Material Type

Recording

Date Range

1994

Fonds

Dr. Hugh Arnold fonds

Description Level

Fonds

Physical Description

1 audio cassette (digital file)

Physical Condition

Excellent

History Biographical

Dr. Arnold donated his papers to the Galt Museum and Archives in September 1993, with the provision that they be available for an independent study project done by University of Lethbridge student Donna Kampen, under the supervision of Professor Bill Baker of the Department of History. Donna Kampen organized Dr. Arnold's papers conducted a series of oral history interviews (8 audio cassettes) with Dr. Arnold.

Acquisition Source

Arnold Dr Hugh A

Scope and Content

The following transcript was prepared by Donna Kampen. Q That should work. I tested it before you arrived. A: Just leave it right there? Q Yes. A: I want to tell you about the possible or probable...the apparent inconsistency between...my mother in Vancouver, when she had we two boys, and my father was overseas, and my mother did some special duty nursing. Q: Yes? A: You raised the question, properly so, about how, when she would be special duty nursing and also taking care of us two boys, who were still fairly young whippersnappers you know. And I think I've arrived at the answer to the proper questions you asked. I discussed it with my brother, and we both have decided that—he was born in 1913,1 was born in 1910--. We lived in two, no three different places during our lives in Vancouver. Each of us attended the same schools—he three years after I. The first school was called Hastings, and the second was McDonald, and the third was Seymore. As nearly as I can put the story together, at this stage of our lives. I was born in 1910, and Dad went to the war in 1914, so I was four years old. My bother, born in 1913 was only a year old when father left. When the war was over in 1918, father came back to Vancouver. He had...he was looking for work, and had difficulty getting the kind of work he wanted. He wanted to get into men's haberdashery...men's clothing, that type of business. He had great difficulty, there was this great rush of people coming back from the army. Q: Yes A: He did contact, or was contacted by someone in Calgary who wanted him to come to Calgary to work for him, and Dad went to Calgary, made inquiries, and took the job ultimately, and for that reason we moved to Calgary in 1921. At that time Dad had been sort of visiting in Vancouver occasionally, but his headquarters was Calgary. The period of time between 1918, when the war was over, and 1921, when we moved to Calgary, my father was at home at intervals. That was when we think our mother did special duty nursing. So that is the closest my brother and I could come in explaining the fact that she did do the special duty nursing. In fact, my brother didn't recall her doing any special duty nursing, but he was very young. In 1918 he would only have been five years old. So I think this explains, certainly to my satisfaction, the reason why my mother was able to nurse. My father was home at intervals. Q: Yes, that makes sense. A: And, as I recall, she didn't nurse when we were in the first home that I remember, in the house that we lived in after we moved from Nanaimo to Vancouver. I don't think she did any special duty nursing at all when we lived there. We moved then a little further toward the downtown area of Vancouver, and at that time I attended school, and I think maybe that she did some nursing, maybe morning or afternoon as a favor to the doctor, to do "in house" nursing. That was where most of her nursing was done. I don't think she ever worked in a hospital at all after she left Nanaimo. But I remember making a meal for my brother and I. He was just a whippersnapper. And the meal that I made was "dark's Pork and Beans". A whole can. I put it into a pot, and put it on the stove and warmed it up and that was our dinner. The only reason I recall that was because that was our dinner. I had made the dinner, and I think on that occasion, Mother had probably been at work that particular afternoon or day. This was in the middle house that we were in. When we moved further towards downtown, I think she...that's where we lived when father came back from overseas, and at that time she may have done some of the nursing I spoke of, when he was there. So I think that explains that. I was confused about that, and I'm glad you raised this question. I was of the opinion that she did the nursing before...this was just my interpretation. Q: Well, you were very young. And it just didn't make sense to me. I knew your mother wouldn't have left a two year old alone. A: You are absolutely right as a matter of fact, and she didn't. Q. I knew she wouldn't. A: I'm glad to~I talked to him a couple of days ago—I'm glad to get that clarified. And you know, he didn't know Dad...This is interesting. He didn't know Dad to the extent that, in March of 1921, when Mother and he and I moved from Vancouver to Calgary, we came by train, and we got off at the CPR station in Calgary. And Mother told Bill, my brother, to go down the platform aways. She could see my father waiting for us. And Bill walked towards his father and didn't recognize him. Didn't know his father at all. Q: Really? A: Yes. Because he hadn't seen him to any extent. He was in Vancouver a couple of times after the war, but he didn't recognize him. Q Well he would have been just a baby when your dad left. A: Yes, he was born in 1913, you see, and Dad left for overseas in 1914 and he was just a year old. My dad was overseas for four-plus years, and that was a big part of my younger brother's life. Q Yes. A: So that was the sequence of events. Q Did your parents ever talk to you about...that must have been very difficult for your parents. I know that a lot of families went through the same thing, but that four and a half years of separation—being apart from your spouse and children for all that time—did they ever talk about that? A: Very seldom. I know it was difficult. We lived two blocks from Hastings Park. Hastings Park is where the Hockey rink and the other sporting events are held in East Vancouver. At that time it was a headquarters for mobilizing of men who were getting their uniforms and equipment and some training, and were going overseas. That's when they were outward bound. When they were demobilizing, after they had come from overseas, they were sent to Hastings Park and dispersed from there. We used to go, I can recall going to...what would it be...the mess? Where the cook cooked—the men cooked their meals... Q Yes. A: I can recall going to Hastings Park and getting bread for the chickens. Mother kept chickens at the back of the lot I think I'm right about this...I know I went and got bread from the Army stores. I used to go and get bread for Mother and she'd feed the chickens. I remember...It was difficult, but we coped. I think it must have been very difficult for my mother. Four years was a long time. And she wasn't long married you know, and she had just a year old baby when Dad left you know. And we moved from one house to the next, to an apartment. Q: Yes, when you think about it, it must have been difficult. Two small children. Probably there would have been some income...I imagine part of your father's army pay would have been... A: Yes. Part of his pay would come to my mother. Q But it still wouldn't have been very much. She would have had to be very very careful. A: Yes. I think that we were...we didn't want for any thing... but there weren't cars in those days or anything. We didn't miss much. It was a great experience. Q: Yes. When we left off last time we were just about.. .We were talking about you andlslay. I'm interested in the War years. I'm interested in the impact of the war on Lethbridge and on the practice of medicine. What was rationed for you during that War...the 1939 war? Meat and sugar were rationed. Gas? A: Yes. Meat was rationed, booze was rationed...(laughs). Sugar...But I don't think we suffered. Q: No?No, I don't think so. Q As a physician, would you have been subject to gas rationing? Or would you have had extra coupons because you had to make housecalls...? A: Oh yes, we made lots of house calls. You know...you've asked me this question, but I don't recall having gas coupons, or being rationed for gasoline. I don't know. Q: I wasn't sure. I know there was gas rationing in some parts of Canada, but I wasn't sure at all. A: I don't recall. Certainly I don't recall it being a hardship. The practice of medicine was not affected except at ...oh there are two or three things I should mention here. Not an inconsiderable...the work we did, as civilians and physicians...we had to examine, or we did examine people who were called up to go into the services. There were a large number of young men who we examined. I can still recall—the fee for examinations on those people was one dollar! Q A complete physical. A: Yes,, a complete physical. We had to determine that they were fit to go on into the services. After our examination, if they were called up, then of course they would be in the hands of the service personnel for another examination. We were sort of doing a preliminary assessment of their health, to determine who could proceed on into the services. Those who had obvious health problems, which we detected or became aware of, they were—they wouldn't go beyond us. Q Yes. A: I can remember going to the hospital, making my rounds at the hospital, and then going straight to my office every morning to examine people who were asked to report. I would spend most of my mornings that way. Q Really. A: Yes. Q I would imagine you would have had to do a fairly extensive physical. A: Yes, well you had a responsibility to determine whether they were fit to go on. You wanted to be...you had to be...you were responsible for serving your country in that regard. Q Sure. A: I became associated with the Sea Cadet organization here at that time, early in the War Years when Sea Cadets were established. I was taken on as what they called a Surgeon-lieutenant in charge of the medical aspects of the corps. After the first year in that position, the commanding officer left, and they appointed me as the commanding officer. I stayed in that position until after the war. We had a crew of about ten officers. Q One of the things that I'm interested in regarding the practice of medicine during the war years, is...did you see any signs of nutritional deficiencies...that kind of thing...during the war years. A: No I didn't. We were...we are an agricultural community. And the beef industry which is extensive here...mind you, a lot of our agriculture and animal products were sent overseas, but we never, as citizens suffered. I don't recall that anyway. We might have been short of sugar...that sort of thing... Q: That wouldn't hurt anybody I guess.(laughs) I'm interested in how...would you say that patients then were less sophisticated than they are now...Do you think that the doctor/patient relationship has changed in the years since you began your practice? A: That's a very good question. The pattern of practice at that time was different from what it is today in many respects, although in many respects it isn't, (pause) What was your question again? Q I asked about the Doctor/patient relationship. A: I don't think...I basically think, as far as my own personal practice is concerned, I don't think there was any basic change between practice in those days—in the late thirties and forties, and practice as it is today. I don't think...I think that the concern of the doctor is the patient. Q Uhuh... A: The doctor patient relationship, which is a very common statement, basically, is what medicine is all about. Or should be. Q Uhuh... A: I think that generally speaking, people, in this community anyways, have been given extremely good medical care. When I say good, I don't mean that we've had all of the avenues of specialty available, but the Doctors and the patients have had an understanding and an appreciation for each other. Generally speaking, the pattern of practice at the beginning of my practicing years, in the late thirties and forties, was more of housecalls...we were open...interestingly our office was open every morning. We used to practice in the office, after we went to the hospitals in the morning, we would come to the office and see patients until noon, have lunch, and then come back to the office for afternoon office hours, and we'd do that from 2:00 o'clock until five or six o'clock. We'd go home for dinner, and then come back to the office around seven and stay until eight-thirty or nine. So we were in the office every day, including Sundays, except Sunday evenings. We made housecalls, we did outclass to the hospitals... Q: I'll tell you why I asked. I was reading a book, published quite recently about the Doctor /patient relationship and how it had s changed over the years, and the author of the book had spent five or six days in a large clinic in Toronto. The average amount of time that a Doctor spent in the room, with the patient, during an office visit, was just under three minutes. I think that's changed. I think that Doctors and patients used to spend more time together. A: This would vary with the Doctor. I think that you would still find some doctors who have a very busy practice...you would find that they wouldn't spend more than a few minutes with the patients, quite often because they just wouldn't have the time to work them all in otherwise. Its true that there are patients who want a specific doctor, and it doesn't matter how long they have to wait, or how busy the doctor is, they want that doctor. There are still, I'm sure, doctors who are very busy, in terms of the patients they have to see, in the course of a day. It depends entirely on the desire of the doctor to see the patient, and the desire on the part of the patient to see a particular doctor. The pattern of practice, I think, is changing. Q: Uhuh... A: There are, of course, many more so-called specialists now, who are available for consultations or second opinions, and this, I think, is good. Its interesting...Its hard to put this in words, but we had a Doctor here, who was one of our senior doctors when I came, whom I really respected, and who I got to know over the years. His name was Dr. Peter Campbell. The Campbell Clinic is named after him. He was a fine gentleman and a good Doctor. He used to exemplify the advice that Oliver Wendell Holmes, a great jurist in the United States said many years ago: "Don't just do something, stand there!" (laughs) Q: Yes. (laughs) A: And this is what Dr. Peter was like. He would listen. And this is what many people wanted and still want...somebody to listen to them. Q: I think that maybe for many Doctor visits, a sympathetic ear is all that's necessary for healing. A: That's true. Our practice of medicine has evolved over the years to the point where the number of drugs that are now available, which have come in to use the last few years, comparatively few years, has multiplied many times. Q: Oh yes. A: You see, when I practiced first, we had aspirin, digitalis, very few other drugs for blood pressure, and other types of stomach trouble, bowel trouble and so on. We had antacids for stomach ulcers, (laughs) But now, the progress, with regard to pharmacology, this is now standard. So the practice of medicine carries with it, to me, not only greater opportunities of approach to illness, but also an equally greater responsibility with regard to knowing what drugs to use and when. This is some of the change that's occurred. Q: Yes. I would think that a Doctor now would have to set aside a certain amount of time every week or every month just to keep himself up to date on new drugs and new procedures. A: I think that that is true. The literature which is available, coming out from the professional societies: The Canadian Medical Association, The Royal College of Physicians and Surgeons of Canada, the—I just got a new publication today~the "Prairie Provinces Medical Journal"—the many excellent journals that come to us from Great Britain-"The Lancet"—the journal of the British Medical Association, and the journals that are published in the United States, the "Journal of Medicine," the "American Medical Journal". Circulars...there are many different specialty publications—all of them are excellent journals. To be on top of everything, the problem is for the busy doctor...when does he get to them? He has to take a night and bone up a bit—do what he can to get to it. there are journal clubs, where a few doctors will sit down once a week or once a month, and one doctor will be responsible for the highlights of one journal and another for another. Q: That's sensible. A: Yes, its a great help. The meetings, which go on, where there is attendance, in person, or conferences by telephone and television as so on. These help to keep us all up to date, and are all very helpful from an educational point of view. Some of the drug companies sponsor meetings at which experts come from Calgary or Edmonton or elsewhere to Lethbridge, for instance, and help keep us up to date. These are all part of the education process which is meeting some of the needs of medicine. Some of my experiences with new drugs are interesting. We were just at the cutting edge of sulfa drugs when I started practice. We had sulfanilamide, which was one of the first of the sulfa drugs, which was anti infection. Since then there have been many other sulfa drugs which have been refined and changed and still many of them are useful. Penicillin was the first antibiotic of consequence that we were able to use. It of course, was one of the great days of medicine. Q. I'm interested in some of your experiences with penicillin and the new drugs. Can you think of a specific case where you... A: Oh yes! I can remember a young man...I had...he had come under my attention through his father and mother and other members of his family. They were farmers east of Coutts, which was a fair distance way. I do remember his father coming in with a hemorrhage-what we call a sub-arachnoid hemorrhage—this is bleeding into the space between the brain and the enveloping tissues which cover the brain... Q Between the dura matter and the... A: Yes, and the pia matter. I can remember the father coming in. He was gravely ill, but eventually got better. They had three boys, and the one boy, who was the youngest of the three. I was called to see him one night, to come down to this hospital...He had been brought in by his parents, about eighty or ninety miles, and he turned out to have a bilateral pneumonia—what we call a double pneumonia. We had penicillin at that time. It was an aqueous solution, and had to be given every three hours, intramuscular. There was no oral penicillin at that time. It was just the only antibiotic we had at that time. I came down here, and slept at this hospital, and gave him the injections every three hours, and after 48 hours he began to improve, and he walked out of here about ten days later. Well, this was wonderful. Wonderful! I didn't have to stay the whole ten days you know, just about 48 hours, but that's what we did. It was just wonderful. A miracle! Q Yes. A: I remember another boy in this same hospital. He was the son of a chap named Hensen. He was with the YMCA. I had recruited him for the YMCA (which I was the chairman of the board at that time). I had gone to a course in Toronto for two months, a refresher course. We had lost our executive secretary of the YMCA at that time—he had submitted his resignation. And I was looking for, on behalf of the board, a man to replace him. I met Mr. Hensen in Toronto, and talked to him, and (fortunately) he decided that he would come west and join us at the YMCA here. He and his wife came. They had one boy, and he was in his early teens. He had rheumatic fever-he had had it at an earlier age. He was in about grade ten or eleven I believe when he had a recurrence of the rheumatic fever. His joints were affected, but more importantly, his heart, within days of the onset of the illness, It became apparent that his heart was being affected by the rheumatic fever. There was a progression of the heart, whereby the valves, the muscle and the lining of the heart were all affected by the rheumatic disease. This boy was...we loaded him up with aspirin, which was the only effective drug that we had for rheumatic fever at that time. We gave him aspirin until his ears were buzzing. But he wasn't getting better, he was getting worse. You could see it. His heart was enlarging, and the valves were getting more involved. And just at this time, this was just after the war... Willard Haig was one of the surgeons at the Haig Clinic. He had gone to the Mayo Clinic for a refresher course, and he came back from the Mayo at the time that this boy was here, at this hospital. I was commenting on this boy to Dr. Haig, and he said: "I've just come from the Mayo Clinic where they have used cortisone for rheumatic fever, and it worked wonders." So I phoned my old professor of medicine at the University Hospital in Edmonton, Dr. John Scott. He was, I think, the Dean of Medicine at that time, he had gone from being a professor of medicine to the Dean. I told him about the boy. He said: "Let me see what I can do." So he phoned Winnipeg and spoke to the Dean of Medicine there. His name was Bell, they called him Buzz Bell. Bell said yes, he would make the cortisone available on an experimental basis for this patient, providing he was given the medicine in a recognized research facility. Now the only place in Albert for that was the University Hospital in Edmonton. So Dr. Scott said he'd have the material, and if I could get him up there... Air Canada used to fly in here from Edmonton to Calgary to Lethbridge a couple of times a day. They had Viscounts. They were a nice plane, but getting him up to Edmonton was a question, a problem. We got him on the plane. We used two seats, had him stretched out, with Oxygen going all the time. We flew him to Edmonton on the Viscount...a regular passenger flight. The ambulance met us at the downtown airport in Edmonton. We took him over to the University Hospital, and he was put into a bed there. I stayed overnight, just to see how he was doing. He withstood the flight very well. He came home, I guess it was about three weeks later, and his heart sounded normal. There was no further rheumatic disease, and the cortisone had been effective at getting this boy back to health. That was in 1950? Maybe the late 40's. Q: It must have been exciting, because that was the time when all those new drugs were being developed. A: Ah yes. Very exciting. You know, that goes back 40 plus years. I had a phone call about two years ago, one afternoon, from that boy. Q Really... A: He was well, had never had another recurrence, he had graduated as an engineer, and it just sent a thrill through me. Q Oh, I'm sure it did. That's wonderful! A: To my knowledge, that was the first cortisone used in Alberta. It was on an experimental basis. Dr. Bell had been given responsibility for this area of Canada, to use the drug. Q: Can we go back for a minute? I'm interested in that man you said had a sub arachnoid Hemorrhage, and he got better. A: He got better. Q Did you have drugs then like Mannitol? or something like that? How did you treat that sort of thing? A: We didn't have a treatment. As a matter of fact the treatment that we undertook at that time was that I put a needle into the spine, into the spinal canal, and the diagnosis was established of course by the fact that he had a severe headache, and there was blood coming out in the needle from the cerebro spinal fluid. Q: Uhuh... A: There was no treatment when the bleeding had occurred. At that time there was no treatment, except to relieve pressure as much as we could. That was accomplished by putting a needle in every day, and pulling blood out. Or rather fluid out. I guess it took about ten days, and then he got better. He wasn't a young man. I guess he was past 50. Q: He was lucky. A: He was very fortunate, yes. Q I just wondered about that, because I know that that can be very serious, even with all the new drugs and technology we have now. A: Yes. We only had one neurosurgeon in the province at that time. Dr. Hepburn at the University Hospital in Edmonton. I can recall, as an intern, after I had finished my courses, my lectures at the University, I worked at the University Hospital as an intern for a while. I can remember one young man being brought in, while I was on the neurosurgeon's service. He was brought in from out in the country outside of Edmonton in the middle of the night. He had a sub arachnoid hemorrhage, and there was nothing we could do. He died that night. Q Yes. I knew it was very serious. And I knew that you didn't have things like Mannitol then, or ways to measure the inter cranial pressure. A: No we didn't have that then. Q. I'd like to get your feelings on...there are issues that physicians face now, that perhaps weren't considered as important...I'm sure you still faced them, but they weren't in the newspaper every day...things like child abuse. Did you ever have situations in your practice where you suspected that might be happening, or... How did you deal with it? I know it must have been happening...it didn't just start in 1980. A: The only definite occasion we found that there was child abuse...frank child abuse...was where the child had been terribly treated by the parents. It was a small baby, the parents had really abused it. The child died at the emergency department of the old regional hospital. We notified the police about the parents, but I don't know if any action was ever taken. Is that the type of abuse you mean? Q. Yes. Its an ethical issue that physicians have had to deal with in the past 20 years or so—there are guidelines and rules now about what has to be reported, when it has to be reported and who has to do the reporting and so on. A: Yes, we were responsible for reporting that. I was on call that particular weekend, when this child was brought in. We had pediatricians. We had a pediatrician in our own clinic—Dr. Cairns. Now we have three or four pediatricians in the city. But that was the only case I was personally involved in, and that was only because I was the doctor on call for our group on that occasion. Yes, that was a very unhappy situation. Q Was it an issue that you may have grappled with, in your clinic, with the other physicians? You know if you didn't see it in your practice, perhaps the pediatrician or the general practitioners did. Did you every talk about it among yourselves? Was it an issue that came up? A: Not very often, no. It would be pretty apparent. No as a rule...it's not easy, and its a very serious decision that you have to make. Q: Yes, I know. It seems that now there are guidelines and even laws in place-teachers and physicians are required by the law to report suspected child abuse. Those laws weren't in place in the 40's A: No, they weren't. Q: I wondered how it was dealt with... A: Yes. Fortunately its very unusual. But it does occur. A: You know, I should get you a copy of the interview I did In Calgary that time. There were parts of that interview that had to do with my experiences relevant to the Alberta Medical Association, of which I was the president at one time. It was part of the concept of the need at the time, when I was president, for a second Medical School in Alberta. I took the opportunity, in my presentation as president elect, when visiting different districts of the province, and the Medical Societies in Calgary, raising the subject there, of requiring another medical school. And that of getting the school in Calgary. We were at that time beginning to need, with an increasing population, a second school. And that developed partly as a result of my concerns in that regard. The other thing that has been a part of the changing scene in Alberta, and in Canada, has been the development of prepaid medical care. Have I talked about that? Q: Well, we didn't talk about the Canadian Medical Plan. We talked briefly about the Lethbridge and Haig Clinic's prepaid medical care plan in the thirties and forties, and I guess fifties, but we haven't talked about the Canada Health Act of about 1964? A: Yes, the Saskatchewan experience. Q Let's talk about that right now. We don't have to stay in chronological order or anything. A: Well this is something that I haven't done since I gave that presentation in Calgary. It was fresher, or at least fresher in my mind at the time I gave that than it is now, but briefly, the concept of prepaid medical care was established in this community long before I came. I think I've told you about that. Q Yes, you have. A: The evolution from the private contract concept of care... and the contract that were in existence when I came here, in 1938, which included the teachers, the Lethbridge Northern Irrigation District contract, which included the farmers which were on the Lethbridge Northern, the miners, (the various mines were still operating, and had contracts with the doctors for their medical care, some of which would include not only medical care, but hospital care, some types of operation, or a percentage of the fee for the operation. The same thing regarding maternity care. And in one case that I recall there was one contract that actually included drugs. Those were existing for years before the eventual evolution of prepaid care as we know it. From the time when Medical Services Incorporated, M.S.I., developed from within the profession itself, and was actually developed, the general manager of which was Dr. Steve Smalz, who was with the Roy Clinic in Lethbridge. He was quite an expert at prepaid medical care, in Lethbridge, having been helping to manage these other groups in Lethbridge and so on. So he eventually moved to Edmonton as general manager of M.S.I. M.S.I. of course, it was replaced by the Alberta Health Plan when the government took over. M.S.I. was operated by the profession. The Alberta Health Plan came into existence of course when the government came into the picture to supervise the plan and distribute the funds and so on. Q Prior to M.S.I., in Lethbridge, while you had these different contracts, did you have an agreement on fees for services? Say one fee for obstetrical services, pre natal care, the delivery and post natal care? Or an amount that was agreed upon for say a gall bladder removal? A: Yes. This was a fee structure, and it was under the direction of the College of Physicians and Surgeons of Alberta. There are two organized bodies in Alberta: The College of Physicians and Surgeons of Alberta, which is responsible for licensing doctors, and for discipline, and they were at that time also responsible for the setting of fees. They would give a fee schedule. Q Was the doctor bound by that fee schedule? Or was it more like a guideline? A: I think it was guidelines, generally speaking. But I know there were many doctors who would not charge the full fee during years like the thirties when things were tough, and there wasn't a lot of money. That's when sometimes we would get a turkey on our doorstep, (laughs) But in any case, to differentiate between the College of Physicians and Surgeons and the Alberta Medical Association, the AMA is a doctor sponsored groups which is responsible, and has been responsible for...it is responsible for organized medicine, so to speak. They are responsible for all the "parts" of the practice of medicine. Those parts, nowadays, (its been changed from the College to the AMA~the question of fees is now in the hands of the Association) They are also responsible for the many, many committees that work in every area of medicine in the province—hospitals, fees (as I said) child health, anesthesia..there are many different committees that are responsible for functions as departments of the AMA. Q And those committees are usually doctors who volunteer or...? A: Yes they are doctors. Often they volunteer, and the committees are set by the executive committee. Q. I'm not sure that I understand exactly how they work though....The college is the disciplinary body. A: The College of Physicians and Surgeons of Alberta...and this body exists in every province...they are responsible for licensing. That is, if you want to practice in Alberta, your application has to go to the college and they have to approve the application. They determine if you have had adequate training, adequate education, and whether you um.... Q Know what you';re doing? A: Whether you've been a "bad boy" or not...(laughs) That's the College. They have their own committees and they are responsible for other aspects...disciplinary, licensing and so on...other aspects of medicine. Q: How does it work then...I know that the CMA and the AMA have ethics committees...! know that because you were the chairman. How does it work...for example...If a patient had a complaint about a doctor...If a patient sent a written complaint to the AMA saying "this doctor behaved unethically "...who would investigate that complaint? A: That's a good question. The general subject that you're raising would fall under the matter of discipline. And discipline is the College. Q: Yet its the AMA who establishes the ethical behavior rules, right? A: This is true. They...on behalf of the physicians of Alberta, the AMA observes the Code of Ethics of the Canadian Medical Association. They formally accept the code of the CMA. The college administers the discipline. Not the AMA, the CMA. Each College, in each province, will be responsible for discipline. And they function! They are a quasi-judicial body. They meet, and they can... Q They can revoke licenses? A: They can revoke licenses, yes. Q. There is also an overarching Royal College of Physicians and Surgeons? A: That's a different group. Q How does that connect with the individual colleges? A: They're not associated. The College of Physicians and Surgeons of the provinces is licensed by the provincial government and they are autonomous. The Royal College of Physicians and Surgeons of Canada is a specialty educational and certificate granting body. If I want to become a specialist, they will tell me how many years of training I have to take for the various branches, and where they would approve me going to take it. They wouldn't approve me working in a hospital in Lethbridge, for example, because there's no teaching going on in that hospital. Q: Right. A: So they determine qualifications and the training accomplishments for specialty licensing. You get the sheepskin from them to indicate that you are a specialist. Q: That's the Royal College. A: Yes. Q: And the provincial colleges are basically for... A: Licensing of physicians. They are responsible for the doctors in their province. Each province has their own college for licensing and discipline.

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