A layperson’s list of New Year's resolutions for physicians (2023)
This article initially appeared in The Medical Post on January 5, 2023.
As one year ends and another begins, we always feel filled with renewal, optimism and hope. But those things seem in short-supply for physicians these days. Patients, too, are feeling the frustration and can only hope for 2023 to be the year when things get better. To that end, here’s a layperson’s list of New Year’s Resolutions for physicians.
1. A voice for physicians. There are dozens of national, provincial and territorial medical associations, colleges, specialist associations and interest groups. Each has its own mandate, agenda and voice. Each can represent the physician view to the public but also cause confusion amongst the public. As a result, the physician voice is as fractured and fragmented as it is heterogeneous. The public would benefit from one united physician voice.
2. A place for productive debate. It’s natural and good for physicians to debate amongst themselves. They need to discuss ideas, research and hypotheses. Today, that ‘conversation’ is splashed all over the pages of social media in short, and often terse, snippets. It’s hardly the stuff of meaningful debate and peer-review. Physicians need a better forum for more meaningful conversation.
3. Put patients first and foremost. The COVID-19 debate has slowly but surely drawn many physicians into political forums. There is nothing wrong with physicians being a part of democratic debate but it can be harmful if it comes at the expense of a patient-centric view. Physicians, when speaking professionally, need to put patients above all else, including their personal ideologies. “Yes” to patients through politics, but “no” to politics over patients.
4. More training spots and more long-term thinking. Patients have paid the price, now more acutely than ever, for short-term thinking more consistent with election cycles than demographic shifts. The days of Barer-Stoddart had a long-term negative effect on the number of physicians. It’s going to take better planning to reverse and recover from it. Otherwise, shortages will get worse. It costs governments money to train physicians but it costs society more if they don’t.
5. Figure out national licensure once and for all. The idea has been bandied about for years but many physicians, governments and regulatory bodies are still unsure of how it will impact their respective jurisdictions. Will it help remote access for rural communities? Will it flood major centres like Toronto and Vancouver? Will it mean more virtual care and less in-person care? Will it mean two-tiers of care—in person for urban centres and virtual care for rural and remote? Will it end the return of service agreement regimes that many provinces use to recruit IMGs into remote areas as a band-aid solution? If national licensure occurs, are national standards far behind? How would those be set? National licensure would, conceivably, be a bold change but the medical profession won’t jump in until they figure some of these things out. Meanwhile, the public waits.
6. One comprehensive, integrated, user-friendly EHR. A system that allows physicians easy, efficient access to a patient’s health records—charts, labs, drug history, etc.—no matter the health setting would ease the administrative burden on physicians and, more importantly, benefit patients immensely. With technology being what it is today, such an option seems like it’s never been closer but anyone who knows anything about the complexity and politics of EMRs and EHRs also knows such a system is probably still just a dream.
7. Preventative care. There is an increasingly long list of things that people do to themselves and others that cause illness in one form or another. Smoking, drinking, reckless driving, and poor eating and exercise habits are just a few of the more obvious ones. But what about things like indoor air quality, or environmental pollution, or microplastics in our water? Our world now seems dominated by respiratory illness and environmental threats. If physicians could forcefully advocate for the air we breathe—indoors and out—and the water we drink to be clean and free of contaminants (while coupling it with consistent, generational advice on healthier lifestyles), patients may be healthier and alleviate pressure on the system. It’s unlikely governments will drive such an initiative so physicians may be among the only groups that can.
Matt Maruca is a lawyer, communications expert and consultant. He is also an expert in physician compensation and spent a decade as a senior executive of a major medical association.