Longwoods Publishing - Interview with Penny Ballem
Posted Nov 21 2008 2:04pm
This article is very interesting - just published - Healthcare Policy / Politiques de Santé, 4(2) 2008: 25-32
Steven Lewis talks with Penny Ballem about the challenges of integrating physicians into health reform, federal-provincial relations and health information management.
Penny Ballem is a former Deputy Minister of Health for British Columbia and a Clinical Professor of Medicine at UBC. She has a long-standing interest in teaching across all health disciplines and in clinical and policy research. During her tenure as Deputy Minister of Health, Dr. Ballem served on the board of the Canadian Institute for Health Information, as a member of Canada Health Infoway, as Liaison Deputy Minister for the Canadian Council for Donation and Transplantation and as co-chair of the Pan Canadian Public Health Surveillance Information System Project. She recently talked with Steven Lewis, health research and policy consultant based in Saskatoon, adjunct professor of health policy at the University of Calgary and Simon Fraser University, and contributing editor of Healthcare Policy.
SL: Some have suggested that one way to get physicians more aligned
with the broader agenda is to integrate them more fully into the
regional health authorities. Do you think that's necessary, and if so,
do you think that it's going to be feasible any time soon?
PB: Yes. Ideally, to really serve the public needs and interests, and
get value for money from the huge taxpayer investment in our healthcare
system, you have to have the physicians integrated and aligned at the
regional level. If we were to follow the lead of most other
international jurisdictions, the physicians' compensation should flow
through the region, because their work is integral to the function and
goals of regional healthcare structures.
But funding for physicians constitutes a large part of overall
government spending, and the physician compensation file is a complex
one. The risk is that some regions will manage the relationship - the
labour relations, the compensation issues - well and others won't. To a
certain extent, that's why governments have hung onto the physician
file and manage it themselves, with variable amounts of input from the
Primary care physicians are a huge issue, because they tend to be the
most isolated in the system, particularly if they're not involved in
hospital work, which in the most populated parts of our country (the
urban areas) they're not. They often experience the interface with the
many parts of the system as an added burden versus something that
should enable them to do a better job. To me, the first job of any
health region should be to bring its primary care physicians into a
more integrated role in the region, recognizing that they are a
critical part of a high-quality healthcare system.