A New Strategic Plan for Doctors of BC (2024 - 2029)

Digital interconnectivity, pushing Gov't to develop (and act upon) a plan to use AI, etc is crucial. Ensuring use of existing vehicles (eg/Canada Health Infoway and implementing Prescribe IT across BC) are practical and achievable solutions.

Since the Federal Government ruined our ability to save for retirement in our Holdco/PracCos in the 2018 budget, we need an entirely new approach to MD retirement planning. Like all BC civil servants we should have a full defined benefit pension. That should be a strategic priority for us.

agree with putting sustainability more front and centre.

I personally feel that we should not be promoting medicine as a "calling". I think we can achieve the values as listed without feeling like we're called to it, which says to me that it can never be turned off, or that i cannot use my time for any other priorities (family, travel etc).

More environmental sustainability and more meat on exactly how we are going to transform the system

I appreciate the effort that has gone into creating this document and am grateful to those who have dedicated time to this process; this must be a very difficult task. Overall, I don't feel the document as it stands reflects what I would have liked to see in a strategic plan. Although the mission and vision mention patient care, quality healthcare and transforming the healthcare system, the strategic priorities focus largely on improving the situation of physicians and amplifying our already (in my opinion) overly powerful voice. I would have liked to see more attention given to the important WAYS that we need to be re-imagining our health-care system collaboratively with patients, other health professionals, other non-health disciplines and Indigenous people to ensure a more equitable and sustainable system that fosters the well-being of the people of our province. As mentioned below, to add Planetary Health into a strategic plan for a health-focused organization in 2023 as a mere after-thought, is profoundly disappointing. The Doctors of BC should be taking a much stronger position on Planetary Health. I would also have liked to see some attention given to the importance of physician leadership in addressing socioeconomic determinants of health and transforming our system and keeping our population healthy and working with other disciplines to ensure everyone's most basic needs (income, housing, food, security) are met, from cradle to grave. A strategic plan that says we envision making a difference for patients and transforming the healthcare system without any indication about HOW the listed strategic priorities will get us there rings hollow for me. An even more physician-centric model of healthcare is certainly not the solution.

Pretty words.

1. Reduce burnout by advocating against family physicians being available 24/7 to patients in areas where there are emergency services. Reduce burnout by paying physicians for being on call.
2. Create a system for locum on call services.
3. Benefits: physicians are struggling with debt repayment and saving for retirement.

I agree we needed to be funded appropriately for leadership and teaching roles. However most of us engage in these activities because we love it and it provides fulfillment for us. I suggest more expicit recognition for the work done by these individuals - this is necessary to improve and sustain engagement.

The leadership of DoBC is clearly seeking to build trust and amplify the voices of doctors in British Columbia. Yet, this task has its hurdles. One key factor to overcoming them is ensuring that everyone in BC truly understands the healthcare projects and initiatives underway. It's not just about knowing what's happening through an announcement by the government, but grasping how these projects directly impact the quality and accessibility of healthcare they receive as they are being developed.
By being transparent about all aspects of these initiatives, it would allow the public to see the big picture through the lens of the doctors - not just the government: the challenges, the successes, and the areas needing attention.

If DoBC could better inform the population, they can support and advocate for meaningful change alongside us. This collective understanding and push for improvement can make our voice even more influential. It would allow us to better share our expertise, and together, shape a healthcare system where doctors’ insights are valued and everyone's well-being is prioritized.

With respect to several priorities, I wonder if the idea of cultural sensitivity/trauma informed care could become an add-on for any specialty of medicine - in which if a doctor has this training, no matter what field, they would be able to advertise this and be compensated better to account for the more challenging referrals and patient encounters they’d be able to handle, including dealing with possibly more no-shows and increased complexity patients. Time and again, I believe that this would be of use.
I believe this would improve the culture of medicine, and it would create a way for us to know where to send our patients for better care.

Mission: DoBC supports the health of patients, professionals, the health care system and THE PLANET
Vision: Make a difference for patients. Enable culturally-safe, relationship centred care. Support the role of all physicians in helping patients, the profession, our health care system and THE PLANET as we face the climate crisis, pollution and loss of biodiversity.
Values: Medicine is the caring application of knowledge and skill to the betterment of patients, the profession, our health care system and THE PLANET. We follow the principles of Justice, Equity, respect for Diversity, and Inclusion. We are courageous in the pursuit of excellence and challenge the status quo.
Strategic Direction: Ensure physician input in HA decision making. (Does this imply that the FEI is a bit of a failure?) Establish DoBC as a thought leader: engage with the public, the profession, the health care system and government; develop strong policy; innovate; partner with other organizations to strengthen our advocacy (e.g. CAPE, D4PH)
Priorities
Physician health, wellness, and safety: [OK]
Compensation and business supports: [OK]
Future of the profession and the culture of medicine: [OK]
NEW Role of all physicians in supporting "public health": All physicians will be supported to learn about the health issues associated with the climate crisis, pollution, and loss of biodiversity; and to implement actions to mitigate or adapt to these issues - including how to practice sustainably and support sustainability in the health care system.
Enablers
Modernization: Modernize DoBC to provide exceptional service to our members while recruiting and retaining great staff, and assist members with modernizing their practice. This will be with a focus on a "net zero" plan for DoBC and for low carbon practice for physicians.
Sustainability: Embed sustainability into all aspects of our work from respecting member and staff capacity to respecting the capacity of the profession and our health care system and THE PLANET. This means understanding the Social, Environmental and Commercial Determinants of Health.
Truth & Reconciliation: [OK] + We will learn from indigenous people the wisdom of stewardship we will need to adopt to face the coming existential climate crisis and our inevitable societal collapse, probable global catastrophe and possible species extinction.

(references available on request)

What is ailing doctors is the ailing healthcare system that is in need of a major redesign. When setting the strat plan this should be acknowledged as a key pillar of supporting physicians. The moral injury of being the front line representatives of a broken system is not sustainable

Three massive system problems are core to the troubles affecting BC health care in general & BC medicine in particular - that DoBC strategy needs tackle:
One: the deep-seated negative attitude of administrators to doctors that has confounded joint understanding, planning & management for at least the last 50 years - and has to come to distort the doctor- patient relationship - for example, through the actions of administrator controlled regulatory colleges. It was not always like this.
Two: the often depressing track record of medical educators in providing appropriate doctor resources for the modern health care system - for example: a] the unnecessarily long time mandated for training both specialists & generalists, b] the too early emphasis on narrow specialisation, c] the failure of post grad programs to meet the balanced needs of today's patients [ eg too many paeds and too few geriatricians], d] blindness to the practical need of their graduates to learn how to beneficially & co-operatively work with paramedics like physician assistants and np's.
Three: the derivation and support for a real world practical livable compromise between the ideas of medicine as a calling and medicine as an economic commodity open to any profitable exercise, however crass.

I am very disappointed to see that "Sustainability" is greenwashed into the document. The first half of the sentence has nothing to do with sustainability as it pertains to planetary health. Healthcare is responsible for 4% of GHG emissions. With Canada already experiencing the health effects of the related change in climate and ecosystems, this needs to be prioritized for the health of this and future generations. I'm actually shocked that the strategic plan does not include it as a priority.

Doctors of BC, to maintain the respect of membership, needs to become a stronger voice for doctors, and focus less on maintaining collaboration with government at all costs. Many doctors (not myself) are strongly wanting a union to represent their interests. I would prefer DoBC step up into that role and work to regain the trust of its members but unapologetically representing the interests of physicians, and by extension patient care, in this province.