As an anesthesiologist in a busy northern Alberta hospital, Alika Lafontaine’s professional world is defined by high-pressure situations.
But even he was unprepared for the level of intensity he would take on as the new president of the Canadian Medical Association, one of the largest and most influential health advocacy organizations in the country.
“I was too ambitious about balancing my life over the next 12 months,” said Dr. Lafontaine, who began his one-year term in August by traveling the country meeting other leaders and health professionals.
At 40, Dr. Lafontaine, father of four children aged 8 to 14, is the youngest president of the 155 years of CMA history. Of Métis, Cree, Anishinaabe and Pacific Islander ancestry, he is also the organization’s first Indigenous leader.
Dr. Lafontaine’s mission, as he takes the reins, is to convince political leaders and decision makers that now is the time to make real and substantial change to systems that have been floundering for decades.
The stakes couldn’t be higher. Over the past few months, emergency room wait times across the country have set new records. Earlier this month, an elderly patient died of an apparent aortic tear in a Quebec emergency room after waiting 16 hours without being seen by a doctor. And a rural hospital in Chesley, Ont., announced that its emergency room would be closed until December due to severe staff shortages. Healthcare workers are reporting unprecedented levels of burnout, with many leaving the profession. And with the number of resident physicians choosing family medicine at its lowest point in the country’s history, millions of Canadians can’t find a family doctor and do not have access to basic medical care outside of an emergency room or walk-in clinic.
Since assuming leadership of the CMA, Dr. Lafontaine has spoken with ministers of health and other elected officials, healthcare professionals and patients about his vision for change and that of of the CMA – primarily, that Canadian leaders would focus less on reducing upfront health care costs and more on patient outcomes and how best to achieve them, for example by investing in family caregivers.
Dr. Lafontaine has a reputation for being friendly and diplomatic, but he often pushes back against misguided narratives, such as the idea that Canada needs to find innovative solutions to its health crisis. If you spend even a few minutes on the subject with him, he will remind you that the country’s current health problems date back decades and the solutions have been clear for just as long.
His immediate predecessor, Katharine Smart, made headlines earlier this year when she proclaimed the country’s healthcare system had collapsed. And Dr. Lafontaine is following in those footsteps by speaking publicly about the complete lack of vision and political will that has brought Canadian health care to its knees. He is frustrated, for example, that Canada does not yet have a national license for doctors, which would allow them to work easily anywhere in the country and immediately address current shortages.
“There’s some high-level stuff that we’ve been talking about for years. If we did, it would transform how the system works,” Dr. Lafontaine said. “We have these conversations and then the crises end and we move on.”
He’s equally outspoken about the human resource shortages that are wreaking havoc in institutions across the country. Instead of tackling the problem, he said, hospitals allowed medical professionals to cover the shortfall by working too many shifts, past the point of exhaustion, creating potentially hazardous conditions. “Now the system is breaking down because people have gotten to the point where they’re saying, ‘I’m just going to walk away.'”
But he is also full of hope for the future. Regarding the balance between health care costs and health care outcomes, he believes that a shift towards the latter is not only possible, but the best way forward. ensuring patients receive high quality care that will also save money in the long run.
Beyond the work he is doing at the CMA, Dr. Lafontaine also hopes that as someone who had a difficult experience in school, he can be a role model for young people with similar difficulties who wish pursue the medical profession.
Although he graduated from high school at 16, got his first college degree at 19, and took the medical school entrance exam on a challenge — and he made it – he had long struggled with self-confidence. Growing up in Regina, he was told he had a learning disability that would put high school graduation out of reach.
“For a long, long time I felt broken from the experiences I had as a child – I was told you’ll never finish high school or go to college because that you have these learning challenges,” said Dr. Lafontaine. .
He credits the support of his family for helping him excel in his studies. His mother chose to homeschool him from 7th grade, an arrangement that continued on and off through high school. Over time, it became clear that he was just as capable as any other kid, and maybe more.
“I ended up having a bit of a surreal shift,” Dr. Lafontaine said. “I went from being labeled as someone who would never accomplish anything to someone being labeled as gifted.”
Having that knowledge still didn’t erase the feeling he had that he wasn’t going to make it. During his undergraduate years at the University of Regina and the University of Saskatchewan medical school, he was often one of the only Indigenous faces in the room, which made it difficult for him to feel ‘membership. Dr. Lafontaine said the first few weeks in medical school in particular were so overwhelming and difficult that he almost dropped out. He recalled an instance in those early days when he asked a professor for extra help with his workload and was rejected.
“I remember at that point I walked out and was like, ‘Why am I here? I don’t have a family here, I don’t fit in with the other kids that are here, I should just go. Who am I kidding?'”
One day in that freshman year, he ran into Val Arnault-Pelletier, the school’s Aboriginal coordinator, on campus. A chance meeting that will change everything.
“I just fell in love with her and told her everything I felt,” recalls Dr. Lafontaine.
She stepped in, arranging meetings for Dr. Lafontaine with William Albritton, the dean of the medical school, and helping him continue his education. Dr. Lafontaine remembers going to Ms. Arnault-Pelletier’s or Dr. Albritton’s office any day of the week and that they always took time for him. And when he came up with a strategy to recruit more Indigenous students into residency training, they both helped him put it in place.
“Her and Bill are the reasons I passed medical school, to be honest,” he said.
Now he hopes he can be an inspiration himself. “I really hope kids thinking about medicine see me and say, ‘If he did it, I could do it too.'”
Ms. Arnault-Pelletier said she was not surprised to see Dr. Lafontaine take on the role of CMA president, as it was clear during his student years that he was a natural leader and that he often held mentorship positions. Beyond that, it also embraces the core values of Indigenous teachings, including honesty, wisdom and bravery, she said. “I could see he had such a kindness about her.”
While Saskatchewan will always be Dr. Lafontaine’s home – his parents still live in the house where he grew up in Regina – he now lives in Grande Prairie, a town of about 67,000 in northwestern Alberta, with his wife and children.
Dr. Lafontaine said becoming head of the CMA was never part of his long-term plan. But much like other key moments in his career, the support of others led him to believe he could do it. And he believes fixing the health care system means bringing people to the table who historically haven’t had a voice, including more Indigenous people.
“If you continue to have the same perspectives on decision-making, you will have the same solutions,” he said.
Now that he has a seat at the biggest table, Dr. Lafontaine has pledged to dismantle the health status quo, saying the time has come for tough conversations and real change.
“You can’t ignore the big issues,” Dr. Lafontaine said. “You have to cross them.”