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'A crisis in family medicine': SMA president

The president of the Saskatchewan Medical Association (SMA) met with physicians from Moose Jaw and surrounding area. The discussion included the primary care shortage, physician burnout, and upcoming contract negotiations
Dr. John Gjevre is the president of the Saskatchewan Medical Association
Dr. John Gjevre, a respirologist working in Saskatoon is the president of the Saskatchewan Medical Association

MOOSE JAW — The president of the Saskatchewan Medical Association (SMA) met with physicians from Moose Jaw and surrounding area on Sept. 22 at the Grant Hotel in downtown Moose Jaw. The discussion included the primary care shortage, physician burnout, and upcoming contract negotiations with the Saskatchewan Health Authority (SHA).

The annual president and vice-president’s tour is an SMA tradition which keeps a finger on the pulse — pun intended — of the organization’s members across the province. This year marks a return to an in-person format.

SMA President Dr. John Gjevre, a respirologist based in Saskatoon, told the Moose Jaw Express that he was pleased with the turnout at the meeting, and thanked everyone from the area who attended.

“We had 31 doctors in the room, talking about various concerns, but especially about the crisis in primary health care,” Gjevre said. “That’s a tremendous turnout for a smaller community like Moose Jaw. To have 31 doctors get together and have some productive discussions around health care solutions is a great thing.”

Crisis in family medicine

Far and away the most concerning topic under discussion was the ongoing, worsening shortage of primary care providers in Canada.

“There is a crisis in family medicine,” Gjevre said. “It’s been building for some time. It’s not just a Saskatchewan problem, it’s a national problem… There’s just not enough family physicians out there to replace those who are retiring or moving elsewhere.

“So, there is a real lack of human resources in family medicine. Other specialties are also affected, but certainly family medicine is the area that there’s a huge lack of new, young residents coming into the practice.”

Another important topic of discussion related to the SMA’s relationship with the SHA. Despite nearly five years having passed since the formation of the health authority, clear bylaws have yet to be enacted.

“We talked about some of the issues around the bylaws with the Health Authority. The SHA has been in existence now for four years, going on five. And we still have just interim bylaws, which is a problem,” Gjevre explained. “We need to have a clear understanding of accountabilities and responsibilities on both sides.”

The last of what Gjevre noted as big issues under discussion was COVID.

“(The situation with) COVID is better, and we’re very grateful for that. But, of course, it is not over. We still have concerns around COVID and how it stresses the healthcare system.”

Contract negotiations

The previous five-year contract with the Saskatchewan Ministry of Health expired on March 31, 2022. It remains in effect until a new contract is ratified.

Gjevre said that a contract consensus is difficult to reach when such a diverse group of physicians meet. Nevertheless, the increasing rate of inflation is on many doctors’ minds.

“Most physicians are essentially small business owners. They pay rent on an office space, they hire receptionists and admin assistants. With inflation going up and up this year, the cost of overhead is increasingly stressful for many of our members.

Most physicians pay between 30 and 40 per cent of their gross compensation for overhead, he noted, and they aren’t free to increase their prices the way other small business owners can — they must negotiate with the government.

Healthcare shortages

Gjevre was asked about

“I certainly can’t speak for the nurse’s union,” he said. “From our standpoint, we want to have a highly functioning, humane, kind healthcare system. And that does require certain investments from the government.

“Nobody wants to have your mother or your father waiting in an ER for hours due to the system being clogged up. That’s not good for the patient or the overall healthcare system… But it’s a complex issue that’s going to take time and effort to improve.”

Gjevre said there are plans to innovate to improve the situation for patients in Saskatchewan, for example by creating more of a team approach where the family physician co-ordinates patient care rather than overseeing it.

“We want a system that’s going to be there for you, for me — at some point we’re all going to be patients. You want a system that is strong, kind, compassionate, and effective, that doesn’t have wait time for surgeries and doesn’t have long waits to get into the emergency room.

“We don’t have that system right now. We’re trying, right? …  We’re going to transform healthcare. That is going to come. But it’s going to take time.”

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