Dr. Siva Karunakaran is excited to begin his term as president of the Saskatchewan Medical Association (SMA) while the provincial health authority is in its infancy.
Physician wellness and negotiating a new contract for doctors with the province are top of mind for the Regina nephrologist who was elected SMA president last week at the association’s Spring Representative Assembly.
Alcohol and drug abuse are issues for some physicians, but the major concern is doctor burnout, he said.
Karunakaran noted an SMA survey done a year ago found 60 per cent of Saskatchewan doctors reported burnout.
“When I looked at that survey I wasn’t so sure — I wondered if they got something wrong, but then the other numbers started coming from Ontario and there were some national surveys done and they were all coming up with this 60 per cent number,” Karunakaran said. “We knew that it was a real, real concern.”
Family doctors from across Saskatchewan spoke about feeling burned out at a recent meeting Karunakaran attended in Regina.
“They see their patients and then they have to stay back for three or four hours and do paperwork,” he said. “That’s becoming a frustrating issue for them.”
Heavy workloads for physicians continue to be a headache despite 900 more doctors practising in Saskatchewan since 2007.
The increase has eased the burden for some doctors — depending on where they work in the province and their type of practice.
Karunakaran has been practising nephrology in Regina since 2001.
Ten years ago, he couldn’t have become president of the SMA because he was too busy caring for patients. Now, with more specialists in urban areas, he has time to take on the new position.
However, some pockets in Saskatchewan — particularly in rural and remote areas of the province — don’t have enough doctors.
“There are some deficiencies in the regional centres and I think the bigger problem is the family doctors,” Karunakaran said.
Another of his priorities during his one-year term is ensuring a new contract for physicians is reached with the province. The current Medical Compensation Review Committee agreement expired March 31, 2017.
“We are in negotiations now, but the progress has been slow,” Karunakaran said.
Doctors are paid in various ways: fee for service, contract or salary.
Some physicians have expressed interest in moving from the fee-for-service model to salaried positions so they can spend more time with patients.
Changes to marijuana laws are also on his radar.
“We have concerns about how it may impact the health of the population especially the younger people,” Karunakaran said. “Just because it’s legal doesn’t mean it’s safe.”
Prescribing opioids is another multi-faceted problem.
“As doctors, we need to be better educated about how to responsibly prescribe opioids,” Karunakaran said. “They are useful for the right person but prescribed indiscriminately, they can do a lot of harm.”
He’s pleased with the number of physicians holding leadership positions with the Saskatchewan Health Authority, but added it’s too early to predict how things will shape up.
“One of the concerns that was raised by the doctors is centralization of services, especially for the rural population,” Karunakaran said. “We have to make sure that people can get their care.”
He was born and raised in northern Sri Lanka where he met his wife, Kumudhini in medical school. The two fled Sri Lanka before graduating due to ethnic conflict on the island, and came to Canada in 1991.
They completed their medical degrees at St. George’s University in Grenada in 1995, and took further training in their specialities in what was then called the Medical College of Ohio in Toledo.
Employment opportunities for both came up in Regina in 2001 so they made the prairie city their home.
“We liked the practice environment in Regina, the hospital, the people here, so we decided to stay long-term,” Karunakaran said.