Brian Day

Brian Day, MRCP (UK), FRCS (Eng), FRCS (C), (born c. 1947) is a physician in Canada and was the 2007–08 president of the Canadian Medical Association. He is known as Dr. Profit by opponents and Dr. Prophet by supporters for his advocacy of a role for private health care. He is the only orthopaedic surgeon in the 146-year history of the CMA to be elected president.

Early life

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.

The area 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 the mid-80s by hooligans looking for drugs.

He was one of very few students from his elementary school who went to university. Day attended the Liverpool Institute High School for Boys, during the era in which Paul McCartney and George Harrison were also there.

Early medical career

He obtained a MB ChB from the University of Manchester and post-graduate qualifications in Britain, in both internal medicine and general surgery, and in 1978 completed his training and a M.Sc. degree at the University of British Columbia in Vancouver, Canada.

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. He is a former Vice-President of the Canadian Orthopaedic Foundation, and in that role, he helped launch the national Hip-Hip Hooray walks that helped raise $20 million for orthopaedic research in Canada.

As an orthopedic surgeon, he earned an international reputation for performing arthroscopic surgery on knees, shoulders, hips and elbows. Day is regarded as being instrumental in the introduction of arthroscopic joint surgery in Canada. His patients have included many famous world-class athletes and many well-known celebrities. He is a past President of the Arthroscopy Association of North America, the world's leading academic society in his field of medical practice. In 2012, Canada's largest newspaper, The Globe and Mail, named him to the annual Power 50 list ranking the players with the influence and desire to affect sport in Canada during 2012.

In 1995, Day founded Cambie Surgery Centre, a for-profit Vancouver hospital. Day is the facility's medical director and is one of over 40 shareholders. The centre operates outside Canada's publicly funded health care system and sees about 4,000 patients a year. It caters mainly to people who have third-party insurance for their operations (such as work injuries) and has also been controversial for allowing patients waiting for care in the public system to access care through the Center. Day decided to set up the Centre, which is non-union, after government funding decreases in the late 1980s cut his operating time at UBC from 22 hours a week to about five, and he had 295 patients on his hospital wait list.

Dr. Day has argued some Canadians are being hypocritical towards private healthcare, since 70% of Canadians buy healthcare insurance but largely oppose private healthcare, neglecting the other 30% of Canadians who cannot afford the extra healthcare insurance.^[1]

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. He 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 for all Canadians and save the Government money by treating people before their condition worsens.^[2] 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^[3]

In 2003, Maclean's Magazine named Day one its top 50 Canadians "to watch", describing him as "an iconoclast, whose time is now."^[4]

In August 2006, Day was elected president of the Canadian Medical Association for the 2007/08 term, despite a challenge from the convention floor regarding Day's views.

During his term as CMA President he promoted a national debate on the health system and its failings. He pointed out that politicians, including those publicly supporting the government monopoly in funding and delivery, were often hypocritical (seeking private options) when it came to their own and their families' care. His efforts have led to the introduction progressive changes, including "Patient Focused Funding" as a replacement for global block funding of hospitals. He also promoted the introduction of a hybrid "European" approach to funding and delivery of care and points out that the public now supports his position. A national Ipsos Reid poll published in June 2012 revealed that 76% of Canadians supported the right to purchase private insurance, something that is currently illegal.

Day has six children and currently lives in Vancouver. His wife is also a physician.

Other medical accomplishments

Day is a Fellow of the Royal College of Surgeons of Canada, the American Academy of Orthopaedic Surgeons, and is certified by the American Board of Orthopaedic Surgery.

From 1970 to 2008, 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.

• 1979: Edouard Samson Award for outstanding orthopaedic research in Canada
• 1989–2003: Vice President, Canadian Orthopaedic Foundation
• 1989–94: Chairman, Examination Test Committee (Orthopaedics), Royal College of Surgeons of Canada
• 1993–2001: Associate Editor, Journal of Arthroscopic Surgery
• 2001: 80th Annual Osler Lecturer, Vancouver Medical Association
• 2003–04: 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)
• 2007–08: President Canadian Medical Association

Issues in United States health reform

In May 2009, Day drew fire from critics by appearing in a television ad^[5] for a US lobby group called Conservatives for Patients' Rights that argues against Obama's healthcare reform plan. Day appeared on the television network BNN on May 11, 2009^[6] stating that he has issued a letter dissociating himself from the ad, and that the sentences were extracted from a 40-minute interview from what he understood was going to be a longer documentary. In a Washington Times article in May 2009^{[citation needed]}, Day explained that he actually supports a government role in health care funding and delivery, and supports Obama's efforts to provide access to necessary health care for all currently under insured US citizens. He has always been a supporter of access for all that is not based on ability to pay but, unlike some of his detractors, he does not support a state monopoly in the delivery or funding of care.

His main issue with the health system in Canada is that it has enacted laws (unique among the approximately 196 countries on earth) that restrict the rights of Canadians suffering on wait lists to choose options outside of the government system. Laws have been introduced that impose fines of between $10,000 and $100,000 if patients use their own financial resources to obtain private care. In 2005, the Supreme Court of Canada declared that Canadians are suffering and dying on wait lists, and quashed Quebec laws that restrict the right to purchase private health insurance. Other provinces have not changed their laws in response to that ruling. Litigation is in progress in 3 provinces to force those changes.

Day has pointed out the paradox that the Obama health plan would be considered an extreme right-wing approach if it were applied to the Canadian health scene.

Day is currently leading a constitutional challenge to laws that deprive Canadians of the right to extricate themselves from their plight as they suffer on public hospital wait lists. In this litigation, he is joined by 5 co-plaintiffs, 3 children and 2 adult cancer patients (a 7th patient plaintiff died of a brain tumor during the delay in getting to trial). After lengthy delays, the action will finally be heard at the Supreme Court of British Columbia starting in September 2014. Legal experts have described this case as the most significant legal challenge in Canadian history.

Notes

References

• Brian Day: CMA’s next president supports private health care, By Michael McCarthy, The Lancet, Oct 14, 2006, Vol 368, p. 1321
• A new Day for health care, By Doug Ward, Vancouver Sun, April 8, 2002
• Faculty Bio - Department of Orthopedics, Faculty of Medicine, University of British Columbia, Retrieved on July 3, 2007
• Day in your life, By Gary Mason, BC Business Magazine, August 2007.

External links

• Official website