Q&A: A Champion for Quality Care (audio clip)
Dr. Brenda Copps moves into role as CPSO President
At the December meeting of Council, Dr. Brenda Copps, a Hamilton family physician, became the new President of the College of Physicians and Surgeons of Ontario.
Most recently, Dr. Copps, a passionate advocate for community health and family medicine, had the high-profile task of chairing the development of the College’s Continuity of Care policies – an initiative that took nearly three years and involved a six-month extended consultation.
Craig Roxborough, Manager of the College’s policy department, said Dr. Copps’ experience and passion made her a natural for the ambitious project.
“As a family physician, Brenda had the insight necessary to see how problems arise when continuity of care breaks down,” said Dr. Roxborough (PhD). “Her understanding of the challenges that patients experience, combined with her dedication to helping patients navigate the system and working collaboratively with her colleagues, ensured we were focused on making improvements where it mattered most,” he said.
Dr. Copps has worked in leadership positions at all levels of the Hamilton health-care system, including a term as chief of the Department of Family Medicine at St. Joseph’s Hospital, and board member and Chairperson of the Hamilton Family Health Team. At the College, Dr. Copps was the long-time chair of the Quality Assurance Committee.
That Dr. Copps has taken such active roles in medicine is not surprising considering that she was born into a politically engaged household. Her father Victor Copps was one of Hamilton’s most beloved mayors, her mother Geraldine was a Hamilton city councilor, and older sister Sheila’s political career spanned 35 years.
Recently, we spoke to Dr. Copps about her work on the Continuity of Care policies and her priorities as President of the CPSO. A complementary audio interview 🔊 includes additional details about Dr. Copps’ goals as president and her commitment to public engagement.
Q. Can you elaborate on why it was so important for the College to address continuity of care issues through policy?
A. We needed to address this as an important patient safety issue. The health-care system has become increasingly complex and Council believed it was time to address information breakdowns in the system that could see patients falling through the cracks.
One of the catalysts for us was learning about the events that led to the death of Greg Price, a vibrant 30-year-old man in Alberta. Multiple gaps in communication prevented Greg from receiving timely, quality care and he eventually died of complications from surgery for testicular cancer.
His tragic death spawned a movement, a new awareness of the importance of continuity of care. Alberta stepped up by addressing the breakdowns in its system and now, with our four inter-related policies, we hope to do the same in Ontario.
Q. As a result of being so fully immersed in continuity of care issues, did you look at the protocols in your own practice more critically?
A. We have an EMR which has kept us in good shape regarding the management of test results, but we have made tweaks in our referral process so that it better aligns with the expectations.
I would encourage all physicians to use the series of checklists that the Ontario Medical Association produced in response to the policies. They are a great way to manage adherence to the expectations.
Q. Were you surprised by what patients said they wanted to see in the policies?
A. Not at all. What we heard was that patients have a huge appetite to be partners in their care. Many patients – as well as other respondents in our consultation — expressed dissatisfaction that out health technology infrastructure was not more advanced in Ontario. But I do see technologies emerging and that makes me hopeful. Patient portals, for example, are becoming more common. We heard loud and clear during the consultation that patients want the opportunity to be able to access their test results directly and in fact, many would like to view their entire record. This is encouraging because engaging patients in this way will complement physicians’ efforts. And as a result, I believe we will see many potential breakdowns in communication avoided.
Q. What did you enjoy about your involvement on the College’s Quality Assurance Committee?
A. I have always been interested in quality: defining it, measuring it and putting systems in place to achieve and sustain it. This is the kind of committee work that I have always gravitated toward.
At the College, I enjoyed working with physicians from other disciplines. And the strong presence and input from public members made the work very stimulating. It was gratifying to provide constructive feedback to help those physicians who may have run into some difficulties or perhaps may have some blind spots in some areas of their practice.
Q. What do you think about the College’s development of new quality improvement tools for the profession?
A. I am excited about it. I believe that the modernization of our quality improvement program, with the use of self-directed tools, such as learning modules, are better aligned with the principles of lifelong learning.
Q. How did you come to see family medicine as your calling?
A. I always had an interest in science and after high school, I enrolled in health studies at the University of Waterloo. My appetite for a medical career began to emerge there. Midway through those studies, my father had a catastrophic and life-changing illness, which would go on to influence and shape the choices that I made throughout my medical career. It reinforced for me that I wanted a practice where I could care for my patients over many years and see them through the difficult and happy times that would arise in their lives. Making a difference in my patients’ lives is what drives professional satisfaction for me.
Q. Your family business is politics. Is holding political office something that may still be in your future?
A. I am definitely the outlier. I see myself as passionate, but not political. I am too thin-skinned and private to withstand a life lived in the public eye. Fortunately, my CPSO involvement has allowed me to contribute to policy development at a different level. I have no designs on leadership beyond that. Having said that, I am pleased that so many of our members participate in matters shaping public policy. It’s important to have physicians at the table for these discussions.
Q. As you move into your role as President, is there a particular area of focus for you?
A. It has been some time since the College has had a family physician in this role. I would like to use the opportunity to highlight and reinforce the importance of the role of the generalist physician in meeting the health care needs of the people of Ontario.
Q. What would you like your legacy as President of this College to be?
A. The College has just launched our new strategic plan, which has at its cornerstone meaningful engagement. Our Registrar, Dr. Nancy Whitmore and past President, Dr. Peeter Poldre, have done an excellent job of outreach to the profession. I see my role during this presidential year as extending that to the public, to allow for more meaningful engagement with patients and the public.
Q. How do you think the CPSO would benefit from more meaningful engagement with the public and patients?
A. I think, perhaps, there is a wider variety of people from whom we still need to hear. For example, I would like to tap into the thoughts of those members of the public who perhaps are more vulnerable or feel disenfranchised. Understanding how to better serve their needs is key to helping us fully deliver on our mandate of protecting the public.
Q. What do you do to relax?
A. I’m an avid gardener. I am also a big reader. In fact, I belong to two book clubs. And my husband and I are both foodies. He is an excellent cook and the best way for us to relax and unwind is to have friends over for dinner. We are also a dog-loving family, and with our two daughters and son-in-law, love to get together to take our dogs for long walks.
🔊 Listen while Dr. Copps discusses why she participates in medical regulation, and her goals to increase patient engagement and stay true to the CPSO’s mission to serve and protect the public during her term as president.
Q: What made you enter the field of medical regulation? Why is medical regulation so important to your own professional life?
Dr. Copps: Well, to be very honest, as I think is the case with a lot of practicing physicians, when I put my name forward for election, in 2013, I wasn’t fully aware of what the scope of medical regulation was, although I did know that, you know, I had some initiatives locally to try to make change within my practice, and I thought it might be an opportunity to, particularly from a systems perspective, might be an opportunity to make change. So, I’ve generally done something that complements clinical work and so I threw my hat into the ring and as I’ve been involved with different committees over the years, I -have found it intellectually stimulating among other things. I’ve really enjoyed working with the staff at the College in and my Council colleagues and the public members whose contributions are legend, and that I was quite naive about prior to doing this work. I guess Family Medicine – I enjoyed working as a team in my clinical practice in life wise, have enjoyed the teamwork college.
Q: You set it as a goal during your time as CPSO President to increase public engagement, why is that so important to you? And what’s this public engagement look like?
Dr. Copps: I’m going to answer the second question. First, I wouldn’t be so bold as to suggest that I know what public engagement should look like, and I think that’s where I see a place to start – and that is to participate in a bit of an environmental scan about different ways that patients can engage. We know that patient engagement makes for better health outcomes. So, I think if we keep that at the cornerstone of this work, it’s self explanatory why I might set it as a priority for my term. I know that the college has had as its strategic plan, meaningful engagement, I emphasize the word meaningful. I think that’s really important. Last year, there was more of an emphasis on the physician engagement because our CEO Dr. Nancy Whitmore was very keen to get out to all of the districts and this was a very successful initiative this year. It’s time to Do the same with public engagement. Currently there is substantial work happening at the College that would fall into the realm of public engagement and outreach. And that includes polling, public consultation for our policies. The College is currently the lead agency for the Citizen Advisory Group that meets regularly to opine on policy work that the different colleges want some input about, there definitely is lots of activity going on. I guess the question is, is it diverse enough? Or are we reaching out to the stakeholders? So, these are sort of the questions that have come up for me that I see this as an opportunity to explore. I do plan to, and I’m excited about, to attend the next meeting of the Citizen Advisory Group to see firsthand how the colleges and this group is a merger of nine different colleges within Ontario, to see how they use this group to help shape their policies.
Q: One of the things that you mentioned is this idea that patients are taking more and more ownership over their own health. They have more access to information than they’ve ever had before, and they’re coming into a doctor’s appointments armed with that information and being more informed than they ever have before for the physicians of Ontario. What are some things that they should keep in mind when they engage with patients who are more informed and are looking to have that more robust conversation with their doctor?
Dr. Copps: Well, I think sort of being patien- centred. Although it sounds a bit catchphrase, really, it’s -really the only way to practice good medicine nowadays. I mean, what is the patient’s agenda? What do they hope to accomplish at the end of a particular visit? Access to their own information – I mean, I have a practice in a very mixed neighborhood. I don’t feel the same urgency to be quite as electronically enabled as perhaps some patients do have their physicians. I know that’s a huge priority amongst some of the Patient Family Advisory Groups, to be more technologically – have their physicians and the system be more technologically enabled. I’m sure it’s frustrating for them. So, the other part of that would really be open to patients. They often will have done some of their own homework, which, you know, are I don’t at all discourage. I think it’s interesting to note the – I think there was a lot of fear about when patients could access their own labs that would result in a lot of patient anxiety. Well, interestingly, I think that has been debunked. That was not the case at all. So, I’m ready for that. And I think most of the profession is also ready for having equal for having patients be equal partners at the table.
Q: You’ve got a year as CPSO President. I know a lot of people in the previous role have said many times that the reason they do this work is because they can have a broader impact on the patients of Ontario. It’s not just about your own practice. It’s influencing policy and improving health care in the province in a broader way. After your 12 months are up, what would you like to say about your work as President the CPSO.
Dr. Copps: Well, I hope that it will be said that I was always true to our mission to serve and protect the public. I believe that that is really it’s got to be front and centre all the time. And I really, I hope that I’m going to be seen as someone who was true to that. Speaking of my own practice, I mean, it has the potential to have suffered a bit, because I’m not there quite as much. I think I made sort of adequate arrangements for coverage there. But it’s interesting, I do feel, you know – I feel, having been, you know, instrumental in the Continuity of Care policy, and perhaps an overly inflated sense of responsibility about that. So, it does create a bit of a paradox – these dual commitments that I have – both to the individual patient, and then more globally to the public.