regina - saskatchewan medical association fall ra... · 2016-11-01 · b) to recess c) questions of...

DELEGATE PACKAGE | NOV. 4-5, 2016

2016FALLRAREGINA

Moving forward: Co-designing an

integrated health system for

Saskatchewan

o5yearsSASKATCHEWANMEDICAL ASSOCIATION

Saskatchewan Medical Association201 - 2174 Airport Drive

Saskatoon, SKCanada S7L 6M6

P: (306) 244-2196 or 1-800-667-3781 (toll-free in Sask.)F: (306) 653-1631E: [email protected]

www.sma.sk.ca

Appendices

CONTENTSRA delegates: the part you play

RA delegates for fall 2016

SMA Board of Directors and staff

Fall 2016 agenda

Agenda highlights for fall 2016

Resolutions: 2016 Spring Representative Assembly

Health system redesign: summary from May to October 2016

Current and past Board of Directors

Board of Directors report

Finance Committee report

Canadian Medical Association report

College of Medicine report

Appendix A - Analysis of modernization session (2016 Spring RA)

Appendix B - Proposed draft budget 2017

Appendix C - Minutes of the 2016 Spring RA

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Moving forward: Co-designing an integrated health system for Saskatchewan

Saskatchewan Medical Association DELEGATE PACKAGE | FALL 2016

2

MEMBER-DRIVENSaskatchewan Medical Association members provide direction and guidance to the organization through the Rep-resentative Assembly and a number of different committees.

RA DELEGATES:

The Representative Assembly is the governing body of the Saskatchewan Medical Association (SMA), compris-ing representatives from regional medical associations, specialty sections, and medical students and residents. It is given the authority to act for the entire member-ship of the association as it considers fit and in the interest of the association and its members.

The Representative Assembly sets the policies of the association. It elects the SMA Board of Directors and

approves the association’s annual budget, including membership dues and other financial policies. It is also responsible for appointing the association’s auditors.

The SMA Board of Directors is responsible to the Representative Assembly and exercises all powers of the association and the Representative Assembly between meetings.

YOUR RESPONSIBILITIESAs an elected member of the Representative Assembly, you have the responsibility of representing your peers in this important forum. To do this, you are expected to engage in association business in a number of ways:

• Participate in bi-annual Representative As-sembly meetings held in May and November in either Saskatoon or Regina.

• Prepare for RA meetings by gathering informa-tion from your colleagues on specific agenda items, as identified by the SMA board and staff.

• Listen to your colleagues and bring their concerns and ideas to the Representative Assembly, either by bringing forward resolutions or by contribut-ing to the debates.

• Welcome comments and feedback from members. Your contact information is made available to SMA members on the secure member section of the SMA website.

The information in this orientation guide is a summa-

ry of information found in the Saskatchewan Medical Association Bylaws, as amended to May 2016.

Observers All SMA members are invited to attend Representa-tive Assembly meetings and have the right to take reasonable part in the deliberations; however, only Representative Assembly delegates have voting powers and will be appropriately identified.

Annual General Meeting All members of the association are entitled to attend and all members are entitled to vote at the annual general meeting, normally held in May. Those mem-bers present constitute a quorum for the transaction of business.

the part you play

3Saskatchewan Medical Association DELEGATE PACKAGE | FALL 2016

Resolutions Delegates are invited to bring resolutions to the Repre-sentative Assembly as a means to establish the SMA’s position on an issue, generate debate on a policy mat-ter, or set direction for the association. For tips on writing a strong resolution, please see page 15.

• Prior to the RA meeting, contact the SMA office at (306) 244-2196 or [email protected], or visit sma.sk.ca to have a resolution added to the agenda and circulated to RA delegates for consideration. SMA staff or committee members may be able to assist delegates in researching or drafting resolutions.

• If a resolution is drafted during the RA meeting, it can be brought forward from the floor at the desig-nated time in the agenda.

Meeting procedures RA meetings are conducted according to Robert’s Rules of Order. The guiding principle is that business will be transacted in an orderly and expeditious manner so as to achieve the will of the majority while allowing the minority to be heard.

A majority of the delegates to the Representative As-sembly constitutes quorum, and all resolutions and motions shall be carried by a majority of the votes cast by those present and voting.

In general, the following order is followed:• The Speaker opens the meeting and outlines the

format for proceedings.

• The Speaker assumes that all delegates will have read and be familiar with the reports that have been circulated in advance. Delegates should come prepared to debate and discuss items on the agenda.

• At the beginning of the RA meeting, a resolution will be introduced to the effect that all reports be received for information.

◊ If this resolution is accepted, each report will be open for discussion as it arises on the agenda.

◊ Resolutions relevant to a report will be re-ceived when the report is under consideration. Recommendations contained in the report will be voted on individually.

• Delegates wishing to speak may rise or proceed to a microphone, and after being recognized by the Speaker, identify themselves.

◊ A delegate may speak more than once to a given subject, provided they do not mo-nopolize the discussion and prevent others from speaking.

◊ The mover of a motion may be allowed to speak last on a motion but this does not automatically close the debate.

• Voting is done by a method determined by the Speaker with the approval of the assembly.◊ Representatives are expected to bring

forward the opinions of those whom they represent. However, voting should be based on merit after hearing the discussion.

The precedence of motions will be:a) To adjournb) To recessc) Questions of privileged) To postpone temporarily (to table)e) To vote immediatelyf ) To limit debateg) To postpone definitelyh) To refer to a committeei) To amendj) To postpone indefinitelyk) The main motion

• Incidental motions such as appeal from the chair, objection to consideration, points of order, parliamentary inquiry, division, etc., will be dealt with as they properly arise.

• Any main resolution, carried or lost, may be reconsidered during the same meeting if, in the judgment of the Speaker, new information might result in a different vote. A resolution previously passed may be rescinded during the same or subsequent meeting but this cannot undo any action which may have been taken since the resolution was adopted.

• If an issue or subject that is insufficiently un-derstood or formulated is brought forward as a resolution, the meeting may decide to consider the subject informally.◊ Formal rules of debate will be suspended, and

a resolution may be formulated by consensus. When a resolution has been worded to the as-sembly’s general satisfaction, the information consideration will end and the resolution will be considered and voted on under regular rules of debate.

◊ If no agreement is reached, the delegates can resolve to end information consideration.


4

Main Motions

MAIN MOTION Purpose: To bring a proposal before the assembly for discussion and decision. Further explanation: The main motion is the presenta-tion by a member to the assembly of any proposal that he/she wishes the group to consider and decide. It is the basic motion for the transaction of business. Since only one subject can be considered at one time, the main motion can be proposed only when no other motion is before the assembly. Main mo-tions that express sentiments or are a formal state-ment of the opinions of the assembly may be stated in the form of resolutions.

MOTION TO RECONSIDER Purpose: To enable the assembly to set aside a vote on a main motion taken at the same meeting or con-vention and to consider the motion again as though no vote had been taken on it.

Further explanation: Main motions are occasionally approved or disapproved under a misapprehension or without adequate information, and sometimes later events cause an assembly to change its mind.

MOTION TO RESCIND

Purpose: To repeal a main motion previously passed. Any main motion that was passed, no matter how long before, may be rescinded unless as a result of the vote something has been done that the assem-bly cannot undo.

Further explanation: The motion to rescind, if passed, af-fects the present and future only, since it is not retroactive.

MOTION TO RESUME CONSIDERATION (TAKE FROM THE TABLE)Purpose: To enable an assembly to take up and con-sider a motion that was postponed temporarily (laid on the table) during the same meeting or convention.

Further explanation: The motion to resume consider-ation is a specific main motion that applies only to a main motion that has been postponed temporarily (laid on the table) at the current meeting or conven-tion. Beyond the current meeting or convention, the temporarily postponed motion lapses and can be brought up only as a new main motion.

Subsidiary Motions

MOTION TO POSTPONE INDEFINITELYPurpose: To prevent discussion, or further discussion, and a vote on the main motion before the assembly; to sup-press the motion without letting it come to a direct vote.

Further explanation: The motion to postpone in-definitely is not a motion to postpone, as its name indicates, but is a motion to suppress or kill the pend-ing main motion. Postponing a motion indefinitely is equivalent to a negative vote on it.

MOTION TO AMENDPurpose: To modify or change a motion that is being considered by the assembly so that it will express more satisfactorily the will of the members.

Further explanation: The most important principle concerning amendments is that they must be ger-mane, that is, they must be relevant to, and have a direct bearing on, the subject of the pending motion that the amendment seeks to change.

MOTION TO REFER TO COMMITTEEPurpose: To transfer a motion that is pending before the assembly to a committee:1. To investigate or study the proposal, make recom-mendations on it and return it to the assembly, or2. To conserve the time of the assembly by del-egating the duty of deciding the proposal, and sometimes of carrying out the decision, to a smaller group, or3. To ensure privacy in considering a delicate matter, or4. To provide a hearing on the proposal, or 5. To defer a decision on the proposal until a more favourable time, or6. To delay or perhaps defeat the proposal by refer-ring it to a hostile committee.

Further explanation: A member may propose the mo-tion in the simple form, “I move to refer this motion to a committee,” or he may include provision in his motion such as: the type of committee, the number of members and how they are to be selected, its chair, or instructions to it.

MOTION TO POSTPONE DEFINITELY Purpose: To put off consideration, or further consid-eration, of a main motion and to fix a definite time for its consideration.

Further explanation: Debate on this motion is restricted to brief discussion of the time or reason for postponement.


MOTION TO LIMIT OR EXTEND DEBATEPurpose: To limit or determine the time that will be devoted to discussion of a pending motion or to modify or remove limitations already imposed on its discussion. MOTION TO VOTE IMMEDIATELYPurpose: To prevent or to stop discussion on the pending question or questions, to prevent the pro-posal of other subsidiary motions except to post-pone temporarily, and to bring the pending question or questions to vote immediately.

Further explanation: The motion to vote immediately is a powerful tool for expediting business. It may be proposed at any time after the motion to which it applies has been stated to the assembly. It cannot be combined with the motion to which it applies; for example, the motion, “I move that we enlarge our assembly hall and that we vote immediately on this motion,” is out of order.

If the motion to vote immediately is proposed as soon as a main motion has been stated to the assembly, its adoption prevents any debate. The motion to vote im-mediately is the most drastic of the motions that seek to control debate. Common parliamentary practice requires a two-thirds vote to terminate debate.

MOTION TO POSTPONE TEMPORARILY (LAY ON THE TABLE)Purpose: To set aside temporarily a pending main motion in such a way that, if the assembly wishes, the postponed motion can be taken up again for con-sideration at any time during the current meeting or convention by a motion to resume its consideration.

Further explanation: A motion to postpone tempo-rarily sets aside the pending main motion for the current meeting or convention unless the assembly votes to resume its consideration. Its effect termi-nates with the current meeting or convention.

Incidental Motions

REQUEST FOR A POINT OF ORDERPurpose: To call the attention of the assembly and of the presiding officer to a violation of the rules, an omission, a mistake or an error in procedure, and to secure a ruling from the presiding officer on the question raised.

Further explanation: A point of order must be raised immediately after the mistake, error or omission occurs. It cannot be brought up later unless the error involved a

violation of law, or of the bylaws, or the accuracy of the minutes. Since it is important that a mistake be cor-rected immediately, a point of order may be raised at any time, even though a speaker has the floor.

MOTION TO APPEALPurpose: To enable a member who believes that the presiding officer is mistaken or unfair in his ruling to have the assembly decide by vote whether the presid-ing officer’s decision should be upheld or overruled. MOTION TO OBJECT TO CONSIDERATION Purpose: To avoid entirely discussion and decision on a main motion that the assembly believes is embar-rassing, unnecessarily contentious, unprofitable or inopportune, or which, for good reason, it does not wish to consider at the time.

Further explanation: Objection to consideration applies only to main motions, including resolutions and recom-mendations, but does not apply to report of officers or committees. When an objection to consideration is made, the presiding officer immediately puts the question to a vote. A two-thirds vote against consid-eration is required to sustain the objection.

If a motion is outrageously tactless, foolish, unnec-essary or completely unsuitable for consideration, or if it is proposed at an inopportune time, or for the purpose of heckling, delaying or embarrassing, the presiding officer may rule the motion out of order on his or her own initiative.

Privileged Motions

QUESTION OF PRIVILEGE Purpose: To enable a member to secure immedi-ate decision and action by the presiding officer on a request that concerns the comfort, convenience, rights or privileges of the assembly or of himself/her-self as a member, or permission to present a motion of an urgent nature, even though other business is pending.

MOTION TO RECESS Purpose: To permit an interlude in a meeting and to set a definite time for continuing the meeting. MOTION TO ADJOURN Purpose: To terminate a meeting or convention.


6

REGIONAL DELEGATES FOR FALL 2016

CYPRESS: Dr. Janna Cuthbert, Dr. Suresh Kassett, Dr. Clare Kozroski, Dr. Amith Mulla

FIVE HILLS: Dr. Mark Brown, Dr. Intheran Pillay, Dr. Fauzi Ramadan, Dr. Kirsty Sanderson, Dr. Brandon Thorpe

HEARTLAND: Dr. Idalberto Jimenez-Guerra, Dr. Francisco Lang, Dr. David Ledding

KEEWATIN YATTHÉ (ATHABASCA): Dr. Melanie Flegel, vacancy

KELSEY TRAIL: Dr. Olabode Ige, Dr. Gert Pieterse, Dr. Eben Strydom

MAMAWETAN CHURCHILL RIVER: Dr. Mike Bayda, Dr. Lee Covenden

PRAIRIE NORTH: Dr. Mahesh Khurana, Dr. Mari La Cock, Dr. Stephen Loden, Dr. Martinus Moolman, Dr. Patrick O’Keeffe, Dr. Janet Tootoosis

PRINCE ALBERT PARKLAND: Dr. Lilanie Cooper, Dr. Rohan Cornelissen, Dr. Collins Egbujuo, Dr. Nnamdi Ndubuka, Dr. Stan Oleksinski, Dr. Joanne Sivertson, Dr. Andre Grobler

REGINA QU’APPELLE: Dr. Mohamed Abdulhadi, Dr. Ramzan Abdulla, Dr. Geeta Achyuthan, Dr. Pamela Arnold, Dr. Mark Cameron, Dr. Patrick Duffy, Dr. Chris Ekong, Dr. Kunal Goyal, Dr. Siva Karunakaran, Dr. Barb Konstantynowicz, Dr. Ryan Lett, Dr. Donald McCarville, Dr. Mohamed Moolla, Dr. Bhanu Tikkisetty Prasad, Dr. Vijay Trivedi

SASKATOON: Dr. Shayne Burwell, Dr. Keith Clark, Dr. Eileen Dahl, Dr. John Dosman, Dr. Annette Epp, Dr. John Gjevre, Dr. Daniel Kirchgesner, Dr. Karen Laframboise, Dr. Barbara Large, Dr. Crystal Litwin, Dr. Selma McMahon, Dr. Dalibor Slavik, Dr. Don Stefiuk, Dr. Grant Stoneham, Dr. Joel Yelland

SUNRISE: Dr. Yusuf Kasim, Dr. Oluwole Oduntan, Dr. Ajibola Ogunbiyi, Dr. Saliu Oloko, Dr. Johann Roodt

SUN COUNTRY: Dr. Nicholaas Botha, Dr. Lise Morin, Dr. Osamudiamen Omosigho

SPEAKER: Dr. Joel YellandDEPUTY SPEAKER: Dr. Clare Kozroski (to be affirmed)SMSS REPS: Ms. Kara Jodouin and Ms. Brooke Hoffman PAIRS REPS: Dr. Neil Kalra and Dr. Chelsea Wilgenbusch

DELEGATES Regional and section delegates hold office for two years, while Student Medical Society of Saskatchewan (SMSS) and Professional Association of Internes and Residents (PAIRS) delegates hold office for one year. The number of regional delegates is dictated by the size of the region: Cypress (4)Five Hills (5)Heartland (3)Keewatin Yatthé (Athabasca) (2)Kelsey Trail (3)Mamawetan Churchill River (2)Prairie North (6) Sections include: anaesthesia, family practice, general surgery, emergency medicine, internal medicine, neurolo-gy, neurosurgery, obstetrics and gynaecology, oncology, ophthalmology, orthopaedics, otolaryngology, paediat-rics, pathology, plastic surgery, physiatry, psychiatry, public health, radiology, retired physicians, sports medicine and urology.

Any branch of the medical profession whose members belong to the College of Physicians & Surgeons of Saskatch-ewan may organize and apply to the board for recognition as a section. A section that represents 10 or more full members of the SMA shall elect, as prescribed by its constitution, one section delegate to the RA.

The association’s immediate past-president is also a RA delegate. The RA Speaker and deputy Speaker are elected by the RA from within its delegation. The SMA holds elections for each region annually, as delegates’ terms ex-pire. All RA delegates must be members of the SMA.

Prince Albert Parkland (7)Regina Qu’Appelle (15)Saskatoon (15)Sunrise (5)Sun Country (3)SMSS (2)PAIRS (2)


SECTION DELEGATES FOR FALL 2016ANAESTHESIA: Dr. Janet Shannon

FAMILY PRACTICE: Dr. Ken Bayly

GENERAL SURGERY: Dr. Ray Deobald

EMERGENCY MEDICINE: Dr. Joanna Smith

INTERNAL MEDICINE: Dr. Guruswamy Sridhar

NEUROLOGY: Dr. Haley Block

NEUROSURGERY: Dr. Joseph Buwembo

OBSTETRICS AND GYNAECOLOGY: Dr. Anita Harding

ONCOLOGY: Dr. Julie Stakiw

OPHTHALMOLOGY: Dr. Ravikrishna Nrusimhadevara

(Saskatoon), Dr. Dustin Coupal (Regina)

ORTHOPAEDICS: Dr. Allan Woo

OTOLARYNGOLOGY: Dr. Mahomed (Shabir) Mia

PAEDIATRICS: Dr. Roona Sinha

PATHOLOGY: Dr. Mary Kinloch

PLASTIC SURGERY: Dr. Geethan Chandran

PHYSIATRY: Dr. Shane Wunder

PSYCHIATRY: Dr. Mysore Renuka-Prasad (Saskatoon),

Dr. Dhanapal Natarajan (Regina)

PUBLIC HEALTH: Dr. Mohammad Khan (south),

Dr. Johnmark Opondo (north)

RADIOLOGY: Dr. Greg Kraushaar

RETIRED PHYSICIANS: Dr. Larry Sandomirsky

SPORTS MEDICINE: Dr. Cole Beavis

UROLOGY: Dr. Kishore Visvanathan

BOARD OF DIRECTORSPRESIDENT: Dr. Intheran Pillay

PAST-PRESIDENT: Dr. Mark Brown

VICE-PRESIDENT: Dr. Joanne Sivertson

HONORARY TREASURER: Dr. Siva Karunakaran

CHAIR: Dr. Thirza Smith

Dr. Chris Ekong, Dr. Annette Epp, Dr. Kunal Goyal, Dr.

Neil Kalra (PAIRS rep), Ms. Bonnie Liu (SMSS rep), Dr.

Barb Konstantynowicz, Dr. Lise Morin, Dr. Guruswamy

Sridhar (CMA rep), Dr. Eben Strydom, Dr. Janet

Tootoosis, Dr. Allan Woo

Board of Directors staff: Ms. Tanessa Bauer, Ms.

Bonnie Brossart

SMA STAFFCindy Anderson - Manager, Benefits & Insurance

Tracey Arnold - Change Management Advisor

Priscilla Bam - Admin. Assistant, Physician Support Programs

Tanessa Bauer - Executive Assistant, Board of Directors

Brenda Bodman - Senior Accountant

Bonnie Brossart - Chief Executive Officer

Mark Ceaser - Economics Director

Sherry Chen - Director, Corporate Services

Gisele Deault - Insurance Administrator

Viktoriia Didkovska - Sr. Compensation Analyst, Economics

Delilah Dueck - Coordinator, Physician Services & Benefits

Nicole Filteau - Change Management Advisor

Carol Friesen - Insurance Assistant

Sheldon Gullason - IT Team Lead

Lana Haight - Communications Advisor

Jane Hickson - Process Improvement Specialist

Ed Hobday - Administrative Director

Randall Kehrig - Coordinator, Physician Relief (Locum) Program

Charlene Koch - Change Management Advisor

Andrea Kohle - Sr. Compensation Analyst, Economics

Joelle Kostiuk - Coordinator, Membership & Benefits

Erin Kulcsar - Change Management Advisor

Jason Loseth - Accounting Technician

Lalania MacNevin - Change Management Advisor

Ivan Muzychka - Senior Communications Advisor

Marcel Nobert - Director, Physician Services & Benefits

Dr. Werner Oberholzer - Director, Physician Advocacy &

Leadership

Elizabeth Pease - Coordinator, EMR Program

Wendy Rink - Executive Assistant / Office Manager

Jo-Ann Rogers - Receptionist

Maria Ryhorski - Communications Advisor

Brenda Senger - Director, Physician Support Programs

Arash Shadmani - Senior IT Programmer (on leave)

Dr. Susan Shaw - Director, Physician Advocacy & Leadership

Sumeet Sheoran - IT Systems / Programmer Analyst

Elaine Stroeder - Receptionist

Samantha Thoen - Coordinator, Membership & Benefits


8

Thursday, November 3Time Topic Location

Section meetings Hotel Saskatchewan

0900 SMA Board of Directors meeting Blue Lounge

2000 Welcome reception - cocktails/appetizers until 2300

All guests welcome Blue Lounge/Library

Friday, November 4Time Topic Presenter/Speaker Location

0745 Registration / hot breakfast Blue Lounge/Library

0830 Representative Assembly convenes Call to order: Welcome and introduc-tions

Dr. Joel Yelland – Speaker Dr. Clare Kozroski – Deputy Speaker

Regency Ballroom

0850 President’s address Dr. Intheran Pillay Regency Ballroom

0905 Minister of Health’s address Honourable Jim Reiter Regency Ballroom

0950 Break/exercise Dr. Shayne Burwell Regency Ballroom

1005 Minutes of the 2016 spring meeting (RA004/16)

Ms. Bonnie Brossart, CEO Regency Ballroom

1010 Review of 2016 spring resolutions Ms. Bonnie Brossart, CEO Regency Ballroom

1020 Finance Committee report Dr. Siva Karunakaran, Honorary Treasurer

Regency Ballroom

1030 College of Medicine questions Dr. Kent Stobart Regency Ballroom

1045 The Physician’s Role in Resource Stewardship

Dr. Carl Nohr, Past-President, AMA

Regency Ballroom

1145 Lunch buffet Blue Lounge/Library

1230 1230 1200

Option 1: Walk the Doc Option 2: Mindfulness session Option 3: Massage therapy

Dr. Eben Strydom Ms. Brenda Senger Regina School of Massage Therapy (sign up at reception)

Lobby Wascana Room Regina Room

1300 Representative Assembly reconvenes Regency Ballroom

1300 Health System Redesign: What’s happened since the spring RA

Dr. Intheran Pillay, President Dr. Joanne Sivertson, Vice-President

Regency Ballroom

1330 Health System Redesign: Opportunities and challenges

Table discussions/report back Regency Ballroom


1445 Leading Change Successfully Dr. Mamta Gautam Regency Ballroom

1600 Update from RMAs/sections and busi-ness from the floor

Regency Ballroom

1615 Resolutions Resolutions Committee Regency Ballroom

1700 Adjourn Regency Ballroom

1800 Cocktail/appetizer reception Blue Lounge/Library

AGENDA Nov. 4-5, 2016 HOTEL SASKATCHEWAN | REGINA


1845 1930 2100

Awards and 50th anniversary celebration Appreciation dinner Entertainment

Regency Ballroom

Saturday, November 5Time Topic Presenter/Speaker Location

0745 Registration/hot breakfast Blue Lounge/Library

0830 Representative Assembly reconvenes Dr. Joel Yelland - Speaker Dr. Clare Kozroski - Deputy Speaker

Regency Ballroom

0830 CMA Board report: Implications for SMA Dr. Guruswamy Sridhar Regency Ballroom

0845 SMA action plan for broad member engagement

In-camera (members only) Regency Ballroom


1000 SMA action plan for broad member engagement (cont.)

In-camera (members only) Regency Ballroom

1100 Resolutions Resolutions Committee Regency Ballroom

1200 Adjourn Regency Ballroom

Friday, November 4 continuedTime Topic Presenter/Speaker Location

The SMA has a storied history dating back to 1905, but in 1966, a motion was passed at a College of Physicians and Surgeons meeting, marking the official founding of the SMA. The association held its first Representative Assembly in 1967 where its first president Dr. M. A. Baltzan was elected. Forty-eight presidents have presided over the SMA since then, leading up to our 50th and current president Dr. Intheran Pillay.

When it began, the SMA had a staff of three. Today, 37 people manage and support various beneficial programs for our physicians. Guided by its membership, the SMA has led the profession through five decades of providing care in an ever-changing health-care landscape; it will continue to do so as physicians actively participate in the redesign of our health-care system, leading the changes that will result in a system that provides better care to patients, better work experiences for physicians, and is sustainable going into the future.

We’re celebrating o5yearsSASKATCHEWANMEDICAL ASSOCIATION

Dr. Marc Baltzan

1st SMA President

1967-1968


10

Dr. Mamta Gautam is a psychiatrist in Ottawa, a clinical professor in the department of psychia-try, University of Ottawa, a certified coach, and president and CEO of PEAK MD. She is a pioneer in the area of physician health and well-being, and is hailed as “the doctor’s doctor.” Mamta is the founding director of the University of Ottawa Faculty of Medicine Wellness Program. This program served as the template for the Canadian Medical Association Centre for Physician Health and Well-being, where she served as the chair of the expert advisory group. She created

the Canadian Psychiatric Association section on physician health and in 2008, she founded the International Alliance on Physician Health, bringing together experts worldwide to collaborate on work in this area. She is the current president of the Federation of Medical Women of Canada.

Dr. Gautam is an internationally known consultant and speaker on professional health and leadership in health care. She wrote a regular column, Helping Hand, in the Medical Post on physician health for many years, and now pens Coach’s Cor-ner, a column in the newsletter for the Canadian Society for Physician Executives. She has written two bestsellers – Irondoc: Practical Stress Management Tools for Physicians and The Tarzan Rule: Tips for a Healthy life in Medicine. Mamta founded PEAK MD in 2009, expanding the concept of physician health to focus on professional wellness, and the proactive primary pre-vention of health of professionals.

She has received numerous awards for her innovative work in professional health, including distinguished fellowships in both the Canadian and American Psychiatric Associations, and was the inaugural recipient of the Canadian Medical As-sociation’s Physician Misericordia Award.

DR. MAMTA GAUTAM LEADING CHANGE SUCCESSFULLY

Dr. Carl Nohr graduated from McGill University in 1978. From 1985 to 1995, he had an academic career at McGill University in general and transplantation surgery. He was a surgery program director, and received an award for excellence in teaching. He obtained a PhD, and engaged in basic and clinical research.

Since 1995, he was re-invented as a community general surgeon in Medicine Hat, Alberta. He has served in leadership roles, including as president of the local medical staff association, co-chair of the working group that wrote the Alberta Health Services provincial Medical Staff Bylaws and Rules, member of College of Physicians and Surgeons of Alberta council, speaker of the Alberta Medical Association (AMA), and president of the AMA.

He has a lifelong passion for patient care, expressed in his interest in professionalism, the social contract, and organized medicine generally. He is an avid student of health legislation, rules of order, and communication skills. He feels it is both a privilege and a duty to assist with the needs of the profession at every level. His vision for the health-care system is based on the principles of shared accountability and stewardship. He supports patients as partners in the co-creation of value in health encounters. The major areas of needed system change are integration, health information management, physician compensation, government relations, precision self-regulation and overall system innovation and design.

DR. CARL NOHR THE PHYSICIAN’S ROLE IN RESOURCE STEWARDSHIP

speaker highlights


Dr. Paul AcheampongDr. Aaron AdesinaDr. Seema AhmedDr. Harmonie Aito

Dr. Omar Al-NourhjiDr. Hope Anigboro

Dr. Farida AtchaDr. Diana Austin

Dr. Abraham AwobemDr. Sarah Bates

Dr. Sanchit BhasinDr. Derek BoechlerDr. Timothy Bradley

Dr. Balraj BrarDr. Barinder Brar

Dr. Ian ChanDr. Ayesha Chandna

Dr. Darren ChewDr. Eke ChukwuDr. Megan Clark

Dr. David ConradDr. Jessica Cowan

Dr. Brindley CupidoDr. Phillip Davis

Dr. Shannon (Starr) DavisDr. Natasha DesjardinsDr. Dorie-Anna Dueck

Dr. Shazia DurraniDr. Bazim EkpenikeDr. Naglaa ElsayedDr. Ehab Eshtaya

Dr. Reuben EzeakaDr. Julia Fox

Dr. Devin FrobbDr. Ashok G. Chhetri

Dr. Kali GartnerDr. Saheed Gbamgbola

Dr. Julia GeigerDr. Remon Ghaly

Dr. Dilip GillDr. Amy GooddayDr. Tyler GormanDr. Peter GrahamDr. Kiran GreywallDr. Amber Grunow

Dr. Haissam HaddadDr. Gregory Hansen

Dr. Robert HaverDr. Jenna Hayden

Dr. Patricia Hizo-AbesDr. Grace Ho

Dr. Nirosha HooverDr. Andrew Huang

Dr. Diphile IradukundaDr. Brenton Janzen

Dr. Sina JavadiDr. Shelby Jenkins

Dr. Eve Marie JohnsonDr. Bradley Joss

Dr. William JourneayDr. Brenda Joyce

Dr. Mohammad KhanDr. Heather Konkin

Dr. Melissa KuhnDr. Alanna Kurytnik

Dr. Matthew KushneriukDr. Irene Lam

Dr. Bernice LauDr. Ronald Laxer

Dr. Arden Lee

Dr. Scott LivingstoneDr. Elizabeth MachneeDr. Catherine MacLean

Dr. Iain MageeDr. Liane ManikkamDr. Andrea Martin

Dr. Sheila MartinsonDr. Elke Mau

Dr. Helen MbataDr. Cheryl Mitchell

Dr. Eric MooreDr. Kimberly Morishita

Dr. Amit MotwaniDr. Kyle Moulton

Dr. Evan NeulsDr. Andreea Nistor

Dr. Afamefuna NwalusiDr. Thomas O’MalleyDr. Jared Oberkirsch

Dr. Joan OdiagahDr. Olumayowa Oke

Dr. Shaqil PeermohamedDr. Thomas Perron

Dr. Tara PetersDr. Dawn PoissonDr. David A PorterDr. Michael Presta

Dr. Gurpreet RakhraDr. Elizabeth RandleDr. Kenneth Ringaert

Dr. Devin RitterDr. Syed Ali Rizvi

Dr. Archie Navid RobertsonDr. James Robertson

Dr. Evelyn Rozenblyum

Dr. Paul RussellDr. Omar Said

Dr. Kerri Lynn SchellenbergDr. Ryck SchielkeDr. Lori Schramm

Dr. Antoine SeguinDr. Mohammadreza Seifolahi

Dr. Ivan SerunkumaDr. Himanshu Shah

Dr. Alyssa ShariffDr. Breanne Silver

Dr. David StammersDr. Jonathon Starr

Dr. Erin SullivanDr. Jacqueline Swan

Dr. Victoria SwanDr. Kimberly TaylorDr. Robyn Tenaski

Dr. Hong TranDr. Jason Trickovic

Dr. Jonathon TuchschererDr. Alison TurnquistDr. Chun-Chun Tyan

Dr. Sabira ValianiDr. Kiran Virik

Dr. Amanda WaldnerDr. Linda Xiao

Dr. Elham YahyaeeDr. Churao YangDr. Tin-Wing YenDr. Colin Yeung

Dr. Yanbo Zhang

CongratulationsWELCOME TO PRACTICE IN SASK!

SASKATCHEWAN MEDICAL ASSOCIATION


12

RESOLUTION 1That the following members have been nominated

as delegates to the Representative Assembly:

• Dr. Melanie Flegel – Keewatin Yatthé (Athabasca)

• Dr. Stephen Loden – Prairie NorthPfeifer/Gjvere - Carried

RESOLUTION 2That the RA appoint Drs. Shayne Burwell, Vijay

Trivedi and Janet Shannon to the Resolutions Com-

mittee.Pfeifer/Sandomirsky - Carried

RESOLUTION 3That the narrative portion of the reports be re-

ceived for information.Sridhar/Pfeifer - Carried

RESOLUTION 4That the minutes of the November 2015 meeting of

the Representative Assembly be approved.Sridhar/Ekong - Carried

RESOLUTION 5That the Representative Assembly approves the ac-

tions of the Board of Directors as reported.Sridhar/Trivedi - Carried

RESOLUTION 6That the Representative Assembly approves the fi-

nancial statements for the year ending December

31, 2015.Shannon/Sridhar - Carried

RESOLUTION 7That the accounting firm of KPMG be appointed as

auditors for the SMA for the year ending December

31, 2016.Shannon/Sridhar - Carried

RESOLUTION 8That the SMA urge the Government of Saskatch-

ewan to work with Indigenous and Northern Af-

fairs Canada, Federation of Saskatchewan Indian

Nations, Metis nation, and northern Saskatchewan

municipal leaders to improve the socio-economic

situation in northern Saskatchewan Indigenous

communities – both on reserve and in municipali-

ties - given the significant impacts that poverty,

crowded housing, unemployment and intergen-

eration trauma associated with residential school

issues have on the physical, mental, social and cul-

tural well-being of these citizens of Saskatchewan.

The Saskatchewan Medical Association’s advocacy

in this issue will improve physician participation

and leadership in the design of community solu-

tions to problems that may lie outside the domain

of traditional health care.Opondo/Ndubuka - Carried

RESOLUTIONS 2016 SPRING REPRESENTATIVE ASSEMBLY


RESOLUTION 9The Saskatchewan Medical Association advocate

that the following should be implemented

as part of the alcohol retail liberalization:

1. Closely manage the availability of alcohol

through the regulation of outlet density, hours

and days of sale.

2. Promote a culture of low-risk drinking in Sas-

katchewan.

3. Provide health and social services that address

substance misuse in the form of alcohol de-

toxification centers and other similar programs

that address the acute and chronic health con-

sequences of alcohol misuse. This is in keeping

with the physician role in leading in the provi-

sion of health care in the community.

Opondo/Ndubuka - Carried

RESOLUTION 10That the SMA pursue a change to the legislation to

permit physicians to dispense medications at their

clinics.Ledding/Strydom - Referred to the Board of Directors

RESOLUTION 11Be it resolved that eHealth be urged to imple-

ment the transfer of health information between

electronic health repositories and physician EMRs

(electronic medical records systems).Sridhar/Thorpe - Carried

RESOLUTION 12The SMA calls on eHealth and regional health au-

thorities to find alternatives to the current practice

of independent regional customization of SCM

(Sunrise Clinic Manager), in order to expedite prov-

ince-wide integration, interoperability, and data

transfer.Sridhar/Thorpe - Carried

RESOLUTION 13That the Family Practice Section of the SMA bring

to the attention of the league presidents and direc-

tors of all levels of hockey that all forms of fighting

and head shots be totally and completely unac-

ceptable and not tolerated. Bayly/Brown - Carried

RESOLUTION 14That the referring physician be compensated for

the time and effort they spend to participate in

LINK and other avenues to contact specialists and

implement recommendations as required on be-

half of patients to expedite patient care. Brown/Konstantynowicz - Carried

RESOLUTION 15The SMA requests that the Government of Sas-

katchewan include the increases in educational op-

portunities and the conviction penalties to reflect

the suffering caused to victims by the consequenc-

es of impaired driving.Bayly/Large - Withdrawn


14

RESOLUTION 16That the SMA continue to work with the Ministry of

Health for the appropriate implementation of the

Planning Tool for Physician Resources in Saskatch-

ewan.Cuthbert/Kozroski - Carried

RESOLUTION 17That the SMA advocate for the abandonment of the

“Whites of the Eyes” principle and for the institu-

tion of appropriate fee codes for communication

with patients via technology.Kozroski/Cuthbert - Carried

RESOLUTION 18The SMA advocate for culturally appropriate tra-

ditional healing, training of Aboriginal students in

health professions and cultural awareness training

for health professionals and students as recom-

mended by the Truth and Reconciliation Commis-

sion.Bayda/Flegel - Carried

RESOLUTION 19The SMA support in principle the development of a

well-coordinated, multidisciplinary team approach

for the treatment of gender dysphoria in Saskatch-

ewan and advocate for additional funding from the

Saskatchewan Ministry of Health for the coordina-

tion/project manager/quality improvement role

of the multidisciplinary team for the treatment of

gender dysphoria. Dosman/Cuthbert - Carried

RESOLUTION 20The SMA encourage physicians in relevant speci-

alities to increase their knowledge and expertise

in treating gender dysphoria, and to provide these

services

• By distributing information on relevant CME

and encouraging physicians to access their

SMA CME funds to attend;

• By supporting clinical traineeships;

• By ensuring remuneration/billing codes for rel-

evant services.Dosman/Cuthbert - Carried


RESOLUTION 21The SMA advocate for the Saskatchewan Ministry

of Health to provide full funding/coverage for pa-

tients seeking treatments that are medically neces-

sary in the treatment of gender dysphoria. These

treatments include psycho-social, medical, phar-

macological and surgical treatments.Dosman/Cuthbert - Carried

RESOLUTION 22The SMA advocate for the Saskatchewan Ministry of

Health to recognize and authorize local Saskatch-

ewan “approvers” (i.e. physicians with appropriate

training and experience) for coverage of medically

necessary procedures in the treatment of gender

dysphoria.Dosman/Cuthbert - Carried

RESOLUTION 23That the SMA work to improve and streamline the

current system of remuneration for physician QI

(quality improvement) work, including projects en-

dorsed at the RHA level.Kozroski/Kassett - Carried

RESOLUTION 24That the SMA should collaborate with the Ministry

of Health to compensate physicians who provide

emergency care to any Canadian resident even

when not covered by any health insurance provi-

sion.Kasim/Omosigho - Carried

RESOLUTION 25The SMA leadership will begin discussions with

the Ministry of Health on major system redesign

to make Saskatchewan the best place to practise

medicine.Sridhar/Brown - Carried

RESOLUTION 26That the SMA advocate for a review of the 42-day

exclusion rule after a procedure.Kozroski/Kassett - Defeated

RESOLUTION 27That the SMA advocate for fee incentives for surgi-

cal practitioners to perform minimally invasive pro-

cedures, as clinically appropriate.Cuthbert/Kassett - Defeated

RESOLUTION 28The SMA works with the Provincial Renal Transplant

Program to cut the wait times for living and cadav-

eric renal transplant recipients.Prasad/Karunakaran - Carried

RESOLUTION 29Be it resolved that SMA, in its continued work with

the Ministry of Health, and regional health authori-

ties, ensure fair and equitable contracts with physi-

cians, including a minimal term of assured employ-

ment.Omosigho/Morin - Carried

RESOLUTION 30The RA thank the committees and staff of the SMA

for their hard work since the last RA.Pfeifer/Harding - Carried


16

BACKGROUND

Modernization of the fee scheduleThe Saskatchewan Medical Association under-took to modernize the physician fee schedule starting in 2015-2016. This process of updating the fee schedule to better reflect technological advances and new modes of medical practice engendered wider discussions about fundamen-tal changes that were urgently needed within the broader health-care system.

The modernization process was bringing to the fore issues related to work-life balance, steward-ship of resources, and continuity of patient care to name but a few. Among those working on the fee schedule update, there was consensus that the update was a mere tweaking, where a sig-nificant overhaul of the health system was likely required.

Many problems initially identified as compensa-tion challenges seemed to be attached to deep-er issues involving management structures and relationships, cultural dynamics and traditions within the health-care system, changes in demo-graphics and advances in technology. It was of-fered that many of the issues identified could be addressed, but more effectively so, if they were considered within a larger re-imagining of the

health system. Modernization of the fee sched-ule is necessary work, but the conversations had broadened and deepened over 2015 and early 2016.

Provincial contextThe discussions the SMA and others were hav-ing around modernization of the fee schedule were also taking place within a provincial politi-cal context. In 2015, the Saskatchewan govern-ment began to experience significant reductions in revenue due to oil and potash price reduc-tions and overall downward trends in the Cana-dian and US economies. When faced with fiscal pressures, governments look carefully at budget allocations, and commonly start in those port-folios with the largest public expenditures (i.e., health). Furthermore, a number of health re-gions in the province are struggling with deficits. The health ministry has signalled that it’s looking for sustainable solutions to these financial pres-sures. Government’s desire to address the cost/quality conundrum in health care is not unique to Saskatchewan.

Quality and outcomesInternational ratings on health system perfor-mance continue to show that Canada does not fare well, typically ranking last or second last

HEALTH SYSTEM REDESIGNsummary from May to October 2016


across a number of aspects. There was a growing impression that Canada was spending a signifi-cant amount of money, but not achieving the ex-pected results when it came to safety or elevated levels of patient care, among others. More and more stakeholders, including the Canadian Med-ical Association, added their voices to the notion that transformational health system change was the only viable path to significantly improve the woes that have dogged provincial health sys-tems.

On the federal scene, a new federal government has announced that it will negotiate a health ac-cord, one that lays out more money for commu-nity and palliative care, both considered areas that need fresh thinking and a stronger, more in-novative strategy. The government is signalling that it is willing to provide more money, but it has voiced concerns to ensure any new monies are applied to specific kinds of programs.

The experience of other PTMAsSome governments have decided to act unilater-ally in terms of health policy design and imple-mentation. In Ontario, a bitter dispute between the Ontario Medical Association (OMA) and the provincial government erupted when the Ontar-io health ministry made unilateral adjustments to the fee schedule to hold costs down. The dis-pute ultimately led to acrimony not just between the OMA and government, but within the OMA itself.

The need for transformation in health care re-mains, and is perhaps more urgent than ever. The deliberations over the past few months have evolved. While the term “modernization” contin-ues to be used, it’s in the context of contempo-rizing the fee schedule. The term “health system redesign”, is meant to be wider, and encapsulates what SMA members and others, are actually talk-ing about and desiring. A reimagined health sys-tem, it is reasoned, will lead to better conditions for patients and for physicians, and will address some of the issues related to compensation. The health system redesign discourse must address

persistent issues including clinical governance, physician leadership, data analytics, and com-pensation. Modernizing the fee schedule is nec-essary, but not sufficient.

2016 SPRING REPRESENTATIVE ASSEMBLY DISCUSSION

The health system redesign discussion was intro-duced at the 2016 Spring Representative Assem-bly held in May 2016 in Regina. The leadership of the SMA felt strongly that it needed to hear from its members on the topic.

In advance of that RA, the SMA prepared a dis-cussion paper titled The Future Physician Role in a Redesigned and Integrated Health System. This discussion paper was e-mailed to all members through eNews, the electronic bi-weekly news-letter, and was discussed by delegates and oth-ers at the RA. The paper was circulated on social media, creating quite a positive buzz both locally and from across Canada. The paper was not pre-scriptive, but its purpose was clear:


18

“The purpose of this discussion paper is to launch a dialogue among our members about the compelling reasons for change and how we want to participate in the change process. Like good medicine, it begins with observation and diagnosis; without agreement on what the is-sues and problems are, no course of action or prescription is likely to lead to the desired out-come. The perspective is global rather than local, and grounded in one overarching ambition: to make Saskatchewan the best place in the world to practise medicine. If we achieve this goal, Sas-katchewan will be the best place in the world to stay healthy, and the best place to receive health care. Our professional ambitions are indistin-guishable from our ambitions for our province and our people.”

At the RA, members shared their reactions to the ideas within the discussion paper and gave SMA leadership the go-ahead to begin discussions on how to co-create a fundamentally redesigned health system. The notion that physicians ought to be involved in fostering positive change in the health system was widely accepted with little debate. Overall, members supported the idea of health system redesign, provided more clar-ity was provided about specific goals and what making “Saskatchewan the best place to practise medicine” would mean for them as individual physicians.

The RA discussions were summarized and sent to all members on eNews. SMA’s Digest magazine, circulated to all members, also carried a couple of feature articles regarding health system rede-sign.

(For a more detailed summary of the discussions held at the 2016 Spring RA, please see Appendix A.)

JULY VISIONING SESSION

In July 2016, the Ministry of Health and SMA co-hosted an intensive, two-day “visioning session” that brought together close to 25 leaders from the ministry, SMA, regional health authorities, College of Medicine and Health Quality Council. Over half of the participants were physicians. The focus was on delving deep into the ideal role of and relationship with physicians in a fully inte-grated and redesigned health system, and to de-liver the best possible care in a sustainable way. The discussions were frank, collegial, and in our view, promising.

CMA GENERAL COUNCIL

The CMA’s General Council was held in August 2016, and the need for serious transformation of the health system loomed large, figuring promi-nently in the remarks made by the federal minis-ter of health Dr. Jane Philpott, and by the newly elected CMA president, Dr. Granger Avery. Com-ments from both illustrated that the need, and

Throughout our system, patients face excessive waiting for care, inadequate patient information transfer and discontinuity of care…

We provide high quality care to patients, but all too often they have waited far too long to receive it. We develop innovative ideas or projects but fail to

scale up these pockets of excellence to the national level. - Dr. Granger Avery, CMA President


the urgency, for transformational health system change. It became clear that the pressing need for health system redesign is not endemic to one province.

In his Inaugural address Dr. Avery noted:“Throughout our system, patients face excessive waiting for care, inadequate patient information transfer and discontinuity of care…However, even after 50 years and myriad advances in med-ical care, care [is not provided] in a seamless and cohesive way. This is Canada’s “crisis of the chron-ic”. We provide high quality care to patients, but all too often they have waited far too long to re-ceive it. We develop innovative ideas or projects but fail to scale up these pockets of excellence to the national level.

“To be truly relevant and effectively respond to Canadians’ present and future needs, our health-care system must…provide patient-centred, in-tegrated, continuing care. We must be able to meet Canada’s acute care requirements as well as the chronic and complex care needs of our growing and aging population.

“Once we reach agreement on the health-care vision, we must use appreciative enquiry ap-proaches to improve the way changes are made to the health-care system. What can I do to achieve this vision — not what I want you to do. …If we are going to seize this moment in time

and actually bring about the crucial changes to our health-care system that will improve access to high-quality care for our patients, we will need to do it by working together.

“I say this with the full understanding that the practice of medicine, and our understanding of the concept of what it means to be a physician, are facing challenges perhaps greater than at any time in recent history.”

In her address to general council, Minister Philpott said:“We spend more per capita on health care than many other countries. What’s worse is that, while we do this, we get poorer outcomes for our pa-tients. You all know the reports of the Common-wealth Fund, including the one that ranked us second from the last in a study that compared Canada to places like Australia, the UK, France, and Germany. The OECD also ranks us poorly on a number of specific areas that will be critical to our future health as a nation.

“This should never be interpreted as a reflec-tion on the quality of care that is delivered. And I want to emphasize that. Canadians, I know, get excellent care – hospital care, medical care. Our institutions in this country are world renowned, for research, for training, and for the provision of specialty care. But the reason to consider this is that we need to think about how that care is pro-vided. Not what the quality of care is, but how


20

it’s delivered, and the extent to which systems in-corporate all the available options and all of the things that we know.

“If we look to our international counterparts who are doing better than we are, we see that the best care is coordinated and comprehensive. We see how financial incentives are aligned with what’s best for patients.

“When we consider the patient’s perspective, one of the most glaring irritants that you live ev-ery day is fragmentation. Fragmentation leads to waste, to frustration, and to dangerous delays in care... Integration is complex, but it’s not rocket science. We know what it should look like. We need an approach where patients are seamlessly connected, both personally and electronically in real time, to their primary care provider, to their hospital as needed, to home care providers, to the pharmacy and to the lab.

“I’ve spent quite a bit of time studying and expe-riencing change in health systems, and one ele-ment that is consistent in any effective change is the absolute necessity of partnership. I’ve told you, and I’m committed to this, that our govern-ment will be a good partner in helping to build

better health care systems. And remember that there has never been a major development in the history of health care in Canada where the federal government was not there, was not be-ing a collaborative player. But governments – provincial, federal, territorial – cannot enable health system improvements alone. We need everyone on board. That includes providers, it includes patients, it includes administrators and activists, educators and inventors, researchers, regulators – I could go on and on.”

HEALTH REGION RESTRUCTURING

If all this was not enough, high level organiza-tional change appears imminent. The advisory panel on health region restructuring has been incredibly busy meeting with and receiving submissions from a broad swath of those work-ing in the health system, and beyond. The SMA was fortunate to meet with the panel and share its hopes and concerns regarding inevitable change, and submit these views subsequently in writing.

2016 FALL RA AND NEXT STEPS

In light of the above, time has been set aside at the 2016 Fall RA to continue the deliberations on health system redesign. Members, via the re-cently concluded President and Vice-president’s Tour, are asking for more clarity around what this might mean for them.

The focus of the deliberative discussions at the fall RA will be to both clarify the membership’s readiness to be active in health system redesign work and to craft action plans related to broadly engaging and involving members.

There’s no question the deliberations at the RA will be candid and thoughtful. We are in the midst of some very important times for the SMA and profession. Let’s plot our course with our eyes wide open, and when we choose our course, let us do so decisively.

Integration is complex, but it’s not rocket science. We know what it should look like. We need an ap-proach where patients are seam-lessly connected, both personally and electronically in real time, to their pri-mary care provider, to their hospital as needed, to home care providers, to the pharmacy and to the lab.


www.sma.sk.ca

• Register for the RA, submit resolutions and access the delegate package.

• Read the latest news and access our SMA Digest and eNews.

• Learn about how the SMA is there to support you through our advocacy, programs and resources.

VISIT US ONLINE TO

SASKATCHEWAN MEDICAL ASSOCIATION

ELECTRONICWe’re going


22

2016 - 2017SMA BOARD OF DIRECTORS

2016-17 Board of DirectorsBack row from left: Dr. Janet Tootoosis, Dr. Barb Konstantyno-wicz, Dr. Neil Kalra (PAIRS), Ms. Tanessa Bauer (SMA staff), Dr. Guruswamy Sridhar (CMA), Dr. Eben Strydom, Dr. Chris Ekong, Mr. Ivan Muzychka (SMA staff), Mr. Marcel Nobert (SMA staff), Dr. Allan Woo, Ms. Bonnie Brossart (SMA staff)

Front row from left: Dr. Lise Morin, Dr. Annette Epp, Dr. Siva Karunakaran (Honorary Treasurer), Mr. Ed Hobday (SMA staff), Dr. Mark Brown (Past-President), Dr. Joanne Sivertson (Vice-Pres-ident), Dr. Intheran Pillay (President), Dr. Thirza Smith (Chair), Dr. Werner Oberholzer (SMA staff)

Missing: Dr. Kunal Goyal, Ms. Bonnie Liu (SMSS)

1968 Board of DirectorsFrom left: Dr. Matthew Davis, Dr. I. Bean, Dr. Marc Baltzan (President), Dr. Park Rich, Dr. Jerry Monks, Dr. Lewis Cawsey, Dr. K. Miller, Dr. Ernie Baergen

o5yearsSASKATCHEWANMEDICAL ASSOCIATION


BOARD OF DIRECTORSBy Dr. Thirza Smith, Chair

MAY 2016

Modernization/health system redesignThe Board of Directors reviewed a discussion paper sent to all RA delegates and which was the focus of a panel discussion and an in-camera discussion at the 2016 Spring RA. The thrust of the paper, and the subsequent discussions, was that health-care system reform will be more successful if physicians are more involved and are leading the change. SMA leadership committed to begin discussing these ideas with the Ministry of Health so as to “make Saskatchewan the best place to practise medicine.”

In May, the board saw an extended discussion on modernization. The SMA recognized this is a strategic priority at present. The board also noted that there exists an appetite on the part of physicians to hear more specifics. There was general agreement that the concept is still somewhat vague at present. The board is committed to engaging with members, using a range of communications methods, so that members’ ideas, questions and concerns can be addressed and more focus and detail can be generated around mod-ernization.

Visibility during provincial election campaignThe board reviewed the outcomes of a proactive me-dia campaign undertaken during the spring provin-cial election. The board was pleased with the results and agreed that similar visibility efforts should con-tinue.

New physician-staff at SMAIn May, the president reported on the hiring of Drs. Werner Oberholzer and Susan Shaw in the shared po-sition of director of physician advocacy & leadership.

Medical assistance in dying (MAID)Issues surrounding MAID were reviewed and there was consensus that more clarity will be key for physi-cians. SMA leadership and staff began working with government to establish guidelines and a process that aims to provide more clarity for physicians.

Improving the resolutions processThe SMA continued to improve the resolution process and the CEO updated the board on some improve-ments. To make the process more efficient and effec-tive, a resolution tip sheet and a new resolution form were adopted for the 2016 Spring RA. The goal is to solicit shorter and more specific resolutions relating to the strategic objectives of the SMA.

Radiology Associates of Regina (RAR)The court challenge that the RAR put to the region was dismissed. The SMA’s involvement continued from the perimeter. The SMA continued to reach out and offer support to RAR.

College of Medicine ACFP contractsIn advance of the May 31 deadline, the SMA provided as much information as possible to assist physicians with their decisions on ACFP with the College of Med-icine. The board discussed issues arising from these contracts and continued to work with members.

Visit by Minister OttenbreitThe board had an opportunity to meet with the Hon-ourable Greg Ottenbreit, minister responsible for rural & remote health, and Max Hendricks, deputy minister of health, among others, from the provincial govern-ment who attended a portion of the May board meet-ing held in advance of the 2016 Spring RA. The board and the minister discussed primary care issues, col-lective bargaining for residents, northern health, sur-gical wait list times, the Physician Planning Tool and ACFP contracts.

Tobacco reduction advocacyThe board fully supported and endorsed a position statement submitted by the Public Health Section pertaining to a number of resolutions passed at the 2015 Fall Representative Assembly (RA) regarding to-bacco reduction strategies. The board directed SMA staff to undertake face-to-face meetings and estab-lish partnerships with other organizations in order to advance the cause of banning smoking in all public places and for a ban on all flavoured tobacco prod-ucts and enacting regulations on e-cigarettes.


24

Resolutions from 2016 Spring RAThe board reviewed resolutions passed at the 2016 Spring RA. The board provided direction to senior SMA staff on the priority level and amount of effort to be expended in the implementation of various aspects of the resolutions. As part of an improved process around resolutions, staff will follow up with mover/seconders to inform them of any proposed next steps on the resolutions they put forward.

RA feedback from members The board received and reviewed a report on the RA evaluation and feedback forms. They heard that overall the RA was seen as a positive experience. The report data indicates that there are opportunities for improvement of the resolution process. Delegates in-dicated that there is a desire to amend the resolution process to allow for delegates to have sufficient time to fully explore and debate the issues being brought forward by the profession.

Medical Assessment BoardThe SMA decided to re-establish its Medical Assess-ment Board (MAB). The MAB is an important mecha-nism for members who need to launch MSB appeals.

Regional medical associations (RMAs)/regional health authorities (RHAs) relationshipsThe board continued to put a high priority on the on-going maintenance of relationships between physi-cians and physician leaders and the RHAs. To that end, the board discussed ways to build positive, trusting relationships between the leadership of the RHAs and the RMAs and looked for ways to continue to resolve conflicts and work co-operatively.

JULY 2016

Board retreat debrief and discussion The Board of Directors tried a method of discussion called generative discovery. Generative discovery enables effective boards to anticipate changes and trends affecting their business landscape. The SMA board also tested the use of a consent agenda which sees selected agenda items accepted without discus-sion, freeing up time for more strategic discussions on other items of business.

Strategic plan The board discussed the need to begin working on a new strategic plan in the coming year, work which is best done in tandem with generative discovery dis-cussions. The board reaffirmed that its focus needs to be on the needs of SMA members.

Modernization presentation and discussionThe board discussed modernization and broached the idea that the SMA needs to engage with govern-

ment on exploring ways to redesign the health-care system. Board members felt that this work is critical but recognize that it will take time. The board was advised about visioning meetings the SMA and other stakeholders will be having with government.

Health System Strategic Plan documents and im-plications for the SMA The board discussed the provincial Health System Strategic Plan documents to explore what implica-tions these documents would have on the SMA. While physician leaders were involved in the creation of the documents, key ideas indicate that further involve-ment would be beneficial. There are also issues in the documents which speak to the need to have physi-cians more involved (i.e. Appropriateness, Choosing Wisely Canada). Discussions on the documents un-derlined the consensus that physician leadership is key, and that the SMA has a role to help physicians make system-wide change. The board looked to con-tinue this discussion at its two-day September board meeting.

Practitioner by-lawsWork continued on these by-laws. The tripartite re-view (Ministry of Health, regional health authorities and SMA) aimed to “tune up” the by-laws in order to ensure that the processes for appointment and reap-pointment of physicians and any disciplinary proce-dures described in the by-laws are reasonable and fair.

Administrative director updateThe board heard an update on the emergency room physician contract (completed), and an update on the alternative funding contracts in relation to physicians at the College of Medicine. Work continues in support of setting up a province-wide approach to radiology remuneration.

SMA 50th anniversary celebrationsThe board provided direction to staff on how to mark the SMA’s 50th anniversary. The goal is to promote the visibility of the SMA and foster greater engage-ment with members and stakeholders. The anniver-sary activities will include a special event at the 2016 Fall Representative Assembly.

SEPTEMBER 2016

Review of draft 2017 budgetThe board reviewed the draft 2017 budget and of-fered some further considerations for the Finance Committee’s final submission to the 2016 Fall Repre-sentative Assembly.

Meeting with the deputy minister of healthThe board met with the deputy minister and assistant deputy minister from the Ministry of Health and had


a candid, respectful, discussion regarding emerging challenges in the health-care system. The deputy minister stated clearly that he views physicians as key leaders in informing health-care policy.

Health system redesign The board held strategic discussions on how to con-tinue to advance health system redesign efforts. The board discussed the need to develop core principles to guide further efforts. The board will oversee the development of a robust plan and struck a commit-tee to undertake this work.

Meeting with section leaders The board took the opportunity to dine with leaders of sections, and listened to their responses to a health redesign discussion.

Policies and procedures for faculty at the College of MedicineThe College of Medicine’s policies and procedures for faculty was discussed, and board members agreed that there needs to be more discussion with College of Medicine staff. Selected board members will move forward with that task.

Health region restructuring The SMA’s response to the panel appointed to study health region structure was discussed. The SMA will continue to advocate for seamless enhanced flow of service and enhanced patient care, and that informa-tion systems must be bolstered to provide real-time intelligence to inform decision making.

Pooled referrals SMA staff updated the board as to some specific im-provements they have received regarding pooled re-ferrals.

Joint Medical Professional Review CommitteeThere was discussion regarding Joint Medical Profes-sional Review Committee process and possible ideas for support to SMA members.

The board recognizes and thanks all our committee mem-bers and chairs for all their work and support this year.

BOARD EXECUTIVE:Dr. Intheran Pillay (President)Dr. Mark Brown (Past-President)Dr. Joanne Sivertson (Vice-President)Dr. Siva Karunakaran (Honorary Treasurer)

DIRECTORS:Dr. Chris EkongDr. Annette EppDr. Kunal GoyalDr. Neil Kalra (PAIRS rep)Ms. Bonnie Liu (SMSS rep)Dr. Barb KonstantynowiczDr. Lise MorinDr. Guruswamy Sridhar (CMA rep)Dr. Eben StrydomDr. Janet TootoosisDr. Allan Woo

CHAIR:Dr. Thirza Smith (Chair)

SMA STAFF:Ms. Tanessa BauerMs. Bonnie Brossart


26

FINANCE COMMITTEEBy Dr. Janet Shannon, Chair

The Finance Committee has met on two occasions since the spring session of the Representative As-sembly (RA).

As a consequence of Canada Revenue Agency’s (CRA) recent ruling that the CMA dues should at-tract GST, the committee met with Mr. Thorimbert, a tax consultant with KPMG, to review the SMA’s status regarding a possible similar ruling by the CRA. After reviewing SMA’s operations, KPMG ad-vised the committee that there is no immediate risk to a GST assessment on SMA membership dues.

Another matter discussed at the July 5 meeting in-cluded a review of the current rental arrangements between the tenants and the numbered company (101211243 Saskatchewan Ltd.) which is jointly owned by the SMA and the CPSS. The committee recommended this issue be further discussed by the board of the numbered company.

Finally, the committee received an update from the SMA staff with respect to (1) the current CMA pension plan deficiency and (2) SMA staff compen-sation strategy. The committee reviewed the infor-mation received from the CMA regarding the CMA staff pension plan (in which SMA staff participate) shortfall and discussed the implication it may have on coming years’ budgets. The committee also ap-

proved recommendations with respect to the SMA staff compensation strategy based on the Hay Group’s job evaluation and market review results.

At its Sept. 21 meeting, the main item of business was consideration of the 2017 SMA budget. In put-ting together the budget, the committee reviewed the financial statements for the first six months of 2016. The committee determined that it would present a balanced budget for the RA’s consider-ation.

On the expenditure side of the budget, provision has been made to provide additional resources for the RA reflecting the increased participation from delegates and members. Increased staffing costs includes provision for an inflationary adjustment, salary progression adjustment, and increased em-ployer pension plan contributions to address the SMA’s share of the current funding shortfall of the CMA pension plan. In addition, there is provision to procure an off-site IT back-up solution. Rent is bud-geted to increase in anticipation of a property tax hike.

In regards to revenues, the committee is recom-mending an increase of three per cent in SMA or-dinary and part-time membership dues bringing them up to $2,060 and $1,215 respectively; an in-crease in student dues from $5 to $8 and resident dues from $7 to $10. The committee is proposing that the administration cost recovery budget lines


be increased by three per cent to offset anticipat-ed inflationary costs of administering the various MCRC negotiated programs and funds. The cost of managing these programs and funds is revenue/cost neutral to the association. These programs/funds include the CME Fund, CMPA Fund, Specialist Recruitment & Retention Fund, Rural & Regional In-centives Fund, Parental Leave Fund, Retention Fund and the Electronic Medical Record Fund.

A new administration cost recovery line of $300,000 per year applied to the Quality & Access Fund (agreed to by the Ministry of Health) has been cre-ated so as to enable the SMA to employ physician leaders and policy/research analysts to advance and implement: a made-in-Saskatchewan physi-cian leadership development program; clinical in-formation and measurement systems relevant to physician performance; and innovative funding models aligned with advancing health system aims and strategic priorities.

The proposed budget which provides a surplus of $180,873 was presented to the Board of Directors for its consideration at its meeting on September 22.

Recommendations:1. That the 2017 ordinary membership dues be

set at $2,060 resulting in the following dues structure:

CMA SMA ConjointOrdinary $495 $2060 $2555Part-time

$248 $1215 $1463

Resident $50 $10 $60Student $12 $8 $20Retired $173 $30 $203Out-of-province

$30

2. That the attached 2017 SMA budget (Appendix B) be approved.

COMMITTEE MEMBERS: Dr. Janet Shannon (Chair)Dr. Siva Karunakaran (Honorary Treasurer)Dr. Kunal GoyalDr. Dalibor SlavikDr. Guruswamy Sridhar

SMA STAFF: Ms. Bonnie BrossartMr. Ed HobdayMs. Sherry ChenMs. Brenda Bodman


28

CANADIAN MEDICAL ASSOCIATIONMODERN CMA

Strategic planningThe CMA continues to execute against its 2015-2017 strategic plan and its three pillars: the profession, pa-tients and the public, and growth and relevance.

The CMA Board of Directors reviewed the results of a priority setting exercise to determine the top prior-ity areas for the remainder of 2016 based on fit, focus and relevance. They are:

• a vision for the future of health care in Canada and the next Health Accord; and

• Canadian Controlled Private Corporations (fed-eral budget implications on medical group struc-tures).

These priorities would complement ongoing advo-cacy work on medical assistance in dying and other key organizational initiatives (e.g., board governance, General Council refresh, 150th anniversary, etc.). Priori-ties will be revisited as the need arises.

The board committed to set aside time at its October meeting to start the next strategic planning cycle (2018-2020).

General Council planningThe board will be recommending changes to General Council to move some business items to the annual meeting of members, including written stewardship reports to be received as part of the annual meeting starting in 2017, appointment of the auditor and by-law amendments. This last change means that Gen-eral Council would no longer be required to approve bylaw amendments; instead it is proposed that bylaw changes be approved by two-thirds of the members in attendance at the annual meeting. And although elections and approval of membership fees could also be included in the above, further consideration will be given to these by the task force on the role of General Council in a modern CMA (see below).

The board also supported interim procedures for member-observer engagement at General Council 2016 to:

• remove the previous requirement that observers needed permission from General Council in order to address the assembly;

• have a separate member-observer microphone managed by the Office of the Speaker; and

• provide open seating to facilitate engagement between observers and delegates.

The board supported the establishment of a task force to review the role of General Council in a mod-ern CMA. Its membership would include representa-tion from the board, Governance Committee, office of the speaker, PTMAs, affiliates, General Council, resi-dents and medical students. Recruitment will begin shortly with a first meeting to be scheduled this fall. This will be followed by consultations and quarterly reporting to the board with anticipated bylaw chang-es as needed in August 2017 and/or 2018 (possible phased approach).

The board also approved changes to the bylaws, for General Council’s consideration, to support the above-noted changes as well as changes to the oper-ating rules and procedures.

The board approved:

• a plan to review board size/composition, which includes temporarily freezing the board’s size and composition until at least 2018 to allow con-sultations, review potential models and recom-mend potential bylaw amendments if necessary (for implementation in 2017/2018);

• a recommendation to General Council to replace the term ‘honorary treasurer’ with ‘chair of the au-dit and finance committee’;

• a plan to review its subsidiary governance struc-ture; and

• revisions to CMA’s corporate privacy policy.

Dr. Brendan Lewis was re-elected honorary treasurer for the 2016-17 association year; Dr. Nasir Jetha was re-elected member-at-large to the Executive Com-mittee; and Dr. Linda Slocombe was re-elected vice-chair of the CMA Board.

MEDICAL PROFESSIONALISM

The board received an update on the multi-year stra-tegic initiative to define a progressive, values-based vision for the future of medical professionalism in Canada.

In light of recent member feedback, directors sup-ported hosting any member discussions on topics related to medical professionalism on the gated por-tion of cma.ca, rather than on the public portion of the website.

The board supported a one-year extension to the cur-rent Memorandum of Understanding (MOU) with the U.S. Liaison Committee on Medical Education with re-gards to accreditation of Canadian medical schools, while a new joint MOU is developed.


The board also approved:

• a Canadian Consensus Framework for Ethical Collaboration between Patient Organizations, Health-care Professionals and the Pharmaceuti-cal Industry;

• a joint policy on access to mental health services; • a request to consult on a revised policy on ap-

pointment/re-appointment privileges; and • joint statements on physical punishment of chil-

dren and youth, and on the Stop Marketing to Kids Coalition.

CMA WELCOMES FEDERAL LAW ON MEDICAL ASSISTED DYING

The CMA was pleased that historic federal legislation on medical assistance in dying was passed by Parlia-ment in mid-June.

For the CMA, this important new law represents the culmination of years of work and consultation with physicians and the public. This extensive outreach informed the CMA’s call for robust federal legislation to ensure access is not impeded, vulnerable patients are protected and personal convictions of health care providers are protected.

The CMA is committed to continued study of this new legislation and its impact on patients. The CMA has also moved to have educational offerings available to help physicians understand and respond appropri-ately to the end-of-life care wishes of their patients. Now available are a foundational online course free of charge for members and a more in-depth face-to-face program for physicians who may wish to provide this service.

• 480 physicians have taken the online course since it was launched in June;

• 30 physicians took the face-to-face course in Van-couver in September (sold-out);

• 36 physicians are registered for the face-to-face course in Toronto in November (over-sold).

In lauding the new legislation as being “a major mile-stone in Canada’s history,” the CMA also stressed that Canada had much work to do to improve access to palliative care for all Canadians who need it, no mat-ter where they live. The CMA is hopeful that there will be a renewed focus on this critical issue and pledged to help ensure that happens.

TOWARD A NEW NATIONAL HEALTH ACCORD

National groups representing patients, doctors, nurs-es and health-care professionals have staked out the latter part of 2016 as the critical period for Canada to develop a new national Health Accord and improving care for seniors continues to be the rallying cry.

The board reviewed a proposal for the CMA’s role in a vision for the future of health care in Canada and the next Health Accord and approved a strategic en-gagement approach to position physicians as a lead stakeholder in Health Accord negotiations with an advocacy platform focused on seniors care and sys-tem accountability.

The CMA is pressing policymakers to act to help en-sure Canada’s health-care system can better care for seniors, which will in turn improve the sustainability of our health-care system as a whole. On Oct. 17, the CMA released its platform for the 2017 Health Accord, the timing of which coincided with the first day of the two-day meeting of federal/provincial and territorial health ministers.

To mark the occasion of the report release, the CMA also hosted a reception in parallel to the health min-isterial meeting. This reception builds on the CMA’s engagement at the pan-Canadian level and follows our previous reception at the last health ministerial meeting in January.

The CMA is advancing three main areas for action in the lead-up to the discussions on the new Health Ac-cord:

• a new demographic top-up to the Canada Health Transfer. This would not change the current transfer formula but would instead deliver new funding to provinces and territories to specifi-cally address the increased costs associated with population aging.

• federal funding for catastrophic pharmaceutical coverage. This would help ensure that Canadians have comparable access to medically necessary prescription drugs.

• increased access to continuing care, including delivering on the federal government’s commit-ment to home care and palliative care with a new home care innovation fund. This fund would also support infrastructure investment for long-term care and provide much-needed support for the backbone of home and community care: the mil-lions of family caregivers across the country.

Expectations are running high for the next Health Ac-cord, which the federal government has pledged to negotiate with the provinces and territories by early 2017. According to the ministerial mandate letters released last November, federal Health Minister Jane Philpott will be in charge of negotiating a new “multi-year Health Accord” with the provinces and territories that “should include a long-term funding agreement.”


30

MEMBER RELEVANCE

The board received an update on recent advocacy relating to the Canadian Controlled Private Corpora-tions and federal budget implications. Since the issue emerged last fall, CMA staff have met with the deputy minister of finance and members of Parliament, in-cluding the parliamentary secretary to the minister of finance and members of the Finance Committee. These meetings validated the CMA’s concerns that group medical structures will likely be impacted by the proposed budget measures.

In advance of the 2017 budget, the CMA has submit-ted a brief detailing our concerns on the proposed tax measure and asking that group medical structures be exempted. CMA members were also asked to partici-pate in a letter-writing campaign to amplify this mes-sage — over 1,300 did so.

Looking ahead, CMA President Dr. Granger Avery will be addressing the Finance Committee on Oct. 26 to reinforce these recommendations. Members will con-tinue to receive updates and grassroots advocacy will continue to ensure broad political awareness at the federal level.

The board also discussed the proposed membership fee for 2017. The board will recommend to General Council that the membership fee for 2017 remain at $495 owing to a variety of factors. However, it is an-ticipated that annual inflationary (CPI) increases will be considered going forward.

CMA BUILDS ON A HISTORY OF INNOVATION WITH NEWEST COMPANY — JOULE

JouleTM is the CMA’s newest company, aimed at foster-ing connections and driving health changes that have an impact on the lives of physicians. Whether through innovation grants and labs, health hacking events, or the delivery of trusted products and services, Joule seeks to provide the edge physicians need every day.

With the recently launched Joule app, members can access trusted clinical and leadership resources and qualify for innovation grants right through their smartphone.

Joule continues to provide best-in-class clinical and professional development resources, making it easier for physicians to be at their best. Online clinical re-sources include:

• DynaMed Plus® — the next-generation point-of-care resource designed to provide quick answers to clinical questions;

• Quantum Clinical SearchTM — your gateway to searching clinical resources on cma.ca;

• leading products including ClinicalKey® and the RxTx Mobile app; and

• CMAJ — Canada’s leading general medical jour-nal.


COLLEGE OF MEDICINEBriefing from Dr. Kent Stobart, Vice-Dean of Education, College of Medicine, University of Saskatchewan

The college has initiated and is embarking on several intense priorities over the next few months including accreditation, a research review, strategic planning, distributed medical education and one faculty. The following are highlights of these critical endeavours.

ACCREDITATION

The college undergoes regular accreditation reviews for all programming areas: undergraduate, postgrad-uate, continuing medical education, and physical therapy.

Following the 2015 Limited Site Visit, the undergradu-ate program received a decision of full accreditation status to March 2018 from its accrediting body, the Committee on Accreditation of Canadian Medical Schools (CACMS) and its American counterpart, the Liaison Committee on Medical Education (LCME).

The program is now preparing for a full accreditation visit from Oct. 29 to Nov. 2, 2017. The preparation for this review has already begun with self-assessment and student feedback already completed. Respond-ing to 12 standards and the corresponding 93 ele-ments is a big task. Medical students, faculty and College of Medicine staff have been hard at work on those items. A mock accreditation visit is scheduled Feb. 5 to 9, 2017, to ready the program for the actual visit. You can follow the UGME accreditation process at http://medicine.usask.ca/students/undergradu-ate/accreditation.php

RESEARCH REVIEW

The office of the vice-dean of research will be con-ducting an external review of research at the College of Medicine. The information and suggestions gath-ered from this external review will assist in develop-ing a progressive strategic plan for research in the col-lege. This review will be conducted from Oct. 30 until Nov. 1, 2016, by five top academics from across North America. The reviewers are:

1. Dr. Gail Annich (SickKids - Hospital for Sick Chil-dren and the University of Toronto)

2. Dr. David Thomas (McGill University)3. Dr. John Wallace (McMaster University)4. Dr. Lorne Tyrell (University of Alberta)5. Dr. Gautam Chaudhuri (UCLA)

STRATEGIC PLANNING

We are at a natural transition point between planning cycles. The university is in the process of a renewal of the vision, mission, and values. Both the College of Medicine and the School of Physical Therapy have initiated a five-year strategic plan (2017-2022). The process to develop the college-wide plan involves several engagement events with a focus on teaching and learning, research and innovation, and clinical care and community engagement.

DISTRIBUTED MEDICAL EDUCATION (DME)

DME is a provincial partnership that offers training and research across the continuum of medical educa-tion, while gaining an understanding of the unique


32

aspects of practicing medicine in rural and remote Saskatchewan. We proudly host seven family medi-cine training centres in La Ronge, North Battleford, Prince Albert, Moose Jaw, Swift Current, Regina and Saskatoon. We are seeing growing retention of our graduates, with 70 to 84 per cent from the DME pro-grams having stayed in rural Saskatchewan. Along-side the robust family medicine program, the college is planning for the launch of longitudinal integrated clerkship (LIC) in 2018. These nine- to 12-month clerkships are based wholly in rural communities where learners participate in the comprehensive care of patients over time, rather than in block rotations.

ONE FACULTY

The college is committed to the notion of One Faculty, in its most inclusive sense, with increased academic engagement from all clinical faculty through con-tributions to research, teaching and administration. Academic programming and the provision of clinical services are overlapping spheres of endeavour. Any new policies or procedures, as well as oversight phi-losophy, style and composition, will need to reflect the realities and complexity of this interface. Efforts to solidify this conceptual model include: de-linking faculty appointment from compensation models, creating new standards for promotion, modifying the policies and procedures to support growing clinical MD faculty membership and ensuring those policies and procedures are fair and equitable.


APPENDIX A Analysis of

SMA MODERNIZATION SESSION2016 Spring Representative Assembly


34

Summary

Reaction to SMA’s discussion paper

Questions:

• Leadership focuso The top three themes derived from the attendees with regards to suggestions for

future SMA focus include: Funding/payment schedule Government advocacy Listening to all physicians/physician support

• Analysis o Feedback on the analysis

All tables that responded unanimously agreed with what they read and heard at the RA and concurred that urgent change is needed.

o What is missing from the analysis? The top three themes derived from the attendees with regards to missing

items from the analysis include: • Health promotion/prevention• Social determinants of health• Better value

• Implications for physicianso The top three themes derived from the attendees with regards to implications of

major change on physician practice include: New team approach Compensation Scope of practice

o The top three themes derived from the attendees with regards to implications of major change on physician well-being include:

Increased stress Improved well-being Loss of autonomy

o The majority of attendees that responded to implications of major change on patient care quality indicated that it would result in better patient care.

o There was a mixed response with regards to comments regarding implications of major change on value for money.


25%

18%

13% 11%

9%

7%

7% 6% 4%

Themes in response to the question "What should the SMA be focussing on as leaders and change agents over the next few

years?" Funding/payment models

Government Advocacy

Physician support

Developing Physician Leadership

Technology (IT/data)

Communication - ClearGoals/messageEducation

Best Practice/Appropriateness

Medical Learner Support

Leadership

What should the SMA be focusing on as leaders and change agents over the next few years?

• 55 responses• Responses from 10 tables• 9 themes:

A. Funding/payment modelB. Government advocacyC. Physician supportD. Developing physician leadershipE. Technology (IT/data)F. Communication - clear

goals/messageG. EducationH. Best practice/appropriatenessI. Medical learner support

A. Funding/payment models• 25% of responses (14 out of 55)

reflect that SMA should be focusing on the funding/payment model.• 60% of tables (6 out of 10) had comments regarding funding/payment models• Some of the interesting responses include:

o “Develop a model of funding that allows physicians to take a more collaborative role and focus on prevention”

o “Reward physicians that participate in preventative/upstream care”B. Government advocacy

• 18% of responses (10 out of 55) reflect that SMA should be focusing on government advocacy.

• 50% of tables (5 out of 10) had comments regarding government advocacy• Some of the interesting responses include:

o “Continue to put pressure on ministry to strengthen primary care”o “Advocacy - seniors care, formulating policy”

C. Physician support• 13% of responses (7 out of 55) reflect that SMA should be focusing on physician support.• 50% of tables (5 out of 10) had comments regarding physician support.• Some of the interesting responses include:

o “SMA needs to visit physicians not attending RA to educate them on future policy/modernization”

o “Listen to retired physicians”D. Developing physician leadership

• 11% of responses (6 out of 55) reflect that SMA should be focusing on developing physician leadership.

• 40% of tables (4 out of 10) had comments regarding developing physician leadership• Some of the interesting responses include:

o “Empower physician leaders to educate their colleagues about change”o “Get physician leadership in CEO/management”


36

E. Technology (IT/data)• 9% of responses (5 out of 55) reflect that SMA should be focusing on technology

(IT/data).• 30% of tables (3 out of 10) had comments regarding technology (IT/data).• Some of the interesting responses include:

o “Get good baseline data”o “Address major IT issues”

F. Communication - clear goals/message• 7% of responses (4 out of 55) reflect that SMA should be focusing on communication -

clear goals/message.• 40% of tables (4 out of 10) had comments regarding communication – clear

goals/message.• Some of the interesting responses include:

o “Determine/define/clarify goals”o “System/inter-system communication around accountability and access”

G. Education• 7% of responses (4 out of 55) reflect that SMA should be focusing on physician education. • 40% of tables (4 out of 10) had comments regarding physician education.• Some of the interesting responses include:

o “Better focus for collaborative care conference (no doctor bashing, less time spent on fee structure)”

o “Education about resources (costs, family demands, impact on wait time)”H. Best practices/appropriateness

• 5% of responses (3 out of 55) reflect that SMA should be focusing on best practices/appropriateness.

• 30% of tables (3 out of 10) had comments regarding best practices/appropriateness• Some of the interesting responses include:

o “Encourage and promote best practices (e.g. choosing wisely)”o “As leaders of change, we need to promote to physicians as well as the public on

the appropriateness of testing/screening procedures”I. Medical learners

• 3% of responses (2 out of 55) reflect that SMA should be focusing on medical learners. • 20% of tables (2 out of 10) had comments regarding medical learners.• Some of the interesting responses include:

o “Engage students in developing ideas”o “Need to focus on the financial burdens of colleagues finishing their training -

how will we address this?”


8%

13%

11%

11%

21%

4%

9%

4%

6%

4% 9%

Themes in response to the question: What is missing from the analysis?

Data Source

Social Determinants of Health

Better Value

Defined Goals

Health Promotion/Prevention

Collaboration with Other Groups

People Focused/Public Input

Increased Government Awareness

Communication/KnowledgeTranslationStandardization

Accountability/Fairness

Reaction to SMA’s discussion paper

1. Do you agree with what you've read and heard yesterday about the urgency of the need to change? • Of the 8 tables that responded to this question, they unanimously agreed to what they

read and heard at the RA and confirmed the urgent need for change. Some notable responses:

o “We need a goal specifically to work towards. We agree that this is a very urgent matter that has been ignored for too long”

o “There is urgent need for change (people getting improperly compensated)”2. What is missing from the analysis?

• 47 responses• Responses from 9 tables• 11 themes

A. Health promotion/preventionB. Social determinants of healthC. Better valueD. Defined goalsE. Accountability/fairnessF. People focused/public inputG. Data sourceH. Communication/knowledge

translationI. Increased government

awarenessJ. StandardizationK. Collaboration with other groups

A. Health promotion/prevention• 21% of responses (10 out of 47)

reflect that the analysis is missing a health promotion/prevention component.• 33% of tables (3 out of 9) had comments regarding a lack of health

promotion/prevention.• Some of the interesting responses include:

o “Targeted teaching/guidance for people to help them make good choices”o “Preventative care”

B. Social Determinants of Health• 13% of responses (6 out of 47) reflect that the analysis is missing a social determinants of

health component.• 67% of tables (6 out of 9) had comments regarding a lack of the social determinants of

health.• Some of the interesting responses include:

o “Focus on physicians in the document but not enough focus on changing determinants of health and lifestyle choices. Need to tackle this before people even make it to the healthcare system”

o “Focus on the social determinants of health (to be funded in the health care budget)”


38

C. Better value• 11% of responses (5 out of 47) reflect that the analysis is missing a better value

component.• 44% tables (4 out of 9) had comments regarding a lack of better value• Some of the interesting responses include:

o “How much could be saved by redundancy?”o “Better value for dollar”

D. Defined goals• 11% of responses (5 out of 47) reflect that the analysis is missing defined goals. • 33% of tables (3 out of 9) had comments regarding a lack of defined goals. • Some of the interesting responses include:

o “How do you define success?”o “Need to know the right goal”

E. Accountability/fairness• 9% of responses (4 out of 47) reflect that the analysis is missing accountability/fairness. • 11% of tables (1 out of 9) had comments regarding lack of accountability/fairness. • Some interesting responses include:

o “Doctors will figure out a way to take advantage (what we need is accountability but we don’t have tools to measure that)”

o “We need a well-compensated model but also fair (until this is addressed, we won’t see change)”

F. People focused/public input• 9% of responses (4 out of 47) reflect that the analysis is missing people focus/public input. • 44% of tables (4 out of 9) had comments regarding lack of people focus/public input. • Some interesting responses include:

o “We do not understand what the public wants from the system”o “Stop talking about patients and start talking about people”

G. Data source• 9% of responses (4 out of 47) reflect that the analysis is missing the data source. • 33% of tables (3 out of 9) had comments regarding the lack of the data source. • Some interesting responses include:

o “Who contributed the information?”o “What data was collected?”

H. Communication/knowledge translation• 6% of responses (3 out of 47) reflect that the analysis is missing a

communication/knowledge translation component. • 22% of tables (2 out of 9) had comments regarding the lack of

communication/knowledge translation. • Some interesting responses include:

o “Communication among colleagues”o “Focus and learn from their own success and success around the world”

I. Increased government awareness• 4% of responses (2 out of 47) reflect that the analysis is missing an increased government

awareness component. • 11% of tables (1 out of 9) had comments regarding the lack of increased government

awareness.


• Some interesting responses include: o “Fiscal responsibility for government to support a physician's understanding to

solve the problem”o “Educational process of the MLAs”

J. Standardization• 4% of responses (2 out of 47) reflect that the analysis is missing a standardization

component. • 22% of tables (2 out of 9) had comments regarding the lack of standardization. • Some interesting responses include:

o “Standardizing certain aspects of family practice (e.g. follow up standards, do not upset physician autonomy)”

o “Tool could look like an electronic system that not only increases access and legibility but also allows someone (auditor) to look at whether the proper steps were taken after someone is diagnosed with something (guidelines)”

K. Collaboration with other groups• 4% of responses (2 out of 47) reflect that the analysis is missing collaboration with other

groups. • 22% of tables (2 out of 9) had comments regarding a lack of collaboration with other

groups. • Some interesting responses include:

o “Integrate social services, corrections, school systems in order to optimize health at every level”

o “More community resources”


40

31%

28%

24%

10%

7%

Responses to the question: What are the possible implications of major change on physician practice?

New team approach

Compensation

Scope of practice

Liability

Need data sharing

Implications for physicians

1. What are the possible implications of major change on physician practice?• 29 responses• Responses from 9 tables• 5 themes

A. New team approachB. Compensation C. Scope of practiceD. LiabilityE. Need data sharing

A. New team approach• 31% of responses (9 out of 29) reflect

that major change would result in the development of a new team approach.

• 56% of tables (5 out of 9) had comments regarding a new teamapproach being the result of major change.

• Some of the interesting comments include: o “Need to be able to work in teams and lose our fear of other health care players

perhaps taking the lead”o “Right people, right job - frees up time to manage chronic diseases (subspecialty

and multidisciplinary)”B. Compensation

• 28% of responses (8 out of 29) reflect that major change would result in a compensation changes.

• 44% of tables (4 out of 9) had comments regarding compensation changes being the result of a major change.

• Some of the interesting comments include: o “If we see more complex cases primarily, we may need to be paid differently (not

by volume, maybe not for procedures)”o “Great change in the way physicians practice and how they are compensated

(ex. Allow physicians to get compensated for meetings over videoconference so that patients in rural areas don’t have to drive in)”

C. Scope of practice• 24% of responses (7 out of 29) reflect that major change would result in scope of practice

changes.• 56% of tables (5 out of 9) had comments regarding scope of practice changes being the

result of major change.• Some of the interesting comments include:

o “Change their practice scope, increase scope so they practice at highest/broadest scope of practice and utilize technology more”

o “Dilution of job”D. Liability

• 10% of responses (3 out of 29) reflect that major change would result in liability changes. • 33% of tables (3 out of 9) had comments regarding liability changes being the result of

major change.


34%

20% 20%

13%

13%

Responses to the question: What are the implications of major change on physicain well-being

Increase stress

Improve well-being

Loss of autonomy

More rewardingpractice

Other

• Some of the interesting comments include: o “Professional legal liability in teams, currently no legal responsibility for teams, it all

falls to MRP”o “Less liability”

E. Need data sharing• 7% of responses (2 out of 29) reflect that major change of would result in a need for data

sharing.• 22% of tables (2 out of 9) had comments regarding a need for data sharing being the

result of major change.• Some of the interesting comments include:

o “Need data collection - increased dialogue/literacy (re: data/data sharing)”o “Lack of valid baseline data. Need better starting information in order to decide

what will work in a new framework (salary vs fee for service) or do we need to design something else”

2. What are the implications of major change on physician well-being?• 15 responses • Responses from 7 tables• 5 themes

A. Increased stressB. Improved well-beingC. Loss of autonomyD. More rewardingE. Other

A. Increased stress• 33% of responses (5 out of 15) reflect

that major change would result in increased stress.

• 57% of tables (4 out of 7) had comments regarding increased stress being the result of major change.

• Some of the interesting comments include:

o “Stressful - cultural change -develop step-wise approach”

o “Struggling to meet targets can increase physicians stress, reduces practice to a statistic”

B. Improve well-being• 20% of responses (3 out of 15) reflect that major change would result in improved

physician well-being.• 43% of tables (3 out of 7) had comments regarding improved physician well-being being

the result of major change.• Some interesting comments include:

o “Overall benefit to physician with less responsibility”o “If we give up some aspects of control, perhaps we will gain more free time

(example, allow pharmacist/counsellors to spend the time with patients we may not always need to spend)”

C. Loss of autonomy• 20% of responses (3 out of 15) reflect that major change would result in a loss of

autonomy.• 43% of tables (3 out of 7) had comments regarding loss of autonomy. • Some interesting comments include:

o “Loss of autonomy (should this threaten us?)”


42

o “Loss of autonomy”D. More rewarding practice

• 13% of responses (2 out of 15) reflect that major change would result in a more rewarding practice.

• 29% of tables (2 out of 7) had comments regarding a more rewarding practice being the result of major change.

• Some of the interesting comments include: o “More satisfaction”o “Currently volume drives payment. Focusing on outcomes would be more

rewarding for physicians”E. Other

• 13% of responses (2 out of 15) reflect that major change would result in other changes to physician well-being.

• These comments include: o “reduction in pay”o “ job security”

3. What are the possible implications of major change on patient care quality?• 7 responses• Responses from 6 tables• For the most part, 71% of responses (5 out of 7) reflect that a major change would result

in better patient care. • 67% of tables (4 out of 6) had comments regarding better patient care. • Some interesting comments include:

o “Better patient care because more competence/coordination”o “Patient centered services”

• Other comments includeo “Focus on meaningful accountability (physicians and hospitals) - not punitive”o “Access to care would be better if we use technology. To do this we could

gather data on its benefits and not rely on the current 'whites of the eyes'”4. What are the possible implications of major change on value for money?

• 5 responseso Due to the small sample size of responses to this question (n=5), all of the

comments will be included. • Responses from 4 tables

o “Value for money - more ancillary - does that decrease physician remuneration does it result in duplication”

o “Accountability for AEFP blended system because reallocation of money”o “As a profession we may need to adjust our perspective/identity as patients may

more actively lead this change. This is a fundamental value change - remember doctors’ strike when Medicare started!”

o “Spend more on bureaucracy and less on care”o “We are not getting value now so to make a major change is necessary cause it's

hard to imagine that we could be any worse off”


APPENDIX B Proposed draft budget 2017


44

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Draft Budget 2017Schedule of Revenue (Schedule 2)

2015 2016 2017

Actual Budget Proposed BudgetGeneral Account:

Membership Fees - SMA 4,178,805$ 4,040,615$ 4,334,108$ Membership Fees - CMA 1,048,608 1,040,000 1,040,000 Membership Fees - RMA 280,239 295,000 295,000 Membership Fees - Sections 99,335 100,000 100,000 Administered Programs 1,442,528 1,650,857 2,073,738 Investment Income 191,159 63,000 87,500 CMA Grant 7,500 7,500 7,500 Health Quality Council 200,000 200,000 200,000

7,448,174 7,396,972 8,137,846

Insurance Administration Account: Insurance allowance/commissions 249,459 254,850 263,000 Other Years Investment Income - - Investment income 42,776 50,000 68,700

Transfer from Health Spending Account 50,000 - Premium rebate allowance and sundry (1,622) 1,600 -

290,613 356,450 331,700

Physician Support Fund: Physician Support Fund Consumption 224,690 - Investment income 181,309 133,000 241,996

181,309 357,690 241,996

Leadership Development Fund: SMA Grant for Leadership 100,000 60,000

Leadership Development Income 28,850 28,850 89,740 Leadership Development Fund Consumption - 6,854 - Investment income 54,495 25,000 65,120

83,345 160,704 214,860

Total Association 8,003,441$ 8,047,126$ 8,926,403$


46

Draft Budget 2017Schedule of Administrative Expenditures (Schedule 3)

2015 2016 2017

Actual Budget Proposed BudgetGeneral Administration Account:Accounting, audit & special services 75,846$ 63,740$ 70,324$Automobile leasing and travel costs 26,076 24,000 26,453Bank charges 5,015 4,000 3,250Credit card processing fees - 5,000 5,000Salaries 1,996,710$ 2,166,718 2,295,662Canada Pension Plan 51,671 50,170 56,739CMA Pension 211,941 217,076 294,304DIP, life, health ins., trans. all. & staff wellness 100,219 109,580 117,532Employment Insurance 23,983 23,484 31,222Workers' Compensation 5,301 5,458 5,360Casual/contract labour 4,213 - 6,000Membership dues, gifts and entertainment 34,715 34,400 68,588Equipment repairs, maintenance agreements & service 76,054 37,562 38,918Website design and maintenance 2,620 - 10,150Information technology & software support 66,111 123,000 102,807Legal & consulting fees 296,537 80,000 153,257President's & Vice President's expenses 8,500 8,500 8,500CEO meeting expense allowance 3,891 10,000 6,000Printing, postage and stationery 67,577 44,000 47,762Rent 71,199 67,500 81,822Telephone 8,501 4,410 9,943Staff education & development 49,091 31,600 32,499Organization development - 60,000 27,929Recruitment/Relocation Cost 8,479 5,000 7,000Publications 18,000 27,265Communication Expenses 1,134 5,000 5,750Insurance-office - 1,600 1,870Member survey 2,209 6,700 7,500Interest 20,000 20,000 7,500Sundry 1,299 - 306

3,218,892$ 3,226,498$ 3,557,213$

Electronic Medical Record FundSalaries 500,806$ 612,180$ 703,591$Canada Pension Plan 16,843 19,404 20,354CMA Pension 70,003 78,573 107,401DIP, life, health ins., trans. all. & staff wellness 31,459 37,000 44,664Employment Insurance 7,850 8,947 10,696Staff education & development - 11,300 9,000Organizational development - 22,500 7,735Printing, postage and stationery 19,888 14,400 17,115Telephones 3,534 2,268 3,563Rent 28,347 26,990 29,319EMR Co-Management Committee (honoraria, per dium, 5,245 7,150 10,000Adhoc/Sundry 3,954 4,300 5,000

687,929$ 845,012$ 968,438$


Schedule of Administrative Expenditures (Schedule 3) 2015 2016 2017

Actual Budget Proposed BudgetInsurance Administration Account:Salaries 183,821$ 215,124$ 212,215$DIP, life, health ins., trans. all. & staff wellness 9,887 10,659 15,177Canada Pension Plan 6,254 8,032 8,015CMA Pension 24,968 27,485 32,908Employment Insurance 3,101 3,792 4,212Accounting, audit & special services 14,849 15,000 15,024Bank charges 1,927 2,200 2,041Printing, postage and stationery 11,119 10,750 8,983Telephone 1,551 1,134 1,870Rent 14,174 13,500 15,389Staff education & development 385 5,000 4,000Organizational development - 10,000 3,438Waived Life Insurance Premiums 775 775 -Membership dues & insurance 1,584 1,999 1,708IT fees - 24,000 -Legal fees 1,200 -Sundry - - -

275,595$ 349,450$ 324,979$

Leadership Development Fund:Accounting, audit & special services 4,800 3,000 4,916Salaries 37,460 40,162 42,295Canada Pension Plan - 448 496CMA Pension 2,979 3,284 3,153DIP, life, health ins.,transp. all. & staff wellness 1,914 1,223 1,391Employment Insurance - 211 261Printing, postage and stationery 1,102 800 567Credit card fees - 400 646Telephone 172 126 118Rent 1,417 1,350 972

49,844$ 51,004$ 54,816$

Physician Support Fund:Accounting, audit & special services 14,400 8,000$ 13,085$Salaries 116,514 162,791 145,631Canada Pension Plan 2,759 4,326 4,071CMA Pension 14,560 22,190 23,103DIP, life, health ins.,transp. all. & staff wellness 6,375 11,826 6,578Employment Insurance 1,316 2,725 2,139Staff education & development - 2,100 2,500Organizational development - 4,200 2,148Printing, postage and stationery 7,716 5,600 4,539Telephone 1,207 882 945Bank charges, interest, and exchange 15 50 15Rent 4,252 4,050 7,775Educational material - 1,500 -Sundry - 2,500 1,000

169,114$ 232,740$ 213,529$

Total Association 4,401,374$ 4,704,704$ 5,118,974$


48

Draft Budget 2017Schedule of Committee Expenses (Schedule 4)

2015 2016 2017

Acutal Budget Proposed BudgetGeneral Account:Representative Assembly 351,032$ 315,000$ 386,205$CMA General Council 70,032 85,000 75,000Primary Health Care 31,505 55,000 64,136Economics & Intersectional Council 45,218 40,000 47,446Finance 14,199 16,000 14,000Insurance 2,854 1,600 2,000Legislative & Policy 16,133 30,000 45,000Representation to Outside Organizations 2,547 3,000 -Health Information 12,339 10,000 9,070Rural Practice 43,550 50,000 45,550SRR 4,767 6,125 6,392Family Physician Comprehensive Care - 2,500 6,701Tariff 8,235 10,000 17,026Uninsured Services - - 4,930Ad Hoc 880 - 1,673

603,291$ 624,225$ 725,130$

Physician Support Fund:Physician Health Program 59,086$ 70,000$ 65,442$JMPRC 19,674 15,000 20,480Medical Benevolent Society 99 250 163Consulting/Intervention 32 -

78,891$ 85,250$ 86,085$

Total Association 682,182$ 709,475$ 811,215$


APPENDIX C Minutes of the

SASKATCHEWAN MEDICAL ASSOCIATION2016 Spring Representative Assembly


50

Spring Representative Assembly May 6-7, 2016 CONFIDENTIAL FOR RA DELEGATES/MEMBERS ONLY

1 | P a g e

MINUTES

Representative Assembly

of the

SASKATCHEWAN MEDICAL ASSOCIATION 001. The Representative Assembly of the Saskatchewan Medical Association met on

May 6-7, 2016, in the Regency Ballroom, Hotel Saskatchewan, Regina, SK. CALL TO ORDER

002. The meeting commenced at 8:30 am Friday, May 6, 2016. 003. Dr. Joel Yelland, speaker, called the meeting to order and advised that business would

be conducted according to Robert’s Rules of Order. ROLL CALL 004. A list of delegates who attended is attached. INTRODUCTION OF MEMBERS/GUESTS 005. Dr. Yelland welcomed RA delegates, observers and guests. The following special guests

were recognized: From the Canadian Medical Association: Dr. Jeff Blackmer, Vice-President of Medical

Professionalism; Dr. Chris Simpson, Past President. From the Ministry of Health: Honourable Greg Ottenbreit, Minister of Rural and Remote Health; Ms. Karen Lautsch, Assistant Deputy Minister; Mr. Christopher Thresher, Chief of Staff to the Minister of Rural and Remote Health; Dr. Ty Josdal, Senior Medical Officer. From the College of Physicians and Surgeons of Saskatchewan: Dr. Karen Shaw, CPSS Registrar; Dr. Micheal Howard-Tripp, Deputy Registrar. From Regional Health Authorities: Mr. Keith Dewar, CEO and President, RQRHR; Ms. Bev Vachon, CEO of Cypress Regional Health Authority; Ms. Cheryl Craig, CEO of Five Hills Health Region and Ms. Cecile Hunt, CEO of Prince Albert Parkland Regional Health Authority, Mr. Andrew Will, Interim CEO, Saskatoon Health Region and CEO, 3S Health Saskatchewan. Other guests included: Ms. Susan Antosh, Chief Executive Officer eHealth Saskatchewan; Dr. Preston Smith, Dean of the College of Medicine; Dr. Dennis Kendel, CEO of saskdocs.

006. Members of the representative assembly introduced themselves and indicated their

practice/specialty and region/section.



2 | P a g e

INTRODUCTION OF NEW MEMBERS 007. Dr. Yelland advised there is one vacancy in the Keewatin Yatthé Medical Association

for a representative assembly delegate. The board, in conjunction with the respective regional executives, recommends the appointment of Dr. Melanie Flegel to fill the vacancy.

RA 16S-01

008. Moved by Dr. Joe Pfeifer, seconded by Dr. John Gjevre. That Dr. Melanie Flegel be appointed as a delegate from the Keewatin Yatthé Regional

Medical Association. 009. Dr. Yelland advised there is one vacancy in the Prairie North Regional Medical

Association for a representative assembly delegate. The board, in conjunction with the respective regional executives, recommends the appointment of Dr. Stephen Loden to fill the vacancy.

That Dr. Stephen Loden be appointed as a delegate from the Saskatoon Regional

Medical Association. “CARRIED” APPOINTMENT OF RESOLUTIONS COMMITTEE 010. Drs. Clare Kozroski, Janet Shannon and Vijay Trivedi were nominated to the Resolutions

Committee.

RA 16S-02 011. Moved by Dr. Joe Pfeifer, seconded by Dr. Larry Sandomirsky. That the RA appoint Drs. Clare Kozroski, Janet Shannon and Vijay Trivedi to the

Resolutions Committee. “CARRIED”

NARRATIVE PORTION OF REPORTS

RA 16S-03 012. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Joe Pfeifer. That the narrative portion of the reports be received for information. “CARRIED”


52


3 | P a g e

PRESIDENT’S ADDRESS

013. Dr. Mark Brown, SMA President, delivered his presidential address highlighting the following issues arising over the past six months of his presidency:

Hiring of two physicians in the shared position of SMA Director of Physician

Advocacy and Leadership: Drs. Werner Oberholzer and Susan Shaw. He emphasized the importance of strong physician leaders working at the SMA.

Preliminary discussions with the Ministry of Health about the role of and relationship with physicians looks like into the future, broadly referenced. These “modernization” discussions have encouraged us to proceed with further conversation with the profession. The board members are ready to engage delegates and members on the next steps toward modernization.

The SMA issued three news releases during the recent provincial election campaign drawing attention to the need for stronger tobacco control measures, for a robust seniors care strategy, and improved access and quality when it comes to mental health services in the province.

The legislation regarding medical assistance in dying (MAID) continues to dominate the news. The implementation of the legislation will have a great impact on the practice of medicine. The SMA supports the CMA position, which includes advocating for better palliative care.

The SMA continues to advocate for healthcare services, including MRIs, based on medical need and not ability to pay.

Physician well-being continues to be a strategic priority of the Board of Directors and is providing direct oversight of the Physician Support Program.

Dr. Brown challenged the delegates to continue working together to make Saskatchewan the best place to practise medicine.

MINISTER OF RURAL AND REMOTE HEALTH ADDRESS 014. The Minister of Rural and Remote Health, Greg Ottenbreit, thanked the SMA for the

opportunity to address the assembly. Minister Ottenbreit highlighted the following government initiatives:

Recruiting and retaining physicians remains a priority for government. There has

been a 36% increase in physicians in the province since 2008. Keeping University of Saskatchewan graduates is part of this priority. The government also recognizes the value of recruiting international medical graduates.

Government has recently released a physician resource planning tool. Minister Ottenbreit expressed appreciation to the SMA for its input into the document.



4 | P a g e

The Ministry receives much correspondence on the issue of medical assistance in dying. The government is taking time to carefully review the proposed legislation (Bill C-14).

Minister Ottenbreit appreciates the leadership of the SMA and its representatives on the Provincial Leadership Team.

He identified seniors care as well as patient flow and ED waits as priorities. The government’s target is to reduce ED waits by 60 percent by March 2019.

He noted two MRI clinics in Regina are providing privately paid for MRIs which he expects will reduce overall wait times. Minister Ottenbreit emphasized a physician referral is still required. He added that the government plans to allow for a similar two-for-one arrangement for CT scans.

The Ministry continues to be focussed on the health system’s strategic aims of: better health, better value, better care, better teams.

015. Dr. James Purnell raised with the Minister continued concerns regarding the challenges

of providing health care to northern Saskatchewan residents. The town of La Loche continues to experience mental health issues in the aftermath of the school shooting earlier this year. Dr. Purnell appealed to the minister that government ensure a sufficient number of physicians be hired to work in the North. The minister replied that government has established a working group to address some of the issues in the North. This will include the need to build into the community and address the core of the issues.

016. Dr. David Ledding asked the minister to work at improving laboratory services in rural

Saskatchewan. The minister replied that he often hears this concern and noted that old equipment and lack of qualified personnel are commonly cited as the main issues. The government is developing a provincial laboratory strategy. Deputy Minister Max Hendricks added that low volumes in laboratory services sometimes impacts patient safety.

017. Dr. Don Stefiuk asked that the provincial government not allow generic oxycontin to be

sold in Saskatchewan in order to keep it off the street. Mr. Hendricks replied Saskatchewan has a tracking system and Dr. Stefiuk’s comments will be forwarded to its formulary committee.

018. Dr. Oluwole Oduntan raised his concerns about patients becoming addicted to pain

management medication and asked the ministry to establish a provincial pain management program. The minister recognized the need for a pain management strategy to alleviate the abuse of prescription drugs. However, he cautioned that this would have to be considered in the context of fiscal restraints.

019. Dr. Melanie Flegel informed the minister of the concerns that physicians of the North

have with the Planning Tool for Physician Resources in Saskatchewan. This document says that the North is over staffed but the numbers doesn’t reflect the burden of disease and the type of population. The minister acknowledged that the North has its own challenges and he reminded the delegates that the report is a tool and not a plan.


54


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020. Dr. Nnamdi Ndubuka asked the minister to work towards establishing long term care facilities on First Nations. The minister replied that health care on-reserve falls under federal jurisdiction. The provincial government is exploring community care and home care. He would like to see more personal care homes established on-reserve.

021. Dr. Mike Bayda asked the ministry to consider decreasing barriers to HIV medication

and increasing training of health care professionals, given the high number HIV cases in the province. The minister noted he is aware of this issue.

022. Dr. Mary Kinloch noted the pathology section supports consolidation of laboratory

services to larger centres with some services still available in smaller centres. She asked the minister to remove barriers that prevent smaller centres from providing certain laboratory services. Mr. Hendricks noted that 3sHealth is looking at how services are organized in the province.

MINUTES OF THE NOVEMBER 2015 MEETING (RA 00/15)

RA 16S-04 023. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Chris Ekong. That the minutes of the previous meeting be adopted. “CARRIED”

REVIEW OF NOVEMBER 2015 RESOLUTIONS (RA 00/15)

024. Ms. Bonnie Brossart provided an update on follow on activities related to resolutions from the November 2015 Representative Assembly.

025. Ms. Brossart noted that from the previous RA evaluation the SMA received feedback

requesting improvement to the resolution process. She advised that the board and staff spoke to this request early in 2016 and have begun to test some improvement ideas related to the preparation of resolutions (i.e., Prescription for a Better Resolution document). Staff are working on creating a database to better track resolutions.

BOARD OF DIRECTORS REPORT

RA 16S-05 026. Dr. Thirza Smith reviewed the Board of Directors report. 027. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Vijay Trivedi. That the RA approve the actions of the Board as reported. “CARRIED”



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NOMINATING COMMITTEE REPORT 028. Dr. Dalibor Slavik reviewed the Nominating Committee report.

FINANCE COMMITTEE REPORT

029. Dr. Joanne Sivertson reviewed the Finance Committee report.

RA 16S-06 030. Moved by Dr. Janet Shannon, seconded by Dr. Guruswamy Sridhar.

That the Representative Assembly approves the audited financial statements for the year ending December 31, 2015.

“CARRIED”

RA 16S-07

031. Moved by Dr. Janet Shannon, seconded by Dr. Guruswamy Sridhar. That the accounting firm of KPMG be appointed as auditors for the SMA for the year

ending December 31, 2016. “CARRIED” MODERNIZATION PRESENTATION 032. Mr. Steven Lewis, facilitator, introduced the modernization panel: Dr. Jeff Blackmer,

Vice-President of Medical Professionalism at the CMA; Dr. Intheran Pillay, Vice-President of SMA; Dr. Janet Tootoosis, member of the SMA Board of Directors; Dr. Werner Oberholzer, SMA Director of Physician Advocacy and Leadership.

033. Dr. Pillay presented “Modernization: Making Saskatchewan the Best Place to Practise

Medicine”. 034. The following questions were posed to the panel and a wide-ranging conversation

ensued:

Do you think the current system is sustainable? Why or why not? What are the most urgently needed reforms? What’s different now? External circumstances? No new money and more physicians

in the system? How do we take steps towards incremental change if we need to accelerate that

change to a quantum level? How can we speed this up to without making it too fast or too risky?

What gives you optimism as we move forward to reforming the health care system?


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RESOLUTIONS

RA 16S-08

035. Moved by Dr. John Mark Opondo, seconded by Dr. Nnamdi Ndbuka. That the SMA urge the Government of Saskatchewan to work with Indigenous and

Northern Affairs Canada, Federation of Saskatchewan Indian Nations, Metis nation, and northern Saskatchewan municipal leaders to improve the socio-economic situation in northern Saskatchewan Indigenous communities – both on reserve and in municipalities - given the significant impacts that poverty, crowded housing, unemployment and intergeneration trauma associated with residential school issues have on the physical, mental, social and cultural well-being of these citizens of Saskatchewan.

The Saskatchewan Medical Association's advocacy in this issue will improve physician

participation and leadership in the design of community solutions to problems that may lie outside the domain of traditional health care.

“CARRIED”

RA 16S-09 036. Moved by Dr. John Mark Opondo, seconded by Dr. Nnamdi Ndbuka. The Saskatchewan Medical Association advocate that the following should be

implemented as part of the alcohol retail liberalization:

i. Closely manage the availability of alcohol through the regulation of outlet density, hours and days of sale.

ii. Promote a culture of low-risk drinking in Saskatchewan. iii. Provide health and social services that address substance misuse in the form of

alcohol detoxification centers and other similar programs that address the acute and chronic health consequences of alcohol misuse. This is in keeping with the physician role in leading in the provision of health care in the community.

“CARRIED”

RA 16S-10 037. Moved by Dr. David Ledding, seconded by Dr. Eben Strydom. That the SMA pursue a change to the legislation to permit physicians to dispense

medications at their clinics. “REFERRED TO THE BOARD”



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KEYNOTE ADDRESS: DR. JIM CROSS 038. Dr. Jim Cross presented “He Ain’t Heavy, He’s My Brother” – A physician’s perspective

on the importance of well-being. 039. The presentation was followed by a question-and-answer period. Dr. Jim Cross thanked the RA for the opportunity and encouraged the physicians in

attendance as well as their colleagues to reach out to Ms. Brenda Senger, Director of Physician Support Programs for support. He acknowledged Ms Senger’s expertise and compassion with helping physicians in need.

LEARNING SESSIONS 040. Given previous RA evaluation feedback, concurrent learning sessions were offered at

this RA. Delegates were asked to move to the appropriate room to take part in the following sessions:

1. Effective Clinical Teaching Strategies presented by Dr. Kalyani Premkumar, University of Saskatchewan 2. CDM-QIP and how to better use flowsheets - Dr. Stefanie Steel and Dr. Tessa Laubscher 3. Medical Professionalism - Ms. Emily Gruenwoldt Carkner and Dr. Jeff Blackmer, VP Medical Professionalism, Canadian Medical Association

COLLEGE OF MEDICINE UPDATE – DR. PRESTON SMITH

041. Dr. Preston Smith, Dean at the College of Medicine presented an update on the activities at the College of Medicine.

042. The presentation was followed by a question-and-answer period.

PROFESSIONAL ASSOCIATION OF INTERNES AND RESIDENTS OF SASKATCHEWAN (PAIRS) REPORT

043. Dr. Neil Kalra opened his comments on how invaluable he has found his experience on the SMA Board of Directors. This has afforded him many networking opportunities and he thanked the Board for speaking on resident issues. He offered the following highlights: PAIRS continues to work with Ministry of Health and the College of Medicine to

secure a new contract. PAIRS and SMSS sponsored a health-care forum in the fall of 2015 that included the

Minister of Health, SMA and the Saskatoon Health Region. This well attended event provided a great opportunity to network.



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Promoting wellness is a priority for PAIRS. Events over the past year have included curling tournament, New Year’s gala, roadmap tours and wellness workshops.

PAIRS will be changing its name to follow national trends. STUDENT MEDICAL SOCIETY OF SASKATCHEWAN (SMSS) REPORT

044. Ms. Brittany Pirlot and Ms. Kara Jodouin presented an update on the activities of the

Student Medical Society of Saskatchewan.

RESOLUTIONS

RA 16S-11 045. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Brandon Thorpe. Be it resolved that eHealth be urged to implement the transfer of health information

between electronic health repositories and physician EMRs (electronic medical records systems).

“CARRIED”

RA 16S-12 046. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Brandon Thorpe. The SMA calls on eHealth and regional health authorities to find alternatives to the

current practice of independent regional customization of SCM (Sunrise Clinic Manager), in order to expedite province-wide integration, interoperability, and data transfer.

“CARRIED”

RA 16S-13 047. Moved by Dr. Ken Bayly, seconded by Dr. Mark Brown. That the Family Practice Section of the SMA bring to the attention of the league

presidents and directors of all levels of hockey that all forms of fighting and head shots be totally and completely unacceptable and not tolerated.

“CARRIED”

RA 16S-14 048. Moved by Dr. Mark Brown, seconded by Dr. Barb Konstantynowicz.


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That the referring physician be compensated for the time and effort they spend to participate in LINK and other avenues to contact specialists and implement recommendations as required on behalf of patients to expedite patient care.

“CARRIED”

RA 16S-15 049. Moved by Dr. Ken Bayly, seconded by Dr. Barb Large. The SMA requests that the Government of Saskatchewan include the increases in

educational opportunities and the conviction penalties to reflect the suffering caused to victims by the consequences of impaired driving.

“WITHDRAWN”

RA 16S-16 050. Moved by Dr. Janna Cuthbert, seconded by Dr. Clare Kozroski. That the SMA continue to work with the Ministry of Health for the appropriate

implementation of the Planning Tool for Physician Resources in Saskatchewan. “CARRIED”

RA 16S-17 051. Moved by Dr. Clare Kozroski, seconded by Dr. Janna Cuthbert. That the SMA advocate for the abandonment of the “Whites of the Eyes” principle and

for the institution of appropriate fee codes for communication with patients via technology.

“CARRIED”

RA 16S-18 052. Moved by Dr. Mike Bayda, seconded by Dr. Melanie Flegel. The SMA advocate for culturally appropriate traditional healing, training of Aboriginal

students in health professions and cultural awareness training for health professionals and students as recommended by the Truth and Reconciliation Commission.

“CARRIED”



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RA 16S-19

053. Moved by Dr. John Dosman, seconded by Dr. Janna Cuthbert. The SMA Support in principle the development of a well-coordinated, multidisciplinary

team approach for the treatment of gender dysphoria in Saskatchewan and advocate for additional funding from the Saskatchewan Ministry of Health for the coordination/project manager/quality improvement role of the multidisciplinary team for the treatment of gender dysphoria.

“CARRIED”

RA 16S-20 054. Moved by Dr. John Dosman, seconded by Dr. Janna Cuthbert. The SMA encourage physicians in relevant specialities to increase their knowledge and

expertise in treating gender dysphoria, and to provide these services • By distributing information on relevant CME and encouraging physicians to access

their SMA CME funds to attend; • By supporting clinical traineeships; • By ensuring remuneration/billing codes for relevant services.

“CARRIED”

RA 16S-21 055. Moved by Dr. John Dosman, seconded by Dr. Janna Cuthbert. The SMA advocate for the Saskatchewan Ministry of Health to provide full

funding/coverage for patients seeking treatments that are medically necessary in the treatment of gender dysphoria. These treatments include psycho-social, medical, pharmacological and surgical treatments.

“CARRIED”

RA 16S-22 056. Moved by Dr. John Dosman, seconded by Dr. Janna Cuthbert. The SMA advocate for the Saskatchewan Ministry of Health to recognize and authorize

local Saskatchewan “approvers” (i.e. physicians with appropriate training and experience) for coverage of medically necessary procedures in the treatment of gender dysphoria.

“CARRIED”


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RA 16S-23

057. Moved by Dr. Clare Kozroski, seconded by Dr. Suresh Kassett. That the SMA work to improve and streamline the current system of remuneration for

physician QI (quality improvement) work, including projects endorsed at the RHA level. “CARREID” ELECTIONS 058. The Speaker advised that Dr. Intheran Pillay had been nominated for President and no

further nominations had been received. 059. Moved by Dr. Mark Brown, seconded by Dr. Guruswamy Sridhar.

That nominations cease.

Dr. Intheran Pillay was declared President of the SMA for 2016/17. 060. The Speaker advised that Dr. Joanne Sivertson had been nominated for Vice-President

and no further nominations had been received. 061. Moved by Dr. Intheran Pillay, seconded by Dr. Guruswamy Sridhar. That nominations cease. Dr. Joanne Sivertson was declared Vice-President of the SMA for 2016/17. 062. The Speaker advised that Dr. Siva Karunakaran had been nominated for Honorary

Treasurer and no further nominations had been received.

063. Moved by Dr. Mark Brown, seconded by Dr. Intheran Pillay. That nominations cease. Dr. Siva Karunakaran was declared Honorary Treasurer of the SMA for 2016/17.

064. The following were nominated as Directors: Drs. Chris Ekong, Annette Epp, Barb Konstantynowicz, Kunal Goyal, Lise Morin, Eben Strydom, Janet Tootoosis and Allan Woo. No further nominations were received.

065. Moved by Dr. Larry Sandomirsky, seconded by Dr. Dalibor Slavik.




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The above were declared as Directors to the SMA Board for 2016/17.

066. Dr. Joel Yelland was nominated as Speaker. No further nominations were received. 067. Moved by Dr. Dalibor Slavik, seconded by Dr. Eileen Dahl


068. Dr. Joe Pfeifer was nominated as Deputy Speaker. No further nominations were received.

069. Moved by Dr. Intheran Pillay, seconded by Dr. Barb Konstantynowicz. That nominations cease. The above were declared as Speaker and Deputy Speaker respectively.

070. Drs. Mark Arsiradam, Barbara Large and Don McCarville were nominated as the Nominating Committee.

071. Moved by Dr. Intheran Pillay, seconded by Dr. Chris Ekong. That nominations cease. The above were elected as the Nominating Committee.

CANADIAN MEDICAL ASSOCIATON (CMA) PRESIDENT’S ADDRESS – DR. CHRIS SIMPSON 072. Dr. Chris Simpson, Past President of the CMA, provided his address to the assembly.

Highlights included the following:

Medical assistance in dying (Bill C-14) legislation is creating an urgency among physicians and governments because medical assistance in dying will become legal in Canada on June 6, 2016. The processes for patients to access services and for physicians to conscientiously object haven’t been determined. The CMA is preparing an online course for physicians available this summer and a face-to-face course available in the fall.

While health care was not specifically noted in the federal budget, it did formally recognize the important contribution of health care professionals as small business owners. The CMA still has some concerns about tax changes that will affect physicians.

The new federal government is committed to working on a health accord.

The CMA’s “Demand a Plan” is a public campaign to encourage the development of a national strategy on seniors care by asking Canadians to add their voice to the


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call for a National Seniors Strategy. The SMA has been leading the charge at the provincial level. The issue of seniors care is impacting the sustainability of health care.

JouleTM is a new CMA company created with today’s rapid pace of change in mind. This unique program is dedicated to facilitating physician-led innovation.

The CMA now has a department of medical professionalism. Physicians need to be leaders in this platform and CMA staff are committed to working closely with the SMA.

The CMA and SMA continue to have a strong bond, linking our professional values and transforming our healthcare system that is worthy of our patients' trust.

073. Dr. Intheran Pillay asked if the CMA is working on developing a national dementia

strategy. Dr. Simpson responded that the Seniors Care Plan includes advanced care directors, palliative care, dementia and a seniors strategy.

074. Dr. Bhanu Prasad inquired what the CMA is doing in regards to individuals who make

poor lifestyle choices that result in health care costs (e.g. overeating, diabetes, etc.). Dr. Simpson replied that social determinants of health, including the early childhood environment, access to food and proper housing, have an impact on prevention. Primary prevention takes years to see results. Secondary prevention requires good management of chronic disease.

075. Dr. Mark Brown thanked the CMA for its leadership in the development of a national

strategy with medical assistance in dying. He expressed concerned at the looming deadline of June 6 and wondered if physician training will be available by that date. Dr. Simpson noted that until the legislation is passed, it is challenging to write training modules. Dr. Simpson said that he doesn’t expect many requests for medical assistance in dying immediately following June 6.

CMA BOARD REPORT – DR. GURUSWAMY SRIDHAR

076. Dr. Guruswamy Sridhar, SMA Representative to the CMA Board of Directors, presented an update on the activities at the CMA Board of Directors over the past six months. He reiterated many of the points Dr. Simpson raised in his address.

COLLEGE OF PHYSICIANS AND SURGEONS OF SASKATCHEWAN (CPSS) REPORT – DR. ALAN BEGGS

077. Dr. Alan Beggs, President of the College of Physician and Surgeons provided an update to the Assembly. Highlights included: CPSS is working with others in Saskatchewan’s health care system, including

government and the SMA to develop medical assistance in dying policies. However, until legislation is finalized, policies cannot be finalized either. Dr. Beggs is uncertain how CPSS policies will affect nurse practitioners, given that they have their own regulatory body. Dr. Beggs expects court challenges over medical assistance



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in dying to continue because the proposed legislation limits this assistance to certain types of patients.

CPSS continues working to improve the prescription review program and hired a pharmacist manager to assist the Registrar, Dr. Shaw.

He reminded delegates to encourage Saskatchewan graduates to allow sufficient time for their licensing applications to processed.

The management of complaints is still a major portion of the work at CPSS. Complaints first go to the Quality of Care Advisory Committee. If they cannot be resolved, they are referred to the Council.

Dr. Beggs shared his view that physicians are privileged to work in a self-regulated profession and with this comes responsibility. CPSS depends on the generous donation of time of physicians to serve on the council and committees. Dr. Beggs asked delegates to return to their regions and ask colleagues to volunteer with CPSS to maintain an effective disciplinary process.

CANADIAN MEDICAL PROTECTIVE ASSOCIATION (CMPA) REPORT – DR. SUSAN HAYTON

078. Dr. Susan Hayton, council member with the CMPA, presented an update on the activities of the CMPA.

079. The presentation was followed by a question-and-answer period. MODERNIZATION: MAKING SASKATCHEWAN THE BEST PLACE TO PRACTICE MEDICINE (IN-CAMERA SESSION)

080. Ms. Brossart facilitated a continuation of the modernization discussion from yesterday. Delegates broke into small groups and discussed questions that were provided. A representative from each group then reported the highlights to the in-camera session.

091. Three topics were discussed:

Do you agree with what you’ve read, and heard yesterday, about the urgency of the need to change? What’s missing from the analysis?

What are the possible implications of major change on physician practice? On physician well-being? On patient care quality? On value for money?

What should be the SMA be focusing on as leaders and change agents over the next few years?

092. The answers from each group will be compiled in a document that will be available in

the RA workroom.


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RESOLUTIONS

RA 16S-24 093. Moved by Dr. Yasif Kasim, seconded by Dr. Charles Omosigho.

That the SMA should collaborate with the Ministry of Health to compensate physicians who provide emergency care to any Canadian resident even when not covered by any health insurance provision.

“CARRIED”

RA 16S-25 094. Moved by Dr. Guruswamy Sridhar, seconded by Dr. Mark Brown.

The SMA leadership will begin discussions with the Ministry of Health on major system redesign to make Saskatchewan the best place to practise medicine.

“CARRIED”

RA 16S-26 095. Moved by Dr. Clare Kozroski, seconded by Dr. Suresh Kassett.

That the SMA advocate for a review of the 42 day exclusion rule after a procedure.

“DEFEATED” RA 16S-27

096. Moved by Dr. Janna Cuthbert, seconded by Dr. Suresh Kassett.

That the SMA advocate for fee incentives for surgical practitioners to perform minimally invasive procedures, as clinically appropriate.

“DEFEATED”

RA 16S-28 097. Moved by Dr. Bhanu Prasad, seconded by Dr. Siva Karunakaran.

The SMA works with the Provincial Renal Transplant Program to cut the wait times for living and cadaveric renal transplant recipients.

“CARRIED”



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RA 16S-29 098. Moved by Dr. Charles Omosigho, seconded by Dr. Lise Morin.

Be it resolved that SMA, in its continued work with the Ministry of Health, and regional health authorities, ensure fair and equitable contracts with physicians, including a minimal term of assured employment.

“CARRIED”

RA 16S-30

099. Moved by Dr. Joe Pfeifer, seconded by Dr. Sheila Harding.

The RA thank the committees and staff of the SMA for their hard work since the last RA.

“CARRIED”

DATE OF THE NEXT MEETING 100. The next meeting of the Representative Assembly will be held November 4-5, 2016 in

Regina at the Hotel Saskatchewan.

101. Moved by Dr. Janet Shannon, seconded by Dr. Vijay Trivedi. That we move to adjourn the meeting of the spring 2016 Representative Assembly.

“CARRIED”

NOTE: ALL PRESENTATIONS ARE AVAILABLE UPON REQUEST BY CONTACTING THE SMA.


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Delegates

Spring Representative Assembly

Hotel Saskatchewan Regina, SK

May 6-7, 2016

Board Executive

President Dr. Mark Brown Moose Jaw Vice President Dr. Intheran Pillay Gravelbourg Honorary Treasurer Dr. Joanne Sivertson Prince Albert Past President Dr. Dalibor Slavik Saskatoon

Board of Directors

Dr. Shayne Burwell Saskatoon Dr. Chris Ekong Regina Dr. Kunal Goyal Regina Dr. Neil Kalra – PAIRS Representative Saskatoon Dr. Siva Karunakaran Regina Ms. Jillian Kerry – SMSS Representative Saskatoon Dr. Barb Konstantynowicz Regina Dr. Lise Morin Arcola Dr. Thira Smith – Board Chair Saskatoon Dr. Guruswamy Sridhar – CMA Board of Directors Representative Regina Dr. Janet Tootoosis Battleford Dr. Allan Woo Saskatoon

Regional Representatives

√ Cypress Dr. Janna Cuthbert Swift Current √ Dr. Suresh Kassett Herbert √ Dr. Clare Kozroski Swift Current √ Dr. Amith Mulla Swift Current √ Five Hills Dr. Mark Brown Moose Jaw √ Dr. Intheran Pillay Gravelbourg Dr. Fauzi Ramadan Moose Jaw √ Dr. Kirsty Sanderson Moose Jaw √ Dr. Brandon Thorpe Moose Jaw


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Heartland Dr. Idalberto Jimenez-Guerra Kindersley Dr. Francisco Lang Davidson √ Dr. David Ledding Rosetown √ Keewatin Yatthe Dr. James Purnell La Loche √ Kelsey Trail Dr. Olabode Ige Melfort Dr. Gert Pieterse Porcupine Plain √ Dr. Eben Strydrom Melfort √ Mamawetan Churchill Dr. Mike Bayda Air Ronge Dr. Lee Covenden La Ronge Prairie North Dr. Mahesh Khurana North Battleford √ Dr. Mari La Cock Battleford √ Dr. Martinus Moolman North Battleford Dr. Patrick O’Keeffe Battleford √ Dr. Janet Tootoosis Battleford √ Prince Albert Parkland Dr. Lilanie Cooper Prince Albert √ Dr. Rohan Cornelissen Prince Albert √ Dr. Collins Egbujuo Prince Albert √ Dr. Nnamdi Ndubuka Prince Albert Dr. Stan Oleksinski Prince Albert √ Dr. Joanne Sivertson Prince Albert √ Regina Qu’Appelle Dr. Mohamed Abdulhadi Regina √ Dr. Ramzan Abdulla Regina √ Dr. Geeta Achyuthan Regina √ Dr. Pamela Arnold White City √ Dr. Mark Cameron Regina √ Dr. Patrick Duffy Regina √ Dr. Chris Ekong Regina √ Dr. Kunal Goyal Regina √ Dr. Siva Karunakaran Regina √ Dr. Barb Konstantynowicz Regina √ Dr. Ryan Lett Regina √ Dr. Donald McCarville Regina Dr. Mohamed Moola Regna √ Dr. Bhanu Tikkisetty Prasad Regina √ Dr. Vijay Trivedi Regina √ Saskatoon Dr. Shayne Burwell Saskatoon √ Dr. Keith Clark Saskatoon √ Dr. Eileen Dahl Saskatoon √ Dr. John Dosman Saskatoon √ Dr. Annette Epp Saskatoon √ Dr. John Gjevre Saskatoon Dr. Daniel Kirchgesner Saskatoon √ Dr. Karen Laframboise Saskatoon √ Dr. Barbara Large Saskatoon √ Dr. Crystal Litwin Wynyard √ Dr. Selma McMahon Saskatoon √ Dr. Dalibor Slavik Saskatoon √ Dr. Don Stefiuk Saskatoon √ Dr. Grant Stoneham Saskatoon √ Dr. Joel Yelland Saskatoon


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√ Sunrise Dr. Yusuf Kasim Yorkton √ Dr. Oluwole Oduntan Yorkton Dr. Ajibola Ogunbiyu Yorkton √ Dr. Saliu Oloko Yorkton Dr. Johann Roodt Yorkton √ Sun Country Dr. Nicholaas Botha Oxbow √ Dr. Lise Morin Arcola √ Dr. Charles Omosigho Estevan

Section Representatives

√ Anaesthesia Dr. Janet Shannon Saskatoon √ General Practice Dr. Ken Bayly Saskatoon √ General Surgery Dr. Joe Pfeifer Saskatoon Emergency Medicine Dr. Joanna Smith Saskatoon √ Internal Medicine Dr. Guruswamy Sridhar Regina Neurology Dr. Haley Block Saskatoon √ Neurosurgery Dr. Joseph Buwembo Regina √ Obstetrics &

Gynaecology Dr. Anita Harding Saskatoon

√ Oncology Dr. Julie Stakiw Saskatoon Ophthalmology Dr. Ravikrishna Nrumhadevara Saskatoon Dr. Dustin Coupal Regina √ Orthopaedics Dr. Allan Woo Saskatoon √ Otolaryngology Dr. Mahomed Mia Saskatoon Paediatrics Dr. Roona Sinha Saskatoon √ Pathology Dr. Mary Kinloch Saskatoon √ Plastic Surgery Dr. Geethan Chandran Saskatoon Physiatry Dr. Barry Bernacki Saskatoon √ Psychiatry Dr. Mysore Renuka-Prasad Saskatoon Dr. Dhanapal Natarajan Regina Public Health Dr. Mohammad Khan Saskatoon √ Dr. Johnmark Opondo Saskatoon √ Radiology Dr. Greg Kraushaar Regina √ Retired Physicians Dr. Larry Sandomirsky Hudson Bay Sports Medicine Dr. Cole Beavis Saskatoon Urology Dr. Kishore Visvanathan Saskatoon

Other Representatives

√ Speaker Dr. Joel Yelland Saskatoon √ Deputy Speaker Dr. Joe Pfeifer Saskatoon √ Student Medical Society

Rep Ms. Kara Jodouin Saskatoon

√ Ms. Brittany Pirlot Saskatoon √ PAIRS Rep Dr. Neil Kalra Saskatoon Dr. Chelsea Wilgenbusch Saskatoon


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SMA Staff

√ Ms. Cindy Anderson Manager, Benefits and Insurance √ Ms. Tanessa Bauer Executive Assistant – Board of Directors √ Ms. Bonnie Brossart Chief Executive Officer √ Mr. Mark Ceaser Director of Economics √ Mr. Doug Dombrosky Director, Saskatchewan EMR Program √ Ms. Lana Haight Communications Advisor √ Mr. Ed Hobday Administrative Director √ Mr. Ivan Muzychka Senior Communications Advisor √ Mr. Marcel Nobert Director, Physician Services and Benefits √ Ms. Wendy Rink Executive Assistant/Office Manager √ Ms. Maria Ryhorski Communications Advisor √ Ms. Brenda Senger Director, Physician Support Programs


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