I always knew I wanted to be a social worker because I wanted to help others. Growing up in a small rural community, being in service to others was how my mother, a registered nurse, spent her career at the coal face of health care in our community. She was always on duty, whether she was in her uniform, or raising her 9 children. I watched my mother give tirelessly with compassion, kindness, and professionalism.

As a social worker, I retired early and returned home to care for my parents when they were both diagnosed with cancer. Grief and anger were a hard pill to swallow as our family faced many challenges in accessing and securing care for our parents. I gave an interview to the local newspaper in frustration, which devasted my mother. As a result, I promised her I would get involved with the health care system, never speak ill of it, and do my best to change it.

The Saskatchewan Patient First Review 20091 called for changes to how patients experienced the health care system, how health care services were delivered, and how the system was administered. I was in the right place at the right time. I was asked to speak at the Cypress Health Region Board to share my story. Having spent many years as a social worker, I understood the culture. As a patient partner for a number of organizations, I received on-the-job training, as there was no formal training, and it was at this time I became interested in measurement and patient-oriented research. I did not understand this culture, but I was mentored by many leaders, clinicians, policy-makers, and researchers willing to share their knowledge and wisdom.

With privilege comes responsibility: To understand the values of the community, the need to see things differently, and to bring voice and vision to how health care could be co-designed, co-delivered, and co-evaluated. A person-centred approach not just from the top down, but also the bottom up. To ask what matters to the patient and the community. To also understand what matters to the clinician, the health care system, and the researcher.

It was after reading Indigenous scholar Dr Shawn Wilson’s book, Research is Ceremony: Indigenous Research Methods,2 that I began to better understand the meaning of relational equity, where every voice is heard, supported to be heard, and equal. Equity, inclusion, and diversity matter. Relational equity is also something carefully cultivated and preserved by those who desire to influence others through trust building. Health care is personal to the recipient of care and a trusting relationship is essential. The importance of trust is also about the provider of care and how their role is valued, as well as how they find value and are recognized for the work they do.

Diversity is more than language or culture. It is understanding our differences as they relate to experiences, beliefs, and perceptions, and through it all, finding a path forward that co-creates trust, facilitates trusting relationships, and creates a profound sense of belonging. The co-creation of a community of belonging where relationships are centred in relational accountability and relational transparency is critical to addressing dilemmas and discovering new ways of caring for patients and their families.

In my journey, I have been guided by many individuals who have given me guidance and wisdom. I have developed an appreciation for policy, continuous quality improvement, and evidence-informed research. Research with the community, led by the community, within the community.

The health system of today has changed and is very different from what was envisioned when universal health care was introduced in Saskatchewan in 1962, and in the rest of Canada between 1968 and 1972. What has not changed is the importance of our relationship with primary care providers and the desire for care to be delivered with compassion and caring, as close to home as possible. Health system transformation requires willingness and vulnerability.

The opinions expressed in forewords are those of the authors. Publication does not imply endorsement by the College of Family Physicians of Canada.

Cet article se trouve aussi en français à la page 376.