November 2015

OCFP President Dr. Sarah-Lynn Newbery's Opening Address

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On Nov. 12, 2015,  the OCFP welcomed Dr. Sarah-Lynn Newbery as its 60th President. The following is a synopsis of the address Dr. Newbery delivered to members at the 2015 Installation and Awards Ceremony.


Good evening. I am grateful for the opportunity to serve you, the members of the OCFP, as your 60th president, and want to begin by thanking my colleagues on the OCFP Board for their confidence and support, and for all that they have taught me over the past few years of work with the board.

I also want to thank my family – my partner Eli, and my sons Ari and Mateo – for their encouragement and support.
I am deeply grateful to my practice colleagues, both current and past, for their willingness to weave their professional lives with my own and teach me as much as they have about the practice of family medicine. I count on you all to keep me grounded.

Our stories shape us

We are our stories. As family physicians who hear the stories of our patients every day, we know this to be true.

My story in relation to family medicine is a pretty simple one. It is the story of a kid, who grew up in the community of Hazelton in Northern B.C. attending both elementary and high school on the Gitanmaax Reserve with a majority First Nations student population.

It is a story of being inspired by rural family physician role models who grappled with issues that came with working in one of the most impoverished communities in B.C. – a community on the “Highway of Tears” and a community that has faced all of the illnesses that come with poverty. It has grieved its very high rate of suicide and it is a community that celebrates the kind of healing that comes with small victories. It was there that I first learned that family medicine matters.

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Now I have the privilege of being a rural family physician in the community of Marathon, on the North Shore of Lake Superior, 300 km from the nearest tertiary hospital in a Local Health Integration Network that covers 47 per cent of Ontario’s landmass, and holds only two per cent of the population. Marathon is rural and remote and beautiful.

For the past 19 years in Marathon, I have been inspired by a remarkable group of local family physicians and a wide group of mentors who embrace the fullness of comprehensive family physician.
I have come to know the challenges that communities encounter when they have inadequate family physician resources. I also have come to more fully understand the tremendous value of skilled family physicians who are willing to enter into rich relationships with their patients and work hard to meet the needs of the communities they serve.

While I have been shaped by many experiences in Marathon, it was wise words from my colleague Dr. Gord Hollway during my first independent ER shift as a new grad that most shaped my philosophy of family medicine as both a practice and a discipline.

At the start of that shift, I was called to the ER trauma room to see a child who had died several hours earlier of SIDS. In that moment, my most important role was to comfort the grieving family and support the first responders. But what struck me fully was the reality of the challenges of care delivery as an isolated family physician in that remote place. That experience shook my confidence and rocked me to my core.
My colleague Gord – like all wise and supportive mentors would – let me cry on his shoulder. He then said the most significant thing that shapes my work and view of family medicine. Very simply, he said, as he helped me put back together my broken sense of self: “Sarah, you can do this job, because we are in it together.”

At that time I understood Gord’s statement to be all about clinical care. It was about relying on one another in challenging and complicated clinical situations where there is in fact no one else better able or more qualified to provide that care than the local family physicians.

OCFP 2015 Awards

See the full list of 201​5 OCFP Award Winners celebrated at the President's Installation and Awards Ceremony, here.
I now know that the notion of “being able, because we are in it together” is about family medicine more broadly and about our role as family physicians in the larger health-care system. Family medicine as a discipline is as broad as it is deep. When we share our collective skills, knowledge and experience, learning from and teaching one another – whether we are urban academics or rural clinicians – we hold high the potential of improving the care of our patients together.

And at the system level, I know that we can do this work - the whole of this complex and challenging work of high-quality primary care delivery - when we come together as family physicians with our partners across the system.

I believe the OCFP is the organization through which we can come together as family physicians in partnership with other organizations like Association of Family Health Teams of Ontario, Health Quality Ontario, the Ontario Medical Association, the Nurse Practitioners' Association of Ontario, the Association of Ontario Health Centres and the universities to understand the needs of our patients, the complexities of the system, and share our ideas and innovative solutions to our challenges.

In Ontario we have some significant challenges, including access to care, inequity of resource distribution, costly and avoidable hospital use, and of most importance, a wide disparity of health outcomes.

Family physicians play a central and critical role in the health-care system and we are now being called upon to undertake the complex task of transforming the primary care system – to lead the charge in better meeting the needs of our population and providing excellent care for all of our citizens, regardless of geography or economic circumstances.

To do this work as individuals and as a College, we need to better understand and share what we know will help us as family physicians to enable successful transformation in primary care. And we need to do that transformative work while maintaining what we know is of fundamental value to our role as family physicians.

Mapping our true North

The father of family medicine in Canada, Dr. Ian MacWhinney talked about the map and the territory of family medicine. He spoke of them in relation to illness and disease, but I think they apply as well to care and system.

As we work with our patients in our clinics, hospitals, hospices and in their homes, we are working and moving in “the territory” of family medicine.

We are now at a time when the “map” of primary care and family medicine is changing – a process which can feel disorienting. We fear losing our way, or finding ourselves at a destination that was not our intention.

In those instances of feeling lost, we can do what all travelers do when they find the map confusing. We can fall back on two things – we can fall back on the reference points in the landscape and we can rely on our “true North”.
And what are our reference points?

Our reference points are our skills as expert clinicians, our ability to understand and serve a defined population in a community context, and our generalist approach – an approach that places the importance of treating the person above treating the minutiae of a person’s disease or perhaps more commonly their diseases!

Despite all of the changes that have arisen since the discipline of family medicine emerged – technology, electronic medical records, globalization, increasing specialization, increasing chronic disease, increasing team based care – these reference points and their value in guiding our work remain constant.

The centrality and continuity of the physician-patient relationship is our “true North” as family physicians. It is the relationship of trust, deep caring and understanding of a patient’s story, family and context that allows for healing even in the presence of disease. This is fundamentally important to our patients and to our role and value in the health-care system.

It is when we hold on to the “true North” of family medicine and our collective commitment to our patients together, across our communities that we can keep the promise of family medicine to society: A commitment to understand and meet the needs of both individual people and whole populations – and to do so in a way that Barbara Starfield and others have shown us, is the most cost effective foundation to a health-care system.

And I believe that we can remain true to that even as the map of primary care and the system change. While it might feel like it is changing around us, it in fact needs to change through us.

Working together to lead through change

I am truly hopeful about the opportunity that family physicians have at this time in our province’s history to better serve our patients and our communities.

The challenges ahead of us are not small. We are challenged to ensure access to care in the community, and we need to measure, understand and be creative in improving the quality of care that we provide to our practice populations as a whole. We need to advocate for the things that will improve the health of our communities. And all the while, we need to remain mindful of the importance and value of the relationships we have with our patients individually.

To do the big work of transformation well, we need to do it together as a whole system – which includes the Ministry of Health and Long-Term Care, the OCFP and other primary care organizations, the hospital sector and our clinics. We need a clear vision for primary care and we need an evidence-informed approach to how we build and sustain a high-quality primary care system in Ontario.

There is a tremendous opportunity for us as a College to support family physicians in bringing their ideas and energy to this work. The OCFP also has the very important role to support how we come together and to help to shape and communicate a shared vision of a high performing primary care system.

The language that comes to my mind at this time goes beyond collaboration and integration. It is “reconciliation”. I don’t mean that in a formal legal way, but in a more conceptual way. In the Gitksan language no one word directly translates the term reconciliation. Rather it is the concept of “getting the canoe upright and paddling together”.

That image is powerful to me. It implies teamwork, commitment to a journey, movement toward a shared goal and the value of clear vision. It also implies engagement. All experienced paddlers know, and all new paddlers quickly learn, that the fastest way to dump a canoe in difficult waters is to stop paddling! We are at a time, when the waters feel a bit uncertain, a time when it is most important to stay engaged – to “keep our paddles in water”.

Adding value to the central role of family physicians in the future

In my role as OCFP President, I am looking forward to supporting physicians to stay engaged in doing our work day-to-day, in supporting our patients and in leading change within our shared primary care system. I also look forward to hearing from you, the members of the College, about what will help you as we move toward a higher quality, more effective health-care system, built on a stronger primary care foundation that values the central role of family physicians.
 
On behalf of the College, I invite you to think about the wonderful work that is being done across the province by thousands of family physicians every day to serve patients, support the health of families and enhance the vitality of our communities. As a College as we celebrate our award recipients, let’s celebrate all family physicians in Ontario and celebrate what is possible in Family Medicine.

Dr. ​Sarah-Lynn Newbery, MD, CCFP, FCFP
President, Ontario College of Family Physicians
president_ocfp@cfpc.ca
Twitter @OntarioCollege