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

Asked these questions at a member event last week. This was the overall response:
Does not represent member voice
Members want authority from Docs of BC
Members want system change, specifically around timely access to referrals
Fair equity and access to services
Real recruitment efforts
Advocacy for Hospitalists

there is no doubt that this document has been well thought out with great intentions and vision. i do feel it might be too superficial in its current state, in that you can sort of "ride on top" of it rather than commit to, or be more accountable for, specific, deeper details. when i imagine DOBC, i imagine firm commitment, transparency and accountability.

some ideas/input (given from a place genuine care and intention and shared passion for healthcare):

in the vision statement you have already included many of the tenets of the quintuple aim of healthcare, but could we include patient satisfaction, health outcomes and resource stewardship as well? .

under values i would love to see the "inclusive" expanded to be "diverse, equitable and inclusive."

for the HA segment - i worry this will end up interpreted or acted upon as a tokenistic "physician at the table" - could we commit to something more like "create intentional, meaningful, and impactful partnerships between HA and physicians..." or something similar?

under "resiliency" - who are we developing mutual trust and accountability with? i think this is a statement your group will understand due to the process of creating the document, but isn't necessarily clear to someone on the outside of the board/working group.

under modernization i don't know what exception services are - is this supposed to be "exceptional" or do you mean along the lines of exempt, or provisional somehow?

under reconciliation as your work moves forward, i think it could be meaningful, specific, and appropriate to say you will work to address the healthcare calls to action from the TRC report across all aspects of the organization (not those exact words) it would acknowledge an even deeper level of commitment and accountability in reconciliation.

other thoughts:

can you please look at making a travel policy that does not penalise or expect leaders who have to travel to pay out of pocket? could we just reimburse the actual hotel fee at specific/recommended rates? i realise you have increased the high season hotel rate but once you add all of the taxes and fees to the DOBC rate (even at the sheraton) it does not cover the cost in both high and low season. other related organizations are obligated to follow the DOBC lead on this as well and cannot exceed set DOBC rates. this can be a considerable inequity or barrier for leaders living outside of vancouver (or major urban areas).

can we please commit to rethinking/restructuring the RA to best leverage the immense concentration of expertise and leadership present (under modernization)?

Can there be a statement about ongoing iteration/evaluation/adaptation of the strategic plan to support the changing needs of members and of healthcare? Or maybe commit to reassess the strategic plan more frequently (example, q 2 years)?

Thank you for asking membership for input on your strategic plan

The World Health Organization has said many times that climate change is the greatest threat to global health of the twenty-first century. Healthy ecosystems are the foundation from which our complex social and structural determinants of health are able to be created.

The healthcare system within BC has already been subject to deadly and costly climate-change-driven events that are having, and will have, fundamental impacts on the sustainability of healthcare within BC unless we more actively become part of the solution by supporting decarbonization of healthcare and adaptation to the changes we see.

I would like to see a greater emphasis on planetary health and decarbonizing healthcare within the draft strategic plan and four priorities to reflect this.

I think physician wellness should also be there in the vision in addition to professional satisfaction. As well, we don't need to just build resiliency (we are resilient, based on MD data, it's the system in which we work that leads to unwell MDs), we need to specifically work towards wellness and wellbeing which I think should be stronger in the priorities.

Medical eduction needs to be influenced by active practitioners. The curriculum and student selection has deviated from a solid, proven system to an experimental and likely detrimental one.

I think our current Mission Statement is better than the proposed because it clearly makes the profession the priority. This is what our professional association is supposed to do. The current Mission Statement reads:
"To promote a social, economic, and political climate
in which members can provide the citizens of BC
with the highest standard of health care while
achieving maximum professional satisfaction and fair
economic reward."
I think the Vision Statement should be re-worked to reflect this.

Also we should be careful not to rely on building "resiliency" to cope with administrative burdens. This is not dealing with the cause. I expect Doctors of BC to advocate forcefully on our behalf to reduce administrative burdens. If it is not going to benefit us or the patient, just say "no"!

to Deardeer:
Do you really think specialists are going to agree to having any kind of equitable compensation shared with us lowly Family Docs?
Do you not realize the power of the Doctors of BC is totally and completely with the Specialists? They can shut the hospitals down immediately, so we have to just do what they want. They want "nurse practitioners" to refer easy-peasy cases to them asap, so anything a little bit difficult, from a medical point of view can just be can be thrown into the "family doctor" garbage can.
Who is acknowledging, or even admitting, this gross disparity of level of care and legal liability, even exists?
Funding, if there is anything left after unionized nursing and para-medical personel get access, should be soley and strictly for Family Physicians providing care for patients who have been referred to them by other so-called primary care practitioners. This referral must be made in the usual way, where the Primary Care Practitioner documents the reason, and attaches appropriate lab/imaging/etc to the document.
This will acknowledge appreciation for the elevated provision of care and hopefully corresponding specialist-level of payment when specialists are unable to manage these patients.

Can we partner with other professionals so that the funding is not just for physicians? It's not helpful when the funding can only be used for physicians. This has led to a discrepancy of physicians to other health professionals ratio --> physicians then are doing other roles like clerical, nursing, social work roles inefficiently.

Physicians should get funding not just for clinical work but to be the well-rounded clinicians who are leaders in healthcare related areas (education, QI, research, policy, etc). BC is in a significant disadvantage to other provinces in recruitment due to the clinical focused contracts that we have.

Our compensation should be equitable between specialties knowing that we are all providing health care instead of surgical or acute receiving more compensation due to historical reasons.

1. Caring should be the first value, not courageous.
2. Amplifying the influence of the physician voice especially at the HA level needs to be prioritized.
3. I would rather Doctors of BC prioritized compensation over business supports.

Under "Compensation and business supports", I would like to see improving equity in pay between the different specialties. Currently, there are wide disparities, with the relatively lower-paid specialties often overrepresented by women (family medicine, pediatrics, psychiatry as examples).

Centralization has hurt medicine. We need to push for community control or valid community input.
We need to better support all physicians in using all of their skills. Help us use our training

It is important that we keep our voice front and centre as health care decisions are made. Longitudinal care is ideal yet fewer physicians wish to have the burden of a 24/7 commitment to their patients. How do we continue to have our physicians not only talk but walk the calling aspect of the profession, rather than letting it just degenerate into any old job? It has always been a privilege to be a physician and feel that you are positively contributing to society.

I would like to hear about GP consultants in the new LFP model. We saw locum coverage but it seems like this was completely overlooked.

Your first priority - amplifying the physician voice in the public health care debates - is key to achieving the other objectives in the Strategic Plan. The BC Government and CPSBC need to know that the public of BC are 100% behind their doctors when we advocate on financial, regulatory and other important policy matters.

To get the full and influential backing of the public, we need to spend money on a PR campaign and then on maintaining a high public profile as the trusted authority on health care. It is important that Doctors of BC be seen by the public as their own best advocate in all Health Matters.

Increasing the influence of OUR voice in the public health debates is key to realising all other priorities. We need to speak with a voice that the BC government and College of Physicians and Surgeons of BC have to listen to. How do we achieve this? By investing substantial financial and human resources in 'building our brand' in the public arena. We need to have the people of BC backing us 100% in our campaign for appropriate compensation and working conditions and we need the public to support our vison for the needed changes in health care delivery. A powerful PR campaign is required, followed by regular public statements giving the Doctors authoritative viewpoint on all medical issues - because Health Matters, and we are the experts!

I echo Dr Ilona Hale's comments. typo in the "modernization" section also. I appreciate the echos of the modified triple aim in the document. we definitely need less silos and more community support & integration for every medical practice in our province. I appreciate the hints at team-based care in the document.

To your fourth point - I have always presumed that the "Doctors of BC" are the representatives of the doctors in BC - not a government ally, nor an organization that oversees and crafts the ethical and cultural changes of medicine.

Docs of BC does not have the mandate to dictate the future of the profession and the culture created therein - this is created by the doctors working in the field, the constraints laid on us by the public, changing society and the current government agendas. It is more appropriately monitored and adjudicated by the College?

To your first point of "increasing the physicians voice" - does this mean getting back to listening to the grassroots of the doctors in the trenches? The transparency of negotiations with the government has been lacking in my opinion. My personal experience is we are working on a rocking boat - we try to plan our practices and suddenly the rules change (again). A case in point most recently - virtual medicine - where there is a mysterious possible change after 3 years of organizing a structure that works in our new reality, but no one is allowed to know. All this ties into the second point of physical wellness, as running a business is a significant mental and financial burden.

There is quite considerable distress that Docs of BC has a fixed agenda of a few and as a result there is talk of a more focused "Union" with grassroots ideals. Having said all this though, there are dedicated and responsive and wonderful people in the Docs of BC. too. I think the scope and mandate of the organization needs to focus down on regaining the support and confidence of the front line doctors as their priority.

This is a very vague plan. I am unsure what the actual objective deliverables are. Of course we support these concepts but there is little to no explanation on how this is meant to be implemented or what actions are being proposed.

Removed by moderator.

A bit too touchy-feely for me. To me Doctors of BC is primarily our negotiating body; your job is to get us the best contracts possible. Number one priority should be remuneration. Everything else smacks as window dressing.