Reflections on 10 years as Paediatrician-in-Chief

Dr. Denis Daneman is the out-going Paediatrician-in-Chief at SickKids. He is also the out-going Department of Paediatrics Chair at the University of Toronto.

For the past 10 years I have had the joyous privilege of serving as SickKids' Paediatrician-in-Chief and the University of Toronto's (U of T) Department of Paediatrics Chair. Our mission statement is "to continuously evolve as one of the world's leading academic departments of paediatrics," integrating excellence in clinical care with outstanding educational programs and leading edge research. The metrics show that these goals have in fact been achieved within the context of our two superb institutions, SickKids and the U of T.

Recently, a member of our faculty asked me: "On balance, was being Chair/Chief a positive or negative experience?" I said: "Ask my wife, Meredyth." Without hesitation, she said, "He loved every single minute of it." What then have I loved so much about the position I have had the singular privilege of occupying as the eighth incumbent? Simply put, it is being part of something quite wonderful, even at times magical: people from very diverse backgrounds working together towards the common goal of Healthier Children. A Better World, a goal that transcends municipal, provincial, national and international boundaries.

The fact that we are in a much better position than we were at the start of my tenure is not a negative reflection of what went before; rather, we were able to build on successes of the past. Each generation stands on the shoulders of the giants of the past. Also, these successes are not achieved by any one person alone, rather due to the dynamic partnerships that our department has with all aspects of SickKids and U of T.

I have seen my major role as the recruitment, retention and reward of members of our faculty at both the junior faculty level as well as leaders in their field. We have hired more than 100 new members of our faculty, which now comprises over 250 full-timers. We have been able to persuade some of the best minds in paediatrics to come to join our department, both at the junior and senior level. The accomplishments of this group continue to be simply magnificent.

I am indebted to many, many people, but none more so than the children and families we serve and who let us into their lives (a three-year-old recently paid an incredible compliment, asking if we could arrange a play date), then on through the health-care professionals who provide their care and the people who keep our institutions in good shape. There are far too many people to mention, but whoever is reading this is likely one.

We stand on the cusp of a health-care revolution, made simpler, and at the same time more complex, by the new sciences of genetics/genomics, brain science, precision and translational medicine, and improvement (safety and quality) science, all fuelled by information science. I am more than a little jealous of those stepping into the fray.

Let me end this reflection with a little satisfaction and a challenge: satisfaction in our increasing emphasis on the role played in child health by the so-called social determinants of health, poverty, food and shelter insecurity, lack of a sense of belonging, and abuse/neglect. The challenge is that we continue to address these inequities, one patient at a time, but also at the societal level.

It has indeed been a privilege and a joy.

Denis