AMS 80th Anniversary: The Past and Future of Canadian Medicare.
AMS in the Beginning; A Pioneer Prepaid Health Care
Associated Medical Services, AMS, was founded by Dr. Jason Hannah in 1937 as Canada’s first physician-sponsored, not-for-profit prepaid health care organization. An Ontario-based corporation, AMS served hundreds of thousands of individual subscribers in Ontario, people who would not otherwise have qualified for membership in a prepaid health insurance plan. The health services included those of a private physician chosen by the patient, diagnostic services, hospital care including surgery, as well as maternal and child-care and home visiting.
AMS’s role as a health care provider concluded on October 1, 1969 after the province of Ontario joined the national Medicare program. AMS continued as an agent of the government of Ontario in the administration of the Ontario Health Services Insurance Plan of the Ontario Department of Health (OHSIP) until 1972.
AMS The Organization
When AMS’s role as a health care provider ceased, the Government of Ontario permitted the corporation to use its remaining reserve fund for charitable purposes. That reserve fund, established from subscriber subscriptions as required by government, became the source of AMS’s income as a self-funded charity.
In July of 1976 AMS was registered under the Federal Income Tax Act as a charitable organization with responsibility for the security of the reserve funds resting with the Board of Directors. The original reserve fund, through careful investment and financial management, continues to be the sole source of AMS revenue.
The History of Medicine and Healthcare in Canada –
The Legacy of Dr. Jason Hannah
The support of scholarly activity in the history of medicine was AMS’s first focus after becoming a charity, as a legacy tribute to founder Hannah. Chairs in the history of medicine named after Hannah were established in the then five Ontario faculties of medicine (health sciences).
The Hannah Institute for the History of Medicine was formed in the 1970’s as an intramural operation funded by AMS. In addition to supervising the activities of the Hannah Chairs, the Hannah Institute was responsible for the administration of all AMS grants and awards in the history of medicine. Commencing in 1999 the Hannah Chairs, in partnerships between AMS and the host universities, were endowed in-perpetuity.
With the support of AMS, history of medicine and healthcare continued to thrive in universities and colleges across Canada. As a result of the growth of the discipline and the burgeoning of scholarship, as well as financial support from other funding bodies, the AMS Board of Directors decided to end its granting programs in 2011. Moving forward, support for scholarly activity in the history of medicine and health would largely be provided through special grants in partnership with other organizations and academic institutions. In 2015, AMS reconfirmed its commitment to the field with the announcement of the 6th Hannah Chair in the History of Aboriginal Health at the Northern Ontario School of Medicine and a new History of Medicine and Healthcare Post-Doctoral Fellowship and Grant Program.
AMS’s Contribution to Education, End of Life Care
In the late 1980’s AMS’s contribution extended to medical education with a new undertaking known as Educating Future Physicians for Ontario (EFPO) that was based on making undergraduate medical education in Ontario more responsive to the changing needs of society. EFPO was undertaken in partnership with the five Ontario medical faculties and the Government of Ontario. An enduring legacy of EFPO is the CanMEDS Framework (Physician Roles) of the Royal College of Physicians and Surgeons of Canada, which has now been adopted by countries on five continents, making it the world’s most recognized competency framework for physicians.
The education focus then shifted to a dedicated initiative on education in care at end of life (“AMS Educational Fellowship in Care at End of Life”) in partnership with five Ontario faculties of medicine, respective academic hospitals and clinical departments and the Council of Academic Hospitals of Ontario (CAHO).
AMS also established bioethics as a discipline within medical faculties in Canada in the late 1990s and supported young scholars in the field, many of whom are now nationally and internationally recognized leaders.
AMS Focuses on Compassionate Care
In June 2011, the Board of Directors of AMS announced an innovative multi-year initiative that focuses on making a positive and lasting difference in how health professionals nurture and sustain the learning and practice of compassionate care. The AMS Phoenix Project: A Call to Caring is based on the premise that health professionals provide the best care when they are able to balance human compassion and technical expertise.
The Project focuses on: developing compassionate care curricula; the adoption of compassionate care standards; championing the voice of the patient and their families; building a cadre of compassionate care leaders and building a platform of publically available resources.
Since the Project’s inception AMS is pleased to have funded 30 AMS Phoenix Fellows who are making incredible inroads in achieving these goals. As well, each year AMS hosts a Phoenix Invitational Conference where thought leaders come together to exchange ideas on bringing compassion to healthcare.
By late 2015, the AMS Phoenix Project had expanded in scope to become the AMS Phoenix Program which encompasses several additional initiatives and partnerships. AMS is working with the Council of Ontario University Programs in Nursing (COUPN) on an 18 month study of Compassionate Care in Nursing Education. In partnership with the Registered Nurses Association of Ontario (RNAO), AMS is funding Advanced Clinical Practice Fellowships in Compassionate Care. Intent on building publically available resources, AMS has also partnered with Faces of Health Care, a photojournalism site, to tell the healthcare stories of patients, caregivers and those who work in healthcare. The two organizations are working together to find an application for these stories in medical school curriculum to foster patient-centred care.
In 2017, AMS celebrated its 80th Anniversary, and while different from the AMS of 1937, continues to pursue innovative ways to contribute to the advancement of the health and health care of Canadians. Along with its current priorities, compassion in healthcare and the understanding of our medical and healthcare history, AMS hosted a Symposium in 2017
titled “Canadian Medicare 2017: Historical Reflections, Future Directions”. This constructive debate will see leading international experts interact on the history and the future of Canada’s universally funded health insurance system. It seems entirely fitting for an organization that started as a health care plan.