WEBVTT
00:00:12.560 --> 00:00:14.640
Hi everyone, and welcome to Shift.
00:00:14.800 --> 00:00:16.480
I'm your host, Kyla Avis.
00:00:16.640 --> 00:00:19.359
I'm coming up on the one-year anniversary of this podcast.
00:00:19.440 --> 00:00:23.120
And if you listen to the very first episode, you might remember how it all started.
00:00:23.359 --> 00:00:25.199
I had an idea for a podcast.
00:00:25.359 --> 00:00:29.760
I shared it with two people, they gave me a thumbs up, and I made a podcast.
00:00:30.000 --> 00:00:34.880
By the end of this year, I'll have recorded more than 30 episodes, and I honestly can't believe it.
00:00:35.119 --> 00:00:36.960
There have been many bumps along the way.
00:00:37.039 --> 00:00:40.880
I've tried things, I've experimented, and some episodes are better than others.
00:00:41.119 --> 00:00:44.719
So to every one of you who is still here and still listening, thank you.
00:00:44.880 --> 00:00:47.520
And thank you for all of the kind feedback this year.
00:00:47.679 --> 00:00:51.600
It gave me the confidence to keep going and to believe this was worth doing.
00:00:51.840 --> 00:00:56.479
As the title of this episode says, Shift is shifting in 2027.
00:00:56.719 --> 00:00:58.240
And I want to tell you why.
00:00:58.479 --> 00:01:05.040
Years ago, I learned a framework from a community organizer named Marshall Ganz that I've been coming back to again and again.
00:01:05.200 --> 00:01:09.040
It's called The Story of Self, The Story of Us, and the Story of Now.
00:01:09.120 --> 00:01:12.879
And I felt like it was the right way to share my thinking about where I'm going with all of this.
00:01:13.120 --> 00:01:15.280
So let me start with my story of self.
00:01:15.519 --> 00:01:22.799
I grew up on a grain farm just outside of a town called Cabrie, out on the bald prairie of southwest Saskatchewan between Sifgren and Leader.
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Cabri was and still is very small, about 500 people when I lived there.
00:01:27.519 --> 00:01:31.359
Looking back, I can see how much growing up in this small town shaped me.
00:01:31.519 --> 00:01:35.040
There were no iPhones back then, nowhere to go, and not much to do.
00:01:35.200 --> 00:01:37.359
So our community was really all we had.
00:01:37.599 --> 00:01:41.519
Getting off the farm was key, so I signed up for anything and everything I could.
00:01:41.680 --> 00:01:52.400
My favorite things were the events where the whole town pulled together, the fall suppers, the drama and music nights the high schoolers put on, curling bonspels, cheering on the Cabri Bulldogs hockey team, Cabri Days.
00:01:52.560 --> 00:01:57.519
I loved them because we all had to work together to make things happen, young, old, and everyone in between.
00:01:57.760 --> 00:02:00.640
It taught me so much about cooperation and collaboration.
00:02:00.799 --> 00:02:03.280
Everyone just did their share and it worked.
00:02:03.519 --> 00:02:06.640
I think the sense of teamwork is what really drew me to nursing.
00:02:06.799 --> 00:02:11.120
I loved the idea of working alongside a whole team of professionals to help people when they were sick.
00:00:12.560 --> 00:00:14.640
Hi everyone, and welcome to Shift.
00:00:14.800 --> 00:00:16.480
I'm your host, Kyla Avis.
00:00:16.640 --> 00:00:19.359
I'm coming up on the one-year anniversary of this podcast.
00:00:19.440 --> 00:00:23.120
And if you listen to the very first episode, you might remember how it all started.
00:00:23.359 --> 00:00:25.199
I had an idea for a podcast.
00:00:25.359 --> 00:00:29.760
I shared it with two people, they gave me a thumbs up, and I made a podcast.
00:00:30.000 --> 00:00:34.880
By the end of this year, I'll have recorded more than 30 episodes, and I honestly can't believe it.
00:00:35.119 --> 00:00:36.960
There have been many bumps along the way.
00:00:37.039 --> 00:00:40.880
I've tried things, I've experimented, and some episodes are better than others.
00:00:41.119 --> 00:00:44.719
So to every one of you who is still here and still listening, thank you.
00:00:44.880 --> 00:00:47.520
And thank you for all of the kind feedback this year.
00:00:47.679 --> 00:00:51.600
It gave me the confidence to keep going and to believe this was worth doing.
00:00:51.840 --> 00:00:56.479
As the title of this episode says, Shift is shifting in 2027.
00:00:56.719 --> 00:00:58.240
And I want to tell you why.
00:00:58.479 --> 00:01:05.040
Years ago, I learned a framework from a community organizer named Marshall Ganz that I've been coming back to again and again.
00:01:05.200 --> 00:01:09.040
It's called The Story of Self, The Story of Us, and the Story of Now.
00:01:09.120 --> 00:01:12.879
And I felt like it was the right way to share my thinking about where I'm going with all of this.
00:01:13.120 --> 00:01:15.280
So let me start with my story of self.
00:01:15.519 --> 00:01:22.799
I grew up on a grain farm just outside of a town called Cabrie, out on the bald prairie of southwest Saskatchewan between Sifgren and Leader.
00:01:22.959 --> 00:01:27.280
Cabri was and still is very small, about 500 people when I lived there.
00:01:27.519 --> 00:01:31.359
Looking back, I can see how much growing up in this small town shaped me.
00:01:31.519 --> 00:01:35.040
There were no iPhones back then, nowhere to go, and not much to do.
00:01:35.200 --> 00:01:37.359
So our community was really all we had.
00:01:37.599 --> 00:01:41.519
Getting off the farm was key, so I signed up for anything and everything I could.
00:01:41.680 --> 00:01:52.400
My favorite things were the events where the whole town pulled together, the fall suppers, the drama and music nights the high schoolers put on, curling bonspels, cheering on the Cabri Bulldogs hockey team, Cabri Days.
00:01:52.560 --> 00:01:57.519
I loved them because we all had to work together to make things happen, young, old, and everyone in between.
00:01:57.760 --> 00:02:00.640
It taught me so much about cooperation and collaboration.
00:02:00.799 --> 00:02:03.280
Everyone just did their share and it worked.
00:02:03.519 --> 00:02:06.640
I think the sense of teamwork is what really drew me to nursing.
00:02:06.799 --> 00:02:11.120
I loved the idea of working alongside a whole team of professionals to help people when they were sick.
00:02:11.360 --> 00:02:12.960
What better career could there be?
00:02:13.199 --> 00:02:17.520
So around grade nine, I decided I wanted to be a nurse, and I never looked back.
00:02:17.680 --> 00:02:25.360
I graduated from nursing in 2000 and worked as an RN in Saskatoon and Calgary, but I soon realized acute care wasn't my path.
00:02:25.599 --> 00:02:42.240
I was very aware of the HIV AIDS crisis in Africa at the time, so I did a master's in community health and epidemiology and headed to Africa for two life-changing experiences: working at an HIV clinic in East London, South Africa, and at a training center for community health workers in Missinga, Mozambique.
00:02:42.400 --> 00:02:47.039
I loved the work, but living and working in Africa turned out to be harder than I expected.
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So in 2008, I came home and landed at the Health Quality Council in Saskatoon.
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I honestly didn't know what I'd be doing there, but I needed a job, and this one looked interesting.
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Little did I know it would set me on a course I could have never imagined.
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HGC was great.
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A new government had just been elected, the economy was booming, and there was a real sense of change in the air.
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I was enamored with the idea that we could change the healthcare system.
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Big, bold change.
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That's what I wanted to be a part of.
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I was privileged to work with nurses on a big provincial improvement project called Releasing Time to Care.
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And I swear there isn't a hospital in this province I didn't visit and work with.
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I loved every minute of it, even on the days where it made me cry because changing things was so hard.
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So I was devastated when releasing time to care was sunseted in 2013, when the Province moved to provincial lean implementation.
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As part of the contract with the consultant, all other provincial quality improvement projects were stopped.
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Other improvement methods were banned and the system moved on.
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I decided not to go with it.
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I had just had my first child and I wasn't prepared to dive into the extreme demands of lean rollout.
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I didn't really have anything against lean as a tool, but I did take issue with the way it was being delivered.
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So I decided to take what I'd learned at HQC and see if anyone wanted a different approach to health system change.
00:04:02.240 --> 00:04:04.960
And I've been working as a consultant ever since.
00:04:05.199 --> 00:04:06.879
I really like being a consultant.
00:04:07.039 --> 00:04:12.719
It lets me work in a lot of different spaces with a lot of different people and hear conversations from every angle of the system.
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I get to cross silos and see connections and disconnections that many people never get the chance to see.
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It's really helped me shape how I think about our healthcare system and how to change it and all the complexities that go into it.
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So all that to say I spent most of my working life trying to help make Saskatchewan's healthcare system work better.
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Last winter I had some downtime between contracts and I wondered what I could do.
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That's when the idea for this podcast was born.
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I started out pretty scared, scared I'd embarrass myself, scared nobody would want to come in on talk.
00:04:43.759 --> 00:04:47.279
And to my deepest relief, I think it turned out okay.
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I mean, I'm no Oprah, but my guests have all been wonderful, and every single episode has given me something meaningful to think about.
00:04:54.480 --> 00:04:58.160
But over the summer I started wondering, could this podcast do more?
00:04:58.319 --> 00:04:59.279
Should it do more?
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And if so, what would that look like?
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I learned that if you have a podcast about healthcare, people really like sharing their experiences with healthcare with you.
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Some good, some bad.
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But let's face it, the bad ones are the ones that always stick with us.
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The ambulance that couldn't find someone out in a rural area, driving hours for a five-minute appointment, waiting two years to see a specialist, people going to other provinces and paying for surgeries they couldn't wait for here, the horror stories of the hallway care and the ER, the elder who went into the hospital for something minor, developed delirium, fell, and within weeks was waiting for a long-term care bed, referrals that weren't received, and on and on.
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And then there's the sheer amount of work people have to do just to coordinate their care.
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The waiting, the phoning, the driving, the searching for information, the worry, the anxiety, knowing the care is out there, but wondering, will I be missed?
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Will I be forgotten?
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Is the system going to work for me?
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And even when it does work this time, will I be so lucky next time?
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When someone you love is going through all that, it stops being about quality improvement and becomes personal.
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It becomes very, very real.
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So I gathered a small group of co-conspirators and shared my vague, disconnected thoughts.
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They shared theirs back, and finally something clicked.
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I did need to think bigger than the podcast.
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I needed this work to be about sparking something in this province.
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And I knew that spark might burn a bridge or two, but it also might light a fire that helps clear out some of the deadfall of a system that is struggling and makes room for something new to grow.
00:06:27.839 --> 00:06:31.040
And this is where the story moves from me to us.
00:06:31.439 --> 00:06:36.240
The story of us really clicked for me when I interviewed Kathy McNeil about her book Dying to Be Seen.
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She was my first guest in September, and I was so inspired by the way she told the story of Medicare being born here in Saskatchewan.
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I don't know if I'd ever really heard that story before or heard it in that way, or if I'd just forgotten, but it made me think differently about what was actually possible.
00:06:52.319 --> 00:06:55.680
What Saskatchewan did in creating Medicare was pretty epic.
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And I kept thinking, what's stopping us from doing something that big again?
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Now, don't get me wrong, I think Tommy Douglas is the cat's meow.
00:07:03.920 --> 00:07:08.160
But I also think we do ourselves a disservice when we put all of Medicare on his shoulders.
00:07:08.319 --> 00:07:19.759
Yes, it was Tommy Douglas's leadership that advanced the cause, but it was also hundreds of regular people, doctors, nurses, moms, grandmas, sons, farmers, miners, all rallying and working for it as well.
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And they did it before text messages, Zoom, and Facebook.
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Can you even imagine how hard that must have been?
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And it wasn't easy.
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It was full of real pain and conflict.
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Stephen Lewis described it as an all-out war.
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Families were scared, communities were divided, doctors went on strike, and in response, citizens organized.
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They formed community clinic associations in towns and cities across the province so their neighbors could still get care.
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And they didn't just hope someone else would do something.
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They did it themselves.
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And what they built spread from Saskatchewan across the whole country because it was right and it was good.
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Kathy's episode reminded me that Saskatchewan can do big things when we come together around a shared and meaningful purpose.
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And I know that spirit is still alive here.
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I often work in local coffee shops, and conversations about health and healthcare are everywhere.
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A parent frustrated trying to get their kid into the specialist, a nurse who hates their job and is looking for something else, unsure if they can make it another five years to retirement.
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Volunteers plotting their next fundraiser for a local charity that fills a gap.
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There's always a conversation happening.
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So I know there's energy out there.
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The desire to make things better is there.
00:08:27.759 --> 00:08:33.519
But a lot of time it feels like there's nothing connecting all that energy together so we can actually move something forward.
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The question we have to ask ourselves is this do we sit and wait for someone or something to fix our healthcare system, or do we start figuring out what we can do to actually make it happen?
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That's where the next chapter comes in, the story of now.
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There's something about 2027.
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For one thing, I'm turning 50, which makes me an official member of the We Do Not Care Club.
00:08:54.559 --> 00:08:57.919
And I think it's going to serve me well in the conversations I want to have.
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It's also been 25 years since the Romano report, which called for changes we still haven't made and warned us about the very situation we're in today.
00:09:05.679 --> 00:09:09.919
And it's 10 years since our health regions were amalgamated in the Saskatchewan Health Authority.
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So I feel like this is a year to take note, a year to reflect on where we've been and where we're going in this province.
00:09:16.720 --> 00:09:22.159
So starting in January, I'm shifting the focus of these conversations from Canada to Saskatchewan.
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The show's new name will be Shift: Conversations on Health and Care in Saskatchewan.
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And you might have noticed I said health and care, not healthcare.
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That's on purpose.
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We tend to treat healthcare services as the end-all and be-all.
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And don't get me wrong, care services are hugely important.
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But remember what Don Berwick said on my Thanksgiving episode?
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Healthcare in itself has no value, none whatsoever.
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The purpose of healthcare is health.
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That's the goal.
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That's what we really, really want.
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Health, wellness, peace, joy, independence, coffee on the deck without a worry in the world, family gatherings with everyone at the table who should still be there.
00:10:01.039 --> 00:10:03.759
So how do we build a system where that's the goal?
00:10:03.919 --> 00:10:11.519
Not just more hospital beds, not just more providers, not just another$8.5 billion poured into the same old system.
00:10:11.759 --> 00:10:21.919
We need to get clear on what we really want and what our healthcare system needs to do to deliver it and how we're going to push for it and hold those who hold the power for change accountable.
00:10:22.240 --> 00:10:24.720
We hear so much in this province about the economy.
00:10:24.799 --> 00:10:26.960
But do you know what helps an economy the most?
00:10:27.200 --> 00:10:32.960
Healthy people, citizens who aren't weighed down by an expensive care system that actually doesn't deliver health.
00:10:33.120 --> 00:10:41.120
According to the Canadian Institute for Health Information, Canada was on track to spend nearly$400 billion on health care in 2025.
00:10:41.360 --> 00:10:45.279
That's almost 13 cents of every dollar our economy produces.
00:10:45.440 --> 00:10:47.440
And that's just the cost of care.
00:10:47.679 --> 00:10:55.519
It doesn't count the work people miss, the family members who stop working because they have to become caregivers or the lives cut short.
00:10:55.759 --> 00:10:57.919
The old way of doing things is done.
00:10:58.159 --> 00:11:00.080
So what are we going to create in its place?
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My goal for 2027 is to spark more conversations across this province about health and care, to get people thinking, to bring on guests who are thinking outside the box or even inside the box.
00:11:10.799 --> 00:11:13.600
Honestly, I don't care which box you're in.
00:11:13.759 --> 00:11:15.679
I just want to hear your thoughts and ideas.
00:11:15.840 --> 00:11:19.039
To bring on guests who are thinking outside the box or inside the box.
00:11:19.200 --> 00:11:21.039
Honestly, I don't care which box you're in.
00:11:21.120 --> 00:11:22.960
I just want to hear your thoughts and ideas.
00:11:23.120 --> 00:11:27.519
If you're trying to make things better, whatever that looks like, I want to hear from you.
00:11:27.679 --> 00:11:32.799
And if you want to be super brave and speak out about what's not working, we can do that too.
00:11:32.960 --> 00:11:35.200
This is your podcast now, Saskatchewan.
00:11:35.360 --> 00:11:37.519
Tell me what conversations you want to have.
00:11:37.759 --> 00:11:40.159
I also know not everyone can speak freely.
00:11:40.240 --> 00:11:42.799
There's a real cloud of fear in this healthcare system.
00:11:43.039 --> 00:11:52.159
People are genuinely scared to talk publicly about their work, even when it's good work, in case they say something wrong or they accidentally make a critique and get in trouble.
00:11:52.320 --> 00:11:53.440
I totally get that.
00:11:53.519 --> 00:11:57.840
But there's lots of us who can speak out and who should be speaking out for those who can't.
00:11:58.080 --> 00:12:05.600
People who have experienced the system firsthand, caregivers, researchers with tenure, people who maybe used to work in the system and don't anymore.
00:12:05.759 --> 00:12:09.919
And physicians, you have more cover than most, so I'd love to hear from you as well.
00:12:10.159 --> 00:12:15.039
And if you don't want to come on an episode but you have an innovation to share, send it to me.
00:12:15.200 --> 00:12:18.799
I'll do my best to weave it into the episode without naming any names.
00:12:19.120 --> 00:12:24.080
This podcast is one part of a bigger piece of work I'm calling Shift Saskatchewan.
00:12:24.240 --> 00:12:28.559
And you can check it out at www.shiftsaskatchewan.ca.
00:12:29.200 --> 00:12:32.720
And as you know by now, the way I roll is to build and change as I go.
00:12:32.879 --> 00:12:35.759
I never start with a perfect plan or perfect ideas.
00:12:35.919 --> 00:12:39.200
So what you see there today will grow and change in the months ahead.
00:12:39.360 --> 00:12:43.039
And while you're there, I'd love you to join the Shift Saskatchewan Network map.
00:12:43.279 --> 00:12:48.159
If you live in Saskatchewan and you're working on health or care improvement initiative, add yourself.
00:12:48.320 --> 00:12:53.120
If you're interested in being involved in improving a certain area of health or care, add yourself.
00:12:53.279 --> 00:12:57.679
If you're a caregiver or someone with lived experience of the system, please add yourself.
00:12:57.840 --> 00:13:01.279
We need to see each other and to be seen in this collective work.
00:13:01.440 --> 00:13:04.159
A visible network of people who care and connect with each other.
00:13:04.320 --> 00:13:06.399
That's how meaningful change starts.
00:13:06.720 --> 00:13:08.399
So here's where I've landed.
00:13:08.639 --> 00:13:12.000
For a long time, I thought the biggest risk was saying too much.
00:13:12.080 --> 00:13:15.200
And I've come to believe that the bigger risk is saying too little.
00:13:15.519 --> 00:13:17.360
Systems don't break in a single moment.
00:13:17.519 --> 00:13:21.919
They wear down slowly, while the people who can see it happening stay quiet.
00:13:22.159 --> 00:13:24.480
Medicare didn't start and end with Tommy Douglas.
00:13:24.639 --> 00:13:28.399
It began with people in the province talking and building momentum for change.
00:13:28.559 --> 00:13:32.480
People who decided they would no longer accept the status quo and did something about it.
00:13:32.639 --> 00:13:36.559
The energy is here already, and what's been missing is a way to connect it.
00:13:36.720 --> 00:13:40.240
That's what I want this podcast and Shift Saskatchewan to be.
00:13:40.480 --> 00:13:44.639
I don't have it all figured out, and I have to keep reminding myself that I don't have to.
00:13:44.879 --> 00:13:47.519
Nobody who builds something new starts with a finished plan.
00:13:47.600 --> 00:13:51.200
You start with a conversation, you see who shows up, and you go from there.
00:13:51.440 --> 00:13:52.799
So that's it, that's all.
00:13:52.960 --> 00:13:59.120
Let me know what you think about this shift by contacting me directly or commenting on my shift podcast Facebook page.
00:13:59.279 --> 00:14:08.320
And next week, tune in for my conversation with Mary Smiley, a Saskatchewan nurse by training and a farmer by marriage, who believes strongly that our collective voice can make a difference too.
00:14:08.399 --> 00:14:11.279
And she'll inspire us to keep asking, how might we?
00:14:11.440 --> 00:14:13.919
And remember, systems don't change unless we do.
00:14:14.080 --> 00:14:15.279
This is my shift.
00:14:15.440 --> 00:14:16.799
See you next time.