It’s no secret that doctors often make lousy leaders. Just think of Francois (Papa Doc) Duvalier (Public Health, Haiti), Bashar Al-Assad (Ophthalmology, Syria), and Radovan Karadžić (Psychiatry, Bosnia).
There are many reasons for the dearth of physicians in politics – after all, the qualities that make the best politicians are not necessarily the same attributes of the finest clinicians. Great politicians may be opportunistic, ambitious, partisan, and calculating. Alternatively, the best clinicians are driven by humility, empathy, curiosity, and passion for patient care. When the physician and politician collide, one is reminded of the famous joke – “What’s the difference between God and a Doctor? God doesn’t think He’s a Doctor.”
To be successful, in both fields, one must understand the limits to one’s skills and power. A leader must recognize what he or she can realistically accomplish; to control situations not simply react to them.
Regrettably, our neophyte Health Minister, Dr. Gaetan Barrette, has charged to power as a victorious conqueror. Like so many before him, he is determined to save us from ourselves. With swift edicts and magisterial decrees, He alone will fix the health care system. Apparently, the solution is simple; like Pharoah, Dr. Barrette has commanded that we all work harder or be punished. Mercifully, Minister Barrette’s proposed contraception policy only imposes steep fines and not discarding in-vitro newborns into the Saint Lawrence River.
Some aspects of Dr. Barrette’s proposed Bill 20 purpose are noble – to promote access to family medicine and specialized services. However, towards this end, Dr. Barrette has prescribed a disappointing, misguided and unimpressive treatment. Like an overbearing parent, Dr. Barrette demands “certain obligations…to provide medical care to a minimum caseload of patients” likes chores for an allowance. Failure to comply will result in monetary punishment to be judged and executed by the authority of the Minister of Health Himself.
Other aspects of Bill 20 are simply nauseating. Women over age 42 are forbidden to have children by IVF, public or private, in Quebec and elsewhere, with fines of up to $150 000. Moreover, the Bill legislates a mandatory prerequisite “period of sexual relations…determined by government regulation.” This is not a typo.
In the end, the Minister will inform us, “by directive, of the rules that [we] must follow.” Supreme Ruler Barrette, like Kim Jong-un, claims to speak for the people and to act in their best interest.
How does this Bill improve access? What brilliant, insightful and innovative mechanisms are established to improve access? Simply – none. The Minister is convinced that doctors that can be scared into seeing more patients, women can be intimidated to work longer hours, and women in their 40s can be frightened not to have children. It is a Bill befit for the “Democratic People’s Republic of Quebec “– not our Quebec.
Our goal for this Bill should be access to quality and timely care – not patients seen. We should be building on a model that allows young physicians to balance family and work, decrease stress, improve flexibility and encourage part-time physicians to carry a broader work load. A load not defined by quantity, but in its complexity (ie. mental health, chronic illness, elderly, etc.).
We need a Minister who listens, a leader who collaborates, and a government that cares about people more than numbers. We need to celebrate families and diversity. Dr. Barrette has no place in our bedrooms or in our offices.
Bill 20 is not bad medicine, it is poison. Bill 20 criminalizes fertility in older women. It antagonizes and discourages young doctors who wish to make a life and family in Quebec and will push older doctors to early retirement. Take note Minister Barrette – Pharoah’s regime ended with the great Exodus. Bill 20 threatens us all.
Dr. Michael Kalin is the Medical Director of GMF Sante Kildare located in Cote Saint Luc.