Brave new world of e-medicine confronts all MDs, incoming president says
CMAJ 2000;163(3):325
Dr. Peter Barrett's marathon running may prove to be invaluable preparation for the strenuous journey he's about to take as the CMA's new president. The Saskatoon urologist, who runs a couple of marathons a year, is getting set to tackle 2 of the toughest issues ever to face Canadian health care: the ramifications of the information revolution and the sustainability of Canada's medicare system. Barrett assumes the presidency later this month during the CMA annual meeting in Saskatoon.
"My fear is that we will have two-tier medicine, not financially but in terms of information," he warns. The wealthy and educated, armed with information from the Internet, will bypass conventional barriers to gain access to health care services. Less fortunate Canadians will not have this knowledge — or power.
"We're going to have to bring them into this world somehow and empower them," says Barrett, a former Saskatchewan Medical Association president who has served on the CMA board since 1998.
He is also convinced that physicians have to start using their "e-resources to the max." Barrett says physicians need peer-reviewed, useful information in a "manageable, edible format. They don't need a whole journal to look through, they need a summary of the key things in that journal that would change how they practise medicine or improve how they practise medicine.
"Within 4 or 5 years, CMAJ, like all other journals, will no longer be available in paper form."
Barrett's other major challenge involves the sustainability of Canada's health care system, which he says cannot endure by accepting the status quo. He advocates a grassroots approach, with solutions emerging through a "dialogue among Canadians." Physicians and politicians can contribute and present the options, he says, but the system's end users have to decide what constitutes the publicly funded system. "Are we spending money on the right things? Maybe, maybe not."
Most important, he said, is stable, accountable funding for health care, which includes reinvestment, particularly in human resources and technology.
Barrett says he is tackling these issues for the most personal of reasons: his 2 new grandchildren. "We have to leave something for them. We can't gobble it all up now and leave them in the same situation as [developing] countries."
Barrett and his wife, Susan, a special education teacher, have 3 grown children — Jennifer, Jonathan and Andrew. The couple moved to Saskatoon from Toronto in 1975 after Barrett finished his residency in urology at the University of Toronto, where he also earned his medical degree. They were looking for new frontiers and planned to stay a few years. "We both love it," says Barrett, who was born in Kingston, Ont. "I have the best of both [academic and clinical] worlds here."
He is a clinical professor of surgery at the University of Saskatchewan and his group practice of 7 urologists serves the entire province and is internationally renowned for its expertise in minimally invasive surgery — one of Barrett's enduring interests.
He'd only been practising for 5 years when he caught the political bug. "My wife started getting mad about my complaining at home and told me to get off my butt and change it if I didn't like it," he recalls. He became president of the Saskatoon City Hospital medical staff and then held several administrative positions.
Provincially, he served the Saskatchewan Medical Association in many roles before becoming president in 1993. After that, he took a few years off to concentrate on making his practice a leader in minimally invasive surgery. "People now know about us in other parts of the world, but they don't know about us in Canada," he says.
Gradually, he slid back into politics as deputy speaker for the SMA's Representative Assembly in 1997 and as a member of the CMA's Political Action Committee in 1998. Within 6 months he was on the CMA Board of Directors. He was already travelling to Ottawa regularly to visit his parents. "The SMA said let us pay your way," he laughs.
Barrett keeps his humour up and stress down by backpacking through the Rockies with friends, fishing at his cabin in Northern Saskatchewan and running. Last year he ran his personal best in the National Capital Marathon, finishing in 3 hours and 17 minutes and placing fourth in his age group.
Through it all, his abiding philosophy remains simple. "If you're not involved in helping change things, then you're probably part of the problem." — Barbara Sibbald, CMAJ
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