After Dr. Mark Wahba sees patients in the emergency room, he gives them his business card.
“People never know who the doctor is in emergency, so I thought, ‘Why don’t I just give them my card?’” says Dr. Wahba, an emergency room doctor and physician executive of Integrated Urban Health with the Saskatchewan Health Authority (SHA).
Dr. Wahba recalls one patient in particular who presented to the emergency room with compression on his spinal cord.
“We got him seen and treated quite promptly, but I was worried the damage had already been done,” says Dr. Wahba, who gave the patient his business card prior to discharging him.
“He got back to me a year later saying how he was doing really well with his rehabilitation, and thanking me and the team for our prompt diagnosis in getting him treated. As emergency room doctors, we often don’t get feedback from patients, so it was really nice to hear that.”
Dr. Wahba says he got into emergency medicine because he likes the variety of the work and the fact that you can change the focus at any point in your career. And that’s exactly what he’s done. Throughout his 14-year practice, Dr. Wahba has worked across Western Canada and in Newfoundland, Australia and New Zealand. He also volunteered with Team Broken Earth in Haiti for a week in 2016.
Dr. Wahba says he’d like to do more volunteer medical work in the future, but for now, his focus is on health care in Saskatchewan.
Dr. Mark Wahba in Saskatoon’s Royal University Hospital emergency staff room celebrating his birthday this past February.
Learning to love medicine in rural Saskatchewan
Initially, Dr. Wahba started out as a family physician just like his father, a man who he says has had the most profound influence on his career.
“I saw how my dad was able to help people in Estevan and how they appreciated that,” he says of his father, who also worked as a general surgeon. “He was approachable, liked to laugh and joke, and didn’t ever take himself too seriously. It was something I admired and wanted to be like.”
After graduating from the University of Saskatchewan with a medical degree, he completed a two-year residency in family medicine in Edmonton, followed by locums (temporary positions) in both family medicine and emergency medicine in Alberta and Saskatchewan.
“Emergency medicine is the best place to work,” Dr. Wahba says with a grin. “It’s just like family medicine – there’s a lot of variety, but in the emergency department you get the acute variety.”
In 2003, shortly after completing two locums that involved emergency medicine, Dr. Wahba’s innate curiosity took him to Australia, where he worked in a Queensland emergency room as a junior physician for six months.
“It was interesting,” he says of his time in Australia, his voice taking on a note of nostalgia as he recalls some of the more unusual ailments, including bites from venomous snakes and stings from poisonous fish, he got to treat as a Canadian doctor.
“At one point, I saw someone who had stepped on a stonefish. It’s a poisonous fish that lies on the ground and looks like a stone,” he recalls. “When the patient came in, his foot was in agony. We gave him morphine and Demerol, but it wasn’t working. So finally, we got a bucket and filled it with water as hot as he could tolerate without burning his skin.
“I remember him sighing with relief as the pain went away,” he says, laughing out loud at the memory of having to heat up a kettle in the staff lounge to treat a patient.
Dr. Wahba enjoyed his experience in Australia so much that, upon his return to Canada, he completed a one-year emergency medicine residency in Calgary, where he worked in both the emergency department and coronary and intensive care units, before moving to Regina in 2005.
“We were looking at going up north to Yellowknife, Iqaluit or Whitehorse,” he says of him and his soon-to-be wife, “but then my dad got sick in Regina, so we moved there.
“I think that’s when things really started to change for me,” he continues. “When my dad was in the hospital, a number of things happened that shouldn’t have happened. It wasn’t anyone’s fault; it was just how the system was designed. That’s when I realized you can learn how to treat diseases in medical school, but if the system doesn’t function well, errors can happen. So, I got more interested in quality improvement and patient safety.”
After his father passed, Dr. Wahba and his wife moved to Saskatoon, where they have lived since 2008, with the exception of a three-month locum in Newfoundland in 2011 and a year in New Zealand in 2017.
Discovering a passion for quality improvement
Shortly after moving to Saskatoon, Dr. Wahba began participating in quality improvement and patient safety programs that have fundamentally changed the way he approaches patient care.
“Up until a few years ago, my career had always been disease-focused: what’s the disease, how can it be fixed? But quality improvement programs have shifted my mindset to be more patient-focused. Instead of focusing on the disease, they have allowed me to ask: what services can we provide to the individual to make their life better?”
In the years since taking on quality improvement initiatives, Dr. Wahba says he has changed how he asks people who present to the emergency department what is bothering them.
“I think doctors are a professional service industry, so a few years ago I started asking patients: 'how can we help you today?' I’ve found that people really respond well to that question, because we’re specifically saying to them that we’re going to help them,” he says.
Dr. Wahba’s breadth of knowledge in quality improvement is expansive, having been a physician lead for quality improvement in the emergency department in Saskatoon and a physician consultant with the Health Quality Council, as well as having been involved in the design and delivery of quality improvement curriculum for resident and physician programs. He is also a co-recipient of the 2015 Dr. Dennis A. Kendel Distinguished Service Award, which recognizes individuals who have made outstanding contributions in Saskatchewan to physician leadership, physician engagement and/or quality improvement.
Dr. Wahba’s passion for quality improvement has allowed him to see firsthand the effects that positive change can have on the health care system, but it has also highlighted the challenges that remain. As a result, in 2016, he started to feel the effects of burnout.
“I don’t think I was fully burned out, but I was going down that path,” he says of himself in the months leading up to his move to New Zealand in January 2017 with his wife and their three children. “I was getting quite frustrated with patient flow through the emergency department and the challenges of being able to see people in a timely fashion and in an appropriate setting. I needed a change.”
Dr. Mark Wahba, his wife and three children in New Zealand.
A change of scenery
A change is exactly what he got, both in New Zealand’s beautiful, warm climate and in the variety of patients he was able to treat in a hospital in Whanganui, a city similar in size to Prince Albert.
Dr. Wahba still remembers the first time a patient came in with leptospirosis, a bacterial infection that people can get when they work with sheep and cattle.
“The first time someone came in with it, I had to look it up,” he says with a self-effacing laugh, adding that practicing medicine in New Zealand wasn’t without its cultural differences.
He still remembers the one-year-old infant who came in with difficulty breathing because of croup, a condition that causes the larynx or trachea in children to become inflamed.
“In Saskatchewan, most kids get better with croup by the time they get to the emergency room because it happens in the winter, and when you take somebody outside, the cold air makes the airway swelling shrink and allows more air to flow through. But in New Zealand, they don’t have air that cold, so I said to the mother, ‘If you’re in a pinch, and the ambulance can’t get to you quick enough, open the freezer and have him breathe in the cold air.’
“I wrote this in the discharge instructions, which go immediately to the family doctor,” he continues. “So, about three hours later, I got a call from the family doctor, saying, ‘I can’t believe you told this patient to stick her baby’s head in the freezer!’
“I said to him, ‘This happens all the time in Canada. People breathe in the cold air and they get better.’
“He said, ‘I don’t think so.’
“We both hung up the phone, each one disappointed in the other person,” he says with a good-natured chuckle, shaking his head at the memory.
In spite of all the benefits of living in New Zealand – warm weather, a new culture, endless hiking and biking opportunities – Dr. Wahba says that when the physician executive position with the Saskatchewan Health Authority was posted, he knew he had to apply.
Coming back home to Saskatchewan
“I’ve wanted to see physician leaders embedded at the highest level of health care for years, so I thought I should put my name in and see what happens,” he says of his decision to apply for the physician executive position, adding that one of the benefits of the new structure is the dyad relationship between physicians and administrative leaders.
“I’m really impressed with her knowledge,” he says of his dyad partner, vice president Integrated Urban Health and Chief Nursing Officer Sharon Garratt. “When we’re at meetings and people ask challenging questions, Sharon is able to provide an eloquent and insightful response that takes into account things I hadn’t even considered. She brings such a wealth of experience and insight into how the system functions.
“What I bring to the table is more clinical in terms of how operational decisions will affect frontline care directly,” Dr. Wahba says of his role as physician executive. “I bring back timely examples of changes to implement. For example, if I’m working in the emergency room on a Friday night, I can come to the leadership table on Tuesday and share my experience of what’s happening, so there’s a real-time connection between the two.”
Dr. Wahba’s dual role as physician executive and emergency room doctor also places him in a unique position to receive and implement feedback from physicians, as well as nurses, pharmacists, physiotherapists and other staff, in a timely manner.
“The other day, I had an email correspondence with a clinical nurse educator who I was working with to make it easier for her to get the information she needs, so staff won’t have to do extra lab tests on patients,” he says. “Once she got this information, she was happy and that made me happy because it showed we can make the system better if we try.”
“I get joy in this job when I know that our care delivery has improved and that both patients and staff are happier. That’s the magic duo,” he adds.
What’s one thing most people don’t know about Dr. Wahba?
“I’m a big comic book nerd!” he says, a grin breaking out on his face.
He proves it by quickly rattling off the first comic book he ever read: Avengers #233.
“I bought my first comic book in the airport when I was 11 or 12, and I’ve been hooked ever since,” he says.
“I should own my own store,” he jokes of the collection of comic books, numbering in the thousands, that he has accumulated over the years.
Even so, it’s not his comic books he can’t live without. It’s his bicycle.
“I really like bicycles,” he says, adding that he used to bike to work when he was a full-time emergency room physician.
“In this new job, I only just started biking to work again, because it took me awhile to figure out how to do it with my new wardrobe,” he says with a laugh, glancing down at his freshly pressed dress shirt and pants.