Many family doctors recently attended the BCMA-sponsored Professional Quality Improvement Days (PQIDs). It seems the health care system is currently having some difficulty meeting the expectations, costs, and demands placed upon it. These demands are generally accepted as programmed inevitably to increase, due to our aging and increasing population, and new expensive investigative, therapeutic, and pharmacological technology.

There were two aspects of the PQIDs that were particularly discouraging:

• The generally depressed, angry, and frustrated mood of most of those practising physicians in attendance. (Not all, a few encouragingly stated that they did still value and enjoy their work.) The specifics of whatever is meant by “primary care reform” may or may not eventually moderate this.

• The thrust of the presentations by the invited internationally expert speakers at the Big PQID at the Bayshore—two Brits, two Americans—was essentially to educate, goad, and encourage practitioners to become more efficient—providing new and improved ways to manipulate the system and its workers. There were few suggestions related to reduction in demand.

The BCMA is to be congratulated for undertaking this proactive activity addressing the real concerns of its members— and of our society. It does so in recognition of its leadership position, which must include responsibilities for informing the public and providing advice to governments. It would have been encouraging to see the BCMA’s PQIDs not only pushing the providers harder, but also developing positions designed to produce less demand and societal expense, politically unpalatable though this might be; we might be talking here about difficult and unquantifiable stuff like school and public health education, societal lifestyle and expectation change, taxation, legal and administrative revisionism, de-insurance, and user-pay services.

Doesn’t the BCMA have as much responsibility at least to discuss publicly and with its membership ways to possibly lighten our carts as it has to promote further flogging of the horses?

—Peter Grantham, MD
West Vancouver