
00:11:05.000 --> 00:11:09.292
How are we making it safe for Indigenous
Canadians to be a part of the health

8d8ad7ce-22fa-40a9-a7ed-025f5dbe358e-1
00:11:09.292 --> 00:11:11.714
system,
the health system they access quite

8d8ad7ce-22fa-40a9-a7ed-025f5dbe358e-2
00:11:11.714 --> 00:11:12.319
frequently?

14a64d1c-6608-489d-9c4a-e21c4a77e20c-0
00:11:14.160 --> 00:11:15.800
We can have monitoring.

e198bbf8-7c17-4a8c-b08d-f533c47bab5b-0
00:11:15.800 --> 00:11:17.400
What are our targets for hiring?

18ae310c-d743-42b4-8ab1-603dba6bb9a9-0
00:11:17.400 --> 00:11:21.680
What are our targets for safety
initiatives, for Wellness strategies?

65029f4a-02e3-4c96-afbd-e07e892f6e74-0
00:11:21.680 --> 00:11:26.343
Do we have access to elders and
traditional ceremonies for for the

65029f4a-02e3-4c96-afbd-e07e892f6e74-1
00:11:26.343 --> 00:11:27.040
workforce?

0279cc09-0280-4ae6-a727-7f63fe449847-0
00:11:27.800 --> 00:11:31.280
Do we know what the racial climate is in
our organization?

cc8a138c-cea4-47e5-b1bf-f2226a88f8e1-0
00:11:31.280 --> 00:11:36.988
We can do surveys and find that
information out, have baselines, measure,

cc8a138c-cea4-47e5-b1bf-f2226a88f8e1-1
00:11:36.988 --> 00:11:38.840
monitor training, right?

f9974192-6378-480b-a3e0-3ac6b4f0795d-0
00:11:38.840 --> 00:11:40.200
What are we doing with that training?

ef22de82-5e33-4aa2-bedc-e527b807b42c-0
00:11:40.200 --> 00:11:41.920
How do we apply that knowledge?

fda81065-fbcf-4e2e-b033-7394fba956c7-0
00:11:42.920 --> 00:11:45.600
And of course,
we need accountability measures.

e1261817-8134-4002-a046-4bea09c5cfae-0
00:11:46.120 --> 00:11:50.811
There's no need moving forward if we're
not holding ourselves accountable in any

e1261817-8134-4002-a046-4bea09c5cfae-1
00:11:50.811 --> 00:11:53.360
of this,
including our work for resiliency.

77a2bfbf-0182-4085-bcae-94848e44a304-0
00:11:53.480 --> 00:11:54.200
Yeah, yeah, go ahead.

699eb9bf-300e-4206-afac-34833d3c60fd-0
00:11:56.200 --> 00:11:59.640
And so these words are Migwitch
Kinanaskumet now.

503e0436-eac6-467b-b953-9ffc7d18412f-0
00:11:59.640 --> 00:12:00.320
Mercy.

bfb951d2-838b-41e6-b6d5-e5f874f45592-0
00:12:00.320 --> 00:12:02.560
And thank you all meaning the same thing.

b5e44561-45c7-49f4-b897-28f3cc88cd6a-0
00:12:02.560 --> 00:12:07.630
So full of gratitude for the opportunity
to share and hopefully plant a,

b5e44561-45c7-49f4-b897-28f3cc88cd6a-1
00:12:07.630 --> 00:12:12.840
a seed or two, provoking thought,
reflection and most importantly, action.

c1d3125e-14f7-4c17-acd5-52bf04933218-0
00:12:13.040 --> 00:12:13.600
So thank you.

6a780713-652a-4d0e-94de-eb1577d7bcb7-0
00:12:21.910 --> 00:12:22.750
Thank you, Charlene.

9666d54d-f52a-4ea7-ae51-721f9d88bda2-0
00:12:22.750 --> 00:12:24.910
I think you've planted many seeds.

55775293-d50a-476a-8b4a-cb0932882422-0
00:12:25.950 --> 00:12:29.221
And I, we,
we are also full of gratitude for,

55775293-d50a-476a-8b4a-cb0932882422-1
00:12:29.221 --> 00:12:33.772
for your sharing and,
and what you think resiliency means as it

55775293-d50a-476a-8b4a-cb0932882422-2
00:12:33.772 --> 00:12:38.536
relates to the indigenous populations,
but also, as you mentioned,

55775293-d50a-476a-8b4a-cb0932882422-3
00:12:38.536 --> 00:12:40.029
to other communities.

ba3e218f-1e6a-4c97-aaa5-c6bf573674f9-0
00:12:41.040 --> 00:12:46.618
And I think part of the conversation we
have to have around resiliency is how

ba3e218f-1e6a-4c97-aaa5-c6bf573674f9-1
00:12:46.618 --> 00:12:52.267
that impacts outcomes and where there are
tailored interventions and strategic

ba3e218f-1e6a-4c97-aaa5-c6bf573674f9-2
00:12:52.267 --> 00:12:55.200
actions that help help elevate the whole.

caed96cb-b2b9-42fe-8193-7fc9f0ba469c-0
00:12:55.200 --> 00:13:00.440
So I appreciate it and I, I thank you,
Doctor Nowak, all over to you.

242ace7d-7e1e-47ca-a662-83d11db568ef-0
00:13:00.520 --> 00:13:04.720
Hard, hard to follow,
but would love to hear your thoughts.

9fd63e45-cf4b-4ff9-aa1d-1a0e50d9129e-0
00:13:05.760 --> 00:13:08.600
I know that you've done a lot of
traveling across the country.

b8ae7682-0b0b-425b-99ba-4f0e5a271563-0
00:13:08.600 --> 00:13:13.000
You've heard from many physicians,
clinicians and and other health

b8ae7682-0b0b-425b-99ba-4f0e5a271563-1
00:13:13.000 --> 00:13:13.920
professionals.

7c4c4f29-a052-42f2-9739-95666ea5f34c-0
00:13:14.200 --> 00:13:19.223
What are your thoughts on the challenges
you see in the workforce today and any

7c4c4f29-a052-42f2-9739-95666ea5f34c-1
00:13:19.223 --> 00:13:21.671
solutions,
any innovations and any key

7c4c4f29-a052-42f2-9739-95666ea5f34c-2
00:13:21.671 --> 00:13:24.560
considerations for the audience to take
away?

5010a23a-77f9-45ef-a618-dddea8542ed0-0
00:13:24.760 --> 00:13:26.844
Yeah,
I do want to ask any health professionals

5010a23a-77f9-45ef-a618-dddea8542ed0-1
00:13:26.844 --> 00:13:27.800
in the room right now.

36faa64e-eb79-4eab-9afd-191f9d0bcdbd-0
00:13:29.080 --> 00:13:29.920
I know there are a few of you.

77fbc27c-665f-44ef-be52-b3df38d0703c-0
00:13:29.920 --> 00:13:31.280
I met you at during the lunch time.

31fa6d45-36c9-487b-ace1-a8869408379c-0
00:13:31.760 --> 00:13:34.595
So around half and then health leaders,
health administrators,

31fa6d45-36c9-487b-ace1-a8869408379c-1
00:13:34.595 --> 00:13:36.440
other other folks involved in healthcare.

7f73fbd9-373b-4438-ba5f-4c790eff2460-0
00:13:36.440 --> 00:13:38.720
So a split, split room between the two.

96b27ea2-9970-4f4c-8534-9427ffd31cd6-0
00:13:39.040 --> 00:13:42.560
And can I do this by the we're allowed to
engage with the we are.

097b97db-a2dc-4ae8-ab4a-a1829c7e0054-0
00:13:42.840 --> 00:13:44.520
And then there's also an online audience.

ca34d415-931d-4d1c-8e01-2d6d47c3f6df-0
00:13:44.520 --> 00:13:47.440
So there we're 200 or so people online.

3cee7529-f4b2-4a62-ad90-734c4bc07c42-0
00:13:47.440 --> 00:13:50.240
So around I'll I'll narrate for the
online audience.

88ab6e13-7cb3-4cd7-8684-8a5065bb4492-0
00:13:50.240 --> 00:13:53.404
We have half a room of health
professionals and half a room of of other

88ab6e13-7cb3-4cd7-8684-8a5065bb4492-1
00:13:53.404 --> 00:13:54.240
healthcare leaders.

4debe559-1188-4d40-915f-f18b5a7bcafe-0
00:13:54.600 --> 00:13:58.402
And for the folks here in the room,
if you were going to share one word that

4debe559-1188-4d40-915f-f18b5a7bcafe-1
00:13:58.402 --> 00:14:01.167
describes the vibe check in healthcare
right now, what,

4debe559-1188-4d40-915f-f18b5a7bcafe-2
00:14:01.167 --> 00:14:05.118
what our healthcare system is like or
working in our healthcare system is like,

4debe559-1188-4d40-915f-f18b5a7bcafe-3
00:14:05.118 --> 00:14:06.600
what are some words you'd use?

afbf6d31-0bfc-4941-a3ae-9a48ad133b80-0
00:14:06.600 --> 00:14:07.280
Just shout it out.

973e8a41-19e6-4717-90a7-2188cb73e4fa-0
00:14:08.960 --> 00:14:09.720
Chaos.

d28f69b7-1d4f-4960-a5b5-fb953899346f-0
00:14:09.720 --> 00:14:09.920
Yeah.

3567f7d3-179c-43b6-837d-3836174d8773-0
00:14:09.920 --> 00:14:10.400
What else?

a58c6db3-db4d-499f-96cf-c2427aaa51c0-0
00:14:11.480 --> 00:14:11.920
Stress.

79babfa6-8c01-41d8-b0e4-55a3df023648-0
00:14:11.920 --> 00:14:12.680
Slow.

91593f88-a555-4508-865c-47580dbe2dda-0
00:14:13.640 --> 00:14:14.080
Exhaustion.

88958fb1-f91e-4312-aac1-b96910601d29-0
00:14:14.080 --> 00:14:14.560
Exhaustion.

5db210a3-c8e0-43a4-b4eb-005c824c9af4-0
00:14:14.880 --> 00:14:15.280
What else?

e7a778d9-18c9-483b-92fb-f074a411060a-0
00:14:15.280 --> 00:14:15.560
Frantic.

95b44581-b950-4a8e-af79-0bfcc4b6ed44-0
00:14:16.400 --> 00:14:17.040
Frantic.

5bef2dcd-cd61-467a-898a-e62c4919c2f8-0
00:14:17.040 --> 00:14:17.800
Megan, you had one.

565c0d0e-dd54-478a-8c42-35b0a4eb105a-0
00:14:18.680 --> 00:14:19.560
Exhausting.

d81f8720-a781-43a4-9d24-19802684779d-0
00:14:19.560 --> 00:14:21.800
Let's get one from that side over over
there, too.

f5fbbc6d-c28c-4b2f-baa9-1c22a6fdd6c8-0
00:14:24.480 --> 00:14:25.200
Overwhelming.

03844357-8d92-4ad3-a971-78021397d5d6-0
00:14:25.200 --> 00:14:25.640
Overwhelming.

970e1246-c28f-47d3-bd53-5155c7b05013-0
00:14:25.640 --> 00:14:25.920
Yeah.

9d593f25-87b2-45e5-9ea1-7145597f93ec-0
00:14:26.160 --> 00:14:32.931
So I want to share with you one concept
that's been important for me as former

9d593f25-87b2-45e5-9ea1-7145597f93ec-1
00:14:32.931 --> 00:14:37.560
OMA President, and that's joy and work,
Joy and work.

4202af0f-7819-46e3-8d8f-e2d67a56e76c-0
00:14:37.560 --> 00:14:41.662
And I'll share with you 3 ideas around
joy and work that I picked up during my

4202af0f-7819-46e3-8d8f-e2d67a56e76c-1
00:14:41.662 --> 00:14:44.000
year as under Medical Association
president.

0ab25103-2403-4ded-bea6-0934829ad2d6-0
00:14:46.400 --> 00:14:51.325
The first one is that health
professionals are already highly

0ab25103-2403-4ded-bea6-0934829ad2d6-1
00:14:51.325 --> 00:14:52.120
resilient.

a0b4f1fd-0807-405d-b4cc-b3affc11f13f-0
00:14:52.120 --> 00:14:56.470
People who look at doctors, nurses,
other people working in healthcare,

a0b4f1fd-0807-405d-b4cc-b3affc11f13f-1
00:14:56.470 --> 00:14:57.920
we're already resilient.

0169f6eb-13f2-4412-860a-d18d11aad413-0
00:14:58.040 --> 00:15:01.600
It's the system that's stressed, strained.

f00a9f09-01ab-48ec-82cd-0d0c5a941a12-0
00:15:02.120 --> 00:15:05.412
I, you know, I,
I make a point to stand at the front of

f00a9f09-01ab-48ec-82cd-0d0c5a941a12-1
00:15:05.412 --> 00:15:10.175
events when I was only president and just
meet people and hear their stories and

f00a9f09-01ab-48ec-82cd-0d0c5a941a12-2
00:15:10.175 --> 00:15:14.880
ask that question of what's one word that
you would use to describe healthcare.

7faad6bc-5d0f-4e27-a1e6-3db8077258c3-0
00:15:15.240 --> 00:15:17.200
And people share those words.

e4f06c75-294d-45fa-bdfd-49584f165c85-0
00:15:17.520 --> 00:15:22.000
They share crisis,
one person said yesterday.

801149f4-98d4-410d-8f0e-8992330ea0a3-0
00:15:22.680 --> 00:15:27.520
Sewell crushing to be working in
healthcare right now.

35f6222a-f3e5-4882-916a-5dce5b03424b-0
00:15:27.760 --> 00:15:31.800
So turnover is up, morale is down.

46d4e642-c0d2-48bd-8b4f-9fd62bac82f5-0
00:15:32.120 --> 00:15:36.502
We know that around half of doctors are
thinking of scaling back or retiring in

46d4e642-c0d2-48bd-8b4f-9fd62bac82f5-1
00:15:36.502 --> 00:15:39.624
in the next few years,
not because their retirement age,

46d4e642-c0d2-48bd-8b4f-9fd62bac82f5-2
00:15:39.624 --> 00:15:40.720
but because of that.

4218943d-6a8a-47bd-9530-d31b12673919-0
00:15:41.000 --> 00:15:45.779
We know that around half of nurses are
thinking of switching careers the next 12

4218943d-6a8a-47bd-9530-d31b12673919-1
00:15:45.779 --> 00:15:46.960
months or so, right?

ff278b50-01ac-4769-9b3f-57916218fa7b-0
00:15:46.960 --> 00:15:49.234
So we have a workforce that's under a lot
of pressure,

ff278b50-01ac-4769-9b3f-57916218fa7b-1
00:15:49.234 --> 00:15:50.640
not because they're not resilient.

40a33bd8-95da-46a1-9c76-3098f6697bd0-0
00:15:50.880 --> 00:15:53.840
So that's the idea #1 around joy and work.

d5ba9c6d-f70c-4174-8acf-52ee2de796b5-0
00:15:55.320 --> 00:16:02.196
Idea number 2 is that there are ways to
talk about joy and work and reframe

d5ba9c6d-f70c-4174-8acf-52ee2de796b5-1
00:16:02.196 --> 00:16:02.920
burnout.

389a8218-cac3-4a7a-a845-f6cfb4da278d-0
00:16:04.200 --> 00:16:06.977
Classically,
this conversation will be around burnout,

389a8218-cac3-4a7a-a845-f6cfb4da278d-1
00:16:06.977 --> 00:16:07.280
right?

93fa98ff-435e-4d7e-9261-c79b3534fd07-0
00:16:07.280 --> 00:16:10.800
But burnout is a very individual level
idea.

f6f7fabb-7bb1-4ff0-935e-2ba4d6a62b7e-0
00:16:11.560 --> 00:16:16.761
Join work means how do we bring back
those things that make healthcare

f6f7fabb-7bb1-4ff0-935e-2ba4d6a62b7e-1
00:16:16.761 --> 00:16:18.960
meaningful, joyful for people?

a3b24f21-15de-40c6-890f-8e5a755daaf6-0
00:16:19.320 --> 00:16:21.560
How do we ask people what what matters to
you?

43c466f3-2528-4752-a6e5-52fc6e26b3a5-0
00:16:22.320 --> 00:16:26.640
How do we make sure to talk about the the
pebbles in people's shoes, right?

e187ff79-730f-4166-9485-c16cc405607b-0
00:16:26.640 --> 00:16:29.120
The things that get in the way of what
matters to them.

165e6948-14cf-403c-a258-5f975493346d-0
00:16:30.000 --> 00:16:34.867
And the Institute for Healthcare
improvement has a phenomenal framework on

165e6948-14cf-403c-a258-5f975493346d-1
00:16:34.867 --> 00:16:36.360
asking those questions.

2dc1051f-b452-4787-a829-cca07a46f9d2-0
00:16:36.360 --> 00:16:37.240
I'm a big fan of it.

65a3e149-5dd1-4f10-8ae6-c550b89ac135-0
00:16:37.240 --> 00:16:42.997
We, you could look online, there's a,
there's actually a guidebook on how do

65a3e149-5dd1-4f10-8ae6-c550b89ac135-1
00:16:42.997 --> 00:16:48.978
you look at for all levels of health
professionals across the frontline, staff,

65a3e149-5dd1-4f10-8ae6-c550b89ac135-2
00:16:48.978 --> 00:16:53.239
managers and senior leaders to executives
in healthcare.

b8e7ca2c-0ccd-4cc3-864d-a75dcd6c98f5-0
00:16:53.440 --> 00:16:58.095
How do you have conversations around joy
and work starting with and what matters

b8e7ca2c-0ccd-4cc3-864d-a75dcd6c98f5-1
00:16:58.095 --> 00:17:00.280
for you when you're having a good day?

c8abf971-0198-4cf2-8b02-092e638e8212-0
00:17:00.320 --> 00:17:04.600
What does that look like when we're as
our at our best as a team?

f71117be-9338-4423-ad2d-db27559b3331-0
00:17:05.200 --> 00:17:05.920
What does that look like?

848a81ee-3766-478e-9cd4-59d1b6210118-0
00:17:05.920 --> 00:17:06.480
Who's doing what?

e26d9493-c1fd-40ba-a8f0-b67b143b7907-0
00:17:06.720 --> 00:17:08.720
How are we sharing and the responsibility?

33c4d6e0-38b1-455d-94b1-a9ded922d57e-0
00:17:09.560 --> 00:17:11.200
What are the pebbles in our shoes?

c64e73b8-59cd-490b-9766-3790ce9ce972-0
00:17:11.200 --> 00:17:12.800
How do we take those pebbles away?

c4fa7001-09b3-47b1-8923-4f4ed0f6b3d0-0
00:17:13.440 --> 00:17:17.893
And then how should we prioritize things
and giving that conversation around

c4fa7001-09b3-47b1-8923-4f4ed0f6b3d0-1
00:17:17.893 --> 00:17:22.288
prioritization over to the health
professionals and other team members that

c4fa7001-09b3-47b1-8923-4f4ed0f6b3d0-2
00:17:22.288 --> 00:17:23.039
we work with.

325579ec-71ac-426e-9fc4-51d67130ce18-0
00:17:23.600 --> 00:17:28.080
There's a way to bring back joy and work
across all levels of healthcare.

09a2ee08-60a8-4a79-9a92-05efa45c93ff-0
00:17:28.520 --> 00:17:29.840
So that's message number 2.

3ad37b96-5ac1-4f90-a8a2-7dc12ddd0f71-0
00:17:29.840 --> 00:17:32.360
Message number one is that health
professionals are resilient.

8bb30c90-55a5-4413-a128-c36d88f3db31-0
00:17:32.600 --> 00:17:34.400
This is not a conversation about burnout.

bc472df0-35a4-4864-8711-83fb0504606d-0
00:17:34.880 --> 00:17:38.960
Message number 2 is that there are ways
to bring back joy and work.

f16fbfc9-7168-459a-bbce-195349c42537-0
00:17:39.240 --> 00:17:43.832
And message number 3 is that they're
actually very specific systems, levels,

f16fbfc9-7168-459a-bbce-195349c42537-1
00:17:43.832 --> 00:17:45.920
ideas that bring back joy and work.

cf56a4d4-cfcc-4c65-810f-5c68a64be39d-0
00:17:46.280 --> 00:17:51.250
So a few years ago at the Ontario Medical
Association,

cf56a4d4-cfcc-4c65-810f-5c68a64be39d-1
00:17:51.250 --> 00:17:58.028
we asked around 3000 doctors for a sample
of what are some systems levels,

cf56a4d4-cfcc-4c65-810f-5c68a64be39d-2
00:17:58.028 --> 00:18:03.360
things that would bring back joy to,
to healthcare, right?

baaa3484-cbb4-45f8-b78d-44267fe3e706-0
00:18:03.360 --> 00:18:05.260
And they,
they actually shared with us some of

baaa3484-cbb4-45f8-b78d-44267fe3e706-1
00:18:05.260 --> 00:18:07.120
these things that we're working on right
now.

3e04eb73-b285-45ea-816d-c344b4bfe73d-0
00:18:07.120 --> 00:18:08.560
And many of you will be working on.

7b9f100c-002a-454e-921b-c1f4918ebf35-0
00:18:08.560 --> 00:18:11.601
I see, you know, Taylor or in the,
in the audience,

7b9f100c-002a-454e-921b-c1f4918ebf35-1
00:18:11.601 --> 00:18:15.638
the sense of community that, that we're,
we're bringing as you know,

7b9f100c-002a-454e-921b-c1f4918ebf35-2
00:18:15.638 --> 00:18:18.680
alumni at IHPME and other places and in
healthcare.

161c89d0-aa85-439e-8f39-4f81e44ac4ed-0
00:18:18.960 --> 00:18:22.232
But the,
the five that they shared with us were

161c89d0-aa85-439e-8f39-4f81e44ac4ed-1
00:18:22.232 --> 00:18:24.960
one around documentation and admin work.

e06214db-9e62-430c-a591-ffa05ecd9acf-0
00:18:25.480 --> 00:18:28.236
Let your health professionals be health
professionals,

e06214db-9e62-430c-a591-ffa05ecd9acf-1
00:18:28.236 --> 00:18:29.640
let your doctors be doctors.

3cf11d34-9107-4789-a0f9-835764a6e7e4-0
00:18:29.960 --> 00:18:33.342
That was #1 all right,
so people want to do the work and are

3cf11d34-9107-4789-a0f9-835764a6e7e4-1
00:18:33.342 --> 00:18:37.168
faced with so many barriers and,
and tasks that they're doing in the

3cf11d34-9107-4789-a0f9-835764a6e7e4-2
00:18:37.168 --> 00:18:40.827
evenings and on weekends that's cutting
into their recovery time,

3cf11d34-9107-4789-a0f9-835764a6e7e4-3
00:18:40.827 --> 00:18:43.600
as we heard in the morning how important
that is.

73013dcc-1dfc-49ff-aae2-98c3f4e44da1-0
00:18:44.360 --> 00:18:48.218
Number 2,
let's make sure to give people fair and

73013dcc-1dfc-49ff-aae2-98c3f4e44da1-1
00:18:48.218 --> 00:18:52.000
equitable compensation for all work done,
right?

490ecc1e-a5e4-4b1f-91ab-3f833d07d8f3-0
00:18:52.000 --> 00:18:57.415
There's there's no world where we should
be undervaluing the important work that

490ecc1e-a5e4-4b1f-91ab-3f833d07d8f3-1
00:18:57.415 --> 00:19:02.095
goes into caring for human beings,
whereas that's what we're doing in

490ecc1e-a5e4-4b1f-91ab-3f833d07d8f3-2
00:19:02.095 --> 00:19:06.909
healthcare across many levels,
across many professions #3 increase work

490ecc1e-a5e4-4b1f-91ab-3f833d07d8f3-3
00:19:06.909 --> 00:19:10.520
life balance by making organizational
policy changes.

59ad872e-64ab-4c00-8556-8efb3f1443ac-0
00:19:11.240 --> 00:19:15.531
And that means, you know, down with this,
this outdated culture of medicine where

59ad872e-64ab-4c00-8556-8efb3f1443ac-1
00:19:15.531 --> 00:19:18.200
we have to be everything to everyone at
all times.

5b3b71db-ac7d-41d8-924e-8f12b0172e16-0
00:19:18.800 --> 00:19:21.908
And he has to, you know,
maybe part time arrangements,

5b3b71db-ac7d-41d8-924e-8f12b0172e16-1
00:19:21.908 --> 00:19:25.300
maybe work sharing,
maybe these kind of flexible things for

5b3b71db-ac7d-41d8-924e-8f12b0172e16-2
00:19:25.300 --> 00:19:26.600
frontline team members.

7f8b7beb-af62-4ba6-8366-680723557ac2-0
00:19:26.600 --> 00:19:29.120
And then also for for leaders.

87526824-6f04-4152-a84c-11a4f2b4226d-0
00:19:29.520 --> 00:19:32.732
I was,
I was talking with one group here where

87526824-6f04-4152-a84c-11a4f2b4226d-1
00:19:32.732 --> 00:19:38.270
we were thinking of what's a world where
we have for leaders A6 month sabbatical

87526824-6f04-4152-a84c-11a4f2b4226d-2
00:19:38.270 --> 00:19:42.440
every five years and we cross cover
during that time, right?

4b8aada4-b67b-4f35-9234-0e06ada27bfe-0
00:19:42.440 --> 00:19:44.160
Is, are there organizations that do that?

4a1fff77-e619-4bb8-af30-e49fcd12f883-0
00:19:44.440 --> 00:19:45.040
Why not, right.

65f76140-83bd-4a1d-9fc6-19fd58c2fdb2-0
00:19:45.320 --> 00:19:46.440
That would be magical.

9aa6f41a-3762-42e4-ad54-ab8de3ab74c2-0
00:19:46.880 --> 00:19:53.049
And imagine the benefit to our workforce
if we did that #4 promote the seamless

9aa6f41a-3762-42e4-ad54-ab8de3ab74c2-1
00:19:53.049 --> 00:19:57.600
integration of digital into health
professional workflows.

c1377276-3691-4b7b-9a20-f60adf693ef0-0
00:19:58.240 --> 00:20:00.706
Right now,
digital is seen as this thing that adds

c1377276-3691-4b7b-9a20-f60adf693ef0-1
00:20:00.706 --> 00:20:01.480
to our workload.

c6b928f4-6fcc-4487-83d4-6d90b7069df0-0
00:20:01.880 --> 00:20:02.760
That's changing.

23ddebbf-9a95-4781-bdca-103b7420f325-0
00:20:02.760 --> 00:20:06.960
We're changing culture with AI Scribe,
AI tools, these sorts of things.

dd1f73f8-f4b0-4e7d-b175-e9f915981e17-0
00:20:07.400 --> 00:20:08.520
That's that takes work.

b257d946-4629-4591-8b5b-a454ea6f7fe3-0
00:20:08.880 --> 00:20:13.563
And it's about concerted efforts around
how does this digital piece actually

b257d946-4629-4591-8b5b-a454ea6f7fe3-1
00:20:13.563 --> 00:20:17.760
improve the joy and work of our health
professionals like AI Scribe.

9d124352-5938-4c7a-9cf0-a190480b6309-0
00:20:18.000 --> 00:20:23.056
The early studies we have show that it
cuts down 3 or 4 hours of documentation

9d124352-5938-4c7a-9cf0-a190480b6309-1
00:20:23.056 --> 00:20:24.720
time for doctors per week.

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-0
00:20:25.600 --> 00:20:29.916
And that means they're spending less time
in the evenings and weekends during

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-1
00:20:29.916 --> 00:20:32.351
documentation and the stuff that,
you know,

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-2
00:20:32.351 --> 00:20:36.225
we don't want to be doing and more time
not just caring for patients,

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-3
00:20:36.225 --> 00:20:38.992
but back with our families and during the
things,

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-4
00:20:38.992 --> 00:20:43.309
the recovery time that we actually need
#5 provide institutional supports and

73ad0d3f-6bdb-46f2-a959-36e6d52b1c83-5
00:20:43.309 --> 00:20:45.800
culture around health professional
Wellness.

712fb058-e20a-47b2-89be-e59a787b1024-0
00:20:46.240 --> 00:20:48.857
And that's,
that's where some of those individual

712fb058-e20a-47b2-89be-e59a787b1024-1
00:20:48.857 --> 00:20:52.627
level pieces come into play,
where we classically think about burn out,

712fb058-e20a-47b2-89be-e59a787b1024-2
00:20:52.627 --> 00:20:55.506
the, you know,
the mental health supports the cultural

712fb058-e20a-47b2-89be-e59a787b1024-3
00:20:55.506 --> 00:20:59.800
pieces of taking time off and recovering,
having coaching team members and so on.

ba158d9a-59f6-4499-b6ee-58c5db4d569a-0
00:21:00.160 --> 00:21:01.640
So that's my message for today.

1c7083bf-47dc-432a-8b39-3ad1961f1c65-0
00:21:01.880 --> 00:21:05.399
One concept that served me so well as
only president,

1c7083bf-47dc-432a-8b39-3ad1961f1c65-1
00:21:05.399 --> 00:21:10.874
which is joy in work and doing everything,
advocating for for everything with a joy

1c7083bf-47dc-432a-8b39-3ad1961f1c65-2
00:21:10.874 --> 00:21:12.960
and work lens for our workforce.

6c2649f9-bf3e-40a6-aefc-fbe0b9c8f717-0
00:21:14.280 --> 00:21:15.120
And three ideas.

af43f393-1013-4154-bb17-65331abdc50d-0
00:21:15.120 --> 00:21:17.756
One,
our health workforce is intrinsically

af43f393-1013-4154-bb17-65331abdc50d-1
00:21:17.756 --> 00:21:21.374
some of the most resilient people I've
ever met, for sure,

af43f393-1013-4154-bb17-65331abdc50d-2
00:21:21.374 --> 00:21:23.520
including many of you in this room.

8e1d49af-9def-46ba-9615-30ac2a5a0434-0
00:21:24.200 --> 00:21:26.080
2, there's a way to do this.

f67123d0-efda-4c9f-beb7-c27335712561-0
00:21:26.280 --> 00:21:28.520
The joy and work framework is one of
those ideas how?

a0c9e325-f2a9-40c1-8fb8-21bd8fd53093-0
00:21:28.880 --> 00:21:31.810
And three,
there are specific systems level

a0c9e325-f2a9-40c1-8fb8-21bd8fd53093-1
00:21:31.810 --> 00:21:37.271
solutions that we can get to and advocate
for to make healthcare caring for human

a0c9e325-f2a9-40c1-8fb8-21bd8fd53093-2
00:21:37.271 --> 00:21:41.800
beings what it should be,
one of the most joyful professions in the

a0c9e325-f2a9-40c1-8fb8-21bd8fd53093-3
00:21:41.800 --> 00:21:42.200
world.

ba61d51b-f6c5-4840-861a-ae89de055cf4-0
00:21:42.480 --> 00:21:43.040
Thanks very much.

25a34c38-e93a-4c5a-abb8-73003beaf5ce-0
00:21:48.160 --> 00:21:48.680
Thank you.

fe0cef0e-2c38-4fb1-bb2a-2baddd8fafad-0
00:21:48.680 --> 00:21:49.600
Thank you, Doctor Novak.

18e08a93-c919-49cd-b718-2a61aec7b42d-0
00:21:49.600 --> 00:21:53.210
I,
I do want to come back a bit to the how

18e08a93-c919-49cd-b718-2a61aec7b42d-1
00:21:53.210 --> 00:21:57.240
because I, it's,
it's hard not to see barriers.

4cedf88f-3a19-4316-a0c7-4158e3585bb4-0
00:21:57.360 --> 00:22:02.360
And I think part of what we need to
discuss is, is how do we start?

3082389d-940b-47b0-8c03-55353225d978-0
00:22:02.440 --> 00:22:09.480
Where do we start despite some of the
constraints that we operate within.

2be1c394-e7c9-4a1d-a81b-8be4e29dd18f-0
00:22:09.480 --> 00:22:12.560
So we'll come back to you,
Doctor David Price.

e9b730db-fd14-4c43-9729-0343ac4c070c-0
00:22:13.120 --> 00:22:14.800
Welcome to the conversation.

e89f1807-4e45-46a5-8ce6-0c85f65e9e3e-0
00:22:15.080 --> 00:22:18.851
Would also love to hear your thoughts on
specific challenges,

e89f1807-4e45-46a5-8ce6-0c85f65e9e3e-1
00:22:18.851 --> 00:22:22.440
solutions and and key considerations for
for the audience.

453fdf44-287c-4647-a128-8eed896744e3-0
00:22:23.840 --> 00:22:26.900
Thanks, Michelle,
and thanks for inviting me to be part of

453fdf44-287c-4647-a128-8eed896744e3-1
00:22:26.900 --> 00:22:27.160
this.

8e78f6b3-d798-4b4f-bf01-0dfc802e3feb-0
00:22:27.160 --> 00:22:30.560
And hello to those of you on the West
Coast.

ec2ecb07-890c-4d4d-8fa6-a55e4d127d9d-0
00:22:30.560 --> 00:22:31.080
Good morning.

1f4d72cd-6686-471d-9494-684fff9cc853-0
00:22:31.080 --> 00:22:36.080
And for those of you who are on the East
Coast, good afternoon Bona Premadzi.

dc90fe89-b6cc-4cdc-8ab2-52f1b4c8ebc9-0
00:22:36.840 --> 00:22:38.360
I'm certainly delighted to be here.

c0de6e4c-7025-4ef0-97cf-a8f1ded8cf4f-0
00:22:38.360 --> 00:22:43.526
I'm currently on the unseated in
traditional territories of the Musqueam

c0de6e4c-7025-4ef0-97cf-a8f1ded8cf4f-1
00:22:43.526 --> 00:22:48.692
and our SFU campuses are on a number of
First Nations Co Salish peoples,

c0de6e4c-7025-4ef0-97cf-a8f1ded8cf4f-2
00:22:48.692 --> 00:22:52.726
including the Cat Sea, the Cakewat,
Coquitlam, Squamish,

c0de6e4c-7025-4ef0-97cf-a8f1ded8cf4f-3
00:22:52.726 --> 00:22:54.920
Sleigh with Tooth and Suwaston.

4202bd2c-e924-4abd-b5e1-e904afde909e-0
00:22:54.920 --> 00:22:59.741
And I think that just illustrates the
richness of the,

4202bd2c-e924-4abd-b5e1-e904afde909e-1
00:22:59.741 --> 00:23:06.492
the culture that's within easy driving
distance of of our our Lower mainland

4202bd2c-e924-4abd-b5e1-e904afde909e-2
00:23:06.492 --> 00:23:07.720
campuses here.

c03794f9-a371-402d-b645-d23bd323aa5d-0
00:23:08.440 --> 00:23:13.129
So I wanted to just maybe start with a
couple of background facts that I think

c03794f9-a371-402d-b645-d23bd323aa5d-1
00:23:13.129 --> 00:23:15.800
will inform where I'm going to go with
this.

f6642b76-7a6f-4fbe-9953-4afa0d35078c-0
00:23:15.800 --> 00:23:19.625
And I'm going to,
I'm going to address a little bit more

f6642b76-7a6f-4fbe-9953-4afa0d35078c-1
00:23:19.625 --> 00:23:23.720
the education of our future workforce
given my current role.

3bd1a0a4-c51c-47fd-86b6-704ea9722f5c-0
00:23:24.520 --> 00:23:27.440
But I think it's important just to sort
of do a quick level set.

95e94d3b-fd81-4748-aa56-e3a63987193b-0
00:23:27.440 --> 00:23:31.596
And you've all heard that six and a half
million Canadians are without access to a

95e94d3b-fd81-4748-aa56-e3a63987193b-1
00:23:31.596 --> 00:23:33.800
family doctor or primary care
practitioner.

f07b4da8-5d3f-4451-b65d-da68244b8396-0
00:23:34.360 --> 00:23:38.365
And really what's happened in Canada is
we've developed a four tier healthcare

f07b4da8-5d3f-4451-b65d-da68244b8396-1
00:23:38.365 --> 00:23:38.720
system.

22db9b03-49e4-4b93-96d5-523d287bcd4b-0
00:23:38.720 --> 00:23:43.546
So forget the two tier system that we've
keep hearing about from our politicians

22db9b03-49e4-4b93-96d5-523d287bcd4b-1
00:23:43.546 --> 00:23:44.560
that's long gone.

cec80d1c-be75-41a8-93b0-2202d88eab4d-0
00:23:44.880 --> 00:23:46.880
We've got a four tier system here in
Canada.

637e65bb-7653-4721-b0d3-1551741b59b1-0
00:23:46.880 --> 00:23:51.640
We've got those that can afford private
care, and that's a very small percentage.

74c9b70e-742a-4ab1-89f7-e0089db12521-0
00:23:51.680 --> 00:23:56.960
Admittedly, it's probably less than .1%,
but it's still not an insignificant

74c9b70e-742a-4ab1-89f7-e0089db12521-1
00:23:56.960 --> 00:23:57.440
number.

fce27a65-f4e4-4352-b86e-46f99dacf02b-0
00:23:58.040 --> 00:24:03.000
We have 15 to 20% of our population that
have absolutely no access to primary care.

9ff95151-815e-47c2-ad86-3f3973c2b671-0
00:24:03.800 --> 00:24:09.605
We've got for sure about 50% that have
access to a fee for service practice,

9ff95151-815e-47c2-ad86-3f3973c2b671-1
00:24:09.605 --> 00:24:13.752
so a single practitioner working in his
or her office,

9ff95151-815e-47c2-ad86-3f3973c2b671-2
00:24:13.752 --> 00:24:18.880
often with another like practitioner,
but definitely not in a team.

6531e17f-17a5-4404-99da-81f16fc6cfc7-0
00:24:18.880 --> 00:24:22.640
And perhaps 30% of the population are
part of the team.

9940e641-2d2b-47ad-a2a6-d98e1188865a-0
00:24:22.640 --> 00:24:26.560
And I'm going to come back to that,
but I think it's an important concept.

89af7d48-d9f7-4d4c-8356-0bebf4d6e731-0
00:24:27.080 --> 00:24:31.686
But if you take that six and a half
million Canadians and say that the

89af7d48-d9f7-4d4c-8356-0bebf4d6e731-1
00:24:31.686 --> 00:24:36.812
average family doctor looks after about
1200 patients each means we need today

89af7d48-d9f7-4d4c-8356-0bebf4d6e731-2
00:24:36.812 --> 00:24:41.484
another 5500 family doctors in this
province or a combination of family

89af7d48-d9f7-4d4c-8356-0bebf4d6e731-3
00:24:41.484 --> 00:24:44.079
doctors, nurse practitioners and others.

31946893-0261-45ee-b624-93fb3bad53a0-0
00:24:44.080 --> 00:24:50.040
And I've given a bit of a generous number
for the number of patients at 1200.

0d9e0af4-4aaa-4000-91b6-0b8b6ba79ce5-0
00:24:50.040 --> 00:24:54.872
It's recent studies are showing that the
numbers that the average doctor is

0d9e0af4-4aaa-4000-91b6-0b8b6ba79ce5-1
00:24:54.872 --> 00:24:57.480
looking after is probably closer to 1000.

718cd788-b281-45c9-a5c3-9aaf206a3e98-0
00:24:57.480 --> 00:25:03.038
And that's in part for some of the
reasons that Dominic outlined in sort of

718cd788-b281-45c9-a5c3-9aaf206a3e98-1
00:25:03.038 --> 00:25:07.720
the shared work part time doing other
things to balance it out.

6743ae99-fae2-4f42-a7b2-9fa77b082d19-0
00:25:07.720 --> 00:25:12.353
But it still means that we're going to
need a a large number of of healthcare

6743ae99-fae2-4f42-a7b2-9fa77b082d19-1
00:25:12.353 --> 00:25:17.045
professionals, primary care professionals,
family doctors to meet the needs of

6743ae99-fae2-4f42-a7b2-9fa77b082d19-2
00:25:17.045 --> 00:25:17.640
Canadians.

da4639a0-6793-410f-81ef-32e1cbf5b2df-0
00:25:18.120 --> 00:25:23.028
And a recent study from the Conference
Board of Canada showed that the average

da4639a0-6793-410f-81ef-32e1cbf5b2df-1
00:25:23.028 --> 00:25:28.000
age of family physicians was about 52 if
you're a male and 47 if you're female.

9c1323b7-8fba-48cf-86d1-f9d78d29c712-0
00:25:28.000 --> 00:25:31.320
And sort of this is divided 5050 in
Canada now.

0bba9aa5-9c55-41cf-b5a6-ba597e391722-0
00:25:31.680 --> 00:25:35.784
And what that means is as we're seeing
the number of women,

0bba9aa5-9c55-41cf-b5a6-ba597e391722-1
00:25:35.784 --> 00:25:41.188
the the percentage will change with time
because certainly we've been seeing a

0bba9aa5-9c55-41cf-b5a6-ba597e391722-2
00:25:41.188 --> 00:25:46.728
much higher percentage of women in the
workforce in the family medicine realm in

0bba9aa5-9c55-41cf-b5a6-ba597e391722-3
00:25:46.728 --> 00:25:47.960
in recent decades.

08ee030f-8596-4f2b-8f5c-afe163a2ea3b-0
00:25:48.440 --> 00:25:53.655
I think it's worth notice noting though,
that 31% of our family physician

08ee030f-8596-4f2b-8f5c-afe163a2ea3b-1
00:25:53.655 --> 00:25:58.800
workforce in this country are
internationally trained medical graduates.

24dfe800-560c-4e95-86d1-57c67d2d6170-0
00:25:59.800 --> 00:26:04.383
Now, maybe with the Trump bump,
we'll see a few more folks come N,

24dfe800-560c-4e95-86d1-57c67d2d6170-1
00:26:04.383 --> 00:26:09.514
but it's not so easy to uproot your
family and change your family practice

24dfe800-560c-4e95-86d1-57c67d2d6170-2
00:26:09.514 --> 00:26:12.319
and move to a completely different world.

8881ccbe-0333-447a-b8fd-05e4531fcfc3-0
00:26:12.880 --> 00:26:17.720
And I think one of the things we've all
started to understand about family

8881ccbe-0333-447a-b8fd-05e4531fcfc3-1
00:26:17.720 --> 00:26:22.882
medicine is it's so context specific in
terms of the community and the cultures

8881ccbe-0333-447a-b8fd-05e4531fcfc3-2
00:26:22.882 --> 00:26:27.658
that you're working within that it's one
thing to take a surgeon who is a

8881ccbe-0333-447a-b8fd-05e4531fcfc3-3
00:26:27.658 --> 00:26:32.240
specialist in his or her field and move
it to a different environment.

781f9d9b-35e0-4fe3-8eb0-13650244dc0f-0
00:26:32.240 --> 00:26:36.528
It's much more difficult for a family
physician to do so and really be

781f9d9b-35e0-4fe3-8eb0-13650244dc0f-1
00:26:36.528 --> 00:26:38.280
effective in their community.

6354dabe-b8fc-461f-a1fa-8c9fab997733-0
00:26:39.120 --> 00:26:43.298
And Charlene,
it's certainly it's evident from that

6354dabe-b8fc-461f-a1fa-8c9fab997733-1
00:26:43.298 --> 00:26:48.200
your your talk as to why you are in the
position you are in.

c5d70bba-e8c1-4150-87af-4e8a25fb756e-0
00:26:49.400 --> 00:26:53.486
I wanted to just reflect a couple
statistics and then pull that back into

c5d70bba-e8c1-4150-87af-4e8a25fb756e-1
00:26:53.486 --> 00:26:55.640
what we're going to do at Simon Fraser.

cd8d2eef-29da-4b29-b5d2-58fc3293917d-0
00:26:56.120 --> 00:27:01.114
5% of the Canadian population is First
Nations are Indigenous and those that

cd8d2eef-29da-4b29-b5d2-58fc3293917d-1
00:27:01.114 --> 00:27:06.173
population has identified that they would
really prefer to have a significant

cd8d2eef-29da-4b29-b5d2-58fc3293917d-2
00:27:06.173 --> 00:27:10.000
amount of their care provided by First
Nations physicians.

5bb129a3-dc7c-485b-a71d-5257526c6195-0
00:27:10.360 --> 00:27:14.982
And so if we say there's approximately
100,000 physicians in Canada,

5bb129a3-dc7c-485b-a71d-5257526c6195-1
00:27:14.982 --> 00:27:20.341
that means that if there should be about
5000 Indigenous physicians across this

5bb129a3-dc7c-485b-a71d-5257526c6195-2
00:27:20.341 --> 00:27:24.160
country and the latest stat shows maybe
900, maybe 1000.

356cf496-b8b0-4990-9661-eab2b9d4b64a-0
00:27:24.160 --> 00:27:30.938
So we're at a very small percentage,
maybe 20% of where we could be in,

356cf496-b8b0-4990-9661-eab2b9d4b64a-1
00:27:30.938 --> 00:27:33.480
in British Columbia, 0.39%.

3ee373c0-0151-4d2b-8c7a-e1bb8a061658-0
00:27:33.480 --> 00:27:39.274
So less than half of 1% of the family
physicians in this province are from a

3ee373c0-0151-4d2b-8c7a-e1bb8a061658-1
00:27:39.274 --> 00:27:42.360
First Nations, Inuit or Metik background.

0ce0dc9c-4d82-4fde-8b17-66308e30d276-0
00:27:42.760 --> 00:27:44.760
So pretty significant gap there.

65692625-6e60-47fc-b10a-7f61754c1df4-0
00:27:45.440 --> 00:27:49.320
And we've all heard that team based care
is going to solve this.

9f8f0ca3-37bb-4de9-8a09-9f4f3d56cf2f-0
00:27:49.720 --> 00:27:53.960
And I'm actually going to go out on a
limb and say that's not the solution.

cf0fc189-3fd6-48e8-86e1-35554eb1402b-0
00:27:54.000 --> 00:27:57.760
I think it's part of the solution,
but it's not the solution itself.

8840fc35-b418-4aa6-8d73-bc3918faf1e0-0
00:27:58.160 --> 00:28:02.753
Because team based care, if we,
if we work in the same models that we're

8840fc35-b418-4aa6-8d73-bc3918faf1e0-1
00:28:02.753 --> 00:28:07.786
currently experiencing and every family
doctor has 1000 to 1200 patients with a

8840fc35-b418-4aa6-8d73-bc3918faf1e0-2
00:28:07.786 --> 00:28:11.813
team around them, we,
we're never going to find that extra 5000

8840fc35-b418-4aa6-8d73-bc3918faf1e0-3
00:28:11.813 --> 00:28:15.400
to 6000 family physicians or other
healthcare providers.

e9527d87-75a0-41ca-8a19-e0165798d306-0
00:28:15.680 --> 00:28:21.527
We just don't have the numbers of teams,
health professionals in this country to

e9527d87-75a0-41ca-8a19-e0165798d306-1
00:28:21.527 --> 00:28:24.560
afford the kind of model that we're doing.

79ae14d6-6643-485e-843e-588e0ae9413e-0
00:28:25.000 --> 00:28:28.720
And we have not had that kind of adult
conversation yet in Canada.

c1677fa7-f869-4c83-a9e7-eaa73eb1c108-0
00:28:28.720 --> 00:28:33.178
But what our system moves towards,
certainly in the primary care system,

c1677fa7-f869-4c83-a9e7-eaa73eb1c108-1
00:28:33.178 --> 00:28:37.209
and if you think about it,
family medicine and primary care looks

c1677fa7-f869-4c83-a9e7-eaa73eb1c108-2
00:28:37.209 --> 00:28:40.079
exactly the way it did 20-30,
forty years ago.

7bc972e3-f27d-4fe4-942c-e8931273ee04-0
00:28:40.320 --> 00:28:43.504
In fact,
I think I would submit that our

7bc972e3-f27d-4fe4-942c-e8931273ee04-1
00:28:43.504 --> 00:28:48.320
grandparents would recognize most of the
the way we practice.

b940b9a7-e69e-4222-b453-a0c5e4d7e347-0
00:28:48.320 --> 00:28:54.602
And clearly if we're going to to achieve
a common access and not sink into private

b940b9a7-e69e-4222-b453-a0c5e4d7e347-1
00:28:54.602 --> 00:29:00.960
pay and a really a proper 2 tiered system,
we've got about to think about how we do

b940b9a7-e69e-4222-b453-a0c5e4d7e347-2
00:29:00.960 --> 00:29:03.079
it a little bit differently.

79975f6d-f5d8-43d0-8cea-5b1d3278e5fc-0
00:29:03.800 --> 00:29:07.480
So maybe I can just finish with four
things that we're thinking about.

997c4280-f240-4579-95e8-c7a7f69d41f2-0
00:29:07.480 --> 00:29:12.254
It's Simon Fraser admissions,
how do we recruit the kind of physicians

997c4280-f240-4579-95e8-c7a7f69d41f2-1
00:29:12.254 --> 00:29:17.634
who are committed to working in primary
care And we are creating a primary care

997c4280-f240-4579-95e8-c7a7f69d41f2-2
00:29:17.634 --> 00:29:21.736
focused medical school,
which does not mean that we won't be

997c4280-f240-4579-95e8-c7a7f69d41f2-3
00:29:21.736 --> 00:29:26.982
thrilled if one of our graduate becomes
the top cardiothoracic surgeon in the

997c4280-f240-4579-95e8-c7a7f69d41f2-4
00:29:26.982 --> 00:29:27.520
country.

947db2b5-7414-476e-b0b5-5d216de090c2-0
00:29:27.880 --> 00:29:30.440
We just hope that they'll really
understand primary care.

157245ce-4203-484e-ad61-daa820f268c3-0
00:29:30.440 --> 00:29:34.479
But if 90% of our graduates want to go
into subspecialty,

157245ce-4203-484e-ad61-daa820f268c3-1
00:29:34.479 --> 00:29:38.240
we'll consider ourselves to have not been
successful.

0776de84-2b11-49c0-871f-356c93c9350f-0
00:29:38.800 --> 00:29:43.200
So how do we do that admissions and just
a word on the Indigenous admissions.

14032a45-d9a1-4987-9b2c-13d2163d8687-0
00:29:44.640 --> 00:29:50.640
We will have criteria for all of our
students to that have to to meet the bar.

b6344680-e829-439c-9051-965df702bdb1-0
00:29:51.400 --> 00:29:56.886
We will once you've got over that bar,
we will no longer consider your marks,

b6344680-e829-439c-9051-965df702bdb1-1
00:29:56.886 --> 00:29:59.560
but we will have two ways of doing it.

8efcb25c-7a2a-4f6e-b902-a47c5e7458d1-0
00:29:59.560 --> 00:30:04.216
And if you think about it,
if we have 2 or 3000 applicants of which

8efcb25c-7a2a-4f6e-b902-a47c5e7458d1-1
00:30:04.216 --> 00:30:08.872
at least half to 2/3 or 3/4 would make
excellent family physicians,

8efcb25c-7a2a-4f6e-b902-a47c5e7458d1-2
00:30:08.872 --> 00:30:11.680
how on earth do differentiate from those?

d7c85acd-a508-416e-a273-9cab917e8826-0
00:30:11.920 --> 00:30:17.109
But if you put small numbers of
indigenous students in that group,

d7c85acd-a508-416e-a273-9cab917e8826-1
00:30:17.109 --> 00:30:23.151
their their numbers get so diluted that
their chances of getting selected and

d7c85acd-a508-416e-a273-9cab917e8826-2
00:30:23.151 --> 00:30:27.876
starting to address the gap that we see
in this province is,

d7c85acd-a508-416e-a273-9cab917e8826-3
00:30:27.876 --> 00:30:30.200
is it's going to take forever.

83dd458f-2e4c-4f3a-9d06-3900a801b379-0
00:30:30.200 --> 00:30:34.865
So how are the ways that we encourage
that and how do we ensure that there are

83dd458f-2e4c-4f3a-9d06-3900a801b379-1
00:30:34.865 --> 00:30:39.058
pathways or Charlene to use your word
term pipelines for students from

83dd458f-2e4c-4f3a-9d06-3900a801b379-2
00:30:39.058 --> 00:30:43.606
elementary school and post secondary
school and and universities to get into

83dd458f-2e4c-4f3a-9d06-3900a801b379-3
00:30:43.606 --> 00:30:48.272
the kind of training that is going to
lead them towards a career in the health

83dd458f-2e4c-4f3a-9d06-3900a801b379-4
00:30:48.272 --> 00:30:49.039
professional.

7795d9dd-904c-4a70-875e-e7fec8598fe8-0
00:30:50.080 --> 00:30:55.710
We are certainly going to be thinking
about interprofessional teams and how do

7795d9dd-904c-4a70-875e-e7fec8598fe8-1
00:30:55.710 --> 00:31:01.411
we function with true interprofessional
education and not and in growing up our

7795d9dd-904c-4a70-875e-e7fec8598fe8-2
00:31:01.411 --> 00:31:05.259
health professionals in the same kind of
environment,

7795d9dd-904c-4a70-875e-e7fec8598fe8-3
00:31:05.259 --> 00:31:10.319
not training them in silos and then
wondering why they don't work well

7795d9dd-904c-4a70-875e-e7fec8598fe8-4
00:31:10.319 --> 00:31:12.599
together once they've graduated.

07c1984c-9add-4896-95a2-77ab7ff36042-0
00:31:12.600 --> 00:31:16.885
So really trying to create the kind of
environment where folks will learn

07c1984c-9add-4896-95a2-77ab7ff36042-1
00:31:16.885 --> 00:31:20.360
alongside and from each other from the
various professions.

a5baa1f1-2001-412e-a4c4-e476412b635c-0
00:31:20.360 --> 00:31:23.040
And that's going to be a real commitment
that we're going to work on.

8ee02053-a037-4dd4-84c7-19ecdcd1b178-0
00:31:24.040 --> 00:31:28.406
Our research will be very much focused on
primary care and primary care research

8ee02053-a037-4dd4-84c7-19ecdcd1b178-1
00:31:28.406 --> 00:31:29.000
and models.

90b7b610-fd1a-4e86-9aee-2d42f0b251c5-0
00:31:29.320 --> 00:31:32.943
And when I say primary care,
I don't mean just family medicine,

90b7b610-fd1a-4e86-9aee-2d42f0b251c5-1
00:31:32.943 --> 00:31:37.190
I mean psychiatry and Pediatrics and
obstetrics and gynecology and general

90b7b610-fd1a-4e86-9aee-2d42f0b251c5-2
00:31:37.190 --> 00:31:41.607
internal medicine and all the other
specialities that where it happens out in

90b7b610-fd1a-4e86-9aee-2d42f0b251c5-3
00:31:41.607 --> 00:31:42.400
the community.

39587c63-a2b7-4b76-b148-27c2a6621dec-0
00:31:42.400 --> 00:31:46.682
And to that end,
our model of of training is instead of it

39587c63-a2b7-4b76-b148-27c2a6621dec-1
00:31:46.682 --> 00:31:51.400
going to be 80% or 70% in the hospital
and 30% in the community,

39587c63-a2b7-4b76-b148-27c2a6621dec-2
00:31:51.400 --> 00:31:56.554
we're turning that on its head,
20% in the hospital and 80% out in the

39587c63-a2b7-4b76-b148-27c2a6621dec-3
00:31:56.554 --> 00:31:57.280
community.

9e5ad948-903a-45fe-8d58-3ee3771c606a-0
00:31:57.280 --> 00:32:02.023
So our students will be spending the vast
majority of their time out in the

9e5ad948-903a-45fe-8d58-3ee3771c606a-1
00:32:02.023 --> 00:32:06.329
community and we're going to try and
understand what are the models,

9e5ad948-903a-45fe-8d58-3ee3771c606a-2
00:32:06.329 --> 00:32:07.640
what are the aspects.

01837d86-f463-4ad8-bdbb-4619ba4adfd0-0
00:32:07.640 --> 00:32:12.150
And so our research will be really
focused on that kind of understanding and

01837d86-f463-4ad8-bdbb-4619ba4adfd0-1
00:32:12.150 --> 00:32:15.840
how do we use the data,
how do we use the technology etcetera.

20c5a53c-b6e7-4bfc-acaa-7522d88d753f-0
00:32:16.720 --> 00:32:22.359
And the last thing I'll say is from the
technology point of view, Dominic, you,

20c5a53c-b6e7-4bfc-acaa-7522d88d753f-1
00:32:22.359 --> 00:32:26.730
you reference AI scribe,
any of us who've used the AI scribe,

20c5a53c-b6e7-4bfc-acaa-7522d88d753f-2
00:32:26.730 --> 00:32:30.184
AI scribes,
certainly the majority of folks are,

20c5a53c-b6e7-4bfc-acaa-7522d88d753f-3
00:32:30.184 --> 00:32:32.440
are quite sold on it, excuse me.

2d31eb35-1d34-4051-99da-5b9f8f25324a-0
00:32:33.160 --> 00:32:36.880
But the question then becomes how do we
use that technology?

a2d6653f-689a-4e5a-9a68-2fba0f13064f-0
00:32:36.880 --> 00:32:38.640
How do we understand to use it?

cf919b3c-7f54-4b44-bc9f-b788ed7474d0-0
00:32:39.120 --> 00:32:43.677
And a really quick example,
speaking with a specialist,

cf919b3c-7f54-4b44-bc9f-b788ed7474d0-1
00:32:43.677 --> 00:32:49.943
she asked a question of one of the the
ChatGPT equivalents and asked about a

cf919b3c-7f54-4b44-bc9f-b788ed7474d0-2
00:32:49.943 --> 00:32:53.280
specific subset in her area of expertise.

48215eab-d7bd-42cc-b6fc-a04a83cfdb9a-0
00:32:53.640 --> 00:32:56.400
And the answer that she got,
if I looked at it,

48215eab-d7bd-42cc-b6fc-a04a83cfdb9a-1
00:32:56.400 --> 00:33:00.080
I would have said that sounds reasonable,
it looks quite right.

6a9a8992-ff7c-4f1b-96e6-22f3a60178e0-0
00:33:00.480 --> 00:33:03.000
From her knowledge, she was able to say,
but it's wrong.

b2f820e4-6811-4a8c-8f56-d5a83ee160cc-0
00:33:04.440 --> 00:33:09.746
The question wasn't asked correctly and
the question that she then said, OK,

b2f820e4-6811-4a8c-8f56-d5a83ee160cc-1
00:33:09.746 --> 00:33:13.605
give me the grade evidence and analyze
and give me the,

b2f820e4-6811-4a8c-8f56-d5a83ee160cc-2
00:33:13.605 --> 00:33:17.119
the references on how I would address the
problem.

3c6e52c9-58c7-4299-9d97-f2c39e60e713-0
00:33:17.360 --> 00:33:21.056
And so she asked the,
the question in a very different way and

3c6e52c9-58c7-4299-9d97-f2c39e60e713-1
00:33:21.056 --> 00:33:25.221
got a very different answer,
which was of course much more nuanced and

3c6e52c9-58c7-4299-9d97-f2c39e60e713-2
00:33:25.221 --> 00:33:29.680
much more helpful for me as a family
physician in caring for a patient with

3c6e52c9-58c7-4299-9d97-f2c39e60e713-3
00:33:29.680 --> 00:33:31.440
that particular type of thing.

d44c5674-7ec3-461e-8882-e9e229390ada-0
00:33:31.440 --> 00:33:35.996
So we need to get,
we're very cognizant about not getting,

d44c5674-7ec3-461e-8882-e9e229390ada-1
00:33:35.996 --> 00:33:41.942
not not getting attracted to those bright
shiny objects and going, you know,

d44c5674-7ec3-461e-8882-e9e229390ada-2
00:33:41.942 --> 00:33:44.800
squirrel, squirrel or whatever it is.

12654764-4b45-488c-aad4-57c9a596b020-0
00:33:44.800 --> 00:33:50.777
And really starting to focus on how do we
train our students to utilize the

12654764-4b45-488c-aad4-57c9a596b020-1
00:33:50.777 --> 00:33:51.800
technologies?

0632c69a-06dc-49d6-8dde-f728e3648031-0
00:33:51.800 --> 00:33:55.555
Because of course,
the technology in 2030 or 2035 when our

0632c69a-06dc-49d6-8dde-f728e3648031-1
00:33:55.555 --> 00:34:00.328
students are graduating and starting
really entering into the workforce is

0632c69a-06dc-49d6-8dde-f728e3648031-2
00:34:00.328 --> 00:34:01.920
going to be so different.

5380aefe-5b7b-40ab-9b78-62135a299395-0
00:34:01.920 --> 00:34:05.051
We can't even imagine right now what it's
going to look like,

5380aefe-5b7b-40ab-9b78-62135a299395-1
00:34:05.051 --> 00:34:09.091
but we need to give them the tools to be
able to understand how to evaluate and

5380aefe-5b7b-40ab-9b78-62135a299395-2
00:34:09.091 --> 00:34:10.000
how to utilize it.

1071b33e-6d5a-47b2-a670-095fbad96cf5-0
00:34:10.320 --> 00:34:15.840
And so that will be a big part of our,
our, our, our training.

cbccac6a-6618-4800-a15e-24208fba4501-0
00:34:16.280 --> 00:34:18.833
And I'll finish by saying, you know,
Michelle,

cbccac6a-6618-4800-a15e-24208fba4501-1
00:34:18.833 --> 00:34:22.908
you asked what are some of the lessons
that you've learned and things that

cbccac6a-6618-4800-a15e-24208fba4501-2
00:34:22.908 --> 00:34:23.560
you've seen?

34266906-5f62-44e0-9b68-ea7ea65b0d9b-0
00:34:24.040 --> 00:34:28.477
We've, when I was at McMaster,
we created a number of primary care

34266906-5f62-44e0-9b68-ea7ea65b0d9b-1
00:34:28.477 --> 00:34:30.200
interprofessional clinics.

3e46c41b-690c-4480-b758-e2781c1b6814-0
00:34:30.760 --> 00:34:36.280
And what I learned from that was that you
needed to evolve one size didn't fit all.

2c2e8eee-5e10-4ec7-a582-79437f777886-0
00:34:36.280 --> 00:34:40.930
And we had three clinics all within about
10 or 15 kilometers of one another,

2c2e8eee-5e10-4ec7-a582-79437f777886-1
00:34:40.930 --> 00:34:45.760
large clinics looking after 15 to 20,
000 patients each or 25,000 patients each.

ce8ddf45-6a2e-4c8e-86ac-7883cde2d8fe-0
00:34:46.840 --> 00:34:50.555
And the, the,
the team needed to be focused on the

ce8ddf45-6a2e-4c8e-86ac-7883cde2d8fe-1
00:34:50.555 --> 00:34:52.960
community that they were serving.

e95d73ca-99ba-4ca8-8d0c-098c35073081-0
00:34:53.440 --> 00:34:58.214
So the ratio of physios to nurse
practitioners to P as to social workers

e95d73ca-99ba-4ca8-8d0c-098c35073081-1
00:34:58.214 --> 00:35:03.054
to system navigators, etcetera,
etcetera was different in each of the the

e95d73ca-99ba-4ca8-8d0c-098c35073081-2
00:35:03.054 --> 00:35:06.586
clinics to to really address the needs of
the people,

e95d73ca-99ba-4ca8-8d0c-098c35073081-3
00:35:06.586 --> 00:35:08.680
the people that we were serving.

b604d4bb-77d8-47c8-a724-6670b030dbc5-0
00:35:09.480 --> 00:35:14.520
And by having that supportive environment,
we had such little turnover.

811305ec-0eaf-4a63-a635-d5ec15323a9c-0
00:35:14.520 --> 00:35:19.088
And so when we talk about burnout amongst
our healthcare professionals,

811305ec-0eaf-4a63-a635-d5ec15323a9c-1
00:35:19.088 --> 00:35:22.133
amongst our workers,
amongst our support staff,

811305ec-0eaf-4a63-a635-d5ec15323a9c-2
00:35:22.133 --> 00:35:25.560
we can build those kind of a supportive
environments.

dcb335c0-3d86-4400-aadb-eee97e06f5bd-0
00:35:25.840 --> 00:35:28.560
But it does require thoughtfulness.

4938d78d-4057-4646-92ca-adbc3669a673-0
00:35:28.560 --> 00:35:31.280
It does require leaders who are focused
on that.

3e0d9fef-070a-4a1a-8fa8-af91befe4633-0
00:35:31.680 --> 00:35:36.838
And I would submit that it requires some
sort of economies of scale so that we can

3e0d9fef-070a-4a1a-8fa8-af91befe4633-1
00:35:36.838 --> 00:35:41.997
cover for each other because gone are the
days when a single physician or a single

3e0d9fef-070a-4a1a-8fa8-af91befe4633-2
00:35:41.997 --> 00:35:47.279
nurse practitioner can provide all of the
care for the people that they are serving.

0450cbb4-efc1-4556-a603-16d3cac86e71-0
00:35:47.280 --> 00:35:48.400
It's just not possible.

f0d3920c-d52b-481b-b51e-e78174743ad2-0
00:35:48.400 --> 00:35:52.776
So we need to think a little bit
differently and that's why I'm excited to

f0d3920c-d52b-481b-b51e-e78174743ad2-1
00:35:52.776 --> 00:35:57.387
be a part of this conversation as we
start to think about what does the future

f0d3920c-d52b-481b-b51e-e78174743ad2-2
00:35:57.387 --> 00:36:00.480
of our workforce look like and our system
look like.

c9d311e8-cffa-423f-89b0-9ee542b89930-0
00:36:00.880 --> 00:36:03.360
Dominic, I think you highlighted it well.

b762613d-8cb0-4dbe-8a23-b4bee304a7c2-0
00:36:03.360 --> 00:36:07.800
It's our system that is the challenge and
how do we evolve the system.

bf5dbd25-4981-4305-a6b7-371edd046b24-0
00:36:08.080 --> 00:36:14.047
And I've yet to hear really meaningful
focus targeted conversations about how we

bf5dbd25-4981-4305-a6b7-371edd046b24-1
00:36:14.047 --> 00:36:18.320
evolve that system to meet the needs for
2030 and beyond.

795cc992-3123-4259-aab7-d943b0ecefd7-0
00:36:18.640 --> 00:36:27.880
So thanks again for having me,
Merci Boku and Doctor Price.

3385fa54-ac22-4534-b222-946c71bdfc8d-0
00:36:28.120 --> 00:36:31.157
I had a few gasps as you were speaking
because, you know,

3385fa54-ac22-4534-b222-946c71bdfc8d-1
00:36:31.157 --> 00:36:33.880
I think some of what you said was both
provocative.

b52e0ff8-f513-41da-9c5a-1342449e18e5-0
00:36:33.880 --> 00:36:38.194
It was challenging,
but it also gave us insight into what

b52e0ff8-f513-41da-9c5a-1342449e18e5-1
00:36:38.194 --> 00:36:42.360
setting a good foundation for the future
may look like.

4ec2513b-90af-4815-9b91-15e1ae23336f-0
00:36:43.400 --> 00:36:47.223
And I think, you know,
the benefit of you getting to build this

4ec2513b-90af-4815-9b91-15e1ae23336f-1
00:36:47.223 --> 00:36:50.448
curriculum at SFU,
but also thinking about, you know,

4ec2513b-90af-4815-9b91-15e1ae23336f-2
00:36:50.448 --> 00:36:52.480
this is this is not a new problem.

dd60f076-6f04-45e6-bf6d-4b06179bd36c-0
00:36:52.480 --> 00:36:55.080
This topic today is not new.

206d0e38-0202-4116-b431-d2427c2ea382-0
00:36:55.480 --> 00:36:59.120
And I think, you know,
we've been facing the challenge for for

206d0e38-0202-4116-b431-d2427c2ea382-1
00:36:59.120 --> 00:37:03.280
decades in terms of the the size and
nature and shape of the workforce.

c1c2802b-1302-4afc-b0de-6a771cda9a27-0
00:37:04.480 --> 00:37:06.800
But things are just happening so fast
today.

777828ee-5e2a-48f9-8f23-514d9602836c-0
00:37:06.800 --> 00:37:09.080
And so I think This is why this topic is
so salient.

f5422cba-5686-41b6-8280-19db194ed616-0
00:37:09.680 --> 00:37:13.625
Maybe Charlene,
if I could just turn it to you just to

f5422cba-5686-41b6-8280-19db194ed616-1
00:37:13.625 --> 00:37:18.000
reflect on some of Doctor Price's
comments around, you know,

f5422cba-5686-41b6-8280-19db194ed616-2
00:37:18.000 --> 00:37:23.093
how do we ensure to your earlier point
that the workforce reflects the

f5422cba-5686-41b6-8280-19db194ed616-3
00:37:23.093 --> 00:37:24.600
populations we serve?

5173c2fb-2c4d-429f-9918-71abd5a3fb63-0
00:37:25.760 --> 00:37:30.065
Is there anything that you can offer the,
the audience here around, you know,

5173c2fb-2c4d-429f-9918-71abd5a3fb63-1
00:37:30.065 --> 00:37:31.280
how might you do that?

015e2574-7c4d-439e-ba02-0a87de9a96b3-0
00:37:31.280 --> 00:37:35.842
How might you Createspace and room,
are there any specific plans in Manitoba

015e2574-7c4d-439e-ba02-0a87de9a96b3-1
00:37:35.842 --> 00:37:39.280
that you're working on to really
diversify the workforce?

47f2d641-ba52-4d33-aaae-8401da031bf9-0
00:37:43.120 --> 00:37:43.680
Thank you.

db0de990-59aa-4553-bc5a-5cd16243b700-0
00:37:44.320 --> 00:37:50.845
I think what I'll start with is saying we
need to move to action and strategy like

db0de990-59aa-4553-bc5a-5cd16243b700-1
00:37:50.845 --> 00:37:55.720
solid strategies and away from what I
call the hope strategy.

6653f618-ee92-4a1e-bd04-55c8f42fc545-0
00:37:56.080 --> 00:37:58.520
I hope they apply, I hope they come in.

e82261bd-0cf0-45c6-bb0b-42102dc5a726-0
00:37:58.760 --> 00:38:02.034
I hope our work like we have to move from
that,

e82261bd-0cf0-45c6-bb0b-42102dc5a726-1
00:38:02.034 --> 00:38:07.355
especially when we're talking about
diversity in the workplace and increasing

e82261bd-0cf0-45c6-bb0b-42102dc5a726-2
00:38:07.355 --> 00:38:11.994
representation of those we serve as
Doctor Price had shared, right,

e82261bd-0cf0-45c6-bb0b-42102dc5a726-3
00:38:11.994 --> 00:38:17.315
like Indigenous people have shared,
they want to receive care from Indigenous

e82261bd-0cf0-45c6-bb0b-42102dc5a726-4
00:38:17.315 --> 00:38:18.680
folks in the system.

5a4dbca2-ac88-4023-ac59-4b55282545c8-0
00:38:18.880 --> 00:38:22.840
We see that in the Truth and
Reconciliation calls to action.

1220186e-c0fc-427b-a4c9-10655204049d-0
00:38:23.160 --> 00:38:24.240
So what can we do?

248ebe80-c794-4aac-88c1-07037ffa3a94-0
00:38:24.240 --> 00:38:29.622
We can rely on pieces of work that have
already been completed in terms of the

248ebe80-c794-4aac-88c1-07037ffa3a94-1
00:38:29.622 --> 00:38:30.440
way forward.

0ea6a6d3-cfe5-4868-ae11-4af84cdd57d8-0
00:38:30.960 --> 00:38:36.280
We can use systems that we already have
inside of our workplaces.

01439b22-2fd4-4d74-b01b-6b048abfc7e3-0
00:38:36.440 --> 00:38:41.597
How do we track and monitor other pieces
that are important to us and how do we

01439b22-2fd4-4d74-b01b-6b048abfc7e3-1
00:38:41.597 --> 00:38:44.240
apply that to diversity in the workplace?

f7e94784-ad64-48c6-accd-c63d20cda27a-0
00:38:44.400 --> 00:38:47.080
And of course, my lens here is Indigenous.

ee9f3a85-61bf-4c72-ad85-b757a25f4258-0
00:38:47.080 --> 00:38:50.050
So how,
how are organizations aligning and

ee9f3a85-61bf-4c72-ad85-b757a25f4258-1
00:38:50.050 --> 00:38:55.094
tracking and measuring and having
accountability if we don't have people

ee9f3a85-61bf-4c72-ad85-b757a25f4258-2
00:38:55.094 --> 00:38:59.861
accountable for this work,
if we just keep looking to the Indigenous

ee9f3a85-61bf-4c72-ad85-b757a25f4258-3
00:38:59.861 --> 00:39:04.352
person or the Indigenous department and
saying what's happening,

ee9f3a85-61bf-4c72-ad85-b757a25f4258-4
00:39:04.352 --> 00:39:06.080
that's not going to work.

25c3c7c5-8569-4eae-b7b8-9ed533df0701-0
00:39:06.360 --> 00:39:10.838
And So what we've done in in Manitoba and
with Shared Health and the rest of the

25c3c7c5-8569-4eae-b7b8-9ed533df0701-1
00:39:10.838 --> 00:39:14.930
health authorities in Manitoba is the
development of an Indigenous health

25c3c7c5-8569-4eae-b7b8-9ed533df0701-2
00:39:14.930 --> 00:39:17.640
operating model,
which has seven core functions.

2801c63d-7bea-4907-b284-b583f7c9854c-0
00:39:17.640 --> 00:39:19.360
I won't get into them all, don't worry.

215df8b5-cf04-4027-8b18-8b78fa1930c1-0
00:39:20.040 --> 00:39:24.735
But they,
one of them is a representative workforce

215df8b5-cf04-4027-8b18-8b78fa1930c1-1
00:39:24.735 --> 00:39:30.243
strategy and creating those pathways,
designating positions,

215df8b5-cf04-4027-8b18-8b78fa1930c1-2
00:39:30.243 --> 00:39:37.558
Indigenous having meaningful space to say
there's a vacancy should this position

215df8b5-cf04-4027-8b18-8b78fa1930c1-3
00:39:37.558 --> 00:39:41.080
become specific to those we're serving.

ce94fcc4-008d-4fc7-8d39-b8291139714c-0
00:39:41.960 --> 00:39:46.760
So is it an do we need an does this need
to turn into an Indigenous position?

88d1896e-39dc-4de7-a395-30fb81921cee-0
00:39:46.920 --> 00:39:51.610
Having Indigenous in the title,
having Indigenous in the job description,

88d1896e-39dc-4de7-a395-30fb81921cee-1
00:39:51.610 --> 00:39:55.160
responding to those community and those
specific needs.

ecf9f0db-e5ff-421a-9d95-07862549c91c-0
00:39:55.160 --> 00:39:58.378
The nuanced approach,
I think was said earlier,

ecf9f0db-e5ff-421a-9d95-07862549c91c-1
00:39:58.378 --> 00:39:59.720
having those pieces.

745dc93c-2985-4413-b0b4-da73c0cf2001-0
00:39:59.720 --> 00:40:05.279
So we really need to track and monitor
move from a hope strategy and actually

745dc93c-2985-4413-b0b4-da73c0cf2001-1
00:40:05.279 --> 00:40:07.560
implement some of those actions.

8ae8e162-70c9-4271-8d2c-64c223b8243c-0
00:40:08.400 --> 00:40:09.880
I don't know if that covers the question.

51d91283-0332-4126-9b78-27f8e810c7da-0
00:40:09.880 --> 00:40:10.440
It does.

9ee821b2-d0d5-4a89-be58-a89167137f40-0
00:40:10.440 --> 00:40:11.160
Thank you, Charlene.

aafe9cca-5619-4dd4-b5ef-a034686103da-0
00:40:11.160 --> 00:40:14.481
I don't know Doctor Nowak or or Doctor
Price if you if you had any additional

aafe9cca-5619-4dd4-b5ef-a034686103da-1
00:40:14.481 --> 00:40:15.120
comments there.

33f2c664-e640-4483-b622-0c17023d1936-0
00:40:15.120 --> 00:40:21.614
But I think your point around making sure
that it's not off the side of 1's desk,

33f2c664-e640-4483-b622-0c17023d1936-1
00:40:21.614 --> 00:40:27.080
that it is built into a strategy in your
case at a provincial level.

10b25fbd-55a7-4933-b0f7-74d0225abff8-0
00:40:28.200 --> 00:40:33.000
And it is, it is being led by,
by the system.

a809525e-dc28-4c0c-b5c3-325fa5d7737a-0
00:40:34.440 --> 00:40:38.363
And so maybe just on that, we've,
we've touched on and Doctor Price,

a809525e-dc28-4c0c-b5c3-325fa5d7737a-1
00:40:38.363 --> 00:40:41.889
he's touched on system and then Charlene,
maybe Doctor Nowak,

a809525e-dc28-4c0c-b5c3-325fa5d7737a-2
00:40:41.889 --> 00:40:46.325
like when we think about, you know,
are we truly operating as a health system

a809525e-dc28-4c0c-b5c3-325fa5d7737a-3
00:40:46.325 --> 00:40:49.452
when, you know,
sometimes it feels like if there's one

a809525e-dc28-4c0c-b5c3-325fa5d7737a-4
00:40:49.452 --> 00:40:53.717
change in one part of the system,
there's an unintended consequence in the

a809525e-dc28-4c0c-b5c3-325fa5d7737a-5
00:40:53.717 --> 00:40:54.400
other parts.

3375b830-1064-41a4-96b7-273fd80afba8-0
00:40:54.800 --> 00:40:57.628
And from a,
from a health workforce standpoint,

3375b830-1064-41a4-96b7-273fd80afba8-1
00:40:57.628 --> 00:40:59.160
it can be quite difficult.

1117fbd4-22d6-4d22-823a-73005bd446af-0
00:41:00.320 --> 00:41:04.457
And so just in, in,
in your learnings and in your travels,

1117fbd4-22d6-4d22-823a-73005bd446af-1
00:41:04.457 --> 00:41:08.383
what would you say we need to do better
as as a system,

1117fbd4-22d6-4d22-823a-73005bd446af-2
00:41:08.383 --> 00:41:13.853
whether that be at the policy level,
the model of care level that really have

1117fbd4-22d6-4d22-823a-73005bd446af-3
00:41:13.853 --> 00:41:17.640
positive impacts on the way we support
our workforce?

c53faab3-0b14-42e9-94d0-f150ed91a8fc-0
00:41:17.640 --> 00:41:20.497
Yeah,
some of the some of the most powerful

c53faab3-0b14-42e9-94d0-f150ed91a8fc-1
00:41:20.497 --> 00:41:25.562
stories I've seen have been when people
have shared models of care that work,

c53faab3-0b14-42e9-94d0-f150ed91a8fc-2
00:41:25.562 --> 00:41:28.160
right, and more creative models of care.

3a9a2de9-a046-4fd1-b9ce-b3fd6e3d73b6-0
00:41:28.520 --> 00:41:30.360
And here's some of the examples.

f7325a1f-5513-456f-a48c-25d55f4b14da-0
00:41:31.840 --> 00:41:37.080
Some of the happiest doctors I've seen
have been doctors who work in teams.

350f88e8-fbaa-4aac-a472-deddf2b27167-0
00:41:37.920 --> 00:41:42.767
Some of the happiest doctors I've seen
have been doctors who have a, you know,

350f88e8-fbaa-4aac-a472-deddf2b27167-1
00:41:42.767 --> 00:41:47.124
have their practice had hired a
registered nurse to do all their inbox

350f88e8-fbaa-4aac-a472-deddf2b27167-2
00:41:47.124 --> 00:41:47.800
management.

a9b2dce1-91bd-48a0-85a3-2f8938ff7586-0
00:41:47.840 --> 00:41:51.230
And now these doctors,
rather than spending 19 hours per week in

a9b2dce1-91bd-48a0-85a3-2f8938ff7586-1
00:41:51.230 --> 00:41:55.246
the evenings and weekends, you know,
doing labs and messages and kind of the

a9b2dce1-91bd-48a0-85a3-2f8938ff7586-2
00:41:55.246 --> 00:41:58.324
e-mail type stuff that has doctors we end
up having to do,

a9b2dce1-91bd-48a0-85a3-2f8938ff7586-3
00:41:58.324 --> 00:42:02.080
they do one hour on Fridays and the rest
of their time is patient care.

e895eedf-8772-4583-80ab-7d328be51c6a-0
00:42:03.040 --> 00:42:07.401
Some of the happiest doctors I've seen
have been doctors that are working in

e895eedf-8772-4583-80ab-7d328be51c6a-1
00:42:07.401 --> 00:42:11.820
dyads where there's an MD and a nurse
practitioner and they share a practice,

e895eedf-8772-4583-80ab-7d328be51c6a-2
00:42:11.820 --> 00:42:12.160
right.

8d3c6f1e-9ceb-4e01-bad7-533074ae61a9-0
00:42:12.160 --> 00:42:16.722
So how do we build out those those type
type of models that are working well in

8d3c6f1e-9ceb-4e01-bad7-533074ae61a9-1
00:42:16.722 --> 00:42:20.943
some places and giving enormous joy and
work for those teams, by the way,

8d3c6f1e-9ceb-4e01-bad7-533074ae61a9-2
00:42:20.943 --> 00:42:25.335
and give people opportunities to say,
look, it doesn't have to be like what,

8d3c6f1e-9ceb-4e01-bad7-533074ae61a9-3
00:42:25.335 --> 00:42:28.357
you know,
all the words that you used earlier today,

8d3c6f1e-9ceb-4e01-bad7-533074ae61a9-4
00:42:28.357 --> 00:42:30.239
doesn't have to be soul crushing.

d73eeff7-3a1a-4bfb-9cca-4214107b7ef1-0
00:42:30.560 --> 00:42:34.000
It doesn't have to be, you know,
stretched crisis, all this stuff.

f3ced73c-a8ae-4f23-9ec4-19336c1a94b5-0
00:42:34.040 --> 00:42:36.280
It can be,
it can be better if there's a way forward.

327390d7-68e0-4105-b02f-550b332803ed-0
00:42:36.280 --> 00:42:37.960
And here's here's how.

4e25f5cb-63ad-4b08-a8b6-71c032147d37-0
00:42:39.000 --> 00:42:41.720
And we trust you to implement this
locally.

fb791c1d-ea2e-41c3-a501-45b11db7d30e-0
00:42:41.720 --> 00:42:44.360
We'll give you funding for it,
we'll support it.

fe4458df-fbb2-49bc-ac9a-92c440d4f2a7-0
00:42:44.600 --> 00:42:46.160
Here's how do it.

36cb72b3-b4cc-4f43-8cf7-4f9ef63ffeca-0
00:42:46.160 --> 00:42:48.400
We can restore joy to to our workforce.

79315be1-f420-452a-a962-400588772304-0
00:42:48.400 --> 00:42:52.572
So I think it is a models of care
conversation really and and sharing

79315be1-f420-452a-a962-400588772304-1
00:42:52.572 --> 00:42:57.461
people a lens of what could be in those
models of care that's different than what

79315be1-f420-452a-a962-400588772304-2
00:42:57.461 --> 00:42:57.640
is.

6eec87c0-67f9-4edd-9595-f56cbee671b6-0
00:42:58.400 --> 00:42:58.800
Thank you.

c4ccdfcf-d438-410f-aa3b-c1ed3378d976-0
00:42:59.000 --> 00:43:04.080
And maybe doctor Price,
just you did touch upon teen based care.

af6681dd-803b-4565-b0d6-4453afb845e4-0
00:43:05.280 --> 00:43:09.069
And so I just wanted to get your thoughts
on on, you know,

af6681dd-803b-4565-b0d6-4453afb845e4-1
00:43:09.069 --> 00:43:14.465
what are the kind of the right archetypes
or right models of care as we think about

af6681dd-803b-4565-b0d6-4453afb845e4-2
00:43:14.465 --> 00:43:18.640
moving beyond the four walls of the
hospital into the community.

c14162a1-bb79-4069-a6af-0a86e9cfd7fe-0
00:43:19.440 --> 00:43:20.760
When does teen based care work?

682849c5-77b2-47dc-89c2-9eaf27954b60-0
00:43:20.760 --> 00:43:21.400
When does it not?

cc3d2aeb-145d-45ae-9c49-3770f62badd1-0
00:43:21.400 --> 00:43:24.200
It was one of the things that struck me
as you, as you spoke earlier.

32fde461-f4cf-42db-9ef4-44b34af9b78c-0
00:43:25.680 --> 00:43:28.520
And how do we do what Doctor Nowak just
suggested?

f83d132e-564d-4a63-867e-e2a447aecca7-0
00:43:30.320 --> 00:43:31.720
It's a huge challenge, isn't it?

77dd3ffd-4ebe-4ed4-b2e6-86adfc7d4219-0
00:43:31.720 --> 00:43:35.988
Because if you think about it,
with the number of family physicians that

77dd3ffd-4ebe-4ed4-b2e6-86adfc7d4219-1
00:43:35.988 --> 00:43:40.491
we have in this country right now,
probably each one of us should be looking

77dd3ffd-4ebe-4ed4-b2e6-86adfc7d4219-2
00:43:40.491 --> 00:43:43.240
after anywhere between 2500 and 4000
patients.

a34a7a1f-b989-48ec-abd1-3c9db0428b5a-0
00:43:43.760 --> 00:43:46.026
And if you,
if I told Dominic he had to look after

a34a7a1f-b989-48ec-abd1-3c9db0428b5a-1
00:43:46.026 --> 00:43:49.360
4000 patients tomorrow he's going to
shake because actually he's going to.

174ef873-d063-47cc-8b25-460eb369a326-0
00:43:49.360 --> 00:43:51.440
If I was there,
he'd kept me under the table and said

174ef873-d063-47cc-8b25-460eb369a326-1
00:43:51.440 --> 00:43:52.520
you've got to be kidding me.

e8a1544f-4977-4f77-ab6e-316a395bb881-0
00:43:53.280 --> 00:43:54.040
And he's right.

ca6a3ad9-c429-4360-a3f4-2a2ff0fb63c8-0
00:43:54.080 --> 00:43:54.480
I can't.

7420fb8d-7433-4054-b489-fb380dd0dbdb-0
00:43:54.480 --> 00:43:58.608
None of us can look after 4000 patients
effectively,

7420fb8d-7433-4054-b489-fb380dd0dbdb-1
00:43:58.608 --> 00:44:04.606
but we can do so if we are part of a
rather large ballistic team that shares

7420fb8d-7433-4054-b489-fb380dd0dbdb-2
00:44:04.606 --> 00:44:09.280
the load and has all of us working to the
top of our scope.

cada64ee-b932-45e5-b1fa-7db1edb652c0-0
00:44:10.040 --> 00:44:15.951
We are going to have to think about how
we have the pharmacist in the community

cada64ee-b932-45e5-b1fa-7db1edb652c0-1
00:44:15.951 --> 00:44:18.760
integrated into our healthcare system.

212207c3-2640-4d46-b8cc-db11282a534c-0
00:44:19.640 --> 00:44:22.200
I think we've made some baby steps in
that direction.

913aa6b5-78b0-4e78-a0ab-f338fcc8fbcb-0
00:44:22.800 --> 00:44:24.280
They are professionals.

43076679-6ade-4acc-80c6-df0cdc0c9e53-0
00:44:24.280 --> 00:44:27.760
They do have a significant amount of
training.

c2206255-31bb-4054-b9c8-a07710de5558-0
00:44:28.360 --> 00:44:31.920
But if they're working in silos,
that's probably not what we all need.

4c5c3b6f-a328-45c5-a6c2-69c1f375ef49-0
00:44:31.920 --> 00:44:33.680
And so how do we start to integrate?

7e2bb526-b2e3-4f80-b881-8bb4802af6ce-0
00:44:33.680 --> 00:44:37.871
How do we start to think about how we
make these teams work and function

7e2bb526-b2e3-4f80-b881-8bb4802af6ce-1
00:44:37.871 --> 00:44:38.560
differently?

4365bb93-ac56-4306-9715-2b1b3ba21af2-0
00:44:38.560 --> 00:44:41.440
And I think that's that's our big
challenge.

56aa304c-a89d-4c0e-a554-f0ea21d96d85-0
00:44:41.880 --> 00:44:46.574
And certainly when I look at it,
and maybe here's one quick example,

56aa304c-a89d-4c0e-a554-f0ea21d96d85-1
00:44:46.574 --> 00:44:51.473
when we started the maternity center in
Hamilton a number of years ago,

56aa304c-a89d-4c0e-a554-f0ea21d96d85-2
00:44:51.473 --> 00:44:56.779
there was 10 family doctors who were
delivering on average about 250 babies a

56aa304c-a89d-4c0e-a554-f0ea21d96d85-3
00:44:56.779 --> 00:44:57.120
year.

3b55912d-0c0b-4aa9-aaa8-50472c617436-0
00:44:57.920 --> 00:45:02.042
By working together as a team,
working with a nurse practitioner,

3b55912d-0c0b-4aa9-aaa8-50472c617436-1
00:45:02.042 --> 00:45:06.853
bringing other individuals on board,
we started to look after 6 to 800 women

3b55912d-0c0b-4aa9-aaa8-50472c617436-2
00:45:06.853 --> 00:45:08.040
on an annual basis.

c1ad5499-5906-4ee3-817d-f4b0847b1c82-0
00:45:08.840 --> 00:45:11.680
And we were providing outstanding quality
of care.

07aab004-42a8-4468-bcd5-b79de59ffa3b-0
00:45:11.680 --> 00:45:15.240
We knew,
we know from some of our quality work

07aab004-42a8-4468-bcd5-b79de59ffa3b-1
00:45:15.240 --> 00:45:18.120
that the outcomes were second to none.

aa1b97d5-989e-4d43-adb2-fe7e2e95c910-0
00:45:19.200 --> 00:45:22.516
And it was really about not continuity of
person,

aa1b97d5-989e-4d43-adb2-fe7e2e95c910-1
00:45:22.516 --> 00:45:27.160
but it was about continuity of philosophy,
continuity of information.

be695d1f-379f-42d5-a8d9-dc12f96389ad-0
00:45:27.160 --> 00:45:31.320
So when a patient came into our office,
we, they didn't, we didn't ask them.

60ee0b00-c058-44ff-9e18-844fd3e7615c-0
00:45:31.320 --> 00:45:33.000
So Gee, tell me your whole story.

93fdd78d-44eb-46f7-8668-c99be170dd0b-0
00:45:33.160 --> 00:45:35.000
Because we all shared the EMR.

3caaf0fc-0bac-4f95-a205-1ee501c59a0b-0
00:45:35.000 --> 00:45:38.418
We knew what their story was,
we knew what the issues were and there

3caaf0fc-0bac-4f95-a205-1ee501c59a0b-1
00:45:38.418 --> 00:45:40.400
was good communication amongst the team.

4187d36e-a3b9-49ba-bce5-bf1234bdc439-0
00:45:40.720 --> 00:45:46.947
But just that simple fact of going from
250 to 800 deliveries a year or shared of

4187d36e-a3b9-49ba-bce5-bf1234bdc439-1
00:45:46.947 --> 00:45:52.870
looking after that number of women,
that is a really significant to me lesson

4187d36e-a3b9-49ba-bce5-bf1234bdc439-2
00:45:52.870 --> 00:45:55.680
about how we can scale our workforce.

daa9723f-38a9-4adc-852d-8d00b12abac7-0
00:45:55.680 --> 00:45:58.600
I just say something.

e36030cc-429f-46a8-b4a1-0dc5a29346e3-0
00:45:58.600 --> 00:46:04.585
What David shared really matters that we
we have this still this baked in previous

e36030cc-429f-46a8-b4a1-0dc5a29346e3-1
00:46:04.585 --> 00:46:10.138
era of healthcare lens of you need to
have the same person looking after you

e36030cc-429f-46a8-b4a1-0dc5a29346e3-2
00:46:10.138 --> 00:46:13.960
over and over and there's value to the
relationship.

48edb3a2-cd8d-4eb6-a75f-6e733a6956ba-0
00:46:14.400 --> 00:46:17.987
There's value to the relationship,
but it's impossible and it's it's not

48edb3a2-cd8d-4eb6-a75f-6e733a6956ba-1
00:46:17.987 --> 00:46:19.560
doable in our healthcare system.

e948272c-4417-4df9-b2f5-a901ccfb33d7-0
00:46:19.560 --> 00:46:24.767
That's stretched and moving to continuity
of team, continuity of philosophy,

e948272c-4417-4df9-b2f5-a901ccfb33d7-1
00:46:24.767 --> 00:46:26.120
continuity of value.

3bf33bda-3096-43a8-9ae0-ae20437e530c-0
00:46:26.120 --> 00:46:29.360
So that there's there are few people,
there's a team looking after you.

64d68f14-b698-4757-9771-2757676263cf-0
00:46:29.680 --> 00:46:34.014
That's the lens that that these kind of
models of care that are doable and,

64d68f14-b698-4757-9771-2757676263cf-1
00:46:34.014 --> 00:46:35.440
and practical would make.

39a599b7-2194-4875-a7a0-8fd6ddffdeb7-0
00:46:35.440 --> 00:46:38.655
I,
I think that the practical element of

39a599b7-2194-4875-a7a0-8fd6ddffdeb7-1
00:46:38.655 --> 00:46:44.458
this and also I think the way that
patients engage in their own health is

39a599b7-2194-4875-a7a0-8fd6ddffdeb7-2
00:46:44.458 --> 00:46:48.928
very different today than it's been ever
in past with a,

39a599b7-2194-4875-a7a0-8fd6ddffdeb7-3
00:46:48.928 --> 00:46:53.320
there's lots of doctor googles around,
as you all know.

c19d8a7d-7339-4d22-a784-d3cd2e28633f-0
00:46:53.320 --> 00:46:59.139
And I think access to information becomes
key to individuals empowerment of their

c19d8a7d-7339-4d22-a784-d3cd2e28633f-1
00:46:59.139 --> 00:46:59.920
own health.

21331254-9c89-4238-b727-8e92e72e3afe-0
00:47:01.120 --> 00:47:05.062
And so they might want to seek you for a
professional opinion,

21331254-9c89-4238-b727-8e92e72e3afe-1
00:47:05.062 --> 00:47:10.320
but there is a drive to engage more with
health professionals in their own journey.

fb05dc65-469f-44db-ada3-0919d0a6ed72-0
00:47:10.800 --> 00:47:15.943
And so one of my questions,
and I open it up to the group is around

fb05dc65-469f-44db-ada3-0919d0a6ed72-1
00:47:15.943 --> 00:47:20.633
we've we've spoken about, you know,
that kind of shift again,

fb05dc65-469f-44db-ada3-0919d0a6ed72-2
00:47:20.633 --> 00:47:22.600
going beyond the hospital.

0d28dec0-f828-4971-9afa-5500b8c76f7e-0
00:47:23.520 --> 00:47:25.680
Our our system is not structured that way.

2d4c487c-8bce-4a73-9e7e-3f35f6e6c371-0
00:47:25.720 --> 00:47:29.200
The majority of our spend greater than
50% is on hospitals.

88bcbcc7-0234-4e93-a5e6-0dd77db2932f-0
00:47:29.440 --> 00:47:33.880
Doctor, sorry,
Doctor Nowak and Doctor Price and drugs.

de6e3db6-09fd-4031-8ff7-323da85560c6-0
00:47:34.680 --> 00:47:40.734
And so part of the shift that we're
hearing and seeing and have evidence for

de6e3db6-09fd-4031-8ff7-323da85560c6-1
00:47:40.734 --> 00:47:46.238
and where we're seeing other
jurisdictions and countries move towards

de6e3db6-09fd-4031-8ff7-323da85560c6-2
00:47:46.238 --> 00:47:50.877
is supporting more upstream investing in
health promotion,

de6e3db6-09fd-4031-8ff7-323da85560c6-3
00:47:50.877 --> 00:47:53.000
investing in in prevention.

2e5d4c2a-7d6f-4c9a-9eb7-ffa659552578-0
00:47:53.640 --> 00:47:56.456
Again,
we're not quite structured that way,

2e5d4c2a-7d6f-4c9a-9eb7-ffa659552578-1
00:47:56.456 --> 00:47:58.760
but any ideas on how we may do that?

7f64d505-fdc7-472e-8014-97bb5a330e09-0
00:47:58.960 --> 00:48:02.947
And even, you know, Doctor Price,
how you might build that into the next

7f64d505-fdc7-472e-8014-97bb5a330e09-1
00:48:02.947 --> 00:48:06.280
generation of, of,
of family physicians that are graduating.

ac4dac76-35a5-43ec-ba53-ccaa439bdaa1-0
00:48:06.280 --> 00:48:08.675
How,
how do we change the paradigm and the

ac4dac76-35a5-43ec-ba53-ccaa439bdaa1-1
00:48:08.675 --> 00:48:09.400
conversation?

1fe7ad37-af1e-429e-9660-f3326c9e05af-0
00:48:10.480 --> 00:48:11.080
Any thoughts?

cab5c294-c15e-4745-a44d-1d389e5332f3-0
00:48:11.280 --> 00:48:14.600
I have some thoughts, but I,
I want to go to their speakers first.

34693fa2-4d9b-4ef3-9551-b4f1c96c862e-0
00:48:16.160 --> 00:48:22.754
Doctor Price, Charlene,
I'm going to go Charlene and I'll follow

34693fa2-4d9b-4ef3-9551-b4f1c96c862e-1
00:48:22.754 --> 00:48:23.160
you.

81112f45-a20e-4bb5-a368-9ccee5d062ad-0
00:48:23.160 --> 00:48:26.920
And she's saying go ahead.

efc467e1-f8a9-451b-89a6-14891ab6d041-0
00:48:28.120 --> 00:48:32.533
So a couple things you're absolutely
right that the patient comes into our

efc467e1-f8a9-451b-89a6-14891ab6d041-1
00:48:32.533 --> 00:48:37.065
office with way more information about
their particular healthcare condition

efc467e1-f8a9-451b-89a6-14891ab6d041-2
00:48:37.065 --> 00:48:38.360
than we all ever have.

436832aa-b6e9-4392-b0d1-fed5e33a7627-0
00:48:38.360 --> 00:48:39.760
They've they've read about it.

8670e37b-3235-4cc8-a1d3-46905725d14c-0
00:48:40.520 --> 00:48:44.920
What our role is becoming increasingly is
not an information broker.

14b8df85-b748-482b-941f-9f92ade2b638-0
00:48:44.920 --> 00:48:49.575
And if I think about it,
when I started X number of decades ago,

14b8df85-b748-482b-941f-9f92ade2b638-1
00:48:49.575 --> 00:48:55.376
too many, I probably knew more about the,
the health issues that the patient was

14b8df85-b748-482b-941f-9f92ade2b638-2
00:48:55.376 --> 00:48:56.880
facing than they did.

cda03c2e-0ced-4f1e-9996-a90dd702626a-0
00:48:56.880 --> 00:49:01.129
I didn't understand their, their,
their lived experience with it, of course,

cda03c2e-0ced-4f1e-9996-a90dd702626a-1
00:49:01.129 --> 00:49:05.544
but I knew about more about the medicine
that power balance or that information

cda03c2e-0ced-4f1e-9996-a90dd702626a-2
00:49:05.544 --> 00:49:07.200
balance is definitely shifted.

cbe02c2a-cc3c-4ad3-b8a6-a8817093162c-0
00:49:08.040 --> 00:49:13.021
But what I think our role is going to be
so much more as contextualizing it for

cbe02c2a-cc3c-4ad3-b8a6-a8817093162c-1
00:49:13.021 --> 00:49:16.258
the patient,
helping the patient to understand what

cbe02c2a-cc3c-4ad3-b8a6-a8817093162c-2
00:49:16.258 --> 00:49:21.240
the implications are of what they've read
are and understanding the statistics.

ead00c75-c1d9-4347-bf22-d631196b5d60-0
00:49:21.240 --> 00:49:23.269
I mean,
you've got a 20% greater chance of having

ead00c75-c1d9-4347-bf22-d631196b5d60-1
00:49:23.269 --> 00:49:23.960
blah, blah, blah.

dda9bd16-8130-4f0b-8c04-bb61498adf1f-0
00:49:24.640 --> 00:49:29.680
But is that mean you've got a 20% chance
of having that or is it 20% of 2%?

4fdfaf9b-eea0-4709-ac13-7bb6525e6918-0
00:49:29.680 --> 00:49:32.880
It's a very different conversation and
different context.

539817e7-d202-4f84-a444-9e5111950a16-0
00:49:33.480 --> 00:49:38.224
And not only putting it into context,
but by understanding the patient's own

539817e7-d202-4f84-a444-9e5111950a16-1
00:49:38.224 --> 00:49:41.304
life trajectory,
we can contextualize it for that

539817e7-d202-4f84-a444-9e5111950a16-2
00:49:41.304 --> 00:49:46.049
individual patient and give them their
and give them the information so that

539817e7-d202-4f84-a444-9e5111950a16-3
00:49:46.049 --> 00:49:48.759
they can make their own informed
decisions.

a8429066-0fc3-485d-b10d-855b9868d735-0
00:49:48.760 --> 00:49:54.078
Because that's what this is all about is
making informed decisions that are right

a8429066-0fc3-485d-b10d-855b9868d735-1
00:49:54.078 --> 00:49:55.440
for me and my family.

5e70c33c-e148-4e1f-8260-6bcb87013541-0
00:49:55.880 --> 00:49:58.880
And it's not about just what is what's
best.

101f40ef-440b-401a-be77-e855cf7565f1-0
00:49:58.880 --> 00:50:05.118
So I think that is that is 1 central area
that we're going to have to really focus

101f40ef-440b-401a-be77-e855cf7565f1-1
00:50:05.118 --> 00:50:05.720
more on.

4be3fc6b-2734-4ba1-b0f4-3a2029c4f839-0
00:50:05.720 --> 00:50:09.240
And so how do we train our workforce to
be able to do that?

0dd4e931-442d-485f-bd32-9f9a5bdcd0a6-0
00:50:09.560 --> 00:50:14.200
So maybe I'll leave it there because I
could go on for an hour on that one.

6f33882e-f912-4d48-8850-304201d2dee6-0
00:50:16.080 --> 00:50:20.414
Charlene,
thank you for sharing that and for always

6f33882e-f912-4d48-8850-304201d2dee6-1
00:50:20.414 --> 00:50:27.082
offering for me to go 1st And thank you
for jumping in where my mind went right

6f33882e-f912-4d48-8850-304201d2dee6-2
00:50:27.082 --> 00:50:33.500
away was around traditional Wellness
practices for Indigenous folks and how,

6f33882e-f912-4d48-8850-304201d2dee6-3
00:50:33.500 --> 00:50:40.502
how did those Wellness practices become a
part of the health system and be accepted

6f33882e-f912-4d48-8850-304201d2dee6-4
00:50:40.502 --> 00:50:42.920
by the Western health system.

e6c1743b-39f6-432d-a878-82dc993cbabe-0
00:50:43.200 --> 00:50:49.015
So when we talk about prevention and good
ways of living and good health and

e6c1743b-39f6-432d-a878-82dc993cbabe-1
00:50:49.015 --> 00:50:52.640
Wellness,
that comes from traditional medicine.

92768d02-46bb-456d-87f5-88493da2c0e1-0
00:50:53.040 --> 00:50:57.000
Traditional medicine is not often where
you go at the end of life.

455dd3f5-7abd-40be-b938-3f1f993d59e4-0
00:50:57.760 --> 00:51:04.240
And so how do we build that into primary
care to other parts of our system?

fb600e0d-0f6c-42b5-b0d2-03d8c5ad7a57-0
00:51:04.600 --> 00:51:07.360
And how do we avoid shaming folks?

fbf9afe2-7b04-451c-8526-e620b397baf8-0
00:51:09.000 --> 00:51:12.080
So we don't want to be shamed.

1dbe9c56-a33e-4336-b24c-ee388049bf6d-0
00:51:13.080 --> 00:51:16.920
And so when we go for help,
how do we not get shamed?

6be1603e-ec72-4409-b505-fb229e473d52-0
00:51:17.560 --> 00:51:21.363
And for Indigenous folks with minimal
trust in the system,

6be1603e-ec72-4409-b505-fb229e473d52-1
00:51:21.363 --> 00:51:23.040
the shame is overwhelming.

a3cc530f-599b-4d4d-8b34-893528f4c2ab-0
00:51:24.040 --> 00:51:32.080
And so I think that's a big piece and not
turning people away when they do go.

c67c8fa6-70dd-46ea-9189-0e9c3fcbd007-0
00:51:33.520 --> 00:51:38.414
So, and in the Indigenous community,
we hear people way often,

c67c8fa6-70dd-46ea-9189-0e9c3fcbd007-1
00:51:38.414 --> 00:51:42.920
too often say they received a Tylenol and
were sent away.

099306da-35f7-4101-9779-f1d6298c67a9-0
00:51:43.760 --> 00:51:49.224
And so how are we looking at those
opportunities for early intervention and

099306da-35f7-4101-9779-f1d6298c67a9-1
00:51:49.224 --> 00:51:54.904
how do we support folks where they're
going and not say you should be here and

099306da-35f7-4101-9779-f1d6298c67a9-2
00:51:54.904 --> 00:52:00.728
you should be there and how do we help
them where they've showed up when they're

099306da-35f7-4101-9779-f1d6298c67a9-3
00:52:00.728 --> 00:52:01.160
ready?

e9584624-968f-4f4f-8dfa-289a503fae32-0
00:52:01.560 --> 00:52:04.120
And I think that does go to the models of
care.

6d1ab114-32b8-4d50-9ebf-09cfff32d6a1-0
00:52:04.360 --> 00:52:09.000
It also goes to how we how our HR systems
are also set up.

3ec91b6c-5384-474c-aa25-1266c2143917-0
00:52:09.320 --> 00:52:12.400
So those are my initial thoughts from
that question.

6ffc9318-4c4a-4594-ad65-3a22c527f36d-0
00:52:12.400 --> 00:52:18.498
Thank you so beautifully shared by
Charlene and the the thing I would add as

6ffc9318-4c4a-4594-ad65-3a22c527f36d-1
00:52:18.498 --> 00:52:20.320
a, as a doc is 2 words.

2aca7b66-c2a5-4550-8ff9-c8ec414492fe-0
00:52:21.360 --> 00:52:23.880
What matters, what matters.

e547801a-d82e-4343-a0bc-75518a4d3dc7-0
00:52:24.240 --> 00:52:29.472
And right now in our I can say this
because I'm past president in our medical

e547801a-d82e-4343-a0bc-75518a4d3dc7-1
00:52:29.472 --> 00:52:32.960
industrial complex and North American in
the world.

099db95c-82cc-4084-bfb7-1765e04ba66d-0
00:52:32.960 --> 00:52:37.589
A lot of what what matters during the
healthcare visit is determined by

099db95c-82cc-4084-bfb7-1765e04ba66d-1
00:52:37.589 --> 00:52:39.840
hospitals, doctors, drug companies.

a022dfe4-fc69-4526-a5cc-fd7d186ca6fe-0
00:52:43.080 --> 00:52:46.040
Is that really what health is, right.

9e55587e-df9b-4236-a094-b84a1a2e701e-0
00:52:46.040 --> 00:52:47.000
And I'm a family doc.

5c057db3-4c5b-4b43-ad2e-2e8355f952e5-0
00:52:47.000 --> 00:52:49.160
I care for people across the lifespan.

c5fb44b8-fe15-498d-9c13-9b832408878c-0
00:52:49.160 --> 00:52:53.665
Some of the most meaningful care I do is
at the end of life,

c5fb44b8-fe15-498d-9c13-9b832408878c-1
00:52:53.665 --> 00:52:59.279
The home visits that I do for people who
are in their last months or weeks,

c5fb44b8-fe15-498d-9c13-9b832408878c-2
00:52:59.279 --> 00:53:01.200
sometimes days of of life.

c3ccb6de-4518-4ece-a75c-41f6296aa945-0
00:53:01.640 --> 00:53:05.687
And it reminds me that, you know,
maybe we should start at,

c3ccb6de-4518-4ece-a75c-41f6296aa945-1
00:53:05.687 --> 00:53:11.285
we should be starting to have those what
matters conversations earlier in people's

c3ccb6de-4518-4ece-a75c-41f6296aa945-2
00:53:11.285 --> 00:53:16.479
health journey rather than kind of give,
giving into that medical industrial

c3ccb6de-4518-4ece-a75c-41f6296aa945-3
00:53:16.479 --> 00:53:21.268
complex lens of hospitals, drugs,
doctors being the thing that matters

c3ccb6de-4518-4ece-a75c-41f6296aa945-4
00:53:21.268 --> 00:53:23.359
during that health interaction.

8e99d985-925f-43e3-a926-e8f139130231-0
00:53:25.400 --> 00:53:30.454
And I mean, I,
I think part of what matters is

8e99d985-925f-43e3-a926-e8f139130231-1
00:53:30.454 --> 00:53:36.800
understanding how, you know,
our policies and our funding.

bba1b4ea-d4ba-4719-b7f3-b87805ce7d27-0
00:53:37.120 --> 00:53:40.535
Funding comes up often as a constraint
and you know,

bba1b4ea-d4ba-4719-b7f3-b87805ce7d27-1
00:53:40.535 --> 00:53:45.240
when we reflect on some of the, you know,
the clients that we work with,

bba1b4ea-d4ba-4719-b7f3-b87805ce7d27-2
00:53:45.240 --> 00:53:48.720
it's always, you know, how do we,
how can we do this?

4c27ddd7-9bd6-485d-b7c6-9f11efcb72b8-0
00:53:48.720 --> 00:53:49.320
We need more money.

9bebba79-637f-424c-b12c-c9ecce623e5a-0
00:53:51.040 --> 00:53:54.993
And the question, I think, you know,
you're speaking to is, well,

9bebba79-637f-424c-b12c-c9ecce623e5a-1
00:53:54.993 --> 00:53:58.108
what matters in assist in a high
performing system,

9bebba79-637f-424c-b12c-c9ecce623e5a-2
00:53:58.108 --> 00:54:02.960
figure out what that is and then figure
out how to use the funds to support that

9bebba79-637f-424c-b12c-c9ecce623e5a-3
00:54:02.960 --> 00:54:03.440
outcome.

de1d9184-aa41-4619-9ff4-e7dfe9dd6ecb-0
00:54:03.880 --> 00:54:08.600
And so I think we need to look at that,
that value money equation often.

d13c8013-09e5-4fb9-8aaa-f61ecbc734bf-0
00:54:09.000 --> 00:54:10.600
And we need to look at it as a system.

17bfb96b-66be-4410-bfab-a2ca68c4ea65-0
00:54:11.000 --> 00:54:12.160
We often do not do that.

7f097aa1-5be5-42a0-bc8e-af40ef56f35e-0
00:54:12.160 --> 00:54:13.400
We often look at it at silos.

dca6a152-8c31-4213-af09-942603465299-0
00:54:13.400 --> 00:54:16.400
And I think that's, you know,
a conversation we can continue to elevate.

5d4f94f9-cb8a-4917-ba0e-62cc7b18f139-0
00:54:16.600 --> 00:54:17.840
And here's so here's one example.

7b2c7477-9cb8-4053-bf3e-8c5110660b11-0
00:54:18.040 --> 00:54:23.169
So a a few months ago we did a,
a project what was a kind of a public

7b2c7477-9cb8-4053-bf3e-8c5110660b11-1
00:54:23.169 --> 00:54:27.640
private partnership with got care,
a home care organization.

4b8f46e8-7d1c-4511-9cf0-0d2871badcc8-0
00:54:28.440 --> 00:54:32.824
And basically the lens was could could we
make a program that has a flexible

4b8f46e8-7d1c-4511-9cf0-0d2871badcc8-1
00:54:32.824 --> 00:54:37.322
prescription that a family doctor can
write or people can self refer for older

4b8f46e8-7d1c-4511-9cf0-0d2871badcc8-2
00:54:37.322 --> 00:54:39.941
adults that are homebound that are,
you know,

4b8f46e8-7d1c-4511-9cf0-0d2871badcc8-3
00:54:39.941 --> 00:54:44.439
at home for most of their their lives and
have difficulty getting out of home.

f64dc675-01f2-40a2-88c5-f24f406a908b-0
00:54:45.160 --> 00:54:50.293
And could that flexible prescription for
a wide variety of things, you know,

f64dc675-01f2-40a2-88c5-f24f406a908b-1
00:54:50.293 --> 00:54:55.426
caregiving supports or a trip to the
grocery store or their doctor's office,

f64dc675-01f2-40a2-88c5-f24f406a908b-2
00:54:55.426 --> 00:54:58.559
could that prevent expensive healthcare
usage?

9f00258f-250a-40f6-8f1f-9354820f27c9-0
00:54:59.040 --> 00:55:00.520
Doctors, drugs, hospitals?

96c2d6a7-be75-4ba4-b90e-145088e4074d-0
00:55:01.400 --> 00:55:05.920
And we evaluated it and actually it
turned out it worked like magic, right?

a2505695-f98d-48ba-ba6a-f85f007b56bd-0
00:55:05.920 --> 00:55:08.720
It was a flexible prescription that
worked like magic.

06fadad2-f180-43c7-9b42-f11a4f9e17a8-0
00:55:08.720 --> 00:55:12.200
And outside of that domain of doctors,
drugs, pharmacies.

84108806-4665-41bd-99cf-783686106f7a-0
00:55:12.200 --> 00:55:16.107
And it LED people to feel more confident
in their care and let them feel like they

84108806-4665-41bd-99cf-783686106f7a-1
00:55:16.107 --> 00:55:19.120
could actually show up to their doctor's
office and feel ready.

e80f90cf-f929-47f7-b2bf-e1b7db3191d3-0
00:55:19.400 --> 00:55:21.208
They could do things that mattered to
them,

e80f90cf-f929-47f7-b2bf-e1b7db3191d3-1
00:55:21.208 --> 00:55:23.920
interact with the healthcare system and
ways that matter to them.

d1d0fec7-8f2d-4e83-8edc-ac26fcdf807c-0
00:55:23.920 --> 00:55:25.960
And it was just so eye opening being part
of that.

8ec8bcf1-552c-47fc-80e8-fe5ff1f0e1ab-0
00:55:26.320 --> 00:55:29.607
And some of these are very low cost
interventions,

8ec8bcf1-552c-47fc-80e8-fe5ff1f0e1ab-1
00:55:29.607 --> 00:55:34.441
like they're not going to 'cause,
you know, millions of dollars, but it's,

8ec8bcf1-552c-47fc-80e8-fe5ff1f0e1ab-2
00:55:34.441 --> 00:55:38.244
it's, it's how we,
how we intervene at the moment that the

8ec8bcf1-552c-47fc-80e8-fe5ff1f0e1ab-3
00:55:38.244 --> 00:55:41.080
patient needs it earlier rather than
later.

b00956d2-9c1b-4815-9029-b25533d8cce4-0
00:55:41.360 --> 00:55:41.960
Doctor Price.

1f4a525e-e21b-4cfe-99b2-279a3bff839b-0
00:55:42.360 --> 00:55:46.378
So one of the things that Dominic, you've,
you've raised, we,

1f4a525e-e21b-4cfe-99b2-279a3bff839b-1
00:55:46.378 --> 00:55:51.305
we created something called Health
Tapestry at McMaster and published it in

1f4a525e-e21b-4cfe-99b2-279a3bff839b-2
00:55:51.305 --> 00:55:55.000
peer reviewed journals and showed that it
was effective.

f64d4f50-1b32-4c76-a6c9-032d948f3b62-0
00:55:55.000 --> 00:55:57.440
Kind of like what the model you were,
you were just describing.

713d6e0c-eb4b-41ed-ac35-0b7fdef8ff3c-0
00:55:58.440 --> 00:56:01.600
But of course we do this all the time in
Canada.

58b8867d-1283-46cd-8a68-360307a2378c-0
00:56:01.600 --> 00:56:06.705
We come up with a model that works in our
environment and then we never able to

58b8867d-1283-46cd-8a68-360307a2378c-1
00:56:06.705 --> 00:56:07.280
scale it.

cde9f09e-4a93-4bb2-b938-2407c8cfa645-0
00:56:07.280 --> 00:56:12.966
We never are able to figure out how to
grow it up from either an urban center

cde9f09e-4a93-4bb2-b938-2407c8cfa645-1
00:56:12.966 --> 00:56:17.560
into a more rural or from a rural into a
more urban, etcetera.

0e06ca3e-1846-4151-a267-4d77edb849c3-0
00:56:18.040 --> 00:56:20.605
And that is,
I think one of our great failings as a

0e06ca3e-1846-4151-a267-4d77edb849c3-1
00:56:20.605 --> 00:56:21.000
country.

e2bf6def-d6af-4f5a-b7ee-67d6988feb80-0
00:56:21.000 --> 00:56:28.520
And that's partly because we are PT
system, a provincial territorial system.

33c4597b-14f8-47c3-8c3f-03489d12a121-0
00:56:29.120 --> 00:56:30.600
We are all in our silos.

110e361a-338a-4143-9f26-db11ceeeddbf-0
00:56:30.600 --> 00:56:34.855
And so one of the things about
understanding of in Canada is how to

110e361a-338a-4143-9f26-db11ceeeddbf-1
00:56:34.855 --> 00:56:38.360
create a system that meets the needs for
all Canadians.

8ae1ddea-7ff6-4f63-a361-ae42c201f6e7-0
00:56:38.360 --> 00:56:41.034
As we,
we are going to have to figure out how to

8ae1ddea-7ff6-4f63-a361-ae42c201f6e7-1
00:56:41.034 --> 00:56:45.400
take some of these great ideas and scale
them so that we start sharing them and

8ae1ddea-7ff6-4f63-a361-ae42c201f6e7-2
00:56:45.400 --> 00:56:49.439
understanding what's effective in
different environments and what are the

8ae1ddea-7ff6-4f63-a361-ae42c201f6e7-3
00:56:49.439 --> 00:56:50.039
principles.

233842c3-dfc7-4c67-a2ae-57a351ddbfbd-0
00:56:50.040 --> 00:56:52.741
And we we have not done a good job of
that,

233842c3-dfc7-4c67-a2ae-57a351ddbfbd-1
00:56:52.741 --> 00:56:55.320
certainly in the the community based care.

84886eca-d5c5-4362-8791-f65e3aed10a2-0
00:56:57.000 --> 00:56:57.720
Thank you, doctor price.

6034dd6b-01ce-462a-bd55-7ce85659e132-0
00:56:57.720 --> 00:57:02.440
So I'm I'm getting the the glances over
here that we're almost near time.

773e872f-fdae-408c-b621-2be7aadd1d71-0
00:57:03.240 --> 00:57:05.800
So I,
I do want to respect everybody's time.

65efabbf-f86d-4bdb-b1c6-f406de8ce425-0
00:57:06.600 --> 00:57:10.920
There were a lot of questions that came
through the online chat.

e74076d9-a795-461e-aea3-23b707c6e482-0
00:57:10.920 --> 00:57:12.800
So I might share that with the three of
you.

befce605-9774-4299-a0ec-087e49a289cd-0
00:57:13.840 --> 00:57:17.756
And then there's a team and,
and an audience here in Toronto that's

befce605-9774-4299-a0ec-087e49a289cd-1
00:57:17.756 --> 00:57:20.635
looking to debrief and discuss exactly,
you know,

befce605-9774-4299-a0ec-087e49a289cd-2
00:57:20.635 --> 00:57:23.400
what we've just spoken about for the past
hour.

b3b66667-b784-49ac-bc1b-27b4bcbe4eaa-0
00:57:23.400 --> 00:57:26.880
There's also another team out in Moncton.

f1e59034-cbf7-4641-b99f-ed8f6dc86aa4-0
00:57:26.880 --> 00:57:31.705
So just want to say thank you on behalf
of everybody for your time today,

f1e59034-cbf7-4641-b99f-ed8f6dc86aa4-1
00:57:31.705 --> 00:57:34.640
for the valuable insights and
contributions.

6d3d394f-f366-4701-94e4-4696dee8d1d8-0
00:57:35.080 --> 00:57:38.249
There is certainly much work to do,
but you know,

6d3d394f-f366-4701-94e4-4696dee8d1d8-1
00:57:38.249 --> 00:57:43.320
some of the paradigm shifts I captured
here, we need to go from silo to system.

1bc8f5e9-45cd-40be-939f-ff57322a96d2-0
00:57:43.320 --> 00:57:48.219
We need to go from hope to action,
and we need to go from exhaustion to joy

1bc8f5e9-45cd-40be-939f-ff57322a96d2-1
00:57:48.219 --> 00:57:48.800
and work.

7641efa9-4215-4491-9e70-8b1390e31b7a-0
00:57:49.040 --> 00:57:51.823
So with that,
thank you everybody who's joined us

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online in the room,
and we will see you again.

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Thank you.