The Good Doctor | Henry Annan | TEDxSaintMarysU

I would like to begin by acknowledging that the land on which you gather is the ancestral and unceded territory of the Magma People. These lands are covered by the treaties of friendship and peace that the people of magma and mouse granted to the British crown in 1725. Good evening everyone, my name is Henry Annan and I am a proud smile. um class of 2014, come on Huskies and I am a second year pediatric resident training to become a pediatrician and I work right down the street at the iwk health center and I have to tell you that despite the long hours on call and the pain that often entails caring for a seriously ill child, I love my job, there is something about the minds and resilience of children that shines the brightest light even on the darkest days and remains. my motivation every morning I get up to go to work.

I consider myself privileged to be part of such a rewarding profession and it is very natural when I receive medical students and prospective medical students who express interest in a Korean pediatrics and come. They ask me for advice, which I encourage because of the way I give them my completely unbiased opinion on how pediatrics is the best specialty in the world. Now I wanted to share with you one of these conversations I had with a

good

friend of mine. A long time ago he was also a medical student and had expressed interest in pediatrics. He had done some rotations in medical school and he thought he could do a very

good

job in the field, but he had a reservation.

Henry told me, you know I love pediatrics. and all, but I just heard that a lot of the things you do as pediatricians are not really related to medicine. Oh, I asked him to explain more. I just heard that there are a lot of social problems that you can't really solve as a

doctor

. I see, tell me better. Don't know. I just feel like it would be frustrating after spending all these years in medical school. I like doing things I was trained to do. Feelings like this are not uncommon in medicine. In fact, they are not unique to pediatrics at all; perhaps now more than ever,

doctor

s are confronted with the social problems their patients face every day.

These are the famous social determinants of health, those characteristics or factors that are not exclusive to a doctor per se. but they are just as, if not more, critical in determining health outcomes and patients and patient populations, for example, in pediatrics. This is the field I know best. We know from a famous study published in the late 1990s that children who experience adverse events such as neglect, abuse and trauma during their childhood can develop biomedical phenomena such as cancer, lung disease and heart disease in adulthood. We know that people who complete college have a longer life expectancy compared to people who have not completed higher education. school and finally, we know that socioeconomic status remains one of the most powerful predictors of health outcomes in children and adults, so social determinants of health are medicine and should concern anyone who has the privilege and responsibility for providing care to patients.

Doctors absolutely accept the idea of ​​having to deal with the social problems their patients face, citing that they represent challenges that are too complicated, too big to deal with, which I find quite ironic because, as doctors, we are trained to do quite a few things. complicated. things I mean when I call the pediatric intensive care unit as I did the other day, I often care for children whose hearts have stopped beating and are therefore connected by tubes to a machine that functions as their heart pumping blood. throughout their body rejecting their organs until, hopefully, one day their hearts will beat again, we see teenagers arrive after serious car accidents with multiple broken bones, multiple organ lacerations and serious spinal injuries, but an interdisciplinary team of doctors, surgeons, nurses and respiratory therapists meet. the Trauma Bay of an emergency department that works systematically to ensure that that child, that adolescent, has the best chance of returning to his or her baseline as humanly possible.

We spent millions and millions of dollars on field experiments after failed experiment after failed experiment, as we should. Trying to discover new therapies for complicated cancers because we collectively believe in our duty to find a cure for this deadly disease, surgeons spend 6, 12, 18, sometimes even more hours in operating rooms, diligently, meticulously, exciting tumors from parts of the body where the difference between life and life is made. death may be a single millimeter, but you still ask the average doctor how they are going to solve climate change, which, by the way, the World Health Organization and basically everyone agrees is the biggest threat to global health in the 21st century and you Be lucky if you laugh, why?

As I thought more about this question, I realized the answer was in that conversation I had with my friend. He said that after all these years in medical school I would like to study. things I was trained to do, that was exactly what doctors are not trained to deal with the social issues that are impacting their patients' daily lives. Listen, if you gave me a newborn that didn't breathe so scary. I know exactly what to do. I do it because I've trained in that scenario in my residency over and over again, so when it actually happens my thinking is automatic, but if you asked me how I was going to solve the systemic racism that has led to health disparities among minority populations compared to those who are not minorities.

I would have to draw on knowledge and skills outside of my formal medical education while I sleep. I can rhyme the diagnostic criteria for rare pediatric rheumatology diseases like Henoch-Schonlein purpura and juvenile idiopathic arthritis. That's because I studied. I studied them in medical school, but I didn't get those kinds of lectures on how to provide primary health care to the 5 million Canadians who don't have access to a family doctor. Now, this is in no way a knock on the Canadian medical education system. I think Canada should be proud of the doctor it produces and who continues to serve its patients and its communities;

However, I maintain that the good doctor should be able to deal with the totality of the factors that affect the health of his patients. The good doctor should be equally competent. like knowing what antibiotic to prescribe for their patients, pneumonia, while prescribing a solution for their low-income patients, which will determine whether they can afford that antibiotic or not. I argued that a good surgeon is as competent at using his scalpel as they are. is using his pen writing letters on behalf of his patients to provincial federal and municipal policymakers who promote healthy and progressive public policies and to those who say that what I am describing is absolutely beyond the scope of medical practice, that the High-quality pedagogy and social determinants of health would be at the expense of producing physicians who are of the highest quality in their clinical acumen, which is what has come to define what a physician is.

I point to the many doctors across the country who are using their platforms to advance and address the biggest social issues. challenges of our time doctors like dr. Gigi Osler, a Manitoba ENT surgeon who also has the distinction of being the first female surgeon to become president of the Canadian Medical Association and uses her platform to advance the causes of gender equity and diversity in medicine and beyond doctors like Dr. Danielle Martin, who published compelling evidence in support of a universal pharmaceutical care system that would ensure all Canadians have access to their prescription medications. Monica Dodd is a public health physician in Cape Breton, Nova Scotia, and she advocates for health policies that are based on our collective belief that access to high-quality health care should not depend on where you live or how much money you have.

University of British Columbia's Center for Excellence and Indigenous Health is led by Canada's first woman and Indigenous surgeon, Dr. Nadine Carroll, who spends time seeking answers and solutions to address the health inequalities faced by the people. indigenous and non-indigenous people in Canada compared to doctors from non-indigenous populations such as dr. Yellowknife's Courtney Howard, who travels the world highlighting the harmful effects climate change is having on our health and medical students like Dr. Vanilla Hackett from Alberta and Dr. Claudel Pittman of José de Quebec we join an international effort to ensure that educational objectives on climate change in health are included in undergraduate medical education curricula in Canada and around the world.

Medical schools emphasize the importance of a holistic approach to healthcare delivery. The approach to healthcare delivery includes addressing the biomedical and social aspects that are impacting patients' lives. Climate change. The increase in economic disparities. The rise of racial tensions. These are things that are not going to resolve themselves. It's time for the doctors to be close and get to work. roll up your sleeves and join the efforts to create healthier communities and from the medical schools of this country take on the challenge of ensuring that our future generation of doctors is prepared to take on the social challenges they will face.

They are impacting the lives of their patients because God knows, looking at the challenges we face and the obstacles ahead of us, we will need everyone, we will need the young, the old and the in-between, we will need men. women and those who do not otherwise identify we will need some passionate activists and some thoughtful advocates we will need some curious students and some dedicated teachers we will need some innovative engineers and some expert scientists and yes, we are going to need all your good doctors to make sure that when look that five-year-old patient in the eyes and tell her that everything is going to be okay, you can really say that everything will be okay and that she will realize it. the future that she so deserves, thank you very much