As an anesthesiologist in a busy northern Alberta hospital, Alika Lafontaine’s professional world is defined by high-pressure situations.
But even he was not prepared for the level of intensity he would be taking on as the new president of the Canadian Medical Association, one of the largest and most influential health advocacy organizations in the country.
“I was overly ambitious with how balanced my life would be over the next 12 months,” said Dr. Lafontaine, who began his year-long term in August by travelling the country to meet with other health care leaders and professionals.
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At age 40, Dr. Lafontaine – a father to four kids between ages eight and 14 – is the youngest president in the CMA’s 155-year history. Of Métis, Cree, Anishinaabe and Pacific Islander ancestry, he’s also the organization’s first Indigenous leader.
Dr. Lafontaine’s mission as he takes the reins is to convince political leaders and policymakers that now is the time to make real, substantive changes to systems that have been floundering for decades.
The stakes could not be higher. In the past few months, wait times at emergency rooms across the country have set new records. Earlier this month, an elderly patient died from an apparent aortic tear in a Quebec ER after waiting 16 hours without being seen by a doctor. And a rural hospital in Chesley, Ont., announced its emergency room will be closed until December as a result of critical staff shortages. Health care workers are reporting unprecedented levels of exhaustion, with many leaving the profession. And as the number of medical residents choosing family medicine is at its lower point in the country’s history, millions of Canadians can’t find a family doctor and have no access to basic medical care outside of an emergency room or walk-in clinic.
Since taking over as head of the CMA, Dr. Lafontaine has been speaking to health ministers and other elected officials, medical professionals and patients about his and the CMA’s vision for change – primarily, that Canadian leaders would focus less on reducing upfront health costs and more on patient outcomes and how best to achieve them, such as by investing in family-care providers.
Dr. Lafontaine has a reputation for being friendly and diplomatic, but he often pushes back on flawed narratives, such as the idea that Canada needs to find innovative solutions for its health crisis. If you spend even a few minutes on the topic with him, he will remind you that the country’s current health care problems date back decades and that the solutions have been clear for just as long.
His immediate predecessor, Katharine Smart, made headlines earlier this year when she proclaimed that the country’s health care system had collapsed. And Dr. Lafontaine is following in those footsteps, publicly speaking about the complete lack of vision and absence of political will that brought health care in Canada to its knees. He’s frustrated, for instance, that Canada doesn’t yet have a national licensure for physicians, which would allow them to easily work anywhere in the country and immediately address current shortages.
“There’s stuff at high levels we talked about for years. If we did it, it would transform the way the system works,” Dr. Lafontaine said. “We have these conversations and then the crises end and we move on.”
He’s equally frank about the human resources shortage that’s creating chaos at institutions across the country. Instead of addressing the issue, he said, hospitals have allowed health professionals to cover the shortfall by working too many shifts, beyond the point of exhaustion, creating potentially unsafe conditions. “Now the system is breaking because people have gotten to the point where they’re saying ‘I’m just going to walk away.’”
But he’s also hopeful for the future. On the topic of balancing health care costs compared with health care outcomes, he thinks a shift toward the latter is not only possible, but is the best way to ensure patients receive high-quality care that will also save money over the long term.
Beyond the work that he does at the CMA, Dr. Lafontaine also hopes that, as someone who had a difficult experience at school, he can be a role model to young people similarly struggling who are interested in pursuing the medical profession.
Though he finished high school at 16, completed his first university degree by age 19, and took the medical school entrance exam on a dare – and passed – he had long struggled with self-confidence. When he was growing up in Regina, he was told that he had a learning disability that would put high school graduation out of reach.
“I, for a very, very long time, felt broken as a result of the experiences I had as a kid – being told you’ll never finish high school or go to university because you have these learning challenges,” Dr. Lafontaine said.
He credits his family’s support for helping him to excel in his studies. His mother chose to home school him starting in Grade 7, an arrangement that continued on and off through high school. Over time, it became clear that he was just as capable as any other kid, and perhaps more so.
“I ended up having a shift that was a bit surreal,” Dr. Lafontaine said. “I went from being labelled as someone who would never achieve anything to someone being labelled as gifted.”
Having this knowledge still didn’t erase the sense he had that he wasn’t going to make it. During his undergrad years at the University of Regina, and at the University of Saskatchewan medical school, he was often one of the only Indigenous faces in the room – making it difficult for him to feel he belonged. Dr. Lafontaine said the first few weeks of medical school in particular were so overwhelming and challenging he nearly gave up. He recalled one instance in those early days when he asked a professor for extra help with his workload and was brushed off.
“I remember in that moment walking out and thinking to myself, ‘Why am I here? I don’t have family here, I don’t fit in with the other kids who are here, I should just go. Who am I kidding?’”
One day that first year, he ran into Val Arnault-Pelletier, the school’s Indigenous co-ordinator, on campus – a chance encounter that would change everything.
“I just broke down to her and told her everything that I was feeling,” recalls Dr. Lafontaine.
She stepped in, arranging meetings for Dr. Lafontaine with William Albritton, the dean of the medical school, and supporting him herself to continue his studies. Dr. Lafontaine recalls stopping by Ms. Arnault-Pelletier or Dr. Albritton’s office any day of the week and them always making time for him. And when he came up with a strategy for recruiting more Indigenous students into residency training, they both helped him put it into place.
“Her and Bill are the reasons why I got through med school, to be honest,” he said.
Now, he’s hoping he can be an inspiration himself. “I really hope for kids who are thinking about medicine that they see me and they say to themselves, ‘If he did it, I could do it, too.’”
Ms. Arnault-Pelletier said she’s not surprised to see Dr. Lafontaine take on the role of CMA president, as it was clear during his student days he was a natural leader and often took on mentoring positions. Beyond that, he also embraces the core values of Indigenous teachings, including honesty, wisdom and bravery, she said. “I could see that he had such a kindness about him.”
While Saskatchewan will always be home for Dr. Lafontaine – his parents still live in the house where he grew up in Regina – he now lives in Grande Prairie, a city of about 67,000 in northwest Alberta, with his wife and children.
Dr. Lafontaine said becoming head of the CMA was never in his long-term plan. But that much like other key moments in his career, the support of others led him to believe he could do it. And he believes that fixing the health care system means inviting people to the table who historically have not been given a voice, including more Indigenous people.
“If you continue to have the same perspectives around decision making, you’re going to have the same solutions,” he said.
Now that he has a seat at the biggest table, Dr. Lafontaine is committed to dismantling the status quo when it comes to health, saying that the time has come for hard conversations and real change.
“You can’t ignore big problems,” Dr. Lafontaine said. “You have to walk through them.”