OCFP President Inaugural Speech – November 17, 2006
Sandy Buchman BA MD CCFP FCFP
President
There is a standing joke within my extended Jewish family circle that goes something like this: It’s
Jan. 20 – and the first Jewish President of the United States is being inaugurated – one hand on the
bible, the other raised up. His mother sits proudly in the first now of the audience watching the
ceremony. She elbows the guest sitting next to her and says: “see - my son the president? His
brother’s a doctor!”
Certainly within my cultural milieu, and within many others, being a doctor is indeed the highest
calling. Perhaps indeed higher than the President of the United States. Why might this be so? I’m not
sure I have the answer, but my own mother sitting proudly right up here at the front might. So mom,
now I’m a president too. But like the story I just told, the real accomplishment of which I am most
proud is being a Family Physician, as I fully believe that our profession provides any individual lucky
and privileged enough to belong, an opportunity for fulfillment and meaning in life that is only
accorded to relatively few of our general population. How is this so?
Well, by way of explanation, according to writer and psychologist Steven Covey-and anyone who
knows me knows I’m a big Covey fan – Covey proposes that in order to achieve fulfillment and
happiness in life, one needs to “live, love, learn and leave a legacy.”
Firstly, we have to be able to physically live –with minimal requirements being a roof over our heads,
clothes on our backs, and food in our bellies. In other words, in our society, we need an income or job
or a means of obtaining these necessities. We also need to “love.” By this he means that we are social
beings, and an absolute necessity is that we seek and experience social connection and support. In
addition, as human beings – we always need to learn, to be constantly stimulated, in order to grow,
develop, mature, gain wisdom and achieve our full potential. If we cease to learn, we stagnate, we
deteriorate.
And finally, as human beings we seek to leave our footprint on our world. What he calls our legacy,
our contribution to our world is tied up in our search for meaning-our spirituality. As many of us in
this room know, being a physician, and in particular a Family Physician, meets all these necessities
for a happy and meaningful existence: It allows us to “live”. It provides us with a good living –
(though I know some will argue this point), allowing us to support our families with a decent standard
of living, especially in a wonderful country like Canada.
It allows us to “love.”: that is, it is the social dynamic - the core relationship between physician and
patient - that allows us to deliver the highest quality and effective health care. Of all the medical
disciplines - it is only Family Medicine that is based on this social dynamic. All other medical
disciplines are anatomically based. Gastroenterology, cardiology, neurosurgery. We usually think of
the patient and their families who benefit from this relationship. But, pause for a moment, and turn
this around. It is we physicians who obtain significant social benefit from our numerous and intimate
professional patient -physician relationships. And not just from our patients of course, but some of the
most important relationships in our lives comes from our relationships with our colleagues, our allied
health professionals, our staff and the broader health care community.
Finally, there’s “leaving a legacy.” This I believe refers to why the profession of medicine is a calling.
The impact we have on our patients’ lives, the contributions we are able to make to the wellbeing of
society at large - be it in clinical care, research, public health, community development, mentoring a
young student or resident – allow us to derive additional and significant meaning in our own lives.
So if Family Medicine is so perfect as a career choice, why have so many of us been so unhappy myself included? Why do so few students choose Family Medicine these days? What has gone
wrong? Why was I so unhappy for years especially after all I’ve said about the benefits and
meaningfulness of a career in Family Medicine? This is my story - and I believe that my story allows
me – especially as President of the OCFP – to bring to the fore the principled solutions to the
problems facing Family Medicine and Family Physicians in Ontario today.
I attended McMaster University Medical School and graduated in 1981. I completed my Family
Medicine residency training at Mount Sinai Hospital in Toronto and received my CCFP in 1983. In
those days, there was no question or issue about comprehensive Family Medicine. It was expected
that you would do obstetrics, emerg and hospital care. I never questioned it. “Comprehensive Family
Medicine?” What does that mean? Family Medicine by definition implied complete, continuous and
comprehensive care. The term comprehensive was redundant. Everyone I knew practiced and
delivered the whole basket of services from OB to Palliative. After completing a summer locum in
Haliburton I joined a group of 6 other family doctors in Mississauga - actually choosing this
community as I wanted to live in the GTA, but really because the Family Doctor was so welcome at
the Mississauga General Hospital. Family Doctors were the Most Responsible Physicians for their
patients – doing active care on all wards. It was a given. I learned so much in those early years from
my colleagues in my group. We made rounds together - all 7 of us - every morning at 7 am on every
patient – so that when we were on call we would know about and be able to respond properly for each
and every patient. This was true mentoring – a dynamic relationship between a junior and senior
physician that through role modeling, support and apprenticeship, I learned not only clinical
management, but I further began to see the primacy of the relationship between physician and patient.
The patients wanted their care from their own personal Family Doctor. Knowing our patient’s course
in hospital easily facilitated care after discharge. On call, again there was no question that if one of
our practice patients had to be seen in Emerg, that we would attend the ER and assess and manage
their care. Doing otherwise would be considered a “dump” on another Family Physician who of
course was working in the ER. And we didn’t even understand the term “rostering” in those days!
My practice grew quickly. I did a lot of obstetrics back then. We did “hard call” for our patients; that
is, one of us was available 24/7 for any deliveries and same day urgent appointments. We made house
calls regularly. We looked after our patients in their homes at the end of life. We worked a 4 day
week, with one rotating day off every week which made for a very reasonable balanced workload and
lifestyle. Even though we billed ‘Fee For Service’ we pooled our income and distributed it evenly
amongst all the doctors. Computerization and the electronic medical record had not yet been
developed, but our charts were dictated and legible. I was very active in our hospital serving as
coordinator of Family Practice rounds to representing Family Medicine with the dept. of obstetrics,
the asthma committee, chairing health records, etc. etc. We never received a cent for our efforts.
Being involved in your hospital in your community was a given, because volunteering as medical
staff was crucial to the functioning of the hospital. Family Physicians’ involvement in the day to day
activity of the hospital was critical and valued.
Then beginning I suppose in the early 1990’s things began to unravel, and I believe my experience
was indicative of a greater problem facing many Family Physicians in this province then and for many
years subsequently, being corrected these days only because of the systemic solutions proposed by the
OCFP, the OMA and others finally working with - as opposed to against - government. Unfortunately
for me, the systemic solutions that would have allowed me to continue to practice comprehensive
Family Medicine were not yet in place when I had to make major changes in my career path and to a
large extent are still not fully in place. There are many problems that still need to be addressed such as
Family Physician retention and recruitment, physician substitution and the delivery of comprehensive
continuous care in an equally accessible way for all Ontarians.
So what happened to me? Well, our practice grew to overwhelming numbers as the population grew
exponentially in the GTA. We were of the opinion that if a person needed our services we would
provide it – it was our obligation. We always managed, somehow we would muddle through. We
didn’t think that our practices should “close” –it just wasn’t considered in those days. In retrospect it
was foolish, but as Family Physicians we always just soaked at up and soldiered on, didn’t we? That
too was part of the problem, our commitment to our patients at our expense and that of our families.
As we became ever so busier, additional challenges arose. Beginning in about 1985 or 86 I began to
see my first HIV/AIDS patients. Knowing nothing about this disease as it really hadn’t existed when I
was in medical school, I offered to refer my patients to a new clinic at Sunnybrook that was just
starting up. My patients were quite ill, and did not want to go to a clinic that was so far away, at great
expense and difficulty given their health problems. They wanted their personal Family Doctor to care
for them. So thus began my interest and involvement in treating people with HIV/ AIDS. As always,
one gains more their one gives. I learned that this disease was part and parcel of Family Medicine and
could be treated in a shared care fashion. The support provided to me by those infectious disease
specialists who began to specialize in HIV/ AIDS care was the first time I began to experience the
concept of true shared care: a model of care with which we’ve become so familiar with these days. A
model of care that permits us to treat patients quickly, efficiently and effectively in our own offices
and thereby reducing waiting time for specialist care significantly.
But along with the positive experience of shared care I was also digging a hole for myself. I was only
one of 2 FD’s in Mississauga providing primary HIV care. It added to the complexity of my practice.
Initially HIV/AIDS care was mostly palliative, and this dimension of my practice increased
significantly. But it was not fair to my partners who had to cover for me. Simultaneously, our hospital
like many others in urban centres across the province began creating a culture of specialist care within
the hospital. Family Physicians were just not as welcome as we once were, especially in the
Emergency Room. The erosion of the Family Physician’s presence in the hospital had begun. Fees
were inadequate to make a decent living and cover our ever-increasing overhead especially for the
work and responsibility of obstetrical care. My partners like many others dropped out of obstetrics. I
was left to continue on my own to deliver all my own patients which became extremely difficult while
looking after 3 young sons. Eventually my partners gave up inpatient hospital care as well. Sharing
call responsibilities became more onerous and complex for me as I wanted to continue inpatient care.
Then we had to look after orphaned patients. As more family docs left hospital, the number of
orphaned patients to take care of became overwhelming. Taking time off for vacation and conferences
became more and more difficult. We were hard pressed to cover for each other given our workload.
Locums were almost impossible to find in our area. Morale plummeted. Then Rae days kicked in. We,
the doctors of Ontario now had to pay a health tax. Our ability to deliver quality care to our patients
became more and more challenging. I felt increasingly frustrated and despondent. I contemplated
giving up my teaching responsibilities with McMaster University so as not to expose students &
residents to this sad state of affairs.
About the same time, medical school and residency positions were reduced by the government using
the logic that fewer doctors meant lower healthcare costs. A casual threat to limit doctor’s fee
payments to 25% of the fee schedule in the GTA led to an exodus of young Family Practitioners to
the U.S. including a great young family doc we had recruited to our practice who moved only to
Buffalo. The future of Family Medicine looked grim.
Through all this time, I continued my involvement with the OCFP - initially working on the Annual
Scientific Assembly and eventually coming onto the Board of Directors as a way to address the many
problems facing Family Physicians and our patients. The OCFP was an oasis of sanity for me, the
place where sane rational supportive voices began focusing on solutions rather than just complaining.
But it was more then just about money. We seriously had to examine and change the way Family
Medicine was practiced in this province, as even the survival of Family Medicine as a profession was
at stake. As critical as the OMA is serving our interests as a profession, especially in the area of
remuneration, it is the OCFP who is the sole organization in this province for Family doctors that
seeks to focus on the creative solutions that facilitate improved quality of health care delivery
specifically by Family Physicians, while creating a practice environment for Family Physicians that is
conducive to the delivery of excellent care. I have always reflected on the question: Where would we
be without the OCFP? Where would I would I receive the quality education I required and trusted?
Where would I go to meet and network with likeminded colleagues? Who was advocating for the
patients of this province to receive the best primary care possible? We know through Barbara
Stanfield’s work that the presence of Family Physicians can improve the general health of the
population being served far more effectively and cost effectively than any other primary care
provider. It was only through the leadership and advocacy provided by the OCFP that I would be able
to make a contribution to the profession and the patients of this province. I truly believe we would be
lost without the OCFP and I am grateful to the founders for their foresight in creating such an
essential organization. It has been the OCFP that has sustained me in a very personal way through my
most trying times as a Family Doctor in recent years.
Clearly I had to make changes in my career path if I was going to survive as a Family Doctor. I could
barely cope with the hours and workload I had to put in to serve my patients. Paperwork was killing
me. I had to refuse requests from downtown hospitals to assume care of their palliative patients in the
community which I had readily done before. I had begun to develop an inpatient palliative care unit at
Trillium Health Centre in Mississauga, my hope being that I could find a practice sharer in my office
and I could focus on developing the PCU and competent Family Physicians to staff it. This I hoped
would encourage some Family Doctors to return to at least some aspect of inpatient hospital care. I
eventually hoped to also provide home-based care in the Mississauga area with this same group. But
this was not to be. Support was not forthcoming from the hospital at that time and my locum decided
to work fulltime in the ER.
I was back to square one.
But I knew I wasn’t going to survive in this practice. My greatest fear was burning out and leaving my
partners and my patients in the lurch. A colleague in Mississauga had just burnt out ending up in
hospital and leaving his practice suddenly orphaned. I knew I was facing the same fate. I had to act. I
knew through my work in the college about Family Health Network development, but these models of
care had not yet begun. Family Health Teams were just beginning to be proposed. My lease was
ending on Dec. 31, 2004 as did my obligations to my partners. But I had obligations to my patients. In
the face of such a shortage of Family Physicians in this province - if I left, where would they go?
Especially my hard-to-place patients - my HIV patients, my pain patients, my palliative patients, my
elderly patients, my patients with significant emotional and mental health problems. No-one would
assume care of these unfortunate folks with their complex problems. Yes, I had to act.
My intellectual and spiritual interests begin pulling me toward End-of-Life Care. As my services were
required less at Trillium, and as my partners left inpatient care, and after receiving the Robert Kemp
Bursary from the CFPC where I studied with Dr. Brian Kerley, a classmate and a Family Physician
providing Palliative Care in St. Catharines, I joined the medical staff at the Baycrest Centre for
Geriatric Care where I assumed responsibility for the in-patient palliative care unit and things started
to become more clear to me. It seemed that practicing Palliative Care fulltime was the culmination of
my skills, the opportunity to get off the FFS treadmill and to practice in a collaborative
interdisciplinary environment which I relished and felt was the most suitable way for me to deliver
quality medical care, while maintaining a balanced lifestyle. And then there was opportunity. The
Temmy Latner Centre for Palliative Care – a community based palliative care program in Toronto
which provided home based palliative care to patients and their families - seemed like the best answer
to my problems. There was a strong academic flavor to the group, a significant teaching component,
and the offer of an Alternative Payment Plan that was a blended salary and FFS model when on call.
Additional payments recognized teaching responsibilities. Conference and vacation time were funded.
There were no overhead or business headaches. I loved seeing patients in their homes. And there was
flexibility to reduce my time commitment when I assumed the presidency of this organization. What a
sane model of health care delivery! It was a no-brainer. Except that I was leaving comprehensive
Family Medicine.
I gave my patients about 9 months’ notice that I was leaving and worked very hard in trying to place
them. Without exception, they understood my decision. The Family Docs in Mississauga – to whom I
will be forever grateful - pulled together and each took a couple of patients to help out, despite the
fact that all their practices were closed. I was extremely fearful that my residents and students would
learn that they should avoid a career in Family Medicine when they saw that I was leaving. In fact, the
opposite happened. When they saw the mutual caring that existed between us, their desire for a
similar career in Family medicine was confirmed.
And my experience as a community based Palliative Care Physician, working closely with RN’s,
CCAC case managers, pharmacists, mental health counselors, social workers, and chaplains (kind of
sounds like a FHT doesn’t it?) in a blended payment model, using the well-honed skills developed
after years of family practice, providing care to a defined population, where the essence of care is the
centrality of the patient-physician relationship, was exactly what the doctor ordered for me. It is
indeed a case of “physician heal thyself “. Does anyone recognize the 4 core principals of Family
Medicine here?
Even two years ago I didn’t have the opportunities and choices that family docs have today. The
leadership of the OCFP –the Peter Deimlings and the Val Rachlis and the Cheryl Levitts and the Ruth
Wilsons leading FHT development along with the incredible negotiators of the OMA and the good
will of government has led to innovative solutions for the delivery of primary care in this province.
Most Family Physicians are happier than 2 or 3 years ago. They do feel that they are better paid: those
that opted for any of the new funding models have seen their incomes rise anywhere from 20 to 50%
for the same amount of work. Government has funded considerably more spaces for medical students
in the province. The new Northern Medical School is up and running. The number of spots for Family
Medicine Residency training is significantly increased. Family Medicine Interest groups are thriving
being supported by the Family Medicine Departments of the Universities and by both our National
and Provincial Colleges. More residents are beginning to choose Family Medicine again. Yes, the
situation is better and more optimistic for the future due to all interested parties pulling together for
the good of us all.
But the challenges remain. We cannot and will not rest upon the significant accomplishments to this
point in time. So, what are the current challenges? What does the future hold for Family Medicine?
Where are we headed? How are we going to get there?
To understand my vision, my hopes about where the OCFP is going, I will share with you how I
approach the challenges in my life as I plan to use the same principles in leading our organization in
approaching the numerous challenging issues facing Family Medicine in this province today.
You’ve already heard about the problems that I faced in my Family Medicine practice, perhaps with
which some of us continue to struggle. I needed to come up with a personal individual solution. The
systemic solutions weren’t in place for me when I needed them. My principles guided me and they
guide me now towards system wide resolutions.
Most of us in this room are familiar with the President’s letter to the membership entitled “Inside
Out” initiated by one of my predecessors Dr. Val Rachlis and continued in rousing fashion by our
immediate past President Dr. Cheryl Levitt.
I believe the name “inside out” is apt, and reflects the approach I take in overcoming life’s challenges,
with thanks again to Steven Covey in providing the basis for my perspectives and strategies.
You see, lasting solutions to problems, lasting success and happiness come from the ‘inside-out’. If
solutions are proposed from the ‘outside’ – imposed on us, say by government, we feel victimized,
immobilized; we blame others for our stagnation.
I try to function from the ‘inside-out’. Inside out means you start with the self: the most basic part of
who you are, your paradigms and models, your character, your reasons and motives.
If you want a happy marriage, be the kind of person who generates positive feelings and energy. If
you want a pleasant cooperative teenager – be a more understanding and empathic and consistent and
loving parent. If you want to be a leader, amongst other things, be trustworthy.
Being trustworthy – worthy of trust - is the essential principle for each of us as a Family Physician.
Trustworthiness is based on character – who and what you are as a person, and on competence: what
you can do.
Say I’m your Family Doctor – if you have faith in my character, but not in my skills and competence
as a physician, you still wouldn’t trust me.
With character and competence, you will. With character and competence, we can show wisdom in
our decisions.
Without meaningful, ongoing professional development, trustworthiness or trust cannot develop.
And as Family Doctors we understand that trust must exist at the interpersonal level. As per the 4th
principle of Family Medicine: The patient – physician relationship is central to the role of the Family
Physician. Trustworthiness – soundness of character and competence – is the foundation of trust.
Trust is the emotional bank account between two people – and between two organizations for that
matter – that enables them to achieve a win-win agreement. Just as in the patient-physician
relationship – trust – or lack of it, is at the root of success or failure of that relationship. It is the
bottom line in business, industry, education and government.
So in an attempt to achieve lasting solutions to our systemic primary health care problems, to ensure
quality professional development and functioning, the OCFP, with your President, Executive and
Board at its core, must develop the trust, both within the organization and without in the broader
community, that results in win-win agreements and synergistic solutions. Should we fight with
nursing organizations who seek to replace Family Physicians with Nurse Practioners? Or should we
seek out principled solutions that are synergistic and win-win? We must follow our principles, from
the inside-out, to be true to ourselves and others. An outside-in approach would state that the problem
and solution is “out-there” – i.e. with government or with other non-physician groups – and if they –
the ‘others’ would just shape up or see our point of view, the problems would be resolved.
Time does not permit the discussion of how this approach and strategic orientation will assist us in
developing sound and creative solutions to our human resource crisis, retention and recruitment
challenges, the issue of physician substitution, the evolution of our practices from the comprehensive
to the more focused, the lack of support for our community–based Family Physician leaders, waittime problems, the private public debate and universal access to health care, the challenge of full
gender and cultural equity in the practice of Family Medicine within and without our organization
etc., etc. We must use this strategic orientation to achieve our mission – the promotion of Family
Medicine through leadership, research, education and advocacy - as our moral compass in guiding us
through these times, as yet uncharted territory.
So we must start from within and to me, we must build on the foundation of this great college and the
leaders who have preceded me. In 1954, our founding “parents” envisioned an educational
organization mandated to assist the newly established Family Medicine programs in Ontario and
provide CME to practicing physicians with the goal of improving the quality of the care people
received in this province. They too were principle-based: The promotion of practice based on our 4
principles and in the ensuing years, this is exactly what the OCFP has done:
1. We support the work of the academic departments of Family Medicine.
2. We provide continuing professional development for Family Physicians.
3. We contribute to the maintenance of high standards of practice of Family Medicine.
4. We promote the facilitation of access to high quality Family Medicine for all Ontarians.
A building with a strong foundation won’t get blown over in a hurricane. Our foundation is one of
strong principles and this empowers us – through trust of the institution and its leaders - to be a leader
in Ontario who contributes to the creative and innovative solutions to our problems as we continue to
be perceived as trustworthy, credible, of sound character and competence.
Though we recall and build upon the foundation that has been given to us, true breakthroughs in
thinking, dramatic transformations and innovative solutions to old problems occur from courageous
breaks with traditional thinking. Paradigm shifts lead to completely different perspectives and
understanding of our world. Christopher Columbus created a paradigm shift in conceiving and
proving the world was round. Copernicus demonstrated that the Sun, not the Earth, was the centre of
our Universe. Overcoming the pull of the past – the habits, our old modus operandi – the older
familiar ways of doing things – can be accomplished only when we have clear identity, vision and
strong purpose – knowing who you are and what you want to accomplish.
My vision is of an Ontario College of Family Physicians that is the leading organization in this
province in promoting and facilitating the practice of the highest quality of Family Medicine possible,
to the benefit of all Family Physicians, our patients and consequently to our society at large. My
vision is that the OCFP is amongst the most credible and trustworthy of organizations committed to
the sound principles of honesty, transparency and ethical behaviour in working with government, our
sister medical organizations and allied health professions in a collaborative synergistic manner. I
believe that by trusting our members and aligning them to these principles, we empower people to
release their creative energy and talents to develop new perspectives and innovative solutions to our
current health care dilemmas. Our direction should be governed by our principles, our enduring
guidelines for human conduct. The world’s major religions all share these principles and teach the
same core beliefs like “you reap what you sew” and “actions speak louder than words”. There are
universal beliefs in fairness, respect, kindness, dignity, service and patience. They are what govern
our effectiveness as human beings.
Indeed, these are at the very core of practicing Family Medicine. These are the principles with which
we are intimately familiar, that have served us so well in treating our patients. We need to make them
more explicit, to raise them to the core of our approach in dealing with others to repair our broken
health care system, as we would seek to repair our individual patient’s “broken health care system”.
From macro to micro to macro again. Principled approaches work on all levels.
These core principles work for me. They are at the centre of my being and who I am. They guided me
through my years as a comprehensive Family Physician and they guided me to the full-time practice
of Palliative Medicine which for me addressed not only lifestyle balance and getting off a fee-forservice treadmill, but at a deeper level permit me to achieve one of my more personal goals in the way
that reflects my intellectual, professional and spiritual interests – allowing me to be the best Family
Physician I can be, to contribute to our world in the way that is most meaningful for me. These
principles have privileged me to travel to developing countries in Africa and South America to deliver
primary health care and has enriched my life with perspective and gratitude.
And gratitude in me abounds these days, literally every single day that I find myself waking up in the
morning. Gratitude to G-d for sustaining me and providing me with life and good health and the
amazing good fortune I’ve experienced in my lifetime. Gratitude to my parents who have honoured
me by their presence here today and who have unfailingly provided all the love, support and
encouragement that any son could ever desire. Gratitude to my phenomenal parents-in-law who are
also here today who are true second parents but also first in my heart. Gratitude to my siblings and
siblings in law who are also sharing in this event today and are always always there for much needed
support and guidance. Gratitude to my friends some of whom are also here today who nourish and
sustain me. Gratitude to my predecessors and colleagues, the staff and the CEO at the OCFP who
have unflinchingly held my hand, propped me up, taught and mentored me according to the true
meaning of the word. Gratitude to my wonderful 3 sons - Daniel, Noah, and Seth - who have skipped
their university classes to celebrate with me today and who have probably taught me more about the
Family in Family Medicine than anyone else and who give all the purpose and meaning I need to do
what I do.
And truly last not but not least, my gratitude, appreciation and thanks to Gail, my wife and life partner
for these last 32 short years who is my rock, my foundation, my reflective mirror, my soul mate. I
could never ever do what I do without you.
So you see I am really just a “front” man as I have so many amazing individuals who support me and
thereby allow me to follow my dreams. And I say to myself how the heck did I find myself in this
position, in this role as president? Like my first day of practice, hanging those diplomas on the wall
and wondering the same thing – how are they letting me out to face this unsuspecting public? I guess
you’ve probably diagnosed ‘The Imposter Syndrome’ by now. But the Cognitive Behaviorial Therapy
I learned in the Collaborative Mental Health Network that this College has developed has me
rationally countering my irrational automatic thoughts. And one is never alone in leading the way.
There are always others who are supporting the guy who is in the lead position. I have an amazing
and dedicated executive and staff here at the College to whom I can turn for guidance and reflection.
I’ve always had and continue to have the solid foundation from which to move forward.
So I commit to you, the members of the OCFP, the Family Physicians of this province, that I will do
my very best to lead this phenomenal organization through its challenges in the coming year with
transparency, honesty, and integrity. I am most grateful to you for allowing me the honour and the
privilege of serving my profession in this way. Again, I owe my gratitude to this amazing discipline
of Family Medicine for leading me to this organization and allowing me to leave my small imprint,
my legacy, for what I hope is to the benefit of the people of Ontario.
Thank you.