HealthPRO board member Marc Toppings imagined he might one day work as a genetic scientist, but he found a happy intersection working as a healthcare lawyer. There’s always variety in the work and it’s not hard to get behind the mission of your employer when that mission is to do good in the world.
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Marc, in your undergraduate and post-graduate education, you focussed on science. Your area of specialization at McGill was genetics, a fascinating field. What motivated you to move from what was clearly a strong interest in science into law?

I did my undergrad in life science and English and then a master’s degree in genetics. It was a very exciting time in genetics. They were doing the Human Genome Project. I remember going into genetics with the intent of going into law after. I think the two are complimentary in that a master’s in science and a law degree are both very much based on inquiry and defensible decision-making and judgment.

I was lucky enough in my master’s to work with Dr. Jacquetta Trasler at McGill in the Montreal Children's Hospital. I was looking at imprinting, which was very important in the genetic world for both cloning and for reproductive technologies.

I was interested in combining that with the law and for a while I thought I’d made it. In law school, I did an internship in my first year at the World Health Organization (WHO) in Geneva in genetics ethics law. A lot of amazing experiences came out of that – I got to attend the World Health Assembly where Bill Gates gave the keynote address.

But ultimately, genetics and genetic policy was not a focus for the World Health Assembly. There were much more pressing issues at the time. So, I went back into private practice and after a few good years at McCarthy’s, started looking for something that was more aligned with why I had initially gone into law. There was an opportunity to go into healthcare and so I went in as the inaugural corporate counsel at St. Mike's Hospital and I haven't looked back.

Was there any hesitation on your part in moving away from strictly genetics?

I'll say this, I'm really glad I did it. It's nice to be able to say that for a part of my life, I was a bench scientist. I think the highs in that are probably as high as it gets because you are pushing the boundary of human knowledge. You might, for a little bit of time, know something that nobody else knows, and that's very exciting.  I really liked that kind of thinking, the academic debate and the rigour. But in terms of what I was reading for pleasure, it was more and more broad policy-based. My interests were changing in that sense.

You’ve worked for several large healthcare organizations in Toronto – Sinai Health System, Baycrest Health Sciences, St. Michael’s Hospital, and now UHN. What’s satisfying about practicing law in a healthcare environment?

I get asked what I like about this work all the time by students who are interested in pursuing careers in health law or working in-house in the hospital. I think first and foremost, it’s the alignment of my values with the client. So, it's very easy as a lawyer to get behind a St Mike's, or a UHN, or a Sinai, or a Baycrest. They're really trying to do good in the world.

As a lawyer, there are always some tasks that you might not love to do. But when you believe ultimately in what your client is doing, I think that makes everything more worthwhile. That’s been really highlighted by the pandemic. UHN was the first hospital to give out a vaccine and the first to set up mobile clinics. We set up two hospital sites in hotels to serve homeless populations.

Another thing is just the sheer variety of work that comes across the general counsel's desk in a hospital. When I was hired at St. Mike's, my then-boss told me you're going to do everything except maritime law. You do a little bit of family, a little bit of corporate, a little bit of real estate, and so on. You never really know what's going to come across your desk in any day and that makes it very intellectually stimulating.

It must also make your life very busy.

Yes, it’s quite busy. It was different at the start of the pandemic because then it was only COVID-19. We shelved everything else as we adapted and focused exclusively on the pandemic and the response. What’s been interesting over the second, third, and fourth waves is all those things that got put aside have come back. You still have COVID in the background, but now you're doing your normal job in addition to that.

In your current position, you’re providing legal counsel to everyone from the Board of Trustees to the leadership team, physicians and researchers. Are there common issues that come up all the time or is every issue different?

Well, I think you're constantly learning, for sure. A lot of the things you do are things you would do as general counsel somewhere else – board issues and governance issues, the bylaws, the contracts, the procurements, the legislative compliance – but then you also have this interesting overlay of a heavily regulated industry and real live patient questions. And that’s what makes the work in the hospital so interesting. Issues specifically related to patient care, such as decision-making capacity, consent, medical assistance in dying, questions around privacy and data security. We deal with all manner of patients, and that’s very rewarding.

When you're mentoring younger lawyers, what are some of the things that you hear from them, or that you really try and teach them through your own experience?

Oh, that's interesting. I don't think you can really do the law without understanding the client and the client's needs. It’s obviously been harder during the pandemic, but I try and teach all the young lawyers to go and meet with the client, have a tour, see what you're trying to support.

So, if they're doing a contract with the transplant team, go and visit that area to see what it's like. Or if they're doing a research agreement on perfusion, go and look at the pig's lung. If you're doing a contract on something like wastewater chillers, you should go and take a tour of that area and that facility.

That’s one of the real benefits of being in a hospital, as opposed to say a private practice lawyer, where we really are much more ingrained with the client. That's part of our value add is understanding the client, understanding what they're going through and understanding their risk tolerance.

What makes the mission of HealthPRO meaningful to you?

I think HealthPRO has this really nice synergy in terms of their basic tenet to make Canada a healthier place. Recognizing that we're only two per cent of the global health market, what can we do to leverage all we have to really drive the best value for the Canadian market? How can we help Canadians to get access? At its core is something that’s very easy to get behind.

The pandemic really shone a light on some of the vulnerabilities we have in terms of supply chain, and the protectionist measures that could be put in place by the States or Europe. It’s really interesting for healthcare GPOs and others to figure out what role are we going to play and how can we be advocates for improved processes going forward.

I admire the way HealthPRO is constantly adapting, monitoring, pushing. It’s an interesting dynamic.

Why is good governance critical in any organization – and specifically in the field of healthcare?

I think the board plays such an important role in an organization because it really is a check and a kind of an overseer on management. I always borrow this line from Arlene Wilgosh, our Board Chair at HealthPRO: the board has noses in and fingers out.

I've definitely found in the hospital sector the boards are so sophisticated and so savvy, they bring a lot of value to the table based on their backgrounds in different industries. That kind of infusion of ideas and sharing of past experience is important from a strategic lens and from a risk lens.

What important lessons have you learned from the mentors in your life?

One thing that you really learn in law is the benefit of having both formal and informal mentors. I have both of those, people I still go to for advice or to ask things. I think sometimes, maybe one of the best lessons is just making yourself available. I find that the mentors who have really helped me the most have been the ones who have been very willing to "talk off the record," or make themselves available to answer any and all questions.

When you need a creative boost, or just to step away, what do you do?

It used to be a lot of squash. Squash went away, although I guess gyms are opening again. We recently got a puppy. And so I very much enjoy doing long walks with the dog. That’s been very nice.