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Lightning in a bottle, 30 years strong

In July 1995, I had the great fortune to have been hired by Noralou Roos, MCHP’s founding and long-serving Director, for a one-month trial to see if I could help her out. It was a strange situation, because I did not fit into any of the ‘work groups’ that existed at MCHP(E!) at that time. There were the researchers – either PhD prepared, or MDs with Master’s degrees and the like; the ‘big thinkers’ that led projects for MCHP and their own independent research and teaching lives. There were the programmers (as we then called them) – experts at wrangling the dauntingly sophisticated SAS system to provide insightful analyses of these huge and complicated administrative datasets. And there were support staff – admin, finance, IT, and others, who wrangled with the also-daunting bureaucratic and financial aspects of both the University and the Government of Manitoba. It was quite a crew! About 35 strong at that time, extremely high-functioning, but with no Organizational Chart at all – which was actually good for me, as I wouldn’t have fit into any of the boxes they might have had.

I have always thought (and often said) that Noralou must have been desperate for help when she hired me, as I had no training or experience in population health or epidemiology or health services research, save for Tom Hassard’s amazing Introduction to Biostatistics. I thought the deal was going to die the day before my interview, when Noralou insisted that I bring my academic transcript along, because, if you must know, my transcript contains at least one of every grade that can be given by the University of Manitoba (yes…). Alas, it was the strong reference from the late Norman Frohlich that clinched the deal. What I did bring to the table was some decent (for the time) skills with Microsoft Excel tables and graphs; enough understanding of statistics to communicate effectively with most staff; and a genuine desire to contribute to this remarkable unit that did the best kind of “science in the public interest.” That goal, and MCHP’s great reputation, made Noralou’s subsequent offer of a one-year contract a thrill to accept, and to continue as long as I could.

As part of it’s 20th Anniversary, MCHP commissioned Gail Marchessault to research and document the history and circumstances leading to the establishment of MCHP in 1990/91. It’s a fantastic read for any who haven’t seen it – and for us that have, a great document to re-visit. What strikes me most in that story is that the establishment of a research centre with significant government funding but empowered with academic freedom was like catching intellectual lightning in a bottle. No other province had anything like it at the time, and some still don’t. Ontario’s somewhat similar organization (IC/ES) was also forming around then, but did not have nearly as close a relationship with provincial stakeholders that MCHP did. And that relationship was critically important in laying the foundation for an ongoing requirement to use rigorous methods to study issues of relevance to those managing the health system – not just the particular interests of academics.

Fast forward to today (literally: this written October 30, 2020), and you’ll find me about to ‘get real’ with the most bittersweet decision of my career: to step away from MCHP, and dedicate myself full-time to my role with the Canadian Institute for Health Information (CIHI). I continue to be fortunate in many ways – including the ability to remain tangentially affiliated with MCHP going forward. So I won’t become a complete stranger, but will have even less time with that wonderful group of people. And I will have to be content with whatever contributions I was able to make during my 25.125 years in that ‘lightning bottle’, still illuminating health services research 30 years on.

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