William R. J. Rennie, M.D., FRCSC
President, The Canadian Orthopaedic Association

We live in interesting but tumultuous times. The past year has been no exception. A year ago, the Romanow Commission had begun its work and we eagerly awaited what we hoped would be a report with a vision for restructuring health care in Canada. Sadly, while suggesting some important new points of focus, the Romanow Report did little or nothing for orthopaedic surgical care in Canada. In particular, it did nothing specific to address the problems of access to surgeons, and access to surgical resources for patients and surgeons. The Kirby Report was only marginally better and seems to have been lost in the circus created by Mr. Romanow. Money for focused priorities in the various provinces needs to be made available so that provincial governments can get on with the business of providing the needed health resources for their populations. The COA provided both a written submission to the Commission as well as a response to the final report. The impact of either may have been questionable.  

Does this mean that we should simply stop speaking out on behalf of our patients? Recent experience in Quebec by our francophone colleagues would suggest no. An ill-conceived legislative programme by the Quebec Government last year attempted to again control the practice locations of Quebec physicians and surgeons. Our colleagues rebelled forcefully and a settlement has been reached. The COA supported Quebec orthopaedic surgeons both verbally and in writing and a degree of peace has been restored. Even politicians will listen sometimes.

The "Canada in Motion" programme continues to try to make a political difference by keeping the access to orthopaedic care agenda in front of decision makers. We continue to look for new partners to allow us to sustain these initiatives.

New opportunities are also developing. At a recent meeting in Calgary, sponsored by IMHA (the Institute of Musculoskeletal Health and Arthritis), a branch of CIHR, a group of interested stakeholders met to determine a further agenda and directions for the National Action Network of the Bone and Joint Decade. A further group under the BJD umbrella will examine the issues concerned with access to care. It is hoped that from many voices will come a unified and concerted effort that will lead to change. Rest assured that the COA will continue to play an important role in these efforts.

On a completely different note, and as your President over the past year, I have taken note of some ongoing concerns about the financial viability of both the COA and the COF. I am delighted to inform you that both organizations are not only alive and well, but flourishing. This has required a tremendous amount of work by people such as Dr. Hubert Labelle (COF President), Doug Thomson (Executive Director, COA & COF) and the entire COA Executive. On behalf of you, the members, I want to thank them all for their industry and wise counsel.

On a happier and more optimistic note, I invite and encourage you to attend the 58^th Annual Meeting of the COA. According to the majority of members' wishes, the meeting has been shortened. Within this new format, however, Dr. Emil H. Schemitsch and the Programme Committee have packed an incredible array of educational opportunities, from live surgery to workshops and symposia and a specialty afternoon. I think you will be pleased. Dr. Barry Malcolm and the Local Arrangements Committee will help to make your stay in Toronto an exciting and vibrant one. Join your friends for the Gala fundraising event "Them Canadian Bones" with great food and entertainment and bid on some great prizes, many donated by your COA colleagues. Not only does this promise to be a fantastic evening, but the proceeds will continue to allow the COA and COF to provide the kind of educational and other programmes that you have told us that you want.

My wife, Norma, and I look forward to renewing old acquaintances and meeting new friends at what should be an outstanding gathering.