Reverberations

Eberhard Renner, MD
Internal Medicine Department Head

Nothing that I have ever written has created so much immediate attention and lead to so many rapid responses than my last blog “About Money”. There were 195 hits on the blog during the first day after posting, and over 250 more since. This is five times the attention that previous postings received. A few colleagues responded in the comment section of the blog, many by e-mail, many more on occasional informal encounters in the hallway. The comments varied widely and ranged from astonished disbelief and feeling disadvantaged, over rationalizing and defending incomes and income differences, to offense, anger, and suspicion this may be the first step into an equalizing payment future.   

None of these reactions were specifically intended. I simply wanted to be transparent and stimulate a discussion, nothing more, nothing less – and am glad that I apparently got your attention. That said, let me clarify some things that came up:

Firstly, and maybe most importantly, the latest blog on facts “about money” should not distract from some other equally or even more important facts, namely that you all should be proud of your accomplishments as compassionate clinicians who competently serve your patients, as engaged teachers and educators who train and mentor the next generation of physicians, and as prolific scholars who innovate and move your fields forward. All this in an environment with a lot of moving parts and huge constraints on many fronts including outdated infrastructure and limited support staff. I fully acknowledge that it is your hard work and achievements that make our Department successful. I would like to thank each of you for your individual contributions many of which are not and cannot be properly rewarded by money.

Secondly, our incomes are largely publicly available by individual provider: fee for service income from Manitoba Health’s annual report (latest version available: Annual Report 2016-2017 – Province of Manitobahttps://www.gov.mb.ca/health/ann/docs/1617.pdf), University salary (over $50k per year) from various libraries (https://legislativelibrary.mb.catalogue.libraries.coop/eg/opac/record/107421669; U of M does not post on line), WRHA income (over $50k per year) from WRHA’s “sunshine list” (http://www.wrha.mb.ca/about/compensation/index.php). All of us and every interested fellow citizen can look this data up, for each of us individually, and do the math.  I was therefore surprised that some colleagues reacted by implying that putting aggregate numbers into the public domain was somehow inappropriate. Conversely, the astonished disbelief conveyed to me by others about the income differences existing in our Department also took me by surprise.

Thirdly, beyond stating that we are privileged, my blog only stated facts and asked questions. I believe it is hard to dispute that we are privileged – but I am open to hear the reason(s) if somebody feels differently. If we all feel that our incomes are justified – and my blog did not say they aren’t – there is no need to justify them to ourselves and/or to our colleagues, as some respondents correctly stated. But if the facts are in the public domain accessible to anybody, I would suggest we better have good arguments to justify them towards the public/taxpayer. The arguments I heard with regards to the latter were not convincing enough for me to trust they would hold up in a public debate, but I have been wrong before… 

Fourthly, since our individual incomes are all available in the public domain, I have difficulties understanding, why my blog has angered or offended some of you. With regards to particulars, I want to stress that ”interventionalist” is a generic term characterizing anybody in any subspecialty performing interventions. In general, as you all know, interventions tend to be better remunerated in any subspecialty than non-interventional activities, and my blog explicitly acknowledged that there are credible reasons for this.

Finally, any interpretation of my blog being a first step towards changing existing remuneration models is not only entirely wrong, but totally overestimates the influence and power of a University Department Head and Shared Health Provincial Specialty Lead: As such, rest assured that I am definitely not in a position to change existing remuneration models, even if I would want to.

That all said, let’s not get too much distracted by the always controversial and often divisive discussion about money. Let’s acknowledge that we are all privileged and keep up the good work!


Doctors Manitoba 2019 Awards

Our sincere congratulations are extended to Dr. Kenneth Kasper recipient of the Health or Safety Award, and Dr. Terry Colbourne recipient of the Resident of the Year Award. The awards were presented at the May 3, 2019 Doctors Manitoba Annual Awards Gala.


Health or Safety Promotion Award

For contribution toward improving and promoting the health or safety of Manitobas specifically or humanity generally.

Dr. Kenneth Kasper

“Dr. Ken Kasper’s efforts to streamline, standardize and improve access to quality HIV care in both the tertiary and primary care setting led to the establishment of the Manitoba HIV Program in 2007 and he has been the HIV Program Director ever since. The Manitoba HIV Program is a true partnership between primary and specialized care and established a centralized referral system to link patients to care quickly and has set standards and quality monitoring processes to ensure people living with HIV in Manitoba are receiving quality HIV care. Dr. Kasper has supported primary care providers at the HIV Program Community Site, Nine Circles, and he has worked to build partnerships with collaborating primary care providers throughout the Province.

Dr. Kasper travels to Churchill regularly to provide care in collaboration with local primary care practitioners. He has made countless trips to Brandon, Swan River and other communities in need to provide direct patient care and education which continues to build capacity and help patients receive care in their own communities. Dr. Kasper’s efforts have led to the establishment of a satellite site of the Manitoba HIV program in Brandon in 2016 and continues to create strong primary care partnerships throughout Manitoba. Since 2011, Dr. Kasper was also the Inaugural ID specialist to develop a relationship with Manitoba’s Stony Mountain federal penitentiary where he spends time now in a developed clinic on site, treating HIV and other Infectious diseases twice per month.

In addition to providing direct clinical care, he has been a strong advocate for patients living with HIV and has been a consultant to the primary care practitioners who provide HIV care in the community at Nine Circles Community Health Centre.Dr. Kasper is an assistant professor in the Department of Internal Medicine at the University of Manitoba and an infectious disease specialist working at Winnipeg’s Health Sciences Center hospital and Nine Circles Community Clinic. He is also the director of the Winnipeg Regional Health Authority HIV Program and the Manitoba HIV Program. His research interests include both medical education with a focus on HIV and an HIV Industry based research program where Manitobans get the opportunity to try the latest HIV medications in phase 3 trials. Dr. Kasper has been a member of the Faculty of Medicine at the University of Manitoba since 1999. He maintains a busy clinical practice in Internal Medicine/Infectious Diseases with his focused HIV care in both the inpatient/ outpatient department at Health Sciences Centre.”

Source: Doctors Manitoba 2019 Annual Awards Program

Resident of the Year

For excellence in academic and clinical training and noteworthy contributions to the resident’s home program/specialty or residency program.

Dr. Terry Colbourne

“Dr. Terry Colbourne always has a fresh and unique viewpoint on multiple different issues regarding resident training and practice. Nationally, he is a leader in advocating for resident privacy and resident input into the accreditation process. He has played an integral role in the development of national principles regarding resident data collection, accreditation and competency based medical education (CBME). These principles serve as the voice for Canadian residents and are used by various policy makers. He has represented the interest of Canadian residents at many tables including sitting on the CaRMS Board and several Royal College Committees. He has also participated in multiple accreditation site visits as a resident surveyor, most recently at the Dalhousie University accreditation in November 2018.

Dr. Colbourne has been actively involved with the Resident Doctors of Canada Board (RDoC) throughout his entire residency. He served a term as Vice President for the organization, on the Board of Directors and as a member and co-chair of their Training Committee for multiple years. He is currently serving as the Training Committee co-chair.

Dr. Terry Colbourne is a final year resident in Respiratory Medicine at the University of Manitoba, having completed his core internal medicine training at the same institution. In addition to his work provincially and nationally, Dr. Colbourne is an excellent respirology fellow. He was selected and served as chief resident for both the internal medicine and respirology programs in his senior years, and has always been regarded as one of the hardest working residents.”

Source: Doctors Manitoba 2019 Annual Awards Gala Program