“I was here doing a locum [standing in for another physician], and I quickly became drawn in by the opportunities in Saskatchewan, so I decided to stay and never looked back,” says the family physician who has been working in Yorkton for nearly two decades. In January, he also became the Saskatchewan Health Authority’s first deputy chief medical officer.
Deputy Chief Medical Officer Dr. Phillip Fourie
The pull of the Saskatchewan prairies
Dr. Fourie says the most interesting aspect of working as a physician in Saskatchewan has been the incredible opportunities it has provided to look at high-performing health care systems elsewhere in the world.
“Because of different leadership opportunities and committees I’ve been on, I’ve had the opportunity to go to Alaska, Seattle, San Francisco and Utah to look at their high-performing health care systems,” he says, explaining that in Alaska he was involved in primary health care re-design; in San Francisco, eHealth and electronic medical records; and in Seattle and Utah, quality improvement initiatives.
“Quality improvement work is something I’ve done from the moment I got to Canada,” he says. “I’ve always believed that every single day, we should look at the things we are doing that are not working and try to fix them so tomorrow can be better than yesterday.
“I think it’s that principle that got me into leadership,” he continues. “When I started practicing as a physician in Yorkton, I realized there are a lot of things I couldn’t do in my clinic because it was dependent on the rest of the system, so I got involved with committees and the Saskatchewan Medical Association (SMA), and gradually moved into various leadership positions.”
In addition to his current role as the Saskatchewan Health Authority’s deputy chief medical officer, Dr. Fourie has been the past-president and former board member of the SMA, as well as chief of family medicine, vice president of medical services and senior medical officer with the former Sunrise Health Region. Through each of these roles, he managed his own private practice for 15 years, before moving to a multi-disciplinary team at the Sunrise Health and Wellness Clinic in 2014.
Dr. Fourie says one of the lessons he’s learned over the years in his leadership positions is that when you listen to other perspectives, there’s a lot more wisdom that comes forward.
“I truly believe in the wisdom of the group,” he says. “All of us have different backgrounds, perspectives, views and ways of looking at things, and when we look at all of that, we have an opportunity to get to a better solution.”
A man unafraid of challenging the status quo
From a young age, Dr. Fourie says he has had a tendency to challenge the status quo.
“But not in a bad way,” he’s quick to add. “In a good way – I want to know why things are the way they are and, if it’s not as good as what it could be, I look for ways of doing it better. I just love discovering challenging problems and finding solutions for them. There’s quite a bit of satisfaction in coming up with something that is better than it was. That’s a win-win solution for everybody.”
Among his achievements, Dr. Fourie says the one he is most proud of is the primary health care network he helped set up in the former Sunrise Health Region. One of the innovations Dr. Fourie strongly advocated for in Yorkton’s primary health care network and innovation site was the use of a different vendor for electronic medical records (EMR) than what was being used by other sites in the province at the time.
“I was looking at future opportunities to link the different clinics with each other, so that we don’t work in silos,” he says. “The EMR we chose enabled us to do that and helped us to provide seamless care to our patients. Now, all the clinics in the former Sunrise Health region under SHA management share the same medical records regardless of whether we see a patient in Preeceville, Foam Lake, Yorkton or Canora.”
Private clinics also have the option to join this data-sharing network. In recent years, this new model of service delivery has been a contributing factor in the former region’s ability to recruit physicians to hard-to-recruit locations.
“Every day when I come to work, I look at what I can do today to make things better,” he says. “I would rather look at what I can contribute than wait for the system to change, because we are the system. Progress is not what one person does; it’s the combined result of everybody’s contributions.”
Discovering his passion for health care in Africa
Dr. Fourie knew he wanted to be a doctor from the time he was a young boy in rural Africa.
“I’ve wanted to be a doctor since I was about five or six, mostly because of the physicians we had in the small community where I grew up,” he says, explaining that he admired their capacity to work with minimal resources.
“I looked up to those physicians who were able to handle all kinds of emergencies and said to myself: ‘That’s something I want to be able to do one day.’”
Dr. Fourie grew up in Lüderitz, a small fishing community on the southwest coast of Namibia.
“I spent a lot of time as a boy fishing,” he says, recalling the three-day-long camping and fishing trips he and his friends took on their own at the young age of 10, 11 and 12.
“It was quite a different time then,” he says, smiling at the memory. “We would catch lobster, and sell them to the hotels at their back door because they got them cheaper from us than elsewhere. Those were good times.”
In Grade 6, he graduated from the small community school he was attending, and moved to a rural community outside Cape Town for boarding school until Grade 12. This was followed by the University of Stellenbosch, where he graduated with a degree in medicine and a diploma in anesthetics. While going to university, he tutored school kids in science and math, and travelled around South Africa and Namibia doing door-to-door sales.
Soon after finishing medical school, Dr. Fourie returned to his home community of Lüderitz in Namibia to do a locum for two physicians who were working there at the time. It was an experience that provided him with his first opportunity to work as a physician in a remote location with minimal resources.
“I remember a patient who had an open fracture and wound from a broken leg,” recalls Dr. Fourie. “As the only physician on site, I had to take him to the operating room to clean out the wound, set the fracture and stabilize it in a cast under spinal anesthesia before referring him to the orthopedic surgeon.
“In that moment, I realized I was doing exactly what I’d always wanted to do,” he says with a grin.
From rural Africa to Saskatchewan’s evolving health care system
Since arriving in Saskatchewan nearly 20 years ago, Dr. Fourie says he has seen a lot of growth in the province’s health care system, and he’s optimistic that there is still a lot to come.
“I think we have the opportunity to be one of the leading health care systems in the world,” he says. “We’ve got the right people with the experience and the will to make things better, and we’re small enough to be able to do it.
“I think our biggest opportunity is to reduce variation and increase standardization, but not with everything. We need to step back and look at where patients are going to see the most improvement to quality and the services they receive. We can provide value and quality at the same time and, if we start with those, I think we’ll get far.”
Making a positive difference in people’s lives is what Dr. Fourie loves most about being a family physician.
“As a family physician, you have very close relationships with people. You go through tough times with them and joyous times,” he says, adding that one of his most memorable patients was an elderly First Nations man who had a stroke and was placed on a ventilator to help him breathe.
“The family made the difficult decision to remove the breathing tube and then, against all expectation, he hung on and gradually started improving,” he says. “He still has a bit of a limp when he walks and hasn’t been able to use one of his arms well, but he was able to go back to his family and go fishing with his grandchildren.
“That gave me a new perspective, and reminded me that even when we think things might go a certain way they can always turn out for the better.”
An eternal optimist
Dr. Fourie says he has always been an optimist, somebody who looks at the glass half full rather than half empty.
“I think it is wasted energy to focus on the negative,” he says. “I feel that before you complain about something, you need to at least try to fix it.”
It’s a lesson he and his wife, Joanne, of 10 years hope to pass on to their two boys: Andre, seven, and Jacques, five.
Dr. Fourie and his two boys, Andre and Jacques
“I hope with all of the experiences I’ve had in my life, I can transfer that to my boys and equip them with the tools to challenge the world and make it even better for the people who come behind them,” he says.
Dr. Fourie says he would like to see a health care system that all people in Saskatchewan, regardless of where they live or who they are – First Nations, Métis, immigrants, seniors or children – can be proud of.
“I think the ideal is to get to a place where we provide high quality care in a responsive system of learning that allows us to continually grow and improve,” he says, adding that health care providers in other provinces are starting to take note of the accomplishments of Saskatchewan’s health care system.
“The system I’m working to improve now is the system my boys will access in the future,” he says. “That’s what we’re all trying to do – to improve the system for our patients and for future generations.”