PSI History Video Transcript
It started as a simple idea, and soon grew in a short time to become a phenomenon.
Physicians’ Services Incorporated, PSI as it would come to be known, opened its doors in November 1947. The times urgently called for a new approach. Doctors in Ontario decided to take action. They wanted to provide comprehensive medical care at a price public could afford and by a method of payment that was convenient and suitable.
Created by the OMA, PSI was operated as a non-profit, independent corporation with its own charter, president, board of directors, and council. It provided unlike insurance companies, a service contract with subscribers, which guaranteed the payment of medical services. To the profession, PSI offered doctors an opportunity to retain control of their business and professional affairs, while leaving the doctor-patient relationship undisturbed. On the human side, it presented a unique challenge for the medical profession to make a real contribution here in Ontario. The participating physicians, your senior colleagues, were the cornerstone of the corporation. Without their cooperation, sense of responsibility, and fairness, there could not have been a PSI. They deserve a great deal of credit for its success.
From the beginning, there never was any doubt about its success. This was due in large measure to the acumen of the management and people who worked with them. Dr. Melville C. Watson, the first president of PSI, was a man of great character, integrity, and vision. A brilliant organizer, he had a special talent for selecting outstanding executives, people like Stewart Major, the first and only general manager of PSI. Mr. Major energized the organization. His dedication, enthusiasm, and eye for detail were important assets that helped PSI to grow for nearly 22 years of enjoyed overwhelming success and became the largest pre-paid medical plan in Canada.
Unfortunately, the end of PSI as a medical plan came in 1969, when the present day OHIP came into being, with legislation prohibiting any other carriers to provide coverage for physician services. With a substantial amount of money remaining in the fund, the 7,250 participating doctors decided to establish a foundation, the income of which would be applied to charitable activities within the health field, The Physicians’ Services Incorporated Foundation.
(3:08) Mr. Arthur Bond: “The doctors who initiated the foundation had a deep regard and concern for their fellow men. And this concern carries on even to this day through the men and women now serving on the Board of Directors. “
The original donated capital of 16.7 million dollars has grown to 65 million dollars. During the same period, the Foundation has expanded on granting activities over 44 million. Today, after 23 years in operation, the PSI Foundation has more than lived up to its original mandate, the advancement of the state of knowledge of a particular disease, the increase in the physicians’ ability to ease the suffering of a patient, and improved access to medical care by patients.
(03:57) Dr. David McNeely: “The grants awarded are looked upon as investments to improve the healthcare of the people of Ontario. The return is measured by the many worthwhile projects supported by the PSI Foundation that result in scholarly publications. These projects are in the areas of health education, health care delivery, and medical research.”
PSI Foundation has supported many different research programs. Among those programs, kidney disease, health care delivery, diabetes research, community-based research, Parkinson’s disease, anaesthesia, arthritis, liver diseases, HIV and AIDS, health systems research, pediatrics, orthopaedics, burn treatments, obstetrics and gynecology, and medical education research.
We would like to now introduce you to a few of the grantees. Dr. James Ruderman and his colleague Dr. Heather Morris (05:00) are studying the effects of obstetrical triage on rates of obstetrical intervention.
(05:07) Dr. Jim Ruderman: “What who we’re looking for was an innovation in healthcare. This triage will represent a big step. It is a different way of doing something that’s been done as certain way for a long time. Our PSI Foundation grant will help us to determine the answers. In the future, it could assist hospitals for becoming more economical and efficient, decrease a woman’s hospital stay during labor and delivery, plus potentially decrease interventions while still maintaining the best care for the mother and baby.”
In the early years, the Foundation leaned towards supportive (05:38) healthcare delivery projects, such as the mobile eye-care unit of the Ontario division of the CNIB. The first unit was put into service in May of 1972, to help care for residents of towns in Northern Ontario, who otherwise would do without or have to travel great distances. This updated unit is staffed by CNIB ophthalmic assistants. Together with volunteer ophthalmologists, they visit small communities performing examinations and deducting (06:10) informal discussions with local physicians. Additional funds have been awarded throughout the years, because of the historical link with the program.
Community-based research grants allow physicians in community settings to undertake a review of their practice patterns, to enhance their effectiveness, and improve patient care. Dr. Grant McKercher of North Bay was awarded a grant to assist him in assessing the needs of caregivers of the elderly.
(06:44) Dr. H. Grant McKercher: “Though there is a relatively high range (06:45) of institutionalized care for the elderly in Canada, the vast majority remain at home, often with supportive, informal caregivers. It’s important to know the needs of these caregivers. My study will hopefully provide information which will aid in the planning for future support services in the community.”
The PSI Foundation has supported a number of projects by Dr. Dimitrios Oreopoulos (07:08) of Toronto Western Hospital in the area of ambulatory peritoneal dialysis.
(07:15) Dr. Dimitrios Oreopoulos: “Back in the seventies, few groups would support my type of research. PSI Foundation have helped us to develop the viability of the technique of continuous ambulatory peritoneal dialysis. We proved in large numbers that it’s very effective. And even today we’re still feeling (07:33) the benefits of this research.”
The Physicians’ Services Incorporated Foundation.
(07:41) “The PSI Foundation has been instrumental in affecting changes. Leading-edge changes.”
(07:48) “The medical profession highly respects and appreciates what the PSI Foundation has helped to accomplish for the people of Ontario.”
(07:56) Dr. J.A. Spencer: “PSI Foundation is an organization where some of the small or more independent studies, such as community-based research, can find funding.”
Over the years, the PSI Foundation has provided hundreds of physicians with fellowship support to undertake training. This program is directed toward physicians residing outside the teaching centres, who wish to bring a needed clinical skill or knowledge to a community, or to undertake training in research methodology.
(08:28) Dr. Thomas C. Elsdon: “The procedure that I received funding for from the PSI Foundation is called the laparoscopic pelvic lymph node dissection. At the time that I received the training, there were no urologists in the Windsor capable of doing this procedure. Patients would have had to travel to London or Toronto or another teaching centre to receive this operation. Since I received my training, I have done over a dozen of these procedures and patients can now be looked after locally.”
Quietly, effectively, through sensible financial planning, the PSI Foundation has grown into a major granter in Ontario. Arthur Bond, the first Executive Director, played a significant role in the success and it was fitting that a new award be established in his honour. The Arthur Bond Fellowship is awarded to physicians with a special interest in innovative healthcare systems research. Dr. Robert Hayward is the first recipient of the award for his work which includes the development of patient-driven computerized questionnaires, which gather health risk data. He is also in receipt of a research grant, for studying ways to change physicians’ behavior to make the quality and the efficiency of healthcare better. The results of this survey could have important implications for the development, dissemination, and implementation of clinical practice guidelines in Canada.
(10:00) Dr. Robert Hayward: “Well it’s tough for young investigators today, particularly for those interested in applied clinical or health services research. There are fewer and fewer sources of funding and it’s uh universities are hard-pressed to provide the kind of support that you need. So for me the PSI was a God-send; this Foundation was interested in new innovation, they wanted new proposals, and best of all they’re genuinely interested in giving a young investigator a good start.”
(10:27) Dr. Ken Mustard: “We intend to continue our ongoing commitment to traditional university-based clinical research. And we also want to expand funding for more direct patient-contact type of research.”
(10:40) Dr. Harry Bain: “The Foundation perceives a gap, a real need. We would like to support investigators who would otherwise not have protected free time to conduct innovative health service research.”
The PSI Foundation is a very unique organization. There is a sense of family in the dealings between the Foundation and its grantees, and a special feeling of pride in their achievements. This extends to the many physicians in the province who act as unpaid reviewers of the many projects submitted to the Foundation for support. Without the assistance of these men and women, and their dedication, the Foundation would not have achieved such a measure of success. Physicians’ Services Incorporated, the Physicians’ Services Incorporated Foundation, proud names with significant historical roots here in this province. Both have made important contributions. For tomorrow, the PSI Foundation will continue, as it has in the past, to strive, to improve the state of healthcare for the people of Ontario and beyond.