Sunday, April 14, 2024

Walt Rosser | A life in Canadian Family Medicine

by Editor

In conversation: The life and career of Professor Walt Rosser


From Student Researcher to World Leader

an academic from the outset...

Well, my research career… I guess I was a medical student back in the 60s and we got involved in writing an article that was published in the CMAJ; on is there any difference between the SGOT when you put a band on the arm or you don’t.  So, anyway, that was the beginning of it. Then I got involved in a number of other research projects. Of course, I never actually practiced on my own, I was always in a family practice right from day one. I had to do three years of Family Medicine training before I was able to go out and write the certification exam, go out and practice and, from then on  I’ve been involved in research all the way through.

 I guess my biggest contribution is getting research started.  Well, research was well started at McMaster but research in Ottawa wasn’t very well started.  It’s become a very strong Research Unit and that’s because of people that I’ve recruited there etc a long time ago now.  McMaster was fairly well established. I think we enhanced it a little bit. Toronto probably was a great breakthrough actually and  there are many different things that they still talk about in Toronto, even though I haven’t been there now for going on 15 years about the the kinds of things that were done to really help research along. And, of course, it’s a powerhouse of research now. I mean, I can’t keep track of all the researchers involved there. So that’s another thing. And then at Queens  we worked hard and got the CPFC going etc. So that’s that’s been my career in research.

When you talk about other accomplishments, I guess the major other accomplishment that I made was over a period of probably 10 or 15 years of getting the government finally to agree to fund Family Health teams, which involved the kind of practice where you had social workers.  We had several social workers, we had physiotherapists, we had a whole group of people.  Then,  that was developed in Ontario.  They built 2 000 of these teams in Ontario so those teams now are in existence.  However, they’re very threatened because they haven’t really shown a big difference in outcome.  Now, I think the issue really is that you need them around for 10 or 15 years to show a difference in outcome, and they’ve only been around probably eight or ten years to any extent. However, our current Premier in Ontario is not in favor of these things. He just wants to get rid of them because they’re they’re costing more money than if you were providing Primary Health Care  just independently.  So that, to me, is a very major issue and I don’t know what more to say about it other than that’s happening and I hope that it doesn’t, but it could.

I worked with WONCA. I was the head of the research committee and we were moderately successful in making things happen. I guess the most important thing that we’ve already referred to is the conference that we had in Kingston in 2003.  And that stimulated a lot of interest around the world because there were people that were there that had never been to a conference like that before. We were able to bring them in, we got funding from,  I guess we got (some) from CIHR and we got some funding from a couple of other places and we were able to bring people in from different parts of the world.  I think there were 36 countries represented.  Great stories from that- one was that somebody came from  Singapore (who) had never experienced any cold weather in their whole life, got off the airplane in Kingston and almost froze to death. So, we had to go get them a heavy coat and all sorts of stuff.  It was March and it was still fairly cold.  I was on trip to Japan, I went to Hong Kong a number of times, I was in Jamaica, the Caribbean quite a few times. We ran a system there.  And, then we did a big project in Brazil, again stimulating research in Brazil and it’s had a fairly significant impact.  In fact, there are now 10 or 15 000 members of the Brazilian College of Family Physicians, which didn’t exist when we started out, so that’s some of the things.  And then I was an external examiner for the UAE on projects over there.  At least, I was external examiner for the final exams, actually, for the medical school in the UAE.  And, so we were involved in a number of different projects around the world.

I think Canadian research is has evolved a great deal over the last probably 20- 25 years.  And, I guess, maybe the most important thing that’s happened to us is that Rick Glazier has been appointed as one of the leaders, well, one of the program directors in in the CIHR. And that really demonstrates, I think, and I’ve written a couple of articles on that already, about the impact of that on Canada.  And it probably goes beyond Canada, but the fact that he was appointed to that group that has been known to be very specialist oriented. And it’s the fact that he got appointed in that position I think is really important. I think we have developed the CPSC which is,  I won’t go through the full name, but it’s that system which now involves 1.5 million patients and doctors right across the country.  That to me is a major answer to many questions.  And already there have been 40 or 50 Publications coming from it, and there are probably a lot more to come in the future.  And that, in itself, is a major sort of step forward. That was probably the result of work that I did back in 2003 -4. One of my students was in the public health department and really championed this idea, and that gave us the 12 million dollars to get it started and, then as a result, it’s carried on. It doesn’t have the funding anymore but it’s still carrying on and it’s getting new funding etc. So that, to me, is a major development in terms of Primary Care research out in the field; measuring prescriptions; measuring health; whatever is happening in the Health Care system. 

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