Brian Day

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Dr. Brian Day
Dr Brian Day speech at the CMA.jpg
Dr. Brian Day speaking as president of the CMA in 2008.
Born (1947-01-29)January 29, 1947
Liverpool, England
Nationality English-Canadian
Education University of Manchester
University of British Columbia
Medical career
Profession Surgeon
Field Orthopedics
Institutions Cambie Surgery Centre
UBC Hospital
Notable prizes Edouard Samson Award

Brian Day MRCP (UK), FRCS (Eng), FRCS (C), (born January 29, 1947) is a physician in Canada who was the 2007-2008 president of the Canadian Medical Association. Day is a founding member and 2004 president of the Arthroscopy Association of North America, and he is known nationally for public and legal challenges against the laws that govern the Canadian Medicare system. In 2011, the British Columbia Medical Services Commission conducted an audit of Cambie Surgeries Corporation, where Day is one of 50 shareholders, and found that the clinic, along with another clinic, had charged patients hundreds of thousands of dollars more for health services covered by the Canadian medicare system than is permitted by law. Day and Cambie Surgeries claim that the prohibition against doctors charging patients more for care is unconstitutional. The case is expected to be heard in the British Columbia Supreme Court in late 2015.[1][2][3][4][5]

Early life[edit]

Day was raised in Toxteth, a working-class area of post-war Liverpool, England. He was one of five children in a family with strong Labour views. Both his mother and father were socialists.[6] Day credited his personal shift from the political left to the political center-right by his disenchantment with the British labour movement's jurisdictional inertia and contributions to inefficiency in health care.[7]

Day attended the Liverpool Institute. His family's neighbourhood could be tough. He has a permanent scar on a finger from a knife fight when he was 10 years old. His father, a pharmacist, was killed in 1981 by hooligans looking for drugs during riots in the neighbourhood.[6]

Medical career[edit]

Day entered medical school at age 18 at the University of Manchester. After an initial interest in general surgery, which he pursued as a postgraduate in Manchester and at the Hammersmith Hospital in London, he focused on orthopaedics.[6] He obtained his medical degrees, MB ChB from the University of Manchester, and post-graduate qualifications in both internal medicine and general surgery. In July 1973, Day moved to Vancouver, Canada.[6] In 1978, Day completed his training and a M.Sc. degree at the University of British Columbia (UBC).

In 1979, Day received the Canadian Orthopaedic Association's Edouard Samson Award, for outstanding orthopaedic research in Canada. Following a fellowship in traumatology, in Basel, Switzerland, Oxford, and Los Angeles, he began practice at the Vancouver General Hospital. After starting in trauma, he developed an interest and expertise in orthopaedic sports medicine and arthroscopy.

As an orthopedic surgeon, he earned an international reputation for performing arthroscopic surgery on hips, knees, shoulders and elbows. In 2004 he was elected President of the Arthroscopy Association of North America, being the second Canadian to hold that position. Day is regarded as being instrumental in the introduction of arthroscopic joint surgery in Canada.[7]

From 1970 to 2014, Day wrote more than 150 scientific articles or book chapters, in areas of orthopaedics and arthroscopic surgery / sports medicine, and on the topic of health policy.[citation needed]

Medical association leadership[edit]

In August 2006, Day was elected president of the Canadian Medical Association (CMA) for the 2007/08 term, despite a challenge at the convention floor by another a British Columbian physician (whom Day had beaten in the nomination process) regarding Day's views about for-profit health care.[6] He was the first orthopaedic surgeon in the 148-year history of the CMA to be elected president.[citation needed] Day claims his advocacy as president of CMA was for a hybrid public-private system not a full replacement by private hospitals.[8]

In 2015, Day was announced as the president-elect for Doctors of BC, the provincial medical association in British Columbia due to a win by a single vote difference. The election was then rescinded due to an error found in properly categorizing one ballot. Dr. Day then lost the subsequent run-off election in June 2015 by 603 votes after the publicity about the single vote win escalated participation to the highest turnout by physician members of the association.[9]

Advocacy for access to private care[edit]

In 2003, Maclean's Magazine named Day one its top 50 Canadians "to watch", describing him as "an iconoclast, whose time is now."[10] He is referred to as Dr. Profit by opponents who believe his legal challenges will threaten Canada's publicly funded medicare system, and Dr. Prophet by supporters for his advocacy of a role for patient choice and the right to obtain private insurance in the face of long government wait lists for care.[7]

Dr. Day has argued many Canadians are being hypocritical towards private healthcare. Stating 70 per cent of Canadians buy healthcare insurance. Many with such insurance themselves claim to oppose private healthcare, while embracing it for themselves. The other 30 per cent of Canadians who cannot afford the extra healthcare insurance receive poorer access to care.[11]

He believes the Canada Health Act of 1984 is responsible for rationing of care that has resulted in over a million Canadians suffering on wait lists, and to more than 5 million without a doctor. In the 2005 Chaoulli decision, the Supreme Court of Canada struck down prohibitions on private insurance in that province because it was an infringement of the Quebec Charter of Human Rights and Freedoms; the decision did not extend to the rest of Canada, but constitutional experts opined that it would certainly have major impact on similar cases brought to court elsewhere.[2] He also supports the end of block funding for hospitals and a change to "Patient Focused Funding" where revenue follows the patient. He advocates a patient-centered system with a greater role for competition in Canadian healthcare as a means to reduce waiting times and save government money by treating people before their condition worsens.[6] He is a frequent spokesman for the topic with news media and submits position papers with government. For instance, his submission to Roy Romanow's Commission on the Future of Health Care in Canada made 10 recommendations:

  1. De-politicize the debate
  2. Repeal the Canada Health Act
  3. Eliminate global budgets and reward productivity
  4. Incorporate business methods
  5. Increase privatization and contracting out
  6. Introduce competition, choice and accountability
  7. Massively reduce bureaucracy
  8. Reduce influence of public sector health unions
  9. Accept economic reality, and introduce user fees
  10. Rank “core services” and deinsure unnecessary services[12]


Cambie Surgery Centre and Constitutional Legal Challenge[edit]

In 1995, Day founded Cambie Surgery Centre, a for-profit Vancouver clinic. Day is the facility's medical director, and one of its 40-plus shareholders.

The Cambie Surgery Centre sees up to 5,000 patients a year. It caters mainly to people who have third-party insurance for their operations. The single biggest client is the provincial Workers' Compensation Board which expedites the care of injured workers in order to reduce their suffering and prevent long term disability. It has also been controversial for allowing patients waiting for surgeries in the public system to "jump the queue." Day argues that they are not jumping the queue, but leaving the queue, thereby reducing the wait for all.[citation needed]

In 2012, the British Columbia Medical Services Commission confirmed what the clinics had openly admitted to doing since 1996 - namely allowing, in violation of the Medicare Protection Act, patients to spend their own funds to jump the queue and access the clinic. [13]

The Commission asked the Cambie Surgery Centre not to permit patients access to earlier treatment.[14] The plaintiffs pointed out the constitutional challenge had been brought before the courts 3 years earlier. In the Supreme Court of British Columbia, the plaintiffs are challenging the prohibition against patients being prohibited from using their own funds to access care, as opposed to in order based on medical priority. Specifically, they are challenging the ban on private health insurance to cover medically necessary care, and the ban preventing doctors from working in both the public and private health systems at the same time. The proceedings are expected to commence sometime in November 2015.[15][16][2][4]

Proponents of publicly funded healthcare in Canada argue that this legal challenge against medicare could set a dangerous precedent. Proponents of for-profit care argue the opposite and that patients will be protected from the dangers of waiting for care. In the Chaoulli decision (2005) the Supreme Court of Canada declared it was a fact that Canadians were suffering and dying on wait lists. If the case is decided at trial in B.C., as is expected, either side may seek an appeal of the outcome at the Supreme Court of Canada. A decision at this level would mean the outcome would be binding in all provinces and territories across the country. Some legal experts have described this case as one of the most significant legal challenges in Canadian history.[17]

US 'Conservatives For Patient Rights' commercial controversy[edit]

In May 2009, Dr. Day drew criticism after he was shown in a series of television ads for a US lobby group called Conservatives for Patients' Rights that opposed President Obama's health care reforms. Dr. Day appeared on the television program BNN on May 11, 2009 to clarify that he issued a letter distancing himself from the ad. He also pointed out that Obamacare was based on private insurance and private delivery, the opposite of what many Canadians believe in. [18]

Recognition[edit]

  • 1993 to 2001 - Associate Editor, Journal of Arthroscopic Surgery
  • 2001 - 80th Annual Osler Lecturer, Vancouver Medical Association
  • 2004 - President, Arthroscopy Association of North America (AANA)
  • 2004 - Honorary Member, Cuban Orthopaedic Association
  • 2004 - Member, Board of Trustees, Journal of Arthroscopy
  • 2005/06 - President, Canadian Independent Medical Clinics Association (CIMCA)
  • 2012 - jointly listed as #38 in the Power50 list for influencers in sport in Canada by The Globe and Mail[19]
  • 2014 Doctors of BC Don Rix Leadership Award

References[edit]

  1. ^ "Medical Services Commission releases audit". gov.bc.ca. 
  2. ^ a b c "Backgrounder: Court challenges to one-tier medicare". umanitoba.ca. 
  3. ^ "Private B.C. hospital told to stop extra billing". thestar.com. 18 July 2012. 
  4. ^ a b "Four points about the pending challenge against medicare". The Globe and Mail. 
  5. ^ "Dr. Brian Day : Curriculum Vitae". brianday.ca. 
  6. ^ a b c d e f Mason, Gary (August 1, 2007). "Brian Day: Day in Your Life". 'BC Business Magazine' (Vancouver). Retrieved August 1, 2014. 
  7. ^ a b c Ward, Doug (April 8, 2002). "A new Day for health care". Vancouver Sun. Retrieved 2 August 2014. 
  8. ^ Day, Brian (June 18, 2015). "Rebuttal from Brian Day: my prescription for Canada's health care". Opinion: National Observer. Retrieved 5 July 2015. 
  9. ^ Canadian Press (June 19, 2015). "B.C. doctors elect new president; Dr. Brian Day loses by 600 votes". Global BC. Retrieved 5 July 2015. 
  10. ^ 50 Canadians to watch in 2003, Maclean's Magazine, January 20, 2003
  11. ^ Brian Day's diagnosis: The president of the Canadian Medical Association explains how to fix our health-care system - Full Comment
  12. ^ Dr. Brian Day - Submission to the Commission on the Future of Health Care in Canada
  13. ^ Ministry of Health Billing Integrity Program (June 2012). Specialist Referral Clinic (Vancouver) Inc. and Cambie Surgeries Corporation: Audit Report (PDF). 
  14. ^ "Medical Services Commission releases audit". gov.bc.ca. 
  15. ^ "Injunction sought against private clinic operating in Vancouver". The Globe and Mail. 
  16. ^ "B.C. doctors urge provincial ministers to take a stand on public health care". The Globe and Mail. 
  17. ^ Macleod, Andrew (17 April 2014). "For-Profit Clinic Lawsuit May Transform Health Care". TheTyee.ca. Retrieved 22 April 2014. 
  18. ^ Ward, Doug (October 10, 2009). "Canadian critics slam Obamacare in U.S.". Vancouver Sun. Retrieved 2 August 2014. 
  19. ^ "The Globe's Power 50 list- 2012". Globe and Mail. Feb 6, 2012. Retrieved 2 August 2014. 
  • Brian Day: CMA’s next president supports private health care, By Michael McCarthy, The Lancet, Oct 14, 2006, Vol 368, p. 1321

External links[edit]

  • BrianDay.ca - Official site
  • Faculty Bio - Department of Orthopedics, Faculty of Medicine, University of British Columbia, Retrieved on July 3, 2007
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