Contents
EDITORIAL
Present, past, and future
Abraham (Rami) Rudnick, MD, PhD
This fall 2025 issue of the Canadian Journal of Physician Leadership (CJPL) focuses on various types of learning. A national review of Canadian data on pathologists’ well-being and workload addresses a much-needed area of learning. Another article addresses the impact of physician leaders with formal training in quality improvement on one of British Columbia’s health authorities.
RESEARCH
Canadian pathologists in crisis: a review of national well-being and workload data
Raymond Maung, MBBS, Michael Bonert, MD, Britney Soll, BSc(Hon), and Heather Dow, CAE, CPC(HC)
Background: Canadian pathologists lack workload protection, resulting in excessive unpaid overtime, which contributes to medical errors, rising medicolegal risk, and mental health deterioration. This crisis has resulted in repeated public inquiries about quality of patient care.
VIEWPOINT
The space between: reclaiming presence in physician leadership
Carlos Yu, MD
Physician leadership today sits inside relentless complexity: cascading decisions, contested priorities, moral distress, and the ambient hum of urgency. The common fix is to do more — optimize another process, add another tool, accelerate the pace. But the more we accelerate, the narrower our attention becomes, and the less we perceive what actually needs our care.
RURAL HEALTH LEADERSHIP
Embedding research in rural hospitals: a leadership priority for reducing health inequities and fostering innovation
Giuseppe Guaiana, MD, PhD
Rural hospitals play a critical role in delivering care to populations that face persistent health inequities compared with their urban counterparts. These inequities include poorer survival rates for time-sensitive conditions, later-stage diagnoses, and reduced access to specialized care. Despite their central role in their communities, rural hospitals remain under-represented in health research and often lack the sustainable infrastructure needed to conduct it. International experience shows that hospitals engaged in research achieve better patient outcomes, greater adherence to evidence-based practice, and stronger workforce retention.
HEALTH ECONOMICS
Analyzing cost-effectiveness data: from calculation to illustration
Jeffrey S. Hoch, PhD, and Carolyn S. Dewa, MPH, PhD
In this sixth article in a series on health economics, we focus on computing cost-effectiveness statistics. We provide examples of how leaders can communicate the findings and illustrate the main points. Building on previous articles, we show calculations and introduce options to communicate the results visually to make the message clear. Although many factors influence a decision, efficiency is an important one, and the results of cost-effectiveness analysis can help guide a value-based strategy in an economically attractive manner.
CASE STUDY
The value of “physician quality leaders” in the Fraser Health Authority
Marshall Cheng, MD, Angela Tecson, RN, Lesli Matheson, MSW, and Dave Williams, MBBS
This case study explores the Fraser Health Authority’s (FHA) experience with the Physician Quality Leader (PQL) program, an initiative designed to embed physicians, who have formal training in quality improvement, into leadership roles. Surveys of stakeholders and participants indicate a high positive impact. PQLs have become trusted partners in system-level decision-making; they are respected for their clinical insight and quality improvement expertise. Executive leadership has reported effective collaboration with PQLs, highlighting improved alignment between frontline care and strategic goals. Overall, the PQL program has strengthened a culture of continuous improvement and multidisciplinary engagement across the FHA.
VIEWPOINT
Looking back on a clinical academic career: a woman physician’s leadership journey
Sandra Fisman, MB
This invited article provides a retrospective composite of the experience and some of the choices made during a clinical academic career. I reflect on joys and challenges experienced through the years and seek to advise young physicians who are on the threshold of a medical career.
BOOK REVIEW
Conflict Resilience: Negotiating Disagreement Without Giving Up or Giving In
Robert C. Bordone, Joel Salinas, MD
Harper Business; March 2025
Reviewed by Ruth Vilayil, MD
In medicine, we’re trained to diagnose and treat disease, but rarely are we taught how to navigate workplace conflict. For many of us, it feels like going into a Code Blue without any ACLS algorithm cards.
