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Just Care: From medicine to politics in pursuit of equity

Federal Health Minister Jane Philpott knows that politics is the strongest form of medicine we have, and how to apply it to the social and economic roots of ill health in Canada.

In this excerpt from Upstream Medicine: Doctors for a Healthier Canada, her daughter Bethany finds out how we can legislate beyond healthcare, to take better care of Canadian health.

Bethany Philpott: [You've told me] there are many things that physicians can do in an office visit to advocate for their patients. Sometimes for medical learners and for those early on in their careers, the concept of advocacy seems very daunting and overwhelming. It can be hard to know where to start. Do you have advice for those entering the field as to how they can be advocates and how they can address the social determinants of health for their patients?

Jane Philpott: Advocacy in medicine at its most basic is being a voice for those whose voices aren’t loud enough. During almost every single visit with a patient you may see ways in which that patient is having trouble accessing what they need to be able to be healthy. And I feel very strongly that when healthcare providers recognize that the system is being unfair to one of their patients, the provider has a responsibility to intervene. Some of the most satisfying things I ever had the opportunity to do for my patients were some of the simplest things. Often it involved just picking up the phone.

There are so many other ways, too, that we can advocate for our patients. Some of the other simple, obvious things include establishing clinical settings that are open and welcoming and that will ensure that patients are cared for with respect and dignity. I was always very proud of the teams that I worked with in family medicine.

For instance, it’s something as simple as the way that a physician sets a tone in their clinic from the moment a patient walks in, and to make sure that your staff realizes that every single person deserves to be treated with the utmost respect and deserves to be listened to. Those are some of the simple things that you can do.

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BP: It sounds like there’s a lot that people can do on that individual basis and in a clinical setting. On the other hand, we also have this metaphor of thinking upstream and trying to solve problems at their source. How has looking upstream impacted the way you work and perhaps your move to politics?

"You may see ways in which that patient is having trouble accessing what they need to be able to be healthy."

JP: Governments play a massive role. One of their most important roles is helping to set the conditions for good health for their citizens. I often say now to my political colleagues that social determinants of health are not solely the responsibility of the health minister but of the whole of government because there isn’t a single department of government that doesn’t somehow have an impact on people’s health. Within health in particular, there are so many policy decisions that will shape the kind of care people have.

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BP: You’re now the federal Minister of Health. What do you hope to achieve? What are your goals for this appointment?

JP: I have, of course, the goals that are a part of the mandate that’s been given to me by the Prime Minister. I think addressing those issues is going to give me a tremendous opportunity to impact the health of Canadians.

Many of my responsibilities have to do with the healthcare system specifically. I’ve been mandated to negotiate a new health accord with provinces and territories that will include things like improving home care and mental healthcare, as well as making sure that prescription drugs are more affordable.

"Social determinants of health are not solely the responsibility of the health minister but of the whole of government."

Canadians are rightfully proud of a health system that involves publicly funded health insurance and has been founded on principles such as patients having access to healthcare based on need and not based on ability to pay.

Having said that, the context of healthcare delivery has changed a great deal over the last fifty years, and the health policy that undergirds it has not been rigorously evaluated and modernized. So a lot of what I will be working on is looking at how we can continue to uphold the basic principles described in the Canada Health Act but make sure we do so in a modern context where healthcare is not provided primarily in hospitals and not provided solely by physicians.

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Read the whole story, and twenty others in the new book Upstream Medicine: Doctors for a Healthier Canada.

Watch the Honourable Jane Philpott at Closing the Gap 2016 below:

Connect upstream.