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Provincial budget responds to doctors’ priorities

Earlier this week, the new provincial government introduced its first budget. Our President Dr. Michael Boroditsky was at the Legislature to hear the budget, meet political leaders, and offer Doctors Manitoba’s reaction to reporters.

The budget clearly prioritizes health care, with dozens of funding commitments. Many of these commitments respond directly to recommendations from Doctors Manitoba, which reflect the concerns and advice we have heard from you, including:

  • Recruiting and retaining more physicians and other health care workers
  • Building capacity, including inpatient hospital beds, surgical and testing capacity and more resources for seniors care
  • Investing in prevention, including full coverage for HIV prevention medications, free birth control, more funding for immunizations, and more

Below you will find our full summary and analysis, and why Dr. Boroditsky said physicians will be ​“encouraged” by the budget. You can also read the full budget here. We will be offering further feedback to the province about the priorities and invite your continued suggestions to general@​doctorsmanitoba.​ca.

Recruitment and Retention

The government made a big commitment to add 1,000 health providers this year, including 100 more doctors. This would be the biggest ever single-year net increase in physicians in Manitoba. The shortages of physicians and other health providers were the top concerns we heard from you.

The budget outlines several steps to support achieving this goal, many of which we recommended:

  • Setting an ambitious target to recruit more doctors
  • Streamlining the licensure process for internationally-trained physicians
  • Better coordinating recruitment efforts
  • Expanding recruitment incentives, including restoring the rural physician recruitment fund

While a longer-term plan, the government is also expanding medical school training and residency spaces, both actions we, and so many of you, have also recommended. The Physician Assistant training program will also be doubled.

The plan acts on our advice to focus on better supporting the physicians we have to retain them, including:

  • Continuing the focus on reducing administrative burdens and reducing burnout
  • Supporting new to practice physicians
  • Focusing on retaining more graduates and residents with opportunities in Manitoba

The budget also follows thought with funding for the 2% increases and new tariffs in our historic Physician Services Agreement, to better support and fund both specialists and family physicians.

The plan also dedicates funding to hire more nurses, health care aides and paramedics, which we know so many of you have advised is critically important.

Building Capacity

Another top priority for physicians is building more capacity in the system, and the budget dedicates funding to achieve. Physicians identified priorities to expand inpatient hospital capacity, surgical and testing capacity, and add more resources for seniors care. 

For hospitals, there is funding to add more inpatient capacity, including:

  • 151 more acute care beds
  • 7 net new ICU beds, with funding to make 30 existing temporary beds permanent
  • 60 more lower acuity beds

For surgery and diagnostics, the budget will fund:

  • A new $50 million Health System Innovation Capacity Fund to reduce wait times for surgeries and tests in Manitoba
  • 10 more surgery slates for Grace and 5 more surgical beds
  • Additional resources for spine surgery at HSC, Brandon and Concordia
  • A mobile MRI for the Northern region

We are pressing for more details on the new Innovation Fund, as we know many physician proposals were left in limbo when the Surgical and Diagnostic Recovery Task Force was disbanded.

There are also more resources for seniors care, including more hours of direct care in PCHs, building four more PCHs including two in Winnipeg and two in rural Manitoba, and implementing a new ​“Safe and Healthy at Home” program.

Aside from these investments, which align with physicians’ recommendations, the government will also fund:

  • Two minor injury and illness clinics, one in Brandon and one in Winnipeg
  • A primary care clinic in Winnipeg
  • Planning towards reopening the Victoria Hospital and Eriksdale ERs

We are urging that physicians be consulted on these projects.

There is also mention of adding incentives to expand team-based care, a top recommendation from physicians, and we are following up to learn more about what this means.

Prevention

The government is also earmarking millions for prevention and health promotion activities. This includes:

  • STBBI and HIV-related testing and care, including full funding for HIV prevention medications 
  • Funding for more immunizations, diabetes action plans, home nutrition, and newborn screening
  • Funding for free birth control and to double the prenatal benefit

The government has committed to creating a supervised consumption site, adding more addiction treatment beds and harm reduction services.

Doctors had recommended many of these actions, including full coverage for PrEP HIV medications and expanded funding for immunizations, as well as listening to the evidence on supporting substance use treatment and recovery. 

Last chance for early bird gala tickets

We hope you will join us at our Annual Awards Gala on Saturday May 11. There are two reasons to purchase your tickets in the next few days:

  1. The Gala is already 50% sold out! Reserve your tickets or table today, even if you don’t have all guests’ information.
  2. Reduced early bird prices are available until Monday, April 8! 

The Gala is the signature event for the medical community, where we celebrate our seven amazing 2024 Award Winners. and we’re making some changes based on your feedback from past years:

  • More time for connecting with friends and colleagues, including an extended cocktail reception. 
  • A new layout for the room with more space for visiting and networking.
  • Exciting changes to our program and amenities on site. 

We are again embracing the cause of our Humanitarian Award winner with a fundraising component to our gala. This year, funds raised will support initiatives at Our Own Health Centre focused on addictions treatment and HIV testing for the 2SLGBTQIA+ community, and the Rainbow Resource Centre’s transformative capital project, Place of Pride. This initiative will establish a new campus offering a comprehensive range of queer services, including a community hub and housing for 2SLGBTQIA+ older adults. Doctors Manitoba will make a donation to support these causes, and guests at the Awards Gala will have the opportunity to support these causes as well through a fundraising initiative.

Get details about the Gala and purchase your tickets here!

Celebrating Dr. Sara Goulet

Dr. Sara Goulet is a family physician focused on creating welcoming and safe environments where Indigenous patients receive high-quality health care, free of racism, by engaging clinical leadership and providers, facilitating education, and encouraging accountability. As medical advisor at Ongomiizwin Health Services, she has pushed for systems to be re-examined, re-imagined, and re-built. As Associate Dean of Admissions for the Max Rady College of Medicine, and in collaboration with other health science faculties, she is clearing a path for traditionally underrepresented groups, including Indigenous, racialized, 2SLGBTQIA+, rural and lower socio-economic applicants, ensuring students are supported to succeed in a system that poses many barriers. Read Dr. Goulet’s full bio here and please join us in honouring all our winners May 11 at our gala event!

Next week: Sick Notes and Return-to-Work Think Tank

This is your last chance to register for our think tank focusing on reducing the time you spend on sick notes, other doctors’ notes and forms from employers, insurance companies and educational institutions. 

Key Details:

  • Date: Thursday, April 11, 2024
  • Time: 1:30 – 4:30 p.m.
  • Location: Masonic Memorial Centre, 420 Corydon Ave. (Confusion Corner)
  • Request attendance here. 
    While the event is planned primarily for in-person participation, a Zoom-based option will be offered for those outside of Winnipeg to participate remotely.

Reminder: April 1 remuneration changes

Monday April 1 marked the across-the-board 2% increase to all fee-for-service tariffs and alternate-funded agreements benefiting all physicians under the new Physician Services Agreement (PSA). A President’s Letter from Dr. Michael Boroditsky was sent last week to offers an overview. New tariffs are available for medical specialists, and Monday also marked the launch of Family Medicine Plus. You can watch a new video from family physicians about why FM+ is a plus for them and their patients. 

Eclipse in sight

On Monday, April 8, for viewers in a narrow path from Mexico through the central United States and across eastern Canada, the moon will appear to completely cover the sun, resulting in a total solar eclipse. 

Here in Manitoba, our view will be of a partial eclipse. In Winnipeg specifically, the eclipse will begin at 12:54 p.m., with maximum eclipse at 2:01 p.m., and will end at 3:08 p.m.

This fleeting event can have long term consequences for your vision. Dr. Jennifer Rahman is an eye physician and surgeon, the Medical Director of GEM Clinic and President of the Eye Physicians and Surgeons of Manitoba.

She is reaching out with her advice and guidance from the Canadian Ophthalmological Society to help make sure anyone who wants to view the eclipse does so safely. 

“A partial eclipse like we’ll be experiencing is more dangerous, because there is not any time that it is safe to view without eclipse viewers,” she said, and only those that comply with the ISO 12312 – 2 Standard should be used. Unfortunately with demand high, there are many counterfeit or untested and unsafe viewers being sold online.

Exposure can result in permanent vision loss. Even as little as a few seconds glancing at the sun can cause solar retinopathy, a photochemical injury to the macular tissue (central retina). Symptoms include blurry vision, vision loss in the centre of vision and eye pain.

Sadly, there is no known treatment for solar retinopathy, and while vision may improve over time, if there are no improvements after six months, the injury is likely permanent. 

Dr. Rahman advises particular caution with children, as their eyes are even more vulnerable to damage. Parents and caregivers should be vigilant to ensure they are wearing viewers properly and following instructions to leave them on throughout the eclipse event. 

She said it is also important to know that viewing the eclipse through a lens, such as a camera or telescope, with or without eclipse viewers is also unsafe, as concentrated solar rays will burn through and can cause serious eye injury.

The Manitoba Museum has an eclipse-viewing resource, including directions on how to make indirect viewing devices if you don’t have approved eclipse glasses. 

Larry comes to the big screen

Take in a free public screening of Larry Saves the Canadian Healthcare System

Friday April 19 and Saturday April 20 at 8 p.m. at The Gargoyle Theatre, 585 Ellice Ave in Winnipeg. 

This research-based musical satire of the healthcare bureaucracy has gone viral, with almost 80,000 YouTube views. Enjoy it on the big screen, followed by a panel and Q&A featuring researcher/​creator Dr. Sara Kreindler (PhD), director Ann Hodges, actor Colleen Furlan, and Emergency physician Dr. Alecs Chochinov. Click through for more information and to reserve your free ticket.

EM:POWERing Emergency Physicians

The Canadian Association of Emergency Physicians released a major report last week from its EM:POWER Task Force. The goals of the Task Force were:

  • to propose a redesigned, integrated framework for emergency care in which form follows function
  • to optimize emergency care delivery within the broader healthcare system, to help achieve the Quintuple Aim.
  • to catalyze change, by empowering from above (system leaders) and below (health workforce)

You can view the news release and full report with recommendations here.

The report was authored by experts from across the country, including Dr. Alecs Chochinov and researcher Dr. Sara Kreindler (PhD) who also are behind the musical satire Larry Saves the Canadian Healthcare System. 

Physician health and well-being opportunities

Group-Based Peer Support

Peer support is confidential and, though peer support may complement clinical approaches, it is not clinical treatment or therapy. It is an evidence-based approach shown to improve coping and self-management skills while lessening distress. Dr. Shelley Anderson facilitates two groups: one for DRMB members with substance use concerns and/​or addiction and another general-purpose group for members struggling with burnout, anxiety, stress, and other mental health concerns. With the recent increase in funding from the new Physician Services Agreement, we have expanded the number of physician peer support groups offered, particularly for equity-deserving DRMB members. They include:

Indigenous Medical Learners (Hybrid) - Physician Facilitator: Dr. Yvette Emerson 

BIPOC Members (Virtual) — Physician Facilitator: Dr. Dilinna Onyiah 

Female Surgeons & Female Surgical Residents (Virtual) — Physician Facilitator: Dr. Heather Ring 

Learn about the current and planned group-based peer support groups

Physician Health Inclusion space on CMA Community

There’s a new space for physicians, residents and medical students with disabilities and chronic conditions looking to find a supportive community of peers and colleagues: the Physician Health Inclusion space on CMA Community.

As a closed group for physicians, residents and medical students with disabilities and chronic conditions, this space is intended to give this community of practice a platform to come together and share, support and accelerate improvements on disability inclusion in the medical workplace. This community was created and is managed by peers, trying to make the health workspace more accessible, one issue at a time.

If you or anyone you know is interested in joining, click here to log in to CMA Community and request to join the Physician Health Inclusion community. Detailed log-in instructions are here.

Please note that you will be asked to confirm that you yourself are a physician, resident or medical student living with a disability or chronic condition in order to join the community. There is no need to disclose your diagnosis. Your disclosure will only be seen by the moderator granting you access to the group.

Please note that you do not have to be a CMA member to join.

Women physician well-being workshop

Take part in an empowering workshop dedicated to enhancing the mental and physical well-being of women physicians. Sessions include physical self-defense and mental resilience training. The workshop takes place Sunday, April 21 from 9 a.m. to 5 p.m. in Gimli. The cost is $225 per person. To register or for further questions please reach out to drastridguenther@​gmail.​com.

View the flyer here.

CFPC Physician Wellness Retreat 

The College of Family Physicians of Canada (CFPC) Physician Wellness Retreat aims to provide family physicians an environment in which they can learn and apply principles of physician wellness. Keynote speakers include Dr. Jillian Horton and Dr. Catherine Hansen

Don’t miss this opportunity to enjoy three nights immersed in the beauty of the Alberta mountains while learning, reconnecting, and engaging with colleagues, old and new.

Event includes:

  • Two-and-a-half days of unparalleled education. Incredible keynotes and engaging wellness sessions. 
  • Daily breakfast and breaks plus two gourmet dinners.
  • Evening social events and fireside chats.

Learning objectives:

  1. Apply evidence-based strategies to enhance overall well-being by implementing physical, mental, and emotional wellness practices,
  2. Plan and implement effective wellness practices both in clinical settings and personal lives,
  3. Develop strategies to foster a culture of well-being within the workplace, sharing resources or materials with colleagues, and exploring collaborative wellness initiatives that can be implemented as a team. 

Learn more here. Register here.

Health System Updates

AIM Process Measures: Are we doing the right steps?

The Access Improvement Model (AIM) program is designed for primary care teams. It focuses on improving patient access through developing and understanding quality improvement, change management, and team-building skills.

Quality improvement work consists not of a single measure but of a family of measures. While outcomes measures (directly tied to your aim statement) are typically the most obvious, process measures are equally valuable in your quest towards making improvements in your clinical operations.

More specifically, a process measure involves looking at your processes and identifying how a specific component of the change is working out or how it is working in a specific setting. In short, a process measure helps answer the question, ​“are we doing the right steps?”. While they may not be obvious at the onset of your quality improvement journey, an appropriate process measure can facilitate pin-pointing potential root causes of your identified issue.

Part of the Access Improvement Model (AIM) training curriculum involves guiding teams through the process of identifying a family of measures in an effort to improve patient access. We are always looking to engage with new primary care clinics and with our schedule fully booked for Spring ​’24, openings as early as Summer ​’24 are available!

If you would like to explore AIM in greater detail, please visit the AIM website and be sure to reach out via aim@​umanitoba.​ca

Fantastic Physicians

Congratulations to Dr. Susan Cuvelier and her team of physicians who were the top fundraisers, raising over $12,000 of the $35,913 raised for Main Street Project through the Into the Cold challenge. This group of generous physicians walked, jogged, ran and did other outdoor activities in March to support the cause. Cumulatively they travelled a distance of 426.2km and spent nearly 52 hours outside. 

ICYMI

Upcoming Events

You can always review upcoming events on our events calendar page.

CMA AGM May 29

This year’s Annual General Meeting for the CMA is special for Manitobans, as CMA President-Elect Dr. Joss Reimer will officially become president. Register to hear from her and other CMA leaders. The CMA AGM will be held virtually on Wednesday, May 29, from 10 a.m. to 2:30 pm. Learn more and register.

Meeting information, including the agenda, is available at cma​.ca/​a​g​m2024. The annual report and additional resources will be added in advance of the meeting.

Questions? Contact memberservicecentre@​cma.​ca.

IPAC Mentorship Gathering 

Registration is open for the Indigenous Physicians Association of Canada’s Annual Mentorship Gathering and AGM July 12 – 14 in Halifax. The gathering is an opportunity for Indigenous medical students, residents, and physicians, both members and potential members, to come together to share stories of their academic journeys, grow their networks, and enjoy cultural activities. The theme of IPAC’s 2024 Annual Mentorship Gathering and AGM is: Our Stories. Our Medicine.

Early bird pricing ends March 29.

Community Engagement of Sexual and Gender Minorities 

Dr. Murdoch Leeies will lead a discussion April 24 from noon to 1 p.m. focused on patient and community engagement of sexual and gender minorities for research leading to health policy change. The engagement process used in a successful research program will be reviewed. Explore the challenges and lessons learned, and discover different strategies for engagement that you can apply in your own work. 

CHI’s Lunchtime Learning is open to all researchers, decision-makers, clinicians, patients and members of the public who want to learn more about the theory and practice of meaningful, inclusive, and safe patient and public engagement. Register now.

2024 Canadian Conference on Physician Leadership — May 24 – 25 in Montréal

Lead the change our healthcare system desperately needs! Attend the CCPL2024 in Montréal, where you’ll gain invaluable insights and skills to drive transformation.

View the conference program here. Register now.

Cancer Day for Primary Care — May 31

The 16th biennial Cancer Day for Primary Care, a collaboration between the Community Oncology Program at Cancer Care Manitoba and the University of Manitoba, is back. This year, our event will be hybrid, offering both virtual and in-person attendance options at Theater B, 727 McDermot Ave, University of Manitoba. Our focus will be on Genitourinary Cancers, covering topics from Prostate to Renal, Urothelial, Testicular, and Bladder cancers, including screening, work-up, and systemic therapy. What sets this event apart is the opportunity for attendees to submit their own cases for discussion by our expert panel. Join us for a dynamic and informative program. Learn more & register.

HPV & Cancer — Interdisciplinary Rounds: Prevention, Treatment & Future Direction — June 5

Speakers include Dr. Vanessa Poliquin, Dr. Ciaran Lane and Dr. Sarah Kean.

Learning objectives

  • Describe the HPV Landscape in Manitoba
  • Explain the pathophysiology of HPV-associated cancers and identify the different types of the cancers
  • List the screening modalities for cervical cancer in Manitoba.
  • Identify the different surgical interventions and reconstructive techniques that are used in head and neck cancer care.

Register now.

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