Family Docs Are Key to Influencing the Future of Health Care, says Dr. Danielle Martin in New Book
Dr. Danielle Martin’s policy expertise and passion for equity has made her a well-known speaker, writer and emerging leader both inside and outside of health care circles. Last week Dr. Martin, faculty member and Vice-President of Medical Affairs and Health System Solutions at Women’s College Hospital, released her first book that brings together many of the ideas she’s been developing over the past several years. Better Now: Six Big Ideas to Improve Health Care for All Canadians outlines six ways Canada can bolster its health care system.
We spoke to Dr. Martin about the book and what messages she gives to family doctors specifically.
When did you originally conceive the six ideas?
In 2014 I first gave a speech called “Three Big Ideas to Deliver on the Promise of Medicare”. I kept working on that speech and all my associated writing over the course of another six months after that until I had what I felt was a complete set of ideas.
When and how did the idea of putting these ideas into book form come up?
With the quantity of writing and speaking I was doing, I came to a point where the amount of content I had could create a book. On top of that, I began to realize how much of the conversations being had around healthcare mainly consisted of medical professionals, academics, policy makers, etc. speaking to each other. What was needed was a way to engage the broader public in the conversation and encouraging them to think differently.
A lot of your book emphasizes the important role of the family physician in the health care system, do you think family doctors are becoming more respected in terms of their value to the healthcare system overall?
Absolutely. I think that’s true among key decision makers more than ever before. The understanding about the healthcare system by policy makers is deeper than ever – they’re realizing a high performing healthcare system is based on high-performing primary care. But our patients have always known what a critical role we play and how well that relationship works when it works well.
In the first idea of the book - ensure every Canadian has regular access to a family doctor or other primary care provider -I talk extensively about the importance of the relationship between patients and their family physicians, but also about the relationships between primary care offices and the rest of the system. We deal with it every day through referrals, patient follow-ups, etc. – it has a huge impact when our office is functioning well with the rest of the system. So it’s not just a message to policy makers and patients, but to healthcare professionals across our system.
What are some of the biggest barriers to achieving your vision?
I think the biggest barrier is inertia and exhaustion. It’s easier to go to work every day and do the same things even though we know there’s better more effective and efficient ways to do things than how we’re doing them. We fall into habits. The same is true for patients: they fall into habits with their health that they know can improve. And same with health organizations: stick with what you know. So the biggest barrier is overcoming that inertia and challenging ourselves to do things differently.
What is the role of family docs in achieving these ideas? And what can medical educators do to help promote leadership in the next generation of family doctors?
At the individual level – every part of our hearts and brains can be engaged in the work of bettering our healthcare system. There’s a lot we can do with the first idea in my book: cultivate strong relationships with our patients and act as brokers and quarterbacks for our patient’s health journey. There’s also a lot we can do with the third big idea: reduce unnecessary tests and interventions. For example, by engaging with and building on the work of Choosing Wisely Canada.
But as academic family physicians, there’s also a lot we can do in the way we teach as educators and the research we do: there’s a lot we can be engaged in. For example, around improving curriculum, the social determinants of health, all the way up to being leaders in system level change and much more. We see examples of that all the time at DFCM. That work is already happening but we need more of it and we need it to be a concerted effort where we’re all pushing in the same direction.
What is the role of academic family doctors specifically?
As an academic family doc, I’m a huge believer that when we recognize that system change needs to occur, the change that happens must be built on our family medicine values like fairness and equity. On top of that, the ideas we put forward for change need to be backed by solid evidence. What I’m trying to do with this book is bring evidence and values together through narrative. While each of these ideas is told through stories, all of my claims and ideas are supported by rigorous evidence. I really think that when we do knowledge translation of this kind, through storytelling and narrative, that we must continue to stay on the path of scholarship and evidence.