Smart choice: New CMA president calls for changes to the culture of medicine

Throughout a richly varied career in pediatrics that has taken her across the country and around the world—including Laos, Uganda, Peru, Australia, western Canada and north to the Yukon—one thing has stayed constant for Dr. Katharine Smart: her passion for advocacy. “The times I’ve always enjoyed the most are when I’ve been able to advocate for patients,” the newly installed president of the Canadian Medical Association told The Medical Post. “My passion for advocacy is one of the major reasons behind the kind of work I’ve done.” She has done a lot—from social medicine in Vancouver downtown’s east side to training in tropical medicine in Peru and, most recently, working in Whitehorse, Yukon as a pediatrician focused on children who have experienced trauma and adverse childhood events. “I’ve worked in some of the most highly resourced environments to ones with the lowest resources,” said Dr. Smart. “Now I’m here in the Yukon where there are a lot of opportunities in pediatrics to make a difference, and I’ve been able to do a lot of things and work with amazing people.” When the Canadian Medical Association elected her to the role of president, Dr. Smart knew what she needed to do: draw on her career experiences and learnings to advocate for the medical profession. She talked to The Medical Post about her new role, her goals and vision for the CMA and its members, and for the country’s healthcare system. What are your priorities as new president of the CMA? The things the CMA has identified with their impact 2040 strategy are the ones that matter to me. As part of this strategy we’ll be focusing on asking questions about what health is and how we define health and wellness. How do we as a profession view and deal with racism and other structural determinants of health? How can we better serve marginalized children? The pandemic made it clear that the foundation of our healthcare system is cracking and crumbling—I think we all knew that before but the pandemic has made it all the more obvious. We need to consider how we build a system that better meets the needs of Canadians but is also sustainable for physicians. Sustainable in what way? One of the challenges with the healthcare system is that it often relies on physicians sacrificing their wellness. Physicians are suffering from an epidemic of burnout that was pre-existing before COVID-19. That’s not a recipe for sustainability or for compassionate care that communities want and deserve. So what needs to be done to address this epidemic of physician burnout? We need to understand the root causes of physician burnout, and there needs to be a change in the culture of medicine. The CMA is providing leadership in terms of addressing these issues. Read: Equity and diversity cannot be left to chance You were president of the Yukon Medical Association. What accomplishments in that role are you most proud of? Establishing a clear relationship with the government where we really tried to help them understand the leadership role that physicians can play to improve the healthcare system. By collaborating with the Yukon government, we were able to identify common shared challenge and solutions. You moved to the Yukon from Vancouver. That must been a big change for you? I grew up in Saskatchewan so I find the climate here not all that different, although we definitely invested in some warm clothes. I moved here with my husband and our two kids, aged 10 and 12. We love to explore nature here. We go to the local ski hill, we get out in the mountains, we go for walks and hikes and camping. Pre-pandemic, we really loved travelling but now I've got my Peloton so I can spin and get a studio in New York piped here. It's been a really great move for our family. How will your experience working as a physician in the Yukon influence your work at the CMA? I feel really fortunate to be able to come to this role with that perspective. A lot of Canadians live in rural and remote communities and the issues that healthcare providers face in these communities are different than those in urban areas. So it’s wonderful to be able to represent that perspective. I also work a lot with First Nations communities and leaders so I’m excited to be able to bring that experience to the CMA at a time when Canada is at a really critical point. With the residential school findings, we’re at a pivotal moment when Canadians are really starting to understand the importance of reconciliation. What does that mean within the context of the CMA? That means us calling for governments to implement the findings of the Truth and Reconciliation Commission. It means recognizing that there is systemic racism in healthcare and putting policies and structures in place. For one, we need to recognize the importance of mentoring and supporting indigenous people to become physicians and or to work in other areas of healthcare. It also means partnering with First Nations communities directly to get their feedback on how their citizens experience the care we provide and how we can do it better. It means bringing indigenous leaders into the room when the CMA is making decisions. Some doctors question the value of the CMA? How do you plan on ensuring the CMA stays valuable and relevant to physicians in Canada? I think we live in a world where we are bombarded with information and misinformation daily. The challenge for the CMA is figuring out how we connect with physicians so they know what we’re doing on their behalf. How we can best engage physicians is something we’re actively exploring. CMA is really trying to redefine itself in terms of the way forward. As the national voice for physicians and the profession, we have an opportunity to promote the evolution of the association and of the healthcare system in ways that best serve physicians and patients. 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Smart choice: New CMA president calls for changes to the culture of medicine

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