Allan Detsky Reflects on Order of Canada Recognition

They desire a better country. These words, the motto of the Order of Canada, ring especially true for one of the Order’s most recent recipients, Dr. Allan Detsky, a Professor at IHPME who has been recognized for his lasting impact and public service in the betterment of the Canadian health system.

“Of course it is a big honour, any Canadian would be proud,” said Detsky, pictured above with granddaughter Blair. “My grandparents, who immigrated from Poland 100 years ago, would have never imagined in a million years that their grandson could receive this kind of recognition.”

In 1988, Detsky joined the Drug Quality and Therapeutics Committee, a body responsible for advising the Minister of Health on how best to pay for drugs under Ontario’s health program. At the time Detsky joined, there was little consideration of the cost-effectiveness of drugs covered under the program, and few guidelines to assess the value of pharmaceutical products being delivered to the public.

“I had not participated in something this broad-based before, we required extensive consultation from the academic community around the world and industry in Canada as we sought to establish Ontario’s guidelines,” remarked Detsky.

By 1994, Ontario published this set of guidelines making it only the second jurisdiction in the world next to Australia to have this prescriptive set of rules for the pharmaceutical industry. For the general population and on a national scale, these guidelines meant resources for health care could be used more efficiently by promoting payment for products that had good value and effectively improving patient outcomes by ensuring only the most economically attractive drugs were paid for by the government of Ontario.

A similar document was soon adopted at the national level, which Detsky co-authored. It formed the basis of principles used by the Common Drug Review at the national level to interpret the value of new drugs.

While Detsky has achieved these great successes in the policy world, he has also been, for many years, a very active physician and general internist, as well as a teacher.

Upon his arrival in Toronto in 1980 Detsky began teaching the health economics course for IHPME’s MHSc students, a course he has returned to teaching in the last few years. This is a program he considers to be at the core of the Institute’s mission to implement improvements in health system design.

Over the course of his career both at IHPME and the Faculty of Medicine he has taught over 4000 indivuduals from pre-med and medical students, residents fellows and faculty members many of whom have have gone onto successful careers in clinical and academic medicine.

“I’ve watched the careers of David Naylor, Allan Garber, Jack Tu, Angela Cheung, Chris Booth and Valerie Palda, just to name a few unfold, and it has been the most personally fulfilling to have advised them and helped them on their way,” said Detsky. “If there is one thing I hope to do at the end of my career, it would be to transmit what I have learned about being an attending physician to the next generation of doctors just starting out.”

For Detsky this includes encouraging new physicians to develop a stronger connection to delivering direct clinical care, something he continued to do even while he was Chief of Medicine when he did five months of inpatient medicine per year.

“I’m very front-line oriented,” said Detsky, “I know a lot of MD’s who have had successful careers in research who have left medicine, but I think it is important for clinical leaders to participate in direct patient care.”

Detsky also advocates for physicians to take ownership of their patients, communicate with consultants and ensure continuity of care. He admits to looking at his patients radiological images alongside the radiologist, and to following up on requests for referrals, “I don’t just let it hang there,” he said.

“I would like to develop a curriculum for new doctors and attendings to pick up these skills,” continued Detsky, “because it is not something you learn in your residency. You learn medicine of course, but not how to become a doctor.”

It is this kind of commitment to our health system, our young leaders, and the next generation of doctors and health administrators, that makes Detsky a deserving winner of one of Canada’s highest civilian honours, as he very clearly desires a better country and a health system for us all.