A blueprint for improving physician engagement and leadership in the Canadian health care system
Johny Van Aerde, MD, PhD, and Graham Dickson, PhD
CSPL WHITE PAPER
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The purpose of the CSPL’s white paper1 is to stimulate dialogue and action: to help develop an environment that will create the energy and commitment needed for physicians to take charge of their own future — on their own and in collaboration with their partners in the health care system. For transformation of the Canadian health care system to be successful, physicians must play a central role in planning and implementing change. This necessitates collaborative and distributive leadership in cooperation with other groups — citizens, administrators, politicians, and allied health care professionals — particularly because of the current fragmentation of the system at many levels.
The content of this paper is fueled by commitment, energy, and passion; guided by a clear goal; and accompanied by concrete suggestions for action drawn from the CSPL community. The paper is based on the results of a study2 conducted by the CSPL, with financial and personnel support from the Canadian Medical Association (CMA) and the Centre for Health Innovation (CHI) at the University of Manitoba; on data from Canadian and international studies on the physician leadership needed for effective reform of the health care system; and on conversations with CSPL members in a workshop setting. Yet, it is only a start. Those writing the paper, and the physicians who contributed to it, are fully aware that a systemic, coordinated effort across the whole health care system is needed to ensure that the contribution physicians can make to reform is realized. The paper is intended to stimulate a next step: dialogue and action crafted together by all agents of the Canadian health care system in support of physician engagement and physician leadership. Top
As a profession, physicians have a unique and central role to play in service delivery, and, in most instances, they are paid directly by government rather than health care service delivery organizations. Currently, the processes and methods dedicated to creating and supporting physician leaders, i.e., education, mentorship, and professional leadership development, are disorganized, episodic, and limited in scope, if they exist at all. When changes in service delivery are expected, physicians must develop a critical mass of knowledgeable and effective leaders to ensure they are partners in the process.
Governments, administrators, and physicians themselves at all levels must formally recognize the role of physicians as leaders. Steps must be taken by all groups to ensure that the scope and breadth of physician leadership needed to effectively transform the health care system exist. To that end, a philosophy and infrastructure supporting the creation of meaningful physician engagement and leadership must be built.
The white paper is the first step toward systematically and strategically improving physician engagement and leadership in the Canadian health care system. The process begins with an argument for and articulation of the goal. However, that in itself is not enough. Such a change requires broader systemic engagement of partners who agree on the challenges and the solutions. We recommend actions to stimulate structural, cultural, political, and personal change. Those actions must be informed by a broader dialogue about whether they are appropriate and, more important, how to make them work. The goal is to generate energy to improve physician leadership at all levels and make physicians true partners in efforts to achieve meaningful large-scale change. Top
Recommendations from the white paper
What physicians should do
We recommend that physicians, individually and collectively:
What health care service organizations should do
We recommend that health care organizations, including hospitals, primary care agencies, health regions, and long-term care organizations, either individually or collectively:
What provinces and medical associations should do
We recommend that provincial ministries and medical associations take steps to:
What Canada should do
We recommend the following actions at the national level:
We hope the white paper will stimulate national, provincial, regional, and local conversations to identify and implement actions that will generate greater physician leadership in the area of health care reform.
References
1.Van Aerde J, Dickson G. Accepting our responsibility: a blueprint for physician leadership in transforming Canada’s health care system (white paper). Ottawa: Canadian Society of Physician Leaders; 2017. Available: tinyurl.com/ht2ykoq
2.Snell A, Dickson G, Wirtzfeld D, Van Aerde J. In their own words: Canadian physician leadership. Leadersh Health Serv 2016;29(3):264-81.
Acknowledgements
The CSPL is grateful for the many thoughtful comments and the rich dialogue from physicians and other health professionals during the development of the white paper. We thank our partners in the initial study: the Canadian Medical Association and the Centre for Health Innovation. We also thank the many physicians who contributed to a workshop on this topic during the 2016 Canadian Conference on Physician Leadership.
Authors
Johny Van Aerde, MD, PhD, is editor-in-chief of the Canadian Journal of Physician Leadership and a past president of the CSPL.
Graham Dickson, PhD, is senior research advisor to the Canadian Society of Physician Leaders.
Correspondence to: johny.vanaerde@gmail.com
Efficient and effective reform of Canada’s health care system cannot occur without the active and willing participation and leadership of physicians. Physicians must work with others to change the structural, cultural, and political environment if we are to accomplish that goal. In addition, physicians’ own views of leadership must change, along with the mindsets of system managers, members of other professions, and providers in pursuit of this aim. A number of challenges exist: capacity challenges, mindset challenges, collaborative leadership challenges, educational challenges, and alignment challenges. However, none of these is insurmountable.
The purpose of the CSPL’s white paper1 is to stimulate dialogue and action: to help develop an environment that will create the energy and commitment needed for physicians to take charge of their own future — on their own and in collaboration with their partners in the health care system. For transformation of the Canadian health care system to be successful, physicians must play a central role in planning and implementing change. This necessitates collaborative and distributive leadership in cooperation with other groups — citizens, administrators, politicians, and allied health care professionals — particularly because of the current fragmentation of the system at many levels.
The content of this paper is fueled by commitment, energy, and passion; guided by a clear goal; and accompanied by concrete suggestions for action drawn from the CSPL community. The paper is based on the results of a study2 conducted by the CSPL, with financial and personnel support from the Canadian Medical Association (CMA) and the Centre for Health Innovation (CHI) at the University of Manitoba; on data from Canadian and international studies on the physician leadership needed for effective reform of the health care system; and on conversations with CSPL members in a workshop setting. Yet, it is only a start. Those writing the paper, and the physicians who contributed to it, are fully aware that a systemic, coordinated effort across the whole health care system is needed to ensure that the contribution physicians can make to reform is realized. The paper is intended to stimulate a next step: dialogue and action crafted together by all agents of the Canadian health care system in support of physician engagement and physician leadership. Top
As a profession, physicians have a unique and central role to play in service delivery, and, in most instances, they are paid directly by government rather than health care service delivery organizations. Currently, the processes and methods dedicated to creating and supporting physician leaders, i.e., education, mentorship, and professional leadership development, are disorganized, episodic, and limited in scope, if they exist at all. When changes in service delivery are expected, physicians must develop a critical mass of knowledgeable and effective leaders to ensure they are partners in the process.
Governments, administrators, and physicians themselves at all levels must formally recognize the role of physicians as leaders. Steps must be taken by all groups to ensure that the scope and breadth of physician leadership needed to effectively transform the health care system exist. To that end, a philosophy and infrastructure supporting the creation of meaningful physician engagement and leadership must be built.
The white paper is the first step toward systematically and strategically improving physician engagement and leadership in the Canadian health care system. The process begins with an argument for and articulation of the goal. However, that in itself is not enough. Such a change requires broader systemic engagement of partners who agree on the challenges and the solutions. We recommend actions to stimulate structural, cultural, political, and personal change. Those actions must be informed by a broader dialogue about whether they are appropriate and, more important, how to make them work. The goal is to generate energy to improve physician leadership at all levels and make physicians true partners in efforts to achieve meaningful large-scale change. Top
Recommendations from the white paper
What physicians should do
We recommend that physicians, individually and collectively:
What health care service organizations should do
We recommend that health care organizations, including hospitals, primary care agencies, health regions, and long-term care organizations, either individually or collectively:
What provinces and medical associations should do
We recommend that provincial ministries and medical associations take steps to:
What Canada should do
We recommend the following actions at the national level:
We hope the white paper will stimulate national, provincial, regional, and local conversations to identify and implement actions that will generate greater physician leadership in the area of health care reform.
References
1.Van Aerde J, Dickson G. Accepting our responsibility: a blueprint for physician leadership in transforming Canada’s health care system (white paper). Ottawa: Canadian Society of Physician Leaders; 2017. Available: tinyurl.com/ht2ykoq
2.Snell A, Dickson G, Wirtzfeld D, Van Aerde J. In their own words: Canadian physician leadership. Leadersh Health Serv 2016;29(3):264-81.
Acknowledgements
The CSPL is grateful for the many thoughtful comments and the rich dialogue from physicians and other health professionals during the development of the white paper. We thank our partners in the initial study: the Canadian Medical Association and the Centre for Health Innovation. We also thank the many physicians who contributed to a workshop on this topic during the 2016 Canadian Conference on Physician Leadership.
Authors
Johny Van Aerde, MD, PhD, is editor-in-chief of the Canadian Journal of Physician Leadership and a past president of the CSPL.
Graham Dickson, PhD, is senior research advisor to the Canadian Society of Physician Leaders.
Correspondence to: johny.vanaerde@gmail.com