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CMAJ August 14, 2007 177(4)
A conversation with Dr. Day: the joys of notoriety
by Wayne Kondro, CMAJ
 Few will likely ever assume the Canadian Medical Association (CMA) presidency with such advance notoriety.
"Dr. Profit" and "Darth Vader" are
among the tags that have been attached
to Vancouver-based orthopedic surgeon
Dr. Brian Day for having founded
and continued to operate a successful
private surgical facility. He's become
embroiled in a public mudslinging
match with federal New Democrat
leader Jack Layton over whether the latter
paid for hernia treatment at a private
Toronto clinic with a credit card. And
the Ottawa-based Canadian Health
Coalition has installed a "Fact check on
Brian Day, MD" section on its Web site.
All this before Day even assumes the
presidency on Aug. 22 during the
CMA's 140th annual meeting in Vancouver.
The controversies, though, seemed
to amuse, if not delight, the 60-year-old
father of 6 during a recent interview
with CMAJ.
Day grinned and noted of the Layton
dust-up that "one of my rules is that I
always tell the truth."
As for the labels, "Dr. Profit is not
bad. I'd sooner be called that than Dr.
Loser. And Darth Vader turned out to
be a good guy when he didn't kill Luke
Skywalker."
Day expressed pride in becoming
the first orthopedic surgeon to assume
the helm of the roughly 65 000-member
association and beating challengers
for his presidency (CMAJ 2006;
175[6]:566). This is the third time in
CMA history that the presidency has
been contested.
Notoriety, says Day, "helps my
cause." In his mind, that cause is simple,
clear and compelling. "I don't
want to do this and not make a difference,"
he notes, re-affirming his oftstated
belief that private health care
delivery can help to reduce wait lists.
The latter issue is the one on which he
hopes to leave his imprimatur. "To
me, access and wait lists are my number
1 issue. I think that leads to everything
else."
"I'm not the voice for private medicine.
I believe in a strong public system,"
he adds, while arguing for a system
in which hospitals receive funding
directly proportional to the number of
patients they treat, rather than a block
grant. "I'd like to see hospitals competing
with one another for patients."
Founder of Cambie Surgeries Co.
and medical director of the for-profit
Cambie Surgery Centre since 1985, Day
says his practice now routinely attracts
elite athletes from the National Basketball
Association and various European
professional soccer leagues. He began
practising at the Vancouver General
Hospital in 1978, and eventually decided
to focus his efforts on the embryonic
field of orthopedic sports medicine
and arthroscopy. "I liked sports
and I liked dealing with sports injuries
and they're great patients because they
all are motivated. They all want to get
better, as quickly as possible. They
want to get back."
The son of a pharmacist who was
murdered by a pair of drug addicts in
his own home after being followed
from his pharmacy, Day grew up in
post-war Liverpool, describing it as a
once-proud shipbuilding port that
had become economically depressed
after its main industry was "destroyed
by the unions."
He recalls being told by visiting doctors,
as a 9-year-old working in his father's
shop, "it's better to be a doctor."
Why?
"Well, because the doctor tells the pharmacist off."
Day graduated from high school at
the age of 17 and enrolled at the University
of Manchester medical school, becoming
a doctor at 21. He interned as a
general surgeon at the Manchester
Royal Infirmary and then at the Hammersmith
Hospital in London, before
accepting a residency in orthopedics at
the University of British Columbia in
1973, where he also completed a Master
of Science degree.
Day chaired the resident academic
program for the university's department
of orthopaedics 197894 and the
Orthopedic Test Committee of the
Royal College of Surgeons of Canada
198994. Other professional activities
have included a stint as president of the Arthroscopy Association of North
America in 2004, as well as involvement
in the formation of the Canadian
Independent Medical Clinics Association;
he has served as president since
its creation in 2005.
Day also takes pride in having been
in the vanguard of the use of technologies
in medicine, noting that he was a
pioneer in the creation of the world's
first surgical robot, was involved in the
"first live satellite transmission to
China," teaching a course to Chinese
medical students, and was an early
proponent of the use of electronic
health records.
"I've always liked toys," he says,
adding that frustration over the lack of
access to new medical technologies lay at
the root of his involvement in Canadian
medical politics. "In the late '80s, early
'90s, the crunch started to come as health
care got more expensive and we were being
denied access to the latest technology.
The other way that they rationed our
access was to cut down on our operating
time. It got cut down from 22 hours a
week to 5 hours and the Canadian Orthopaedic
Association recommends 15
hours to maintain competence."
"That's when we decided to build
our own centre. Or else we had to leave
the country."
"Now I've seen that the private sector
has a role to play," Day adds. "It can
complement the public system and yet
all of the rhetoric is built up around the
anti-private sector' component,
notwithstanding the fact that 30% of the
health care in Canada is already private."
Day and his wife, Dr. Nina Bland, a
family physician and former Canadian
tennis champion, have 4 young children:
Alexander, Jamie, Stephanie and
Andrew. Day has 2 children by his first
marriage, Christopher and Jonathan.
"The most stressful thing I do is go
watch my kids play soccer," the Everton
football fan says. Notoriety, by contrast,
"doesn't stress me out."
»
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