As the first female surgeon and woman of colour to be named president of the Canadian Medical Association, she became a national voice for thousands of students, residents and doctors, advocating for physician well-being and greater diversity in health care.

Gigi Osler also happens to be married to the great-great-great nephew of Sir William Osler, a.k.a. the Father of Modern Medicine, who held the post in 1884.

“I think when people hear [Osler] and see me, it’s a bit of a disconnect,” she has said. “He’s this dignified white man with a handlebar moustache, and they get me instead.” President David Barnard caught up with the alumna—who was raised on hospital grounds by her mother, a nurse from the Philippines, and her father, a physician from India—to talk about burnout, Drs. Siri and Alexa, and how she got the name Gigi.

PRESIDENT BARNARD: What was it like growing up on the grounds of the Municipal Hospital in Winnipeg?

GIGI OSLER: It has now evolved into Riverview Health Centre. At the time, my father was the doctor in residence. There was this beautiful stone building and three hospitals—the King Edward, the King George and the Princess Elizabeth—and these beautiful landscaped grounds.

I remember as a child, playing outside in the grass and loving the peony bushes. Every time I see peony bushes, it reminds me of there. My father could come home for lunch. So, he could have lunch with my mother and I. It was very idyllic….

My inspiration for becoming a doctor was my father.

The CMA did a survey that shows Canadians are ready for an Amazon-like online experience in health care. What does that look like?

Think about all the technology that we have in our day-to-day life. For example, this interview (via Skype)—we’re in two different countries—and yet, we’re able to do an interview. Health care is still decades behind. You can track packages from Amazon online, but there’s no way that you can track your doctor’s appointments, your specialist appointments, your X-ray appointments online, all in one place.

We still have pagers and fax machines being used in hospitals. There’s all this technology that’s out there that has been adopted into other sectors, that we’ve been slower to adopt in health care. So, when we use the term “Amazon-like experience,” it means we’re seamless or integrated; we’re more effective—more satisfaction for the user or the patient.

Your report showed Canadians want 24-hours-a-day, seven-days-a-week access to doctors, all of our medical information on one platform—even having Alexa or Siri monitor our health and relay [data] to a health professional. What’s standing in the way?

Some of those experiences are present in Canada right now, but more in the private health-care system. At the CMA, we have a task force looking at: What are the privacy barriers? The infrastructure barriers? The education barriers? The technology barriers? And what do we need to do to remove or lower them so we can start to adopt technology on a wider scale to deliver health care more effectively and efficiently? I’m not even saying it has to be robots delivering health care. It could be something as simple as having online communication between you and your physician about test results. I mean, who thought you could take a picture of a cheque and send it to your bank and have it deposited, and yet, I can’t email one of my patients to let them know the results of their CT scan, because email is not considered secure? We’ve got patients and doctors wanting to have that conversation together to make change.

You’ve called the health impact of climate change “the public health imperative of our time.” What would be the first thing to address that?

One of our priorities is to try to raise awareness about the link between climate change—the severe weather events that we’ve seen—and the effects on our health. It isn’t a link that people make automatically. But when you look at the forest fires—for example, in B.C., up north, in northwestern Ontario, Alberta—we see more respiratory-related illnesses. We see increases in emergency-room visits because of asthma. When you see the change in temperatures, diseases borne by ticks—Lyme disease, for example—are starting to spread more and more across southern Ontario, even into Manitoba. So, we, as physicians, are seeing these links between climate change, how it’s impacting our health, in a very real way. And I think it kind-of forces physicians to recognize and call out climate change as a public health issue—one of the greatest public health issues of our time.

At the University of Manitoba medical school, we’ve been pretty proud of the move that’s been made in terms of almost gender equity, and much more representation of socio-economic variation—not just children of wealthy people coming to medical school. Are we doing enough as universities?

I see a shift. Change is going to come bottom up and top down, and it’s that middle part where change might be happening at a slightly slower level. We’ve got learners who want change and who recognize that change is needed. And we have leadership such as yourself, and that is sometimes the hardest first step—to get the leadership involved to say this isn’t acceptable, we have to make sure we have policies in place, and make sure that the right procedures are used. We need a physician workforce that reflects Canada’s diversity. For me, it’s more than a professional issue. It’s a deeply personal one.

I’m extremely proud of the work we’ve been doing at University of Manitoba, with a commitment towards diversity that you’d be hard-pressed to find at any other medical school in Canada. And, with that diversity, I see a commitment from the university at working towards inclusion, because that’s ultimately the end goal. The end goal isn’t achieving diversity. It isn’t achieving equity—the end goal is inclusion, where everyone feels supported and respected, working together for positive change.

Tell me about physician burnout. And what kind of challenges are driving people to that state?

It’s a deep, deep feeling of physical, mental, spiritual and emotional exhaustion. You’re at the bottom of your tank, with nothing left to give. Another component of burnout is high levels of depersonalization. And that really means a degree of negative, cynical, detached attitude towards work, towards life, towards everything.

And it’s hard as a physician, who’s very empathetic and caring, to see our patients suffer, to see them not be able to ask for what they need, not be able to get homecare, not be able to get long-term care and not be able to afford prescription medications. And what breaks my heart is seeing physicians continue to work day after day, trying to do their best until they can’t go on anymore.

How do you look after your own mental health?

A number of years ago, when both my kids were busy teenagers, going through their own teenage problems, I had a busy surgical practice. I was running not only on all cylinders but I was juggling many balls in the air. My husband works full time, runs a company. So that was all going on. And then my dad had a short, sudden illness and passed away. That period of time just broke me. Coming out of that, I recognized I had to ensure that I was practicing what I was preaching—because I was working too long, too many hours. And when something happened, acutely, it just tipped the scales. So that was my wake-up call. I had to, in my own self, reset my mind and recognize that I couldn’t do all 1,400 things that I thought I wanted to do. I had to make time for myself mentally, physically, spiritually. But I still am that driven person who likes to say yes to things that I’m passionate about. So, it’s a constant work-in-progress for me.

We hear a lot of talk about integrated health care. What does that mean to you?

Integration can be defined a few different ways. One of the definitions that I’m excited about is integrating health-care teams…where you might have a psychologist, nurse or nurse practitioner, or physician assistance, physiotherapist, dietitians working with the team, so it becomes more of a holistic care.

We’ve had some changes made in the Rady Faculty of Health Sciences. Students are being put together into integrative teams and this is an unusual thing in Canada.

It’s breaking down those silos. So much of health care is siloed. So you continue to work in your medicine silo, and you may work with nursing colleagues, but they’re over there in their silo. So, bringing them together at the very early stages of their training, does, in my opinion, lead to a shift in their thinking. And it leads to integrating knowledge and skills, and team building at a much earlier stage than I recall in my training. Back then, you had your defined roles and your defined lanes. And so, it’s an innovative way to start the team building early in careers. We’ve been talking about more virtual care in medicine—but for a lot of the teamwork that needs to develop, bringing people physically together in one shared space is important, particularly in the early stages when you’re building those relationships.

What was a standout moment from your time as CMA president?

I had learners and physicians come up to me and tell me how they had never seen someone who looked like them in a role like that. And because of me, they could see themselves in that role someday.