- Canadian healthcare is incredibly fragmented, making it difficult for different organizations to share patient information and expedite care.
- Canadian physicians running their own practice are expected to also take charge of all the business and administrative aspects of the practice.
- The biggest challenge facing Canadian healthcare is our lack of an answer to the problem of demand and capacity.
To address the problem of demand and capacity in Canadian healthcare, Canada must create a unified approach to the management of practices, to reduce the burden on physicians and increase the quality of life. This will not only attract more physicians, it will also improve patient care.
What do you love most about being an entrepreneur and what do you think is in an entrepreneur’s DNA?
Entrepreneurs love to create activity and flexibility. I grew up in New Brunswick where, within a kilometre of my house, there are multiple billionaire families. The majority of the people in New Brunswick end up working for these billionaire families. They are happy to get a paycheck, go home and live a good lifestyle. But I think people need to take risks, create innovation, and look at things differently. Do not think the same as everyone else. Working as an employee for a major organization and executing tasks is one thing but you can step outside of that to think about where the real problems in the country lie and how we can change things for the better.
All of the really successful entrepreneurs I have met are humble and they have come from a meagre upbringing. For the most part, they have seen what real struggle is like. They have started a business and worry at night about making payroll and staying awake for their employees. They understand the stewardship of being an entrepreneur in providing these people with key employment opportunities. Those people put faith in you to be able to support their families. You need to take that seriously but also have fun doing it at the same time.
When and how did you get into the health innovation industry? What excites you most about the industry and where it is heading?
I have worked in various healthcare sectors for the last 15 years and only within the last year and a half did I move to the MD space. My significant other is a cardiologist and that helped lead me into this path. My first activity in healthcare was in veterinary medicine. I worked with a couple of great guys out of Toronto, Orin Litman, Jon Shell and Ross McKay, who founded Vet Strategy, which is now the largest veterinary healthcare provider in Canada. I left that and went to work in the dental space starting a specialty-focused dental partnership program throughout the country, which is currently the largest orthodontic platform in Canada.
In 2021, I started looking at the cardiology space after my family moved back to New Brunswick, where my significant other was starting up her practice. I realized how much work it is for a physician to actually start a practice. Prior to that, I always thought that it was not that difficult. I thought that doctors only practice and do not do anything beyond that because the government pays for everything. But in going through that process with her, I realized that MDs have to struggle with all the same issues that dentists and veterinarians do when it comes to running a practice.
“Doctors deal with all the administrative tasks in the hospital that, in my opinion, should not fall on them.”
In certain provinces, doctors may only have two or three employees, but this does not change the amount of work they need to do to deal with their lease, buy supplies, or manage patients. Doctors deal with all the administrative tasks in the hospital that, in my opinion, should not fall on them. If you need to transfer a patient or if you are seeing a patient who has some special disease that you cannot diagnose, you should be able to hand the case to a nurse or an administrator and have them coordinate the patient transfer to a more specialized center. However, today, doctors are the ones who are usually leading these transfers, as well as all the care and pieces in between to coordinate that patient transfer.
We spoke to a friend of mine who had a large group of cardiovascular practices in Ottawa. They were looking for a transition. They built a very large practice with 19 physicians and a staff of about 60, with complete outpatient testing centers. They realized that they had created a large business that was much larger than what other physicians will be able to acquire coming out of school. Many probably would not want to take it on, considering the amount of work. I started to understand these issues and tried to help change that.
What is the state of Canadian healthcare today? What are the major trends or forces shaping it?
In one word, Canadian healthcare is fragmented. It is fragmented provincially. It is fragmented regionally. Its urban centers are fragmented. You have different health organizations throughout different sections of the country or region. There is a lack of communication within healthcare in general, regardless of what area we are looking at, whether it is provincial, federal, or regional. There could be more collaboration among Canadian healthcare organizations and different hospitals to allow for better patient care. One of the things that I found living in Quebec was that if a physician was seeing a patient who had previous tests that were still valid, and even if the physician had no reason to run a new test, they would still have to run a new test on that patient – not because they needed that test but because they could not get the previous test from the facility that did them before.
“There is such a great opportunity in creating digital healthcare platforms that can connect patient care across the country.”
That is why there is such a great opportunity in creating digital healthcare platforms that can connect patient care across the country. That is something that has been worked on for years, but we are still years away from having a unified digital approach to Canadian healthcare.
What are the next steps in that process and who should be leading the way?
Different levels of government have an impact on healthcare from the federal government all the way to the township level. We need one unified approach as to how a digital healthcare platform will work from a big-picture perspective and roll that out across the country. We must all know how we are going to be able to access patient information.
What are the opportunities for entrepreneurs within Canadian healthcare?
There is a great opportunity for entrepreneurs who want to be involved in the community healthcare space today. There are more problems to be solved than there are people attempting to help solve the problems. I encourage anyone who is interested in doing something in healthcare to run with it, explore it, and see if it can help improve the delivery of healthcare.
There is a lot of opportunity for growth on the digital health side. But there are also a lot of things that digital health cannot do. For a certain set of patients, it is necessary for a physician to see them in person. In cardiology, if a patient has new symptoms or if the doctor has a new patient, they may get an inaccurate analysis of the patient if they cannot see the patient and do a physical exam on the person.
“Canada needs more people to help physicians manage practices and reduce the time they spend on non-medical-related activities to create additional capacity in the health care system.”
As such, the biggest opportunity for growth is unified management for physicians across the country. Right now, physicians have to run a real business. But the new generation coming out of school does not want to carry the patient load of the previous generation. They also do not want to run their own practice with the amount of work there is. Canada needs more people to help physicians manage practices and reduce the time they spend on non-medical-related activities to create additional capacity in the health care system.
I would be very surprised if over 10% of physicians in Canada are working in a managed service or organization-type environment where they just show up, see patients, and leave.
“By creating a better lifestyle for physicians, you will be able to attract more of them to your region.”
When you speak to the physicians who are in the back half of their careers, you learn that they had a different approach. A lot of physicians back then were in single-worker households where the physician had a partner who did not work and looked after everything at home. Today, the majority of physicians would say that their partners also work full time and that they are trying to balance their lifestyle and their children and their family. By creating a better lifestyle for physicians, you will be able to attract more of them to your region and subsequently create better care for the people who live there.
Specialty Medical Partners recently received funding from the Canadian Business Growth Fund. How did that come about and what does that funding mean for your future plans?
The Canadian Business Growth Fund (CBGF) is a minority shareholder only. They do not want to take control and they cannot as part of their mandate for investing. We really needed the skill set that CBGF brought, but we did not want to give up all control of the company. When we were introduced to the team, we realized that this strategy worked and that it was something unique and very valuable to Canadian entrepreneurs. An investment from CBGF will allow us to continue to grow for the next 5 years before we need to look for any external help.
What does the government need to do now to improve healthcare and entrepreneurship in healthcare?
The government must put aside regional differences and create a national approach to how they manage healthcare from coast to coast. We need to move away from arguing with one another as that does nothing to drive improvement in Canadian healthcare. We should not be spending more time debating than actually taking action.
What must the Canadian healthcare industry do to improve and make itself as competitive as possible?
The biggest challenge facing medical care in Canada is the increasing demand on the system and the fact that we are not adding any additional trained professionals to the sector at a greater rate than we were previously. In cardiology specifically, over 50% of cardiologists in Canada as of 2018 were over 45 years old.
We need to figure out a way for Canadian physicians to be able to see all the patients. What we lack in Canada is preventative healthcare – it does not exist. Urgent care is all the system can manage.