The frontier medicine woman

The frontier medicine woman

Nobody saw it coming. Not politicians. Not even physicians. COVID-19 has upended the world. Just ask Nancy MacCready-Williams, CEO of Doctors Nova Scotia

Once upon a time, Nancy MacCready-Williams spoke brilliantly, unabashedly about health care in Nova Scotia. It’s the best system in the world, she would say before explaining how it could be dramatically improved. As the CEO of Doctors Nova Scotia—the oldest medical association in Canada representing more than 3,500 practising and retired physicians, medical students and residents—she still does. 

These days, the thrust and parry of her rhetoric seems more measured. She seems more measured. A pandemic that’s infected millions around the world and inspired your home province to declare a state of emergency will do that to you. 

“Doctors Nova Scotia continues to work closely with the Nova Scotia Department of Health and Wellness and the health authorities to ensure critical information from the experts is reaching physicians and patients in our province,”  says the Atlantic Business Magazine Top 50 CEO Hall of Famer (2010) in an email. “We have followed the lead of our public health officials.”

How, exactly? 

“We worked closely with government to enable the redeployment of community-based family physicians and specialists where they were needed to test and treat patients with COVID-19.  Together, we expanded virtual care tools and compensation frameworks.”

And now? 

“There is still much work to be done as we prepare for the anticipated second wave of the virus, including ensuring that interim virtual care tools set to expire at the end of September 2020 are made permanent. Our partners are willing to do this work with us.”

Ah, yes. 

Responsible. 

Measured.

But a million years ago (which works out to about 10 months in the virally contracted timescale of COVID-19) the former head of Nova Scotia’s Workers’ Compensation Board, who enthusiastically grabbed the reigns of Doctors NS in 2011, waxed triumphantly about a new and long-overdue contract for the province’s physicians; about the ongoing fight for better compensation; about the need to fill the perennial doctor shortage in the province; about burnout; and about leadership.

“There simply aren’t enough (doctors) in the province and there are a whole host of reasons for that,” she said. “We have a new contract now. But there are other things, too. We want to take an organization cultural approach to burnout. The things that drive highly engaged employees are not purely compensational. The things that matter are feeling valued, and knowing you have the supports you need to do your job. That’s the area we want to focus on as we move forward—things that will restore the joy in the practice of medicine.”

Back then, in the stone age that was January 2020, she was making leadership a personal mission. “It’s like weaving things together—leadership development and support,” she said. “How do they shape the healthcare system of the future?”

There was the Physician Leadership Development Program (PLDP), designed for doctors, delivered by doctors.  It would create more visionary, collaborative, effective leaders, she said. “We’re dealing with so many areas that are the very same things that drive highly inspired employees in high performing organizations everywhere,” she said.

The passion, the enthusiasm in her voice was clear to anyone who could listen. To hear her speak then, you’d be forgiven for thinking she had led a charmed life—cognizant of, but undaunted by, the manufactured misery of modern times. You’d be forgiven because you would not be wrong. 

“I was raised by parents who instilled in me that anything was possible,” she said. “That was just from a place of working hard and treating people with kindness. I grew up thinking that everybody had the same unconditional support. I was fortunate to be raised in a joy-filled environment. That shaped me from the very beginning.”

It shaped her well enough for law school at Dalhousie University (LLB, 1989) and, later, a Master’s degree in Industrial Relations from Queen’s University in Kingston, Ontario. It shaped her well enough to help her rise to the top at the Workers Compensation Board of Nova Scotia, where she presided over crucial policies that affected 19,500 employers in 335,000 employees in the province. When she resigned to take over at Doctors Nova Scotia, the WCB almost tearfully acknowledged that her seven-year stewardship of the organization “changed how a province thinks about occupational health and safety and return to work. The WCB of today is a different organization than it was seven years ago. Nancy leaves the organization at a high point.”

High point. That was then, of course. That was before the frontier of medicine changed literally overnight. 

On Sunday, March 22, as MacCready-Williams carefully crafts her responses to my questions about the urgent conversation of today, Nova Scotia premier Stephen MacNeill is preparing his own missive to a million Nova Scotians. 

“The Province of Nova Scotia has declared a state of emergency,” Nova Scotia premier Stephen MacNeill stated on Sunday, March 22. “Over the weekend I saw and heard of far too many incidents of people gathering, blatantly disregarding the social and physical distance rules of staying six feet or two meters apart. 

“I cannot allow a certain level of Nova Scotians to disregard the order of the chief medical officer or law enforcement when it comes to ensuring we protect the health and safety of all, and that is why we were forced to do what we are doing today.”

His chief medical officer, Dr. Robert Strang, concurred in his own statement: “Everyone is at some level of risk. We need to use some common sense. Now is not the time to be piling into a car, and park next to 100 other vehicles at a beach or a park.”

Of course, things got better. The “Atlantic Bubble” inflated. People began to breathe again. We took it day by day. We still do.  Now, MacCready-Williams says, “I encourage the public to continue to listen to the experts. We have strong leadership in Dr. Robert Strang, chief public health officer of Nova Scotia and his team of medical officers.”

She also says, “The Atlantic Bubble and mandatory masking protocols have worked well for us as we compare our COVID experience to elsewhere in Canada and in the U.S.  We need to stay vigilant as more Nova Scotians transition from home back into the physical workplace, and back to school this fall.” 

She continues: “This adherence to public health protocols will serve us all well as we patiently wait for a vaccine. We are strong and we can get through this if we are in this together.” 

 And, we always have been, she says. At least that much remains unchanged. •

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