A call to action: Advancing Métis health and partnerships during Métis Week and beyond

Read time: 10 minutes

By Reagan Bartel, Director of Health, Métis Nation of Alberta

At the heart of Alberta lies a history, culture and community that is distinctively Métis. As a distinct Indigenous people whose post-contact origins are found on the buffalo-rich plains of what is now southern Manitoba, the Métis emerged as a distinct nation before the existence of Canada. This gave rise to a beautiful way of life, creating a vibrant identity rooted in resilience, self-governance and kinship networks. However, like many Indigenous communities, Métis Albertans have faced systemic barriers to health and well-being, resulting in unique health challenges and disparities.

As healthcare professionals, you are called to be more than caregivers—you are also advocates, allies and champions for equitable health care. I extend an invitation to walk with us in a spirit of partnership, embracing cultural humility and fostering cultural safety for Métis Albertans. Together, we can close the health equity gap and nurture a healthcare system where every patient feels seen, heard and respected.

The journey toward reconciliation in health care is one that calls for reflection, honesty and intentional change. The Canadian Medical Association (CMA) made this clear in its September 2024 Apology to Indigenous Peoples¹, acknowledging the role healthcare professionals and institutions have played in perpetuating harm. “We apologize for the harm caused by racism, discrimination, and cultural bias,” the CMA stated. “We recognize that this harm has disproportionately impacted Indigenous peoples and has contributed to unacceptable health disparities.”

Importantly, the CMA also recognized that, while “the health system is broken, the people within it don’t have to be.” This is a powerful call to action, reminding healthcare professionals that change begins from within—with individual responsibility, reflection and the commitment to do better. Through acts of cultural humility, education and advocacy, physicians can play a vital role in restoring trust and creating a healthcare system that is truly inclusive and safe for Métis Albertans.

The CMA’s apology serves as a powerful reminder that the healthcare system must not only address the mistakes of the past but actively strive to build safer, more inclusive spaces for the future. This is particularly important for Métis Albertans, who have often been overlooked in health policy discussions. Acknowledging this exclusion is a first step; action must follow.

As the CMA emphasized, “Reconciliation is not just about words—it’s about meaningful action and systemic change.” Métis Week, which takes place from Nov. 10-16, is a timely opportunity for the College of Physicians & Surgeons of Alberta (CPSA) and its members to reflect on these commitments. Together, we can ensure that Métis Albertans experience a healthcare system that honors their identity, values their voices and supports their well-being—not only during Métis Week but every day of the year.

The challenge: Why Métis Albertans need your support

Métis Albertans often fall through the cracks of health policy and programming. We face higher rates of chronic conditions such as diabetes, mental health challenges and cardiovascular disease, compounded by barriers to accessing culturally appropriate care.² Misconceptions about Métis identity can lead to feelings of exclusion or invisibility, resulting in care that lacks empathy or understanding.

For many Métis, colonialism isn’t just history—it shapes health care today. Exclusion from services, unequal access and erasure of Métis identity have left deep scars in our communities. Denied health benefits given to other Indigenous groups, Métis communities face generational care gaps. Racial profiling, delayed treatment and lack of culturally competent care worsen outcomes and fuel mistrust.^{3, 4, 5}

Unfortunately, this context means that many Métis patients enter care environments already burdened with fear of judgment, discrimination or dismissal. Therefore, to build trust, we must go beyond good intentions—fostering culturally safe environments where Métis Albertans feel they belong.

What can CPSA and physicians do?

It begins with cultural humility—a lifelong journey of learning, listening and self-reflection.^{6, 7, 8} Rather than assuming expertise about Métis health, practitioners are invited to ask questions, remain curious and be willing to learn directly from Métis patients and communities. Cultural humility acknowledges that even with the best intentions, biases can unconsciously shape care and interactions.

Here are five key actions physicians can take to promote cultural safety and humility in their practice:

1. Educate yourself on Métis history and identity

Understanding the history of the Métis Nation involves more than cultural appreciation—it requires acknowledging the systemic racism and discrimination Métis people have endured, including within the healthcare system. From the denial of land rights and exclusion from benefits to the impacts of Residential Schools and the Sixties Scoop, the Métis have been marginalized both socially and medically. This exclusion created significant gaps in healthcare access, leaving many Métis people without adequate services.

However, it is important to remember that shame is not a particularly helpful emotion when addressing past and present injustices. Shame can lead to avoidance and defensiveness, which blocks the path toward meaningful change. Instead, cultural humility encourages healthcare professionals to approach these conversations with openness and curiosity, focusing on the shared goal of healing rather than guilt. By acknowledging mistakes without self-reproach, healthcare providers can actively engage in creating solutions, fostering an environment where Métis patients feel safe, respected and seen.

Developing this deeper knowledge not only enriches patient care but also fosters rapport, creating a foundation for trust and healing in healthcare settings where Métis individuals often feel unseen or misunderstood. Embracing this process as a continuous journey—free of judgment but full of intention—makes space for reconciliation and lasting relationships.

2. Integrate Métis voices in care plans

Empowering Métis patients means going beyond routine consultation—it requires actively integrating their voices at every stage of care. Respect their lived experiences, personal knowledge and cultural practices by making them equal partners in their healthcare journey. This involves strategically embedding Métis health navigators, elders and knowledge keepers into care teams to act as cultural liaisons and advocates. Their presence can bridge gaps between Western medical practices and Métis ways of healing, ensuring care plans reflect the unique needs and values of Métis individuals.

A collaborative approach to care planning also requires flexibility. Physicians and care providers should recognize that Métis patients may draw on both traditional healing methods and modern medicine. Offering options for blended care plans promotes trust and reduces resistance, resulting in better health outcomes. Additionally, adjusting appointment structures and communication styles—such as accommodating storytelling as a way of expressing symptoms or concerns—can foster deeper engagement.

From a strategic perspective, co-developing care protocols with Métis health leaders and including Métis input in healthcare policies ensures that care is designed with, not just for, the Métis community. On a systemic level, health data collection frameworks should be inclusive of Métis identity and health outcomes, ensuring that Métis Albertans are visible within healthcare statistics and initiatives.

When care plans align with cultural values and include Métis voices at both individual and systemic levels, patients experience greater agency, trust and satisfaction, leading to long-term improvements in health and well-being.

3. Challenge bias and racism

Implicit biases—those unconscious attitudes and stereotypes we carry—can significantly impact how healthcare providers interact with Métis patients. Dr. Pam Roach⁹, a Métis health researcher from the University of Calgary, and her colleagues emphasize the profound impact of these biases on patient care. Their work highlights that many healthcare professionals, despite good intentions, may not be aware of how their behavior communicates unconscious exclusion, judgment or even racism. This reinforces mistrust and discourages Métis patients from seeking care or following through with treatment plans.

Research emphasizes the importance of anti-racism training across healthcare settings. Such training helps practitioners become more aware of their biases, equipping them to identify and dismantle stereotypes that may affect care. For example, assumptions that all Métis patients share the same cultural practices, or generalizing Indigenous experiences to Métis populations, can erode trust and undermine personalized care.

Language is one of the most subtle, yet powerful ways bias can manifest. Métis health professionals and community members caution healthcare providers to listen actively to patients and avoid interrupting or dismissing concerns. Simple phrases like “I didn’t know that about the Métis” or asking questions with genuine curiosity can foster connection and signal respect. Non-verbal cues—such as body language or tone—are equally important. For instance, avoiding eye contact or seeming rushed can unintentionally communicate disinterest or disrespect, exacerbating feelings of invisibility or exclusion for Métis patients.

It is important to note that systemic change must accompany individual efforts. Healthcare regulatory bodies and institutions need to commit to and prioritize anti-racism training, not as a one-time initiative but as part of ongoing professional development. Creating safe spaces for providers to discuss their biases openly—without fear of judgment—encourages continuous learning and accountability.

While we are discussing these changes in the context of Indigenous and, more specifically, Métis health, it is important to emphasize that these approaches will benefit far more than Métis people. Newcomers, refugees and other underserved or marginalized populations—who also face significant barriers to care—will feel the impact of this work. Addressing implicit bias and fostering cultural safety creates a more inclusive healthcare system where all patients feel respected and valued, regardless of their cultural background or status.

When healthcare providers and institutions engage in anti-racism efforts and embrace cultural humility, they contribute to a healthcare environment where trust, empathy and better outcomes are possible for all patients—building not only health equity for Métis Albertans but improving care across the board for every marginalized group.

4. Support Métis-specific health programs

Physicians and healthcare providers have the opportunity to be genuine partners in the journey toward health equity, working hand-in-hand with Métis people and organizations to design and deliver care that aligns with Métis needs, culture and values. Collaboration with Métis communities helps bridge the gap between conventional health care and culturally relevant approaches, fostering trust and respect.

However, healthcare providers can go beyond collaboration—they can also be innovative within their practices by integrating distinctions-based programming. This approach tailors care to the specific needs and realities of Métis, First Nations and Inuit populations, recognizing that each Indigenous group has distinct experiences and traditions. For Métis Albertans, this means centering care plans around the practices, values and historical experiences unique to the Métis Nation and the Métis Settlements. Physicians can engage Métis health navigators and elders in care delivery or create dedicated spaces for Métis patients to access both traditional healing methods and Western medical care.

Supporting the use of culturally relevant services—such as traditional medicines, healing circles and ceremonies—alongside conventional treatments demonstrates a holistic approach to care. When both paths are honored as complementary rather than conflicting, patients experience deeper engagement, better outcomes and a sense of empowerment in their health journey.

Distinctions-based programming is not only about providing better care to Métis Albertans; it also positions physicians and healthcare providers as leaders in innovation. By incorporating culturally tailored practices and promoting flexibility in care models, healthcare providers set a powerful example for inclusive, patient-centered care that can benefit other underserved populations. These innovative approaches foster an environment where all patients—Indigenous and non-Indigenous alike—feel respected and supported, regardless of their cultural identity.

5. Use your influence to drive systemic change

As physicians, you hold a position of profound influence and responsibility—not only in the lives of individual patients but also within the broader healthcare system. With your authority comes the power to push for systemic changes that can meaningfully impact the health and well-being of Métis Albertans. Your voice carries weight with policymakers, institutions and health organizations. As an example, by advocating for increased funding for Métis health programs, improved data collection specific to Métis health outcomes and policies that acknowledge Métis rights and needs, you can directly contribute to a more equitable healthcare landscape.

Healthcare systems often reflect the biases and structures of the past, but you can reshape those systems, making them more inclusive and responsive. Recognizing the exclusion of Métis people from many health programs and data frameworks is only the first step—meaningful advocacy and action must follow.

Your leadership in demanding policy changes that honor the unique status and experiences of Métis people will ripple through the healthcare system, setting a precedent for accountability and inclusion. These efforts will not only improve outcomes for Métis Albertans but also strengthen the healthcare system for all patients, ensuring it becomes a space where equity and respect are the norm.

When physicians actively leverage their influence to champion systemic change, they embody the principles of cultural humility and reconciliation, showing that healthcare providers are not just participants in the system but key architects of its transformation.

Walking the path together

Cultural safety is not a destination; it is a relationship—one built on mutual respect, trust and shared understanding.^{10, 11} As healthcare providers, your role is vital. Each interaction with a Métis patient is an opportunity to build bridges, repair past harms and ensure that future generations of Métis Albertans can thrive in a healthcare system that truly cares for them.

This work demands more than good intentions. It calls for courage and bravery. It takes bravery to question deeply held assumptions, confront unconscious biases and challenge a system that was not built to serve all equitably. Being brave means leaning into discomfort, making space for Métis voices and learning from experiences that might feel unfamiliar or challenging.

By embracing cultural humility and embedding cultural safety into your practice, you transform from being providers of care to becoming trusted allies on the journey toward reconciliation. It takes bravery to walk this path together knowing that reconciliation is not a simple fix, but an ongoing relationship requiring intentional action and accountability.

Each step toward cultural safety contributes to a future where every Métis Albertan can access health care that nurtures their whole being—offering dignity, compassion and respect. In doing so, you set a powerful example for what is possible when we walk the path of reconciliation with open hearts and a shared commitment to change.

Conclusion: A timely opportunity for action

As Métis Week continues, we are reminded of the importance of honoring the history, culture and contributions of the Métis People. This is a time to not only celebrate but also to reflect on the systemic barriers that Métis Albertans continue to face—particularly in health care. The journey toward reconciliation in health care requires more than symbolic gestures. It demands brave, intentional actions from all of us—especially physicians and healthcare providers, whose influence, authority and responsibility have the power to create meaningful change.

By committing to cultural humility, anti-racism efforts and distinctions-based programming, and by advocating for Métis-specific policies, you can be both a partner and a leader in transforming the healthcare system. Every interaction with a Métis patient, every care plan co-created and every policy shift driven by your advocacy contributes to a future where Métis Albertans feel truly seen, valued and empowered in every healthcare setting.

This Métis Week provides an opportunity for CPSA and all healthcare providers, to reflect on the path we have walked together and the road that lies ahead. Let us use this moment to reaffirm our commitment to reconciliation—ensuring that Métis Albertans and all marginalized communities receive the care they deserve, with dignity, compassion and respect.

Together, we can build a healthcare system that nurtures every patient’s whole being—not just during Métis Week, but every day of the year.

Reagan Bartel (MPH, RN, BScN, CNCC(C)) earned her Master of Public Health and Bachelor of Science in Nursing from the University of Alberta. She has more than 16 years of critical care nursing experience delivering front line care in an Edmonton ICU before moving into population health as the Director of Health for the Métis Nation of Alberta (MNA). She is a daughter, granddaughter, wife, and auntie. She is a proud Métis woman. Her focus is on ensuring that Métis stories, experiences, and perceptions gifted to the MNA are incorporated into health advocacy, policy, programs, and services. She values leadership, kindness, community, growth, and transparency in her life and work.

References

1. The CMA’s apology to Indigenous Peoples
2. Health Research and Advocacy
3. The perspectives of health professionals and patients on racism in healthcare: A qualitative systematic review
4. Sharing Métis Experiences: Cultural Safety in Healthcare
5. Métis Leaders in Ontario, Alberta and Saskatchewan Address Racism in Healthcare
6. BC Health Regulators – Cultural Safety and Humility
7. BC Health Regulators (BCHR)
8. Embracing Cultural Humility and Community Engagement
9. Prevalence and characteristics of anti-Indigenous bias among Albertan physicians: a cross-sectional survey and framework analysis
10. First Nations Health Authority – Cultural Safety and Humility
11. Fraser Health – Cultural Safety and Humility