After nearly 14 years as CEO and medical officer of health with the Northwestern Health Unit, Dr. Pete Sarsfield has announced he will be retiring in December.
In an interview Friday, Dr. Sarsfield said that at age 62, working 60-80 hours a week, and spending sometimes half the year travelling across the region and back-and-forth to Toronto, has begun to wear him down.
“I’m feeling more and more tired,” said Dr. Sarsfield. “And not just physically tired. Emotionally.
“The illness of [former Ontario chief medical officer of health] Sheela Basrur, who is a colleague and a friend, her illness has been sobering for many a medical officer of health,” he added.
“You can’t draw a direct line between the stress of the job and the cancer, but I don’t think the stress, the sleeplessness, the demands of her job helped any.
“And I’ve had that feeling, for the last two or three years, when you wake up in the morning and say, ‘I don’t know if I can do this today.’ I’ve had that feeling more than ever in my life, and I think I better start listening,” noted Dr. Sarsfield.
“I feel tired in my heart. Not of the region, not of the board. I feel like I just can’t keep up the pace that needs to be done if you’re going to do the job,” he conceded.
Referring to the demands of public health in Ontario, Dr. Sarsfield said the “treadmill is increasing in speed.”
“I think there needs to be a younger person in this position. I think it needs a person who isn’t seeing the same issues cycle through for the 12th time,” he remarked.
Dr. Sarsfield said he made the announcement well before his intended retirement date in order to give the local health unit enough time to find someone and recruit them to take up the position—something which likely will be more difficult than it sounds.
“It’s not just in Northwestern Ontario, but right across the country, there’s a shortage of medical officers of health, especially in northern, rural remote areas,” he noted.
“I’m concerned about it.”
Dr. Sarsfield said there’s several reasons for this, including the fact that not only are medical specialists urban trained, “which sets up a pattern of experience that is city-based,” but that most physicians are upper- and middle-class, with 75-80 percent coming from urban backgrounds.
“You end up with people not wanting to move to rural areas,” he explained.
Another factor is that most doctors, including Dr. Sarsfield himself, can’t find temporary replacements to take time off and so are on-call all the time. Most physicians, just like everyone else, want at least some guaranteed free time.
“That works against the job,” said Dr. Sarsfield, noting there are 60 positions for medical officers of health [full and associate] and that 20 of them are vacant.
“It’s the lowest-paid of all of the medical specialties,” he noted. “When you combine that with the political scrutiny, the isolation, the lack of back-up, some people don’t like the CEO aspect—it makes it extremely difficult to fill.”
John Albanese, chair of the Northwestern Health Unit’s board of health, said Monday that he’s staying positive about finding a new medical officer of health.
“It’s a concern, especially when Thunder Bay searched for somebody for two-and-a-half years,” he admitted. “It’s going to be a little tough for the board to recruit somebody, but let’s keep our fingers crossed.
“We’re going to be advertising all over the province and throughout Canada to get a qualified MoH to fill the big shoes Pete’s going to leave,” added Albanese.
Despite the demands of the job, Dr. Sarsfield said he’s found it to be very satisfying.
“I was in family practice for almost 15 years, and the reason I went into public health is I wanted to do something regarding the prevention of disease as opposed to just treating it,” he explained.
“I often felt when I was working in northern Canada—Labrador, Northwest Territories, northern Manitoba—I often felt like I was putting Band-Aids on amputations,” said Dr. Sarsfield. “I was doing nothing to prevent the problems that were coming in day after day after day.
“I was doing more of the prevention work in the evenings and on the weekends when the clinic was empty. So I thought, ‘Why don’t I do this for a living?’
“The ability to focus on prevention of disease and promotion of well-being is a very attractive part,” he noted. “The ability to work in a team—led by public health nurses and inspectors, but also with the administrative and financial staff—is wonderful.
“I work with some of the best people I’ve ever worked with—Bill Limerick, Val Mann, Karen Essery, Lois Bailey, Mark Perrault. These are good folks.
“I enjoy the interaction with a multi-disciplinary team,” he stressed. “It happens more in this than when I was family practice.”
Dr. Sarsfield also said he enjoys being CEO of the health unit, which goes hand-in-hand with being medical officer of health.
“I can actually have some influence on the programs we do, as opposed to a chief of staff at a hospital who can argue with the CEO or beg or plead,” he explained.
“Even though part of the job can be a pain, like deciding who answers the phone at noon hour in Dryden when nobody wants to, you do have influence in the community over the programs you deliver.
“That rarely happens with physicians.”
Dr. Sarsfield also said that contrary to some rumours circulating in the region, his resignation is not an example of him leaving in “a characteristic huff” or because the board has pushed him to resign for any reason.
“I’ve enjoyed working with the board,” he remarked. “The last three years with the board have been excellent, just superb. They’ve been very caring, willing to make the hard moves, and doing the questioning as they should.
“It’s genuinely, cross my heart, related to fatigue. It’s a demanding job,” stressed Dr. Sarsfield. “It wears thin. I just need to stay home and wash my clothes.
“I’m not leaving in a huff. I’m not leaving alienated. I don’t think I’ve alienated the board of staff,” he concluded. “It’s really just time for someone with fresh legs.”
Albanese said Dr. Sarsfield will be sorely missed.
“We’re talking about a gentleman who’s worked hard to make this happen in Northwestern Ontario. He has done a lot of good for the Northwestern Health Unit,” Albanese remarked.
“We’re going to greatly miss him, but he’ll be around for a while until we can find someone who’s proven they can replace him,” added Albanese.
As for life after retirement, Dr. Sarsfield—a published author—said he’s going to focus on his writing “at least 75 percent of the time.”
“It’s been a part of my life since my teens. It isn’t a recent infatuation,” he noted.
He also said he may do some consultant work in the area of public health, particularly if it’s with area First Nations. “It depends if I believe in the cause, the topic, the organization,” said Dr. Sarsfield.
A native of Nova Scotia, Dr. Sarsfield first started in the medical field as an orderly in 1965 at the Waterville Psychiatric Hospital before getting his pre-med at Mount Allison University in Sackville, N.B. and then his M.D. at Dalhousie University in Halifax.
After graduating in 1973, he went to Labrador for 12 years as a travelling general practitioner, also spending some time in the Northwest Territories.
In the 1980s, Dr. Sarsfield underwent specialization training in public health at the University of Manitoba, then became director of environmental health for the province of Manitoba for five years.
He moved to Kenora in 1994 after successfully applying to be the medical officer of health and CEO of the Northwestern Health Unit.