Robert M. Hollinshead, M.D., FRCSC
Incoming President,
The Canadian Orthopaedic Association

My fellow orthopods, I hope you are all having a great summer with family and friends.

Well, I've had a tumultuous start to my time as President of the Canadian Orthopaedic Association. When I started as President of the Alberta Medical Association in September 2002, within my first month in office the CEO announced he was leaving to become our College Registrar, I was badly misquoted in the media, and the Minister of Health announced he was rolling back part of our 22% fee increase temporarily because of over-utilization.  

As I looked forward to the COA's Annual Meeting in Toronto, little did I know about another turbulent start on the horizon. Your Executive found itself between a rock and a hard place as we faced the first SARS crisis in planning for the Toronto meeting. Just as we thought we were out of the woods, the second SARS flare came and this time the index case was an orthopaedic patient in his 90's at North York General Hospital. We were told five orthopods were quarantined along with hundreds of other health care workers. Faced with up to $240,000 in cancellation penalties and considering the incredible hard work the Toronto Local Arrangements Committee had done, we wanted to go forward with the meeting if at all possible, but three days out we had to make a very tough decision. Concerned about the unlikely but possible scenario of orthopaedic surgeons from across Canada facing quarantine on their return to their home cities, we decided to cancel the meeting.

Our CEO, Doug Thomson, and his outstanding staff made great efforts to notify everyone in time. Yuri Kojima was able to get Air Canada to allow rebooking without cancellation penalty - no mean feat in itself, given Air Canada's present difficulties. Doug Thomson has worked hard to negotiate down our penalties. In the wake of this decision, Dr. William R.J. Rennie, our Outgoing President, set the wheels in motion to resurrect a scaled-down but top quality meeting which is now rescheduled for October 3 - 5, 2003 in Winnipeg, Manitoba at the Convention Centre there.

I want to personally thank Dr. Barry W. Malcolm and his Toronto LAC for all their efforts in organizing the Toronto meeting. Dr. Emil H. Schemitsch's hard work as Programme Chair has laid the foundation for a successful scientific programme at the Winnipeg meeting. Mrs. Robbin Richards, our hardworking Secretary's spouse, had organized a silent auction to raise funds towards a Young Investigator Award, recognizing the many contributions of Dr. Sandy Kirkley during her career, all too tragically cut short following her untimely death in September of last year. Robbin's outstanding job in organizing that silent auction towards Sandy's legacy fund will be realized at the Gala Night entitled "Them Canadian Bones" to be held on the Saturday night in Winnipeg.

My Presidential address in Winnipeg will highlight why I believe medical politics plays such an important role to health care reform here in Canada. In that regard, as your incoming President I have been investigating whether or not the COA should seek intervenor status in a Supreme Court of Canada case in which a physician, Dr. Jacques Chaoulli and his patient, George Zeliotis, have been given leave to appeal. Mr. Zeliotis waited over twelve months to get a total hip replacement in Quebec and their Supreme Court case is based on a breach of the Charter of Rights and Freedoms, specifically regarding being denied the ability to purchase private insurance.

I have spoken to Senator Michael Kirby, the author of the Senate Report on Health Reform released last fall regarding this case, on a couple of occasions. His Senate Committee members are also intervening in this case, which he described to me as being the "health care case of the decade".

At the time of writing, your Executive is looking at this intervention on the grounds of a "care guarantee" where a standard of care for access to bone and joint care is defined. Our perspective on behalf of our thousands of suffering patients on waiting lists with respect to both direct and indirect costs, as well as quality of life and morbidity, needs to be heard by the Supreme Court of Canada. You will be interested to know that the European Union has passed a law taking effect in 2004 which allows patients in any EU country to access treatment in another member's health system if the wait in their own country is too long. All operations will have to be sanctioned prior to leaving but the home country cannot deny a valid case.

Before any final decision is made by the Board of Directors, we will need to find possible ways to fund our intervention. If we do go ahead, even if their appeal is unsuccessful, I believe we will have enough media attention around this case to highlight the very long waiting lists our orthopaedic patients have here in Canada.

I look forward to seeing many of you in Winnipeg at our Annual Meeting where we can share some science, and as one of our Past-Presidents - Dr. D. William C. (Bill) Johnston would say, bring the "orthopaedic family" together.