Volume 11 | No. 6 | Nov / Dec 2023 query_builder 5 minutes

Outgoing registrar’s message: reflections on two decades in medical regulation

Dr. Heidi Oetter


Dr. Heidi M. Oetter retired in December, after nearly two decades working at the College, first as deputy registrar since 2004 then as registrar and CEO since 2008. She sat down with the College Connector editorial team to reflect on her time in medical regulation.

Tell us about the evolution of medical regulation since you started at the College.

When I think back to 2004, professional regulation was viewed as exclusively the domain of the professional. This has certainly evolved—now we see regulation as shared work done by both the public and the profession. While it may still be described as professionally led regulation, it is clearly a shared model and there is an expectation that the public is able to participate and contribute.

Since 2004, there has also been a significant transformation around transparency. Regulators are required to show the end product of their work, but also be open about how that work is being done. 

Another meaningful change since 2004 is the clear expectation that in addition to licensing registrants and addressing complaints, regulators are administering quality assurance programs to ensure registrants remain competent and fit to practise over their career. I think the College was a little ahead of the curve when I started here because they had already started this proactive work, which is now a regulatory requirement.

More specifically, how has the College changed since 2004?

Nineteen years ago, the College was a small organization. Since then, we've greatly expanded and we’ve developed a business enterprise approach to our regulatory work. We have a variety of departments with different business plans and budgets that work together to support our overarching strategic plan. 

We have moved from an organization based entirely on paper files and brought it into an electronic world. Going electronic has not only been positive for ensuring effective records retention, but has also allowed us to become a data-driven organization. We can extract meaningful reports on everything from the diversity of our employee workforce to complaints trends and use that data to make strategic decisions.

What stands out as milestones or pivotal moments in your career here?

One change that comes to mind is purchasing and moving in to our current office space. I think moving downtown to a modern corporate space was very symbolic because it was also a time that we were developing a modern executive structure and embracing technological change. During that time, we brought in a lot of skilled staff to do our work—not just physicians, but professional staff with expertise in all areas of the business. We made sure to hire the right people to help us evolve into the future and that we were supporting those people in their professional development.

What developments or achievements are you most proud of?

One is our new brand—this was a really significant project which required support from our entire Board and staff. A major part of deciding to take on a project this big was our commitment to decolonization. You can't really start to decolonize unless you can admit that you are colonial. So I think it really shows the willingness of our Board and our staff to self-reflect and decide that it was important to retire the colonial crest and adopt a modern logo reflective of our values. It’s also been very gratifying to see our staff living our new brand strategy―I can really see that every day at work.

Another achievement I’m proud of is just working with a resilient and sophisticated organization that can take on anything. We have played an important role in many complicated health-care circumstances over the past number of years, including the COVID-19 pandemic. The next major project will be the transition to a new legislative framework, the Health Professions and Occupations Act (HPOA), and I have every confidence that we will successfully shift to and grow under the new Act.

Looking ahead, what is the biggest opportunity you see for the College and for regulation in general?

I see a big opportunity to continue to evolve our regulatory processes to address the inequities in our health-care system. The Human Rights Code is embedded in the HPOA, which signals a new and important direction. The HPOA states that “in exercising the powers and performing duties under this Act, a person must act to protect the public from harm and discrimination”—this is the first time we've seen discrimination articulated as more than and distinct from harm. 

So, there will be an explicit expectation to support and promote reconciliation with Indigenous Peoples and to address Indigenous-specific racism. The College has an opportunity to engage in regulatory processes that are anti-racist, to protect patients from discrimination, to ensure that physicians and surgeons are aware of the requirement to treat patients in a culturally safe and respectful manner, and to promote open dialogue that encourages patients to participate in their health-care decisions.

What words of advice do you have for your successor, Dr. Patrick Rowe?

Patrick needs no advice from me. He is a consummate professional and he really understands the work of the College, having served as a board member for a long period, and as president for two terms. He also brings years of direct experience as a front line physician working in Northern Health.

What are you looking forward to in retirement?

I'm just looking forward to spending time with my family and friends! But I will say that I am going to miss everyone here who I have worked with, some for many years. And I'm certainly going to miss what I think are the exciting opportunities for regulators, in particular, advancing our work in cultural safety, cultural humility, and reconciliation.

Heidi M. Oetter, MD
Registrar and CEO

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