Eliminating health care arrogance as important as building medical school | The Eastern Graphic

Eliminating health care arrogance as important as building medical school | The Eastern Graphic

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Paul MacNeill




It’s the worst kept secret on the Island. UPEI President Alaa Abd-El-Aziz wants to build a medical school, which could provide the province a much needed local source of doctors, and deliver the type of professional gravitas needed to attract research dollars to the province.

So far it’s nothing more than inside chatter among the university, health care and political class. But it does seem to have credible momentum, despite what would be significant upfront and ongoing operational costs. Speculation is that a UPEI medical school would partner with an already established school, such as Memorial in Newfoundland or Northern Ontario School of Medicine, the two leaders in rural focused medical training in the country. 

The school idea isn’t new. It was first proposed by former Island NDP leader Herb Dickieson, who tried unsuccessfully to build the needed coalition. But perceptions change and a school is now seen as one piece toward improving PEI as a work destination for health care providers. But if we don’t deal with other issues, like the ‘toxic’ work environment described by many departing Health PEI employees, a medical school investment will likely be a waste of time and money. 

The toxic environment is a byproduct of a top down approach, driven by political interference and an unwieldy bureaucracy disparate in focus and priorities, and prone to promotion of pet projects like the mental health research centre that will do nothing to improve frontline services in the province. 

An issue that is equally tough to fix is the PEI College of Physicians and Surgeons, a self-regulating body for Island MDs that is too often an impediment to problem solving. 

Self-regulating bodies have the power to make up, and enforce, their own rules for entry. The college has historically been unnecessarily slow to accept foreign medical school credentials. Part of the issue is college self-importance. Part is fear of shrinking the lobby power of doctors by eliminating the chronic shortage (Negotiating power is always stronger when demand outstrips supply).  And part is no doubt driven by public interest. 

But someone needs to oversee the college, which has authority to investigate and deliver penalties to its members.

One recent decision involved a Montague GP.  For the record my doctor, who I have always found to be courteous, professional and competent. I won’t detail the allegations, which the doctor self reported to the college and were the focus of numerous news stories. The punishment, for the most part, seemed reasonable. Save one. A demand that if the doctor returns to practice she: “Shall live outside the community where she practices …”

Shall is a powerful word in the law. It compels an action. 

The problem with telling anyone where they can live is it runs smack dab into the Constitution of Canada and specifically mobility rights enshrined under Section 6. 

I asked the college for a legal opinion to support its residence demand. The college was indignant, ridiculously saying it is a suggestion on where the doctor can practice, not where they must live.

Words matter. This is clearly not what the college ruling states.

Once again I asked for a legal opinion in support of its position. Once again crickets from the PEI College of Physicians and Surgeons.

Now to be fair, George Carruthers is new to the college and was only recently named registrar after serving a high-risk Charlottetown population with distinction for years. The issue is not with Carruthers but the institutional bias within the college that suggests its decision making is beyond reproach. 

Look at this decision – and this specific demand – through the lens of a doctor who may be interested in moving to PEI. It can easily be viewed as unnecessarily heavy-handed and over the top. And quite possibly contrary to the Constitution of Canada. It could be an impediment to successful recruitment.

If our province wants to build a sustainable health system that recruits and retains health professionals, including doctors, we need more than a medical school. We need to strip away self-important silos found in the health care bureaucracy and College of Physicians and Surgeons because they are not always focused on the greater good.

Paul MacNeill is Publisher of Island Press Limited. He can be contacted at [email protected]

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