Oct 5, 2021

Chair's Column: Where we are fighting fires now to prevent them in the future

Chair's Column: Where we are fighting fires now to prevent them in the future
By Dr. Gillian Hawker
Gillian Hawker
Dr. Gillian Hawker

I sincerely hope that you all had a chance to relax and enjoy the sun this summer. I know for many, the summer was far too brief, and the fall brings new concerns about COVID resurgence. As your Chair, I am finding the distance from you difficult. It is hard to judge how much to try advancing our strategic priorities versus letting things go while the pandemic is upon us. As you can imagine, there is a diversity of opinion on this matter. As I’ve said many times, we are not all in the same boat, just the same storm.

Where there is consensus, however, is that we absolutely cannot go back to "pre-COVID normal." We have learned so much in the past 19 months and counting. We’ve witnessed worsening economic inequalities and come to recognize the depth of systemic racism and discrimination in our health care system and the combined effects on the health of the population. We want to see change in how we practice as individual clinicians, how we organize care in the hospitals and clinics where we work, and, more fundamentally, how we partner with other organizations, including provincial and municipal Public Health, involved in the care of our patients.

Even before to the pandemic, we knew that gross disparities existed in basic health outcomes and in the healthcare individuals received (or had access to) based on where they lived, their gender, race or ethnicity, income, and other differences. The pandemic has both underscored and exacerbated these issues. The past 19 months have also brought into sharp relief the degree to which the climate crisis has fully arrived. Debilitating and deadly heat domes passed over large parts of Western Canada this summer. Smoke from wildfires in northwestern Ontario produced a continuous haze as far south as Toronto some weeks. If we have not been rattled to the core by these developments, it’s only because we already feel that we have so many other fires to put out.

In late 2019, we finalized the Department’s Vision and Strategic Priorities for 2019-2024. Admittedly that feels like a lifetime ago. But, characteristic of this remarkable department, one of the four strategic priorities we set for ourselves was to use our privilege to engage in transformational change as leaders, partners, and effective followers – to get political. Early in the pandemic, many people quoted Winston Churchill’s famous line, while working to form the United Nations after WWII, “Never let a good crisis go to waste.” All these months later, many of you have been pushed to the limits—on work and home fronts—for so long and to such an extent, that the only opportunity you feel up to meeting right now is for this crisis to end. Yet this is still a crisis. We owe it to ourselves and our patients not to let it go to waste.

Collectively, you are perhaps (in my mind 'undoubtedly') the smartest, kindest, and most creative group of academic physicians anywhere! You have already demonstrated your ability to turn on a dime when needed to ensure the best care to your patients, the best teaching to our learners, and the most scholarly approach to addressing the challenges that COVID has caused.

While we have celebrated many truly impressive accomplishments since the pandemic began, the pandemic continues, and the need for more fundamental and systemic changes are evident. To use a metaphor of the wildfires and the climate crisis, while some individuals must focus on putting out the wildfires that continue to rage across British Columbia, northwestern Ontario and elsewhere in the world, others must focus on identifying and addressing the root causes of those fires.

Unfortunately, the opportunity to use this crisis to bring about fundamental transformation comes at a time when most of us feel least able to take on anything new. We recognize this. Not everyone has the capacity right now to engage in the challenging work of identifying concrete ways in which we can bring about needed transformations. But we want to try.

Later this fall, we will be fielding the 2021 Faculty Survey, which is very much focused on gaining a better understanding of how you have been impacted by COVID, what you have learned from your experiences, and your thoughts on how best to address current and future needs. We hope you will find the time to participate.

We also hope you will participate in think tanks to be held this fall. We want to brainstorm tangible ways in which we might collectively address the impacts of the climate crisis, worsening economic inequalities, and ongoing systemic racism. Kaveh Shojania, Vice Chair, Quality and Innovation, will soon be sending out a call inviting you to participate. We have set aside some funds to support this activity but felt it most appropriate to start with some brainstorming and collective decision making about how best to use this money.

Events over the last 19 months have highlighted deep societal problems and inequities in both health and healthcare. The pandemic is an opportunity for change, and I believe there is appetite for change. Let’s take this opportunity to use our privilege to engage actively as leaders, partners, and effective followers in the transformational changes that are needed to ensure the health and wellbeing of society.