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Victoria is facing a public-safety crisis

We’re super lucky. Got a good family doc when we moved out here- she’s approximately my age, been a doc since 2013 or so. I’m super easy as a patient, but sheMs been amazing with my wife...- particularly in giving her the time to really listen. She’s freshly back to work after two kids in quick succession, so we’re hoping we’ll have her for another twenty years or so.

Flip side to that, my mom and stepdad, him with bad Leukemia, have no family doctor. Almost zero chance of getting one. But for the leukemia he’d likely be getting no meaningful care at all. And a great many people have similarly no access to regular care- I see it on my neighborhood Facebook group all the time, people looking for family clinics taking patients.

My cousin finished residency not too long ago. From some really candid conversation, the system by which we create doctors is brutal; we have resident in clinical settings working shifts 24 hours long, hopefully napping for a couple hours during that time and hoping they don’t crash the car on the way home. And that’s a conscious part of the resourcing model for hospital ERs.

The costs of medical school are horrendous, dissuading many from ever getting into the profession. Family physicians running a clinic eat the bulk of the overhead, which pushes more of them away from family medicine and into hospitals where they practice without paying for the infrastructure.

There needs to be a holistic look, combining both federal and provincial levels, into how Canada generates intake into the healthcare field, and how the practitioners are supported and sustained.
I'm not as intimately linked to the general Canadian healthcare system as you are(still CAF, and mostly healthy), but what I have learned makes my blood boil.

The working conditions we subject new Drs. and nurses to is completely broken. On one had the system screams that they have no nurses, and on the other, ensures all new nurses/Drs. have the crap shifts, and no stability.... Who wants to spend years, and tens(hundreds) of thousands of dollars to be treated poorly?
 
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I'm not as intimately linked to the general Canadian healthcare system as you are(still CAF, and mostly healthy), but what I have learned makes my blood boil.

The working conditions we subject new Drs. and nurses to is completely broken. On one had the system screams that they have no nurses, and on the other, ensures all new nurses/Drs. have the crap shifts, and no stability.... Who wants to spend years, and tens(hundreds) of thousands of dollars to be treated poorly?

CAF GOFOs? ;)
 
The guy looking after our daughter for her diabetes, was a spinal surgeon in India and is excellent to deal with. They can't call him "Doctor" as he is not certified here, we call him doctor because he does excellent work for us. The have about 6 "Case Managers" as they call these trained doctors. The medical profession is very much about guarding the sandbox for people trained in the "right schools".
Back in the early 2000s a family member of mine was going to Ryerson for health inspecting and had a former brain surgeon from Russia in the course. The reason being is they refused to let them practice medicine in Canada so health inspecting was the quickest and easiest thing for them to become qualified in. A lot of the health care problems are self inflicted. Ontario for example cut med school positions to save on costs in the 90s. It did save them on costs at that moment, but it seriously screwed us long term.

Not a huge advocate of private healthcare, but it seems to me like we took over the private system, and then proceeded not to make any actual gains in it, rather just sustaining what we had despite a growing and aging population. It would be very interesting if someone was to take a look at what our actual capabilities were in the late 70s to now and see if the public model really did us any favours or not.
 
Hope they never deinstitutionalize Penetang. What a spooky place that was! :)
The centre is still there. The old scary Oak Ridge building (which was actually built in the 1930s - maybe they chose the scary Victorian style for effect). They still have the 'forensics unit' but it's in a newer building. The accused in my first homicide back in 1979 was found 'not guilty by reason of insanity' back when that was a thing. I periodically checked (they were pretty strong on privacy) but he was still there in the late '90s. A friend of ours used to sit on the Ontario Review Board which reviews persons who are institutionalized by the court ('at the Lieutenant Governor's Pleasure' as they used to say).

*****

As a post-retirement gig I used to conduct background investigations for gaming licencing. I lost track of the number of foreign doctors and other health care professionals (along with other professions) who were lining up for a job as a casino dealer. I have a number of doctors in my extended family (not my side of the family - it shows) and two were educated in a very-much first world country overseas, yet were still considered foreign trained and had to jump through a bunch of additional (one did her residency in the US for chrissake). I get that there is a difference between Harvard and U Mogadishu, and it strikes me as making sense to create a list of 'acceptable' foreign medical schools that would allow a more seamless acceptance.

As far as crappy shifts, I am convinced that the practice of residency, much like articling in the law profession, is partly because 'they' had to do it (and it's a pool of eager, pliable and cheap labour).
 
None of this gets fixed unless Canadian voters convince Canadian politicians that it is the only election issue.

Coincidentally, this crew met in Victoria last month to try to make that happen:

Premiers gather in Victoria to present united demand for more health-care cash​

Premiers are asking Ottawa to increase its share of health-care funding from 22 to 35 per cent​


 
None of this gets fixed unless Canadian voters convince Canadian politicians that it is the only election issue.
... and when people in big cities like Toronto, Montreal etc. can't get the care they want.
Coincidentally, this crew met in Victoria last month to try to make that happen:

Premiers gather in Victoria to present united demand for more health-care cash​

Premiers are asking Ottawa to increase its share of health-care funding from 22 to 35 per cent​


We'll see what happens. I remember when Team Blue was in Ottawa, and didn't want to meet with Premiers, other Team Blue types would say, "all they're doing is whining, anyway" - even if some of the Premiers asking for more health money then were also Team Blue.
 
Peter sends it....

Incentives for complex care keep other patients from finding physicians: doctor​


Dr. Peter Vizsolyi says the problem is not with physicians — to whom he’s grateful for taking some of his patients — “it’s the system.”

 

Premiers gather in Victoria to present united demand for more health-care cash​


Yeah, noted that a couple days ago or whenever it was. Hence my comment, wherever it was, about provinces wanting the feds to take the political hit for taxes and allow the provinces to harvest the political approval for more spending. My response would be that the 2 points taken off the GST years ago are still there to be taken up by any province that wants the money.

I remember when Team Blue was in Ottawa, and didn't want to meet with Premiers

That was deliberate, but it wasn't that they didn't want to meet with Premiers. Harper simply wouldn't submit to the collective bullying shtick, which was (is) just a forum for a chorus of whinging. He would meet one-on-one, though. The complaint that he wouldn't meet holds no water. And keep in mind that the Harper government retained, and extended, Paul Martin's "health care fix for a generation". Then the opposition and its supportive media tried to portray the termination that Martin's government programmed in as "conservatives cutting health care". Fuck them all for their bad-faith misrepresentations and water-carrying.
 
Back in the early 2000s a family member of mine was going to Ryerson for health inspecting and had a former brain surgeon from Russia in the course. The reason being is they refused to let them practice medicine in Canada so health inspecting was the quickest and easiest thing for them to become qualified in. A lot of the health care problems are self inflicted. Ontario for example cut med school positions to save on costs in the 90s. It did save them on costs at that moment, but it seriously screwed us long term.

Not a huge advocate of private healthcare, but it seems to me like we took over the private system, and then proceeded not to make any actual gains in it, rather just sustaining what we had despite a growing and aging population. It would be very interesting if someone was to take a look at what our actual capabilities were in the late 70s to now and see if the public model really did us any favours or not.
My wife is Malaysian, they have a full public healthcare system and a full private one as well. Plus they do both western and eastern medicine. Nobody blinks an eye if you jump from public to private and then back to public. Somehow a "developing country" is able to manage doing both systems simultaneously, which apparently is beyond what Canada can do. I suspect that for to many people our public healthcare system is the only thing that makes them feel Canadian and they treat it like a religion.
 
I believe, based on nothing, that there is no interest in opening the pipe to making doctors- because then they’d have to be employed. The public wouldn’t stand out of work doctors and that’s expensive. So an extremely nonsensical development system is used. It may not even be on design- it’s just a pleasant bug there is no desire to REALLY address.
 
My wife is Malaysian, they have a full public healthcare system and a full private one as well. Plus they do both western and eastern medicine. Nobody blinks an eye if you jump from public to private and then back to public. Somehow a "developing country" is able to manage doing both systems simultaneously, which apparently is beyond what Canada can do. I suspect that for to many people our public healthcare system is the only thing that makes them feel Canadian and they treat it like a religion.

And don't get me started on their LNG infrastructure (which we don't have) ;)
 
I believe, based on nothing, that there is no interest in opening the pipe to making doctors- because then they’d have to be employed. The public wouldn’t stand out of work doctors and that’s expensive. So an extremely nonsensical development system is used. It may not even be on design- it’s just a pleasant bug there is no desire to REALLY address.
I'm more inclined the think that the provinces are reluctant to add more billing numbers. I don't think finding gainful employment will be a problem for doctors and an out-of-work doctor (has there ever been such a thing?) isn't billing the system. I couldn't find and kind of regional breakdown of doctor shortages for Ontario to know whether urban areas fare any better or worse than rural/remote areas. At least in a urban or near urban area, the next clinic or ER might be a handful of kilometers away; in northern Ontario, it can be measured in the hundreds.

This G&M article tells a familiar tale to our experience with our family doctor. I can't remember the last time the office actually picked up the phone.


Interesting that the author paints Nurse Practitioners as a big part of the solution. Back in the '70s, I had never heard of such a beast until I started dealing with the federal system servicing FNTs. I think they provide an outstanding service - we just need more. The 'team' that our doctor is connected to has one, but she books up very early in the day. I think there is a lot of turf protecting that is preventing greater expansion of NPs.

It seems we are way off topic here.
 
I believe, based on nothing

Your belief isn't based on nothing. A while back the "doctor pipeline" was crimped because the people responsible for measuring such things forecasted that we would soon have underemployed doctors. Either no-one kept measuring and adjusting, or they forgot to turn the pipeline back on, or they'd rather spend money on exciting new things like saving the world instead of doing maintenance mode work on boring old social programs from decades ago.

The public wouldn’t stand out of work doctors

Well, we got them anyways - all the doctors whose training didn't make them fit to practice in Canada.
 
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