Dr. Hugh Scully is shedding jobs across the country as he prepares to become the CMA's 129th president later this month. He will become the first surgeon in 13 years to hold the association's top job.
Scully, professor of surgery at the University of Toronto and senior cardiac surgeon at the Toronto General Hospital, is stepping down as president of the Canadian Cardiovascular Society and as a member of Council for the Royal College of Physicians and Surgeons of Canada. Back in Toronto, 8 of his colleagues will assume some of his surgical responsibilities as he clears the deck to free up the 180 days he estimates he will need to fulfil his CMA duties.
This type of juggling act is nothing new for Scully, who has been adjusting priorities and passions since serving as president of his high school class at the International School of Geneva in Switzerland. The same activism followed him into medicine. As an intern he became founding president of the Professional Association of Internes and Residents of Ontario (PAIRO), and he went on to head the Ontario Medical Association (OMA). His professional appointments range from chief of staff and later deputy surgeon-in-chief at the Toronto Hospital to consultant surgeon with the National Ballet of Canada.
"I've always hoped to make a difference to the quality of health and health care and to the quality of life here in Canada," he says with a shrug. "That's why I went into medicine in the first place, and it's certainly the reason I've sought out leadership positions."
In fact, one of the few positions he won't be giving up this year is the presidency of the International Council of Motor Sport Science (see sidebar).
Scully has already identified 3 major issues that he thinks will dominate his presidency:
- shortages and imbalances within the medical and health care workforce;
- reasonable professional accountability by all partners to ensure timely access to quality health care; and
- physician leadership and input when key decisions are being made about the future of health and health care. The first area is nothing new, since workforce issues have been a dominant theme throughout his career. Scully, who chaired the Royal College's Physician Workforce Committee for 5 years, can cite alarming data from memory. For instance, of the 660 practitioners in Winnipeg, only 6 are taking new patients. Meanwhile, Ontario has a shortage of 700 family physicians. Nationally, there is a shortage of 88 cardiac surgeons, at least 200 anesthetists, "and counting."
Scully is also worried about trends in medical school enrolment, postgraduate programs, career flexibility and re-entry to training, as well as issues surrounding international medical graduates wanting to practise in Canada. He thinks advocacy in these and other areas "is the CMA's most important role." Figure 1
Figure 1. Scully (left) with Finance Minister Paul Martin: "advocacy is our most important role"
Scully, who was born in Windsor, Ont., in 1940, grew up in Ottawa and Europe because his father was with the federal government's trade and commerce division. He graduated from Queen's University, first in arts and then in medicine (1965), and finally earned a master's degree. He then completed postgraduate training, first in general surgery then in cardiovascular and thoracic surgery at the University of Toronto.
As the founding president of PAIRO in 1969-70, he made some university administrators so angry they wanted him turfed from his residency program. "We believed we needed more balance in the experience of residents," he says. In the late '60s, PAIRO was pushing for reasonable personal, education and on-call times, plus sufficient compensation to prevent further debt during training. "We're still addressing these things," he says.
In July of 1970 he went to the Massachusetts General Hospital to do cardiac research, and 4 years later he joined the cardiovascular surgical staff at the Toronto General Hospital. The dean of medicine soon invited him to represent Ontario's medical schools on the OMA Board of Directors. He went on to become a chief negotiator and, in 1987, the OMA president. He was also intensely involved with the CMA, first on the board and executive, and then as chair of the Council on Health Policy and Economics from 1989 to 1993.
Although Scully hails from the corridors of power provided by an elite Toronto hospital and surgical team, he says he will have no trouble relating to the problems physicians face in small-town and rural Canada. In part that's due to the 3 summers he spent in Labrador City, working as a labourer in heavy construction - and occasionally an operating room assistant - to help pay his way through university. "I got a real sense of how difficult access is in that kind of community," he says. Years later, as OMA president, he started the tradition of completing a "president's tour" that allowed him to meet doctors in all corners of the province.
Although he's had an active academic career, Scully's first love is the OR - over the years he has performed more than 6000 operations. A recent one involved a 91-year-old bridegroom who developed cardiac problems while on his honeymoon. His 78-years-young bride blushingly quipped: "That's what happens when an older man marries a younger woman."
"I felt he deserved an operation," Scully says with a laugh.
He's not surprised that he's the first surgeon in more than a decade to hold the CMA's top job - he thinks this fact reflects the nature of surgery. "There is less flexibility because of surgical schedules, less time for other things."
On one recent weekend, Scully worked from 5 am to 11 pm on Saturday and Sunday. He arrived at work on Saturday to find he had 21 new patients.
His typical work week lasts about 80 hours, and he performs surgery from 8 am to 5 pm up to 5 days a week. He's lucky to be home "one evening a week," and between New Year's Day and May he was free for only a single Saturday. "Luckily, Vanessa is also a professional and is very busy, and my family is very understanding and supportive."
He revels in telling the story of how he met Vanessa Harwood, a former prima ballerina with the National Ballet of Canada, on a blind date. Harwood now works as a dancer, choreographer, actress and advocate for all performing arts.
Scully has 3 children. Laura, 31, inherited his passion for skiing and works as a ski pro in Mont-Tremblant, Que., and Whistler, BC. In the summer, she and her husband, Louis Joncas, employ 40 people in a successful landscape gardening business in Mont-Tremblant. Alexa, 23, also a keen skier and canoe tripper, recently completed her degree in native studies and comparative development at Trent University. She is adjusting her life as she recovers from the tragic accidental death of her partner Michel ("Mike") Trudeau last fall. Fifteen-year-old Shannon, an accomplished swimmer, is "considering a career in marine biology or art . . . or something else."
Scully wouldn't hesitate to encourage his children to pursue careers in medicine. "It's a wonderful profession," he says. "I love what I've done. The future of medicine is very exciting."
Doctor in a hurry
How is motorsport like cardiac surgery? If you really want to know, as Hugh Scully. The CMA's incoming president is a cardiac surgeon and avid participant in all aspects of autosport safety and medicine. "Racing is a high-performance field and I'm in a high-performance specialty," he explains. "It involves the same thought processes: we're making decisions under pressure and organizing the team to make things happen. It's very, very similar." Figure 2
Figure 2. Scully: on track in motorsport too
Scully began working in autosport as an intern, earning $50 a day at Ontario's Mosport Raceway. Not satisfied with the uneven medical services available during races, he helped launch a provincial association of race physicians in 1969 and was its president from 1970 to 1991. He also worked at the national and international levels, travelling officially to races around the world. He has made many friends from all walks of life and from many countries. One of these friends, a young Austrian driver, was killed during a Formula One race in 1974 because of faulty safety equipment. "After going through that, I said, 'Scully, you either have to leave this or get involved to make a difference.'"
Between 1981 and 1992 he represented Canada and the US by proxy on the medical commission of the Federation internationale due sport d'automobile, and he helped to write the safety rule book that's now in use worldwide. In 1996 Scully became the first Canadian to serve as president of the International Council of Motorsport Science.
Their efforts have paid off. In the 1960s, 1 in 6 race-car drivers involved in high-speed crashes died. Today's ratio is 1 in 360 because of improvements in car design, restraint systems, helmets and protective clothing. Scully was the medical director of the Formula One Grand Prix of Canada in Montreal from 1978 to 1991. He has been the medical director of the Molson Indy (CART) in Toronto since the first race in 1985.
Has Scully ever been tempted to race? "I don't fit into the single seaters anymore," he said with a grin.