I Spoke Out about Health Care. The Premier of PEI Took It Very Personally

I’m an anesthesiologist in Grande Prairie, Alberta, and for most of my career, I’ve worked on two questions. How do people and systems move through change successfully? What circumstances break them?

I spent years leading health system reform and reconciliation work—including as president of the Canadian Medical Association, the first Indigenous physician and the youngest person to hold the role—and the through-line of all of it was emotion. Not policy. Not strategy or resources. I came to understand that most failed attempts to fix hard problems in hospitals, in governments, and around kitchen tables fail for one reason: someone misread the emotion in front of them.

I eventually turned those insights into a book called The Outrage Cure, which was published a few months ago. That’s how I found myself in Charlottetown for a keynote and book signing. Following the events, I spoke with a reporter from the local newspaper, the Guardian. He was well versed in the topic he wanted to talk about: Prince Edward Island’s health system.

We spent most of the interview bouncing back and forth between two things—him steering toward PEI’s troubles, while I tied the themes and lessons of The Outrage Cure into our discussion. Somewhere in that conversation, I said something I viewed as unremarkable—that what physicians are living through in PEI is what they’re living through everywhere, and that government action had contributed to a loss of trust between doctors and the system. Governments across the country are going through this, and it’s been going on for years. To say health care workers generally mistrust the systems they work in should not raise the eyebrows of anybody.

What ran, days later, was that single line under a headline about PEI doctors losing faith in their government. It reached the floor of the legislature by the official opposition. And the premier, Rob Lantz, answered it with a line that made the rounds: he would take his cues from the doctors of his own province, he said, “not some doctor from wherever he’s from.” There were other things said, but I’ll let you search for those yourself.

I’m not sharing this to be a story about me but instead a story about misreading emotions. If there is a single skill this age of outrage demands, it’s the discipline of reading the emotion in front of you and linking it to what it actually means.

So let me help you, from my perspective, read this differently.

We are living in an age defined by outrage and betrayal, two emotions that are part of a causal chain that starts with problems we feel are worth solving and ends with us giving up on change ever happening at all. In The Outrage Cure, I map this out in great detail, through experiences I’ve been a part of over my lifetime. The relevant lesson is how common it is to collapse anger and outrage into the same thing, and how that collapse is behind most failed attempts to fix serious, complicated problems.

Anger is what we feel when something important is taken from us. It points outward as a call to “come help me.” It’s constructive, legible, and answerable, as long as someone is paying attention and responds. Betrayal is what anger curdles into when the people who were supposed to respond remain silent, minimize our calls to action, or otherwise reject them.

We ask ourselves whether those people—those in power, those who have the knowledge, those who have influence—have the skills and wisdom to solve our problem. The angry don’t ask if the problem is worth fixing; of course it is, because the problem is right in front of us! They instead question why their anger is going unanswered. Do the people they’re calling out have the skills to solve our problem? Even worse, are they not answering because they’re bad people? Eventually, trust fractures as the sense that those people didn’t come when I called, so something must be wrong with them.

Feelings of betrayal in PEI long predated my quote, and based on the reaction to it, those feelings have not gone away. In the summer of 2024, the province, Health PEI, and the medical society signed a physician services agreement that promised some of the highest family doctor pay in the country. A genuine high point.

Then came implementation—the transition from promises made to promises kept. A doctor’s panel is the roster of patients they’re responsible for, and its size is the single biggest lever on their annual workload: the larger the panel, the heavier the workload and downstream impacts, like less time per patient, longer waits, more after-hours paperwork, and a doctor running steadily closer to burnout.

A draft Health PEI plan set 1,600 patients as the minimum panel a physician would be expected to carry—a number they didn’t feel they’d agreed to and couldn’t meet without compromising patient care. That expectation gap is where anger turned to betrayal. With that imposition, doctors lost confidence that the government was dealing in good faith.

A revised deal in December 2025 replaced the rigid target with more flexible models, but the damage had been done. A letter signed by roughly a hundred physicians spoke to an erosion of trust. Outrage was rampant. The province’s health authority chief executive officer was gone by March. All the while, the accessibility crisis was getting worse: by the end of April, more than 34,000 Islanders had no family doctor or nurse practitioner—up from 33,000 at the start of the year.

The core of the agreement is still paused. As of what I know in this moment, none of that is settled yet.

Because anger and problems go hand in hand, unanswered problems also lead to feelings of betrayal. Over time, people lose patience with the promises of solutions just around the corner. When it comes to governments and physicians, the situation was likely exacerbated by the structure of the problem solving. First, there can be very long pauses between sides during active communication. The government isn’t a monolith; they have a lot of teams that have to sign off on issues like setting clinical practice expectations. What’s tough is, on the outside, to the uninitiated, this looks like incompetence.

Second, the empty spaces between communication are like vacuums begging to be filled. Impressions become beliefs given enough time and rumination. This all depends on the recent state of the relationship and how it bears that load of uncertainty. In this situation, it was clear to me that it could not.

There’s one final piece I’ll mention that most people miss because it doesn’t make headlines. When trust breaks down, it is essential that someone stays at the table with the intent to rebuild the relationship. In the case of doctors, it’s almost always the medical association—and in PEI, it was acting as that honest broker while the temperature ran high.

In March, the PEI government and medical society were “back to working together in a way that is more aligned with the intent and spirit” of the agreement. That is what early repair looks like: not a grand reconciliation but a few people holding on and rebuilding in the background while everyone else is still angry and outraged.

Repair at one table is not repair of the room, obviously. While the medical society and the government are finding their way back toward the agreement’s intent, the doctors who’ve already decided to leave are not at that table; neither were the tens of thousands of Islanders still without care; neither was the official opposition. A relationship can be mending in one corner and remain broken in another, in the same hour, over the same facts. Both are true at once. Declaring the matter resolved because your corner of it has cooled is its own kind of error.

Which brings me back to the premier.

Premier Lantz didn’t write that agreement, and he wasn’t premier when it was signed. He first inherited the office almost overnight in February 2025, when his predecessor, Dennis King, resigned without public warning and Lantz was sworn in less than a day later. He stepped away from the role at the end of that year to run for the permanent leadership—and won it in his own right, returning as premier in February 2026, only months before my quote surfaced.

However he came to the chair, he inherited the doctors’ dispute the same way: fully formed, not of his making. There’s another personal detail I found striking—his grandfather was one of the founders of the Island’s first medical clinic. He didn’t merely step into a political file. He stepped into a history his own family was woven into.

So when the flattened headline about lost trust landed on the legislature floor—while his government was, in one corner, slowly rebuilding that trust—he did something very human. He defended the relationship he was trying to repair and treated the outside voice as a threat to it. He even accused the opposition of trying to drive “a wedge between this government and doctors.”

Read against the emotion he was managing, “some doctor from wherever he’s from” isn’t really an insult. It’s a man guarding a fragile, half-mended thread from outside interference. And on that narrow point, he wasn’t wrong. I was, for a moment, a potential wedge—which is exactly why I did not respond to media about the issue. The most useful thing I could do was get out of the way.

That is one of the loneliest facts of leadership. Leaders inherit betrayal. The betrayal people attached to the role long before you filled it, and other betrayals that have scarred over, waiting to erupt again. The moment you step into a leadership role, present and past betrayal becomes yours to hold, and few are skilled enough to disown it (though some are—a future topic). Almost no one is trained for that part of the job.

While my interview sat firmly in the register of fixing problems—this is hard, it’s national, here’s the work, I’m still hopeful—it was heard differently on the way from me to the final publication. The flattened headline took my analysis of the problem and presented a call for reform and retaliation.

The premier’s health minister, seeing the headline, wondered aloud whether he was reading an old newspaper and called my comment uninformed. He was half right—and the half he got wrong is the important one. At his negotiating table, yes, the worst of it was months behind him. But a province is not a negotiating table. Out in it, the outrage wasn’t stale at all—it was current, and legitimate, and not his to declare expired.

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This is the claim The Outrage Cure keeps circling, and PEI showed it from every angle at once: you can mend one relationship while another is falling apart; you can be right that things improved and wrong to expect anyone to feel it yet.

It’s also on leaders to realize that the outraged do not owe you any grace. Their anger went unanswered, and that debt doesn’t expire because an institution or leader wants it to. There were comments that the news was old, that the negativity was unhelpful, that it’s time to move on. These are the very things that get people even more angry, betrayed, and outraged. I can extend the premier generosity precisely because I wasn’t the one betrayed; my equanimity is a luxury of my distance to the problems Islanders have been facing for a very long time. It would be presumptuous to allocate the forgiveness of the physician who left or the family still waiting for a doctor as though it were mine to give.

Which is why the burden of staying at the table belongs first to the people who hold power and the people who broke the trust—not to the ones carrying the wound. It’s true that nothing gets fixed if everyone walks away: when a relationship is abandoned, the system goes with it, and the people already without care pay first. But the answer to that is not to ask the betrayed to be bigger about it. It’s for those with the capacity to rebuild to keep reaching, and keep reaching, and to never mistake the first sign of their own relief for the end of anyone else’s anger or outrage.

That’s what I’d want anyone to take from a small story about a flattened headline and a premier. In such a winding tale about problems that were touching so many people, it was a mistake to assume everyone was feeling the same thing. The outrage that defines this age is betrayal made loud—many betrayals, at many volumes, experienced by many people, from many sources, all at once.

And just because one corner of the noise has gone quiet, it doesn’t mean the rest of the room is at peace.

Adapted from “The Age of Outrage and Betrayal” by Alika Lafontaine (Substack). Reprinted with permission of the author.