Notes For
An Address To The
1988 Graduates In
Health Sciences
University Of British Columbia
By Ian A. Barclay

Date: May 27, 1988

Your Honour, Mr. Chancellor, Mr. Chancellor Emeritus, Mr. President, distinguished members of the platform party, ladies and gentlemen but especially the graduates and their families.

You are to be congratulated on your success in reaching a meaningful goal achieved after much perseverance and a lot of hard work.

It is with great humility and pleasure that I accept my honourary degree. UBC is an outstanding university and I will do my best to honour it as it honours me.

For our family this is a nostalgic occasion. Both my grandfather and father received doctorates in divinity and law respectively and our son-in-law graduated here, as one of you, in medicine not too many, many years ago.

My brief remarks this morning are to you as the future leaders of your respective fields. Not from one who has just become an 'instant doctor' but one who brings an off-campus and non-professional perspective to some of the wider issues I see facing you.

We live in an enormously stimulating society. The technological advances being made weekly stagger the mind.

In the field of medicine the strides made in the past few years seem light years away from what was thought possible only a decade ago.

But the technological age exacts its price.

In health care - a multi-billion dollar industry in our country - we have seen cost containment issues come to the forefront, not only for consumers worried about the price of drugs, but also for policy makers and administrators faced with the real cost of running hospitals and other health care facilities. They face growing pressures to provide more service while trying to hold cost increases and find more flexible and efficient ways of doing things. Tough decisions are being made.

I fear that health science professionals, because they are perceived as poor managers, face a growing isolation from this decision-making process. This means budgets that have to be lived with, and decisions being made are not always based on adequate input from the people who deliver the service.

Given today's realities, cost containment and better management are essential, but they must result in quality community health care.

Health care professionals must be heard as priorities are being determined. But this will only happen if you are prepared to be active participants in social decision-making -to be aware of the pressures that face policy makers and to take the initiative to be part of that process.

Just asking for more or being negative will not do. Making a positive and constructive contribution to meeting the broader challenges will ensure your voice and your viewpoint are heard.

Those of you in nursing and social work have a particular contribution to make as you are closer to where the service is being delivered than many of your colleagues.

As graduates in the health sciences, you face enormous burdens and responsibility for the welfare of your fellow human beings. You have, in common, the very direct contribution you have to make to society. Take away any group of you and life would quickly become intolerable for most of us.

You are caring professionals, but caregivers are also subject to the same social and economic pressures as everyone else.

The challenge is to maintain perspective and in an era of increasing complexity to remember that the overall physical and emotional stability of the patient as a human being is the bottom line.

There have been truly amazing advances and yet somehow I feel we are leaving some basic facets of caring behind. When a patient is festooned with an array of tubes, wires, drips and other paraphernalia, designed for physical maintenance of the body, let us not lose sight for one second that behind it all is a human being, a human spirit yearning for warmth, care and, above all, respect.

Society faces a major dilemma with the blurring array of costly specializations. The number of specialities represented here this morning is indicative and you only represent the first tier. There are specialities within specialities. The dilemma is - how do they inter-relate for common benefit?

Are we now going to have to create yet another speciality - the co-ordinator to liaise between the proliferation of specialists? Is that what we are coming to or will the specialists themselves increase the dialogue between themselves and re-focus on the patient? How much unnecessary cost results from this present system of traffic control and where do the 'para-medical' fit into this picture? Is there a place for more volunteers?

Surely the time is right to return to a more holistic approach to healthcare. Surely this approach is better for people and more satisfying for the practitioner.

Your textbooks and training have shown you how to diagnose, but have they honed your instincts? Intuition and sensitivity are great assets. They help you to hear what people are really telling you. How often is a mother right in her intuition about what is wrong with her child? And how often is this intuition inappropriately overruled? Or ignored?

Intuition and age-old wisdom also tells us that an ounce of prevention is worth a pound of cure. I'll spare you the metric conversion.

The movement towards preventive medicine is here to stay and will accelerate. It certainly costs less to prevent than to treat and usually feels a lot better too. People today recognize the co-relation between lifestyle and health. You can provide dimension and credibility to this movement by getting involved and not leaving a vacuum for others, less qualified, to fill.

And what about ethical concerns? The advances that have taken place in your fields have far outpaced society's capacity to resolve the ethical and moral questions raised by the new technologies: prolonging life of the terminally ill, euthanasia and genetic engineering to name a few.

Again this wonderful, technologically oriented world is opening access to a vast area of potential for the betterment of mankind but where we draw the boundaries is a debate you are going to have to actively participate in.

Don't just stand on the sideline. Think these and other issues through. Take a stand.

Not only do I urge you to think about where you stand as you develop your career, but also I urge you to be better communicators and receptors of information ... to be aware of the world around you.

In your students days, not long past, you were swamped with information, an almost insurmountable volume, and yet you persevered. This modern world is a seething cauldron of data. We are faced with information coming at us from all directions. In your special fields of endeavour, there is much to be gleaned on developments happening in other parts of the globe, don't close your minds to them. If you see new techniques or developments that might impact favourably here, donít stand back waiting for it to happen .... Seek out more knowledge, be prepared to communicate with your colleagues about it.

A caution - you have now become an elite. But please watch out for the dangers it can spawn, there is a tendency with humans who have gone through much adversity together, and letís face it your last few years certainly qualify you, for you to feel somehow different from other mere mortals. It can make you clannish, seeking only the company of fellow travellers. Such feelings are dangerous. They will inhibit your ability not only to communicate with other healthcare professions, but also your patients.

I am appealing to you today, representing so many health care disciplines, to stay in touch with each other. Not only personally but professionally. There are so many areas of specialization. There is no one source for all the answers. Yet one of your colleagues may well have what you I re looking for or knows someone who does.

I have tried to deal with some of the issues, the problems, the challenges, the opportunities that await you.

Thank you for your patience and your attention.

This is an exciting day in your lives, an achievement of excellence, a time to look forward and a time to look back. I envy you the challenge and the great potential for accomplishment that lies ahead.

I salute you.

Good luck.