Russell MacDonald, MD, MPH, FCFP, FRCPC
Region 7 Director
Medical Director, Ornge
Associate Professor, University of Toronto
Dr. Russell MacDonald is a specialist in emergency medicine, Canada’s first formally trained subspecialist in emergency medical services, and has a Masters Degree in Public Health. Dr. MacDonald has worked in tertiary care teaching centers and held academic appointments in emergency medicine in both Canada and the United States. His expertise includes emergency medicine, prehospital care, critical care and air medical transport, and public health. He is currently a Professor and Co-Director of the Emergency Medicine Fellowship Program at the University of Toronto, Medical Director at Ornge Transport Medicine, Medical Director for Toronto Paramedic Services and Toronto’s Central Ambulance Communications Centre.
Russell has built a career as an international leader in prehospital and transport medicine, is a respected consultant and content matter expert, and presents at conference and symposia internationally. He also serves on several industry-related boards of directors and journal editorial boards. He has authored more than 130 peer-reviewed publications, and is the editor-in-chief of Canada’s national paramedic textbook. He currently chairs the Royal College of Physicians and Surgeons of Canada’s committee implementing the AFC-Diploma in Prehospital and Transport Medicine.
Q: Tell us about your job and what you love most about it.
A: I have the privilege of working for Ornge, Canada’s largest and busiest air medical and land critical care transport agency. We serve the entire Province of Ontario, with 14 million people in a diverse geographic area that is larger than France and Spain combined. We bring critical care to the roughly 20,000 patients we fly each year, be it on a fixed wing aircraft responding to the far north, a helicopter at a scene call, or a land critical care vehicle moving a patient from a community hospital ICU to an ICU at a teaching hospital. Doing this poses many challenges given great distances, diverse cultural and ethnic groups, and fact that our health care system is highly regionalised in centers of excellence.
What I enjoy most is working with a highly skilled, dedicated group of people from diverse backgrounds – health care, aviation, communications, business – coming together to provide service to those who need it most. In many ways, we are the gateway to emergent and specialty care for many we serve. We meet the challenges with innovative programs and ways of thinking – a true ‘we can do that’ attitude.
I also enjoy the bridge I provide, between providing the service and academia. As a faculty member at the University of Toronto, I can leverage ‘the ivory tower’ to generate new knowledge, translate that knowledge to the transport environment, and provide cutting-edge care to the patients we serve.
Q: What / Who inspired you to follow an air medical / critical care transport career path and how did you break into it?
A: I have several ‘roots’ in transport. The first was an assessment of access to tertiary care for time-sensitive conditions. It was at the time when Canada was developing a network of trauma centers. Air medical transport was being implemented as part of the network, and it seemed like the best thing for the patient. My work found it was not always the case, with the best approach needing to incorporate an appropriate level of care and timeliness in order to have the biggest impact on patient care. My involvement in better integrating air medical resources into the broader system opened my eyes to the potential impact of air medical transport. The fact that I could ride out on a helicopter to ‘see the system’ didn’t hurt either!
The second were the words of wisdom two mentors I had while working in Boston, very early in my career. These two ‘elder statesmen’ in emergency medicine and prehospital care helped me develop some long-term career goals, showed me how to link service and academia to better serve an entire population, and how to work with and lead interdisciplinary teams. Their sage advice and words of wisdom still ring true today, nearly 25 years later.
While working in Boston was a great way to leap-frog my career, the key opportunity arose when I was ‘head-hunted’ to return to Canada in the role of Provincial Medical Director (equivalent to State Medical Director in the US). I spent 3 years helping build a provincial EMS system, and ended up being the successful candidate for a nationwide search for my current role at Ornge.
Q: What is your proudest career-defining moment that best represents your overall professional expertise and experience?
A: I have two career-defining moments. The first is receiving a Lifetime Achievement Award from the Air Medical Physicians’ Asssociation. Being recognized by my peers is truly an honor. The second is promoted to Full Professor in the Faculty of Medicine at the University of Toronto. The University is one of the world’s top 20 universities, and the road to Full Professor requires long-standing impact and international recognition in one’s field. I am only one of a handful Full Professors in Emergency Medicine, and the first in a field related to prehospital and transport medicine.
Q: What inspired you to join the AAMS Board?
A: I was inspired to join the AAMS Board because I saw the Association as a much-needed voice in our industry. I also wanted to represent my program and my country as a whole in an Association that was increasingly reaching to the global air medical and critical care transport community.
I also had the privilege of serving on the Association’s (Medevac) Foundation Board for a number of years, and saw the work of the parent AAMS Board as part of my commitment to serve the industry as a whole. What clinched the deal were suggestions from Former Board members that I could contribute in a meaningful way.
Q: What are your top three impact goals you plan to achieve as a board member?
A: 1) Enhance the Association’s understanding of and outreach to air medical and critical care land transport agencies and organizations in my ‘region’ – which encompasses a huge part of the planet.
2) Provide medical input and content expertise to board decision-making and strategic planning as the Association moves forward in challenging times.
3) Promote knowledge sharing and translation of new concepts, while at the same time representing the Association at international ‘gatherings’ (meetings, conferences, other related venues) related to air medical and land critical care transport.
Q: What do you see as the future of our industry and what is the best way to adapt to a changing landscape; and given that, what are the role do you see AAMS play in that change?
A: Our industry plays a key role in providing access to specialty care, particularly to those who need it in a timely manner. We can deliver a top-notch service, but part of delivering it successfully involves being integrated into the health care system as a whole. That is a challenge in many settings because of competition, difficulties working across multiple systems, and a regulatory framework that may not see the benefit of the service we deliver. I work in a system where some of these issues have been overcome, and the perspective I bring to the Board can help guide AAMS to play a role in change for the better.
Q: What’s your favorite book / movie / movie quote and why?
A: Favorite movie: Casablanca – great plot, interesting characters, classic performances by terrific actors.
Favorite quote #1: Albert Einstein – “The definition of insanity is doing the same thing over and over again and expecting different results.”
Favorite quote #2: Elon Musk – “Constantly think about how you could be doing things better. Keep questioning yourself.”
Favorite book #1: George Orwell’s ‘1984’ – a fascinating foreshadow of present ‘big brothers’ – can you think of any?
Favorite book #2: Lawrence Wright’s ‘The End of October’ – I finished this one while in Southeast Asia in late 2019, only to have an unnerving fiction-to-fact reality check thanks to COVID-19 months later! I’m not going to read similar books for a while…