TRANSCRIPT

Judith McErvel: You might refer to the beginnings of SHUTC too.

Martin Barkin: Yes, I've got quite a story.

MB: We're now sort of in 1968, 69 and we were trying to build a staff here. And we had a little staff association some of the first surgeons to join the staff, people like me and Marv Tile that I think were some of the first... at that time we called ourselves the young surgeons. I don't know that we would dare use that term today.

Judith McErvel: Well it was true then.

MB: But Al Harrison asked me if I would write a report on how the medical staff should organize itself. And this, it was his view that we had a unique opportunity before we built up an entrenched staff that had a modus operandi, we could try to set up something and he had in his mind's eye that Sunnybrook should be like in Mayo Clinic with a medical staff dedicated to the hospital in some way as opposed to each medical staff being an independent self-employed entrepreneur operating for service. Because I'd had a fair amount in my, through my medical school, business experience. I'd run my father's business, and run a chain of coin operated laundry machine and had a textile plant and built a bunch of apartment buildings, all the while this was going on they thought that I had enough business sense in me to do that. So it was kind of a report of one, and I think that report will be found somewhere in the SHUTC archives.

It was the report that described the exact way that SHUTC should be set up.

Oh, really?

Because Al gave me, and in that I coined the term semi-autonomous clinical units. In other words, each clinical unit or each clinical division would have its own global budget that the doctors would be paid a salary centrally, that we would have a central pension fund administered by the U of T because we were technically employees of the university of to under that circumstance. And that by pooling their revenues they could recruit experts who did not necessarily, who could not in the beginning support themselves in their own earnings, but who the group would support from the collective earnings. And the second thing, by pooling the earnings in the individual units, we could have the individuals in those units become more focused and more specialized, so that they could do what they were best at doing without having to worry about whether this was good or bad for making a living. And we no longer had the internal competition, 'I need more operating room or space, I have less operating room than him.' It was a question of each service had a lot of operating time and those who could best use it would use it. And that became Sunnybrook University of Toronto Clinics and I was on its first chairman I think was Art Chisolm, if I'm right. The first executive person on it was Al Harrison, and in fact Art Chisholm and Al Harrison signed the first letters of incorporation and put up the necessary few hundred dollars for the lawyers to do that incorporation out of their own pockets . And I served on the board of SHUTC for almost its entire, almost my entire career at the hospital. SHUTC was ultimately formed in 1971 or 72, and it...

Judith McErvel: And its beginnings were a little teetery, weren't they Marvin?

MB: Yeah they were. But they were pretty solid..

[overlapping chatter]

MB: ...we recruited people like Tanner, we recruited people like McMurtry. Come back to some of the things that we were able to do with that. Quite frankly I think SHUTC was the single thing that set this hospital apart from all the others, and allowed the hospital to succeed at the rate that it did.

You have to consider that this was a discarded veterans' hospital, handed in a dilapidated state to the University of Toronto in a city in which there were veritable lions of teaching hospitals, and for it to emerge as one of the preeminent teaching hospitals in Canada over a relatively short period of time is a significant achievement.

But almost anyone looking, and with a little hindsight will tell you, that it was its relationship with its medical staff that allowed that to take place.