Good article. Obvious to all who have had recent interactions with their family doctor. (Those lucky enough to have one). The solution (or possible solution) is obvious. Two tier medicine and let the market set the wages and working conditions for doctors. Also another solution is awarding a new medical school to private interests. Or maybe 5 new schools. Change the way we train doctors. Continuing the same old system (which Canada is doing) is a recipe for disaster.
I'm well acquainted socially with several doctors in our local rural clinic that operates as a partnership. The situation described by Dr. Taylor is dreadfully, devastatingly accurate.
The problem is even more acute in a rural practice. In fact, our overloaded regional urban clinics often are so stacked up that patients are routinely willing to travel an hour's drive away to come to our rural clinic in the hopes the lineup to see a doctor will be a bit shorter.
It's insane, and I can tell you that my doctor acquaintances are (at minimum) demoralized and (at maximum) likely suffering from clinical depression themselves. Ask yourself how the nursing and other support staff in their clinics are doing when their bosses (the doctors that own and operate the clinics and hire the staff) are in such a state.
Change is absolutely essential - the solution is a hybrid system like many European countries have.
I've been saying this for more than a quarter century.
Canadians seem to think their cherished health care system will have its normal shortcomings.
The aging hippie Canuck crooner Bruce Cockburn was right.
A system where the users and providers are pitted against each other. Our politicians over promise and our governments under deliver. As our governments insert themselves further into our lives a bureaucracy is created to manage us all, users and providers alike. Surveilling and correcting us, gradually being replaced by AI. Our healthcare system is no longer fit for purpose but to coarse correct would mean fixing it. Then it would no longer be the convenient political football it has become. Public services have be poisoned by the politics and all of us are suffering in one way or another.
I wonder why the solution is presented as "more doctors" (however they are funded) rather than "less sickness"? Our system might function sustainably if our doctors' energies could be spent on cancer diagnoses, broken legs and strep infections. Instead, our society has allowed preventable illness that stems from lack of self care, such as obesity and addiction, to drain our resources beyond capacity. Blaming patients for illness-causing lifestyle may not be the answer....it's obviously complex. But are we not even allowed to mention it? Where does personal accountability fit in to this discourse?
Certainly obesity and addiction increase costs to the health-care system. But I'd argue the biggest driver are the more & better treatments for diseases like cancer, heart disease & stroke allow people to live longer than they did even a decade or two ago. And then couple that with an aging population, who need more health-care services the older they get.
I suggest learned helplessness is an informal Canadian government objective, all governments. Their initial response to newly-identified problems is writing cheques (after an involved application process that includes gender and identity information). New regulation and an extensive approval process is the second response.
At no time do our governments review the damaging or limiting impacts of existing regulation. Income redistribution by government program is the goal of federal and provincial governments.
👏👏👏 You are so right! Learned helplessness is a huge objective of Canadian government. The goal is a docile population which then looks to Government to provide answers. That it stifles innnovation and deters self reliance - and punishing those who exhibit these traits is considered an acceptable price to live in Canada.
I know my late husband, a family doctor, would agree with much/everything I read here, as would my brother a now retired family doctor.
It is time that so many who instantly think that we will have the US system realized that there are other models. Think Western Europe. Mixed systems that work better than ours.
Stop the obsession that the only alternative to ours is the American system of health care.
I have relatives who are doctors in South Africa. They came here to do locums. Loved it. Generally healthy population, polite, educated patients, who had appreciation, and made off like bandits. Don't begruge the money doctors make (GPs make between 300 k and 500 k - I will not tell you how I know), as they can head to the USA at any time and make a little more (liabilility insurance reduces any windfall). Enlarge Medical Schools in Canada so Canadians can get in. This is far better than bringing in others, with poorer education and language skills.
This is utterly brilliant. I see my family doctor rarely, and right after she asks me how I am, I ask her how she is. I figured out a long time ago that Doug Ford doesn't give the tiniest little crap about public healthcare and is making life as miserable as possible everyone involved in it. Lessons about staffing should have been learned from COVID. They haven't. Lessons about time allotment per appointment should be obvious, yet aren't. Government paperwork takes an increasing amount of time when it should be streamlined. Every single consultant in healthcare should be fired. Healthcare is not a "Dale Carnegie" profession.
I wish I had an answer. It’s doesn’t seem to be the management of demand by waitlist or denial of service administered by faceless government clerks. Private insurance companies in the US have the same system.
I think a major factor is unrealistic expectations laid onto physicians by the patients and encouraged by politicians.
Politicians of all stripes and civil servants who work for them are part of a system that rewards cowardice. They avoid all risks and put out policies where others take the brunt of the consequences. A prime example as I remember from Covid days was controlling access to grocery stores and enforcing mask mandates. This fell on 18 year old grocery clerks who had to take on the role of policemen and were cursed and spat upon as a result -,to the extent that anti spit shields were installed to protect the staff.
Similarly doctors are expected to say no to patients who have expectations of miracles or prompt service for free. I don’t see cowardly MPs or MPPs or being asked to explain to patients why they can expect to die on a waiting list.
Lets get more doctors. Lets get more nurses. Lets get more specialists
There is another side to this. I campaigned for the former minister of health in Alberta Jason Copping whom I thought was a very good minister. He said that he had gone to a conference in Copenhagen in the summer of 2022, A conference of various health ministers and health specialists. He said that one interesting thing he learned was that doctors in Europe are paid a lot less money than doctors in North America.
Good article. Obvious to all who have had recent interactions with their family doctor. (Those lucky enough to have one). The solution (or possible solution) is obvious. Two tier medicine and let the market set the wages and working conditions for doctors. Also another solution is awarding a new medical school to private interests. Or maybe 5 new schools. Change the way we train doctors. Continuing the same old system (which Canada is doing) is a recipe for disaster.
Two tier is already here and has been forever. That will continue because this is an unsolveable challenge - everyone loses their #$%*$#%## minds.
Facts.
I'm well acquainted socially with several doctors in our local rural clinic that operates as a partnership. The situation described by Dr. Taylor is dreadfully, devastatingly accurate.
The problem is even more acute in a rural practice. In fact, our overloaded regional urban clinics often are so stacked up that patients are routinely willing to travel an hour's drive away to come to our rural clinic in the hopes the lineup to see a doctor will be a bit shorter.
It's insane, and I can tell you that my doctor acquaintances are (at minimum) demoralized and (at maximum) likely suffering from clinical depression themselves. Ask yourself how the nursing and other support staff in their clinics are doing when their bosses (the doctors that own and operate the clinics and hire the staff) are in such a state.
Change is absolutely essential - the solution is a hybrid system like many European countries have.
I've been saying this for more than a quarter century.
Canadians seem to think their cherished health care system will have its normal shortcomings.
The aging hippie Canuck crooner Bruce Cockburn was right.
The Trouble With Normal Is It Always Gets Worse!
A system where the users and providers are pitted against each other. Our politicians over promise and our governments under deliver. As our governments insert themselves further into our lives a bureaucracy is created to manage us all, users and providers alike. Surveilling and correcting us, gradually being replaced by AI. Our healthcare system is no longer fit for purpose but to coarse correct would mean fixing it. Then it would no longer be the convenient political football it has become. Public services have be poisoned by the politics and all of us are suffering in one way or another.
I wonder why the solution is presented as "more doctors" (however they are funded) rather than "less sickness"? Our system might function sustainably if our doctors' energies could be spent on cancer diagnoses, broken legs and strep infections. Instead, our society has allowed preventable illness that stems from lack of self care, such as obesity and addiction, to drain our resources beyond capacity. Blaming patients for illness-causing lifestyle may not be the answer....it's obviously complex. But are we not even allowed to mention it? Where does personal accountability fit in to this discourse?
Certainly obesity and addiction increase costs to the health-care system. But I'd argue the biggest driver are the more & better treatments for diseases like cancer, heart disease & stroke allow people to live longer than they did even a decade or two ago. And then couple that with an aging population, who need more health-care services the older they get.
I suggest learned helplessness is an informal Canadian government objective, all governments. Their initial response to newly-identified problems is writing cheques (after an involved application process that includes gender and identity information). New regulation and an extensive approval process is the second response.
At no time do our governments review the damaging or limiting impacts of existing regulation. Income redistribution by government program is the goal of federal and provincial governments.
👏👏👏 You are so right! Learned helplessness is a huge objective of Canadian government. The goal is a docile population which then looks to Government to provide answers. That it stifles innnovation and deters self reliance - and punishing those who exhibit these traits is considered an acceptable price to live in Canada.
I know my late husband, a family doctor, would agree with much/everything I read here, as would my brother a now retired family doctor.
It is time that so many who instantly think that we will have the US system realized that there are other models. Think Western Europe. Mixed systems that work better than ours.
Stop the obsession that the only alternative to ours is the American system of health care.
We can do better and we must.
Canadian primary care doctors are completely taken for granted by an entitled yet personal responsibility culture.
That said, they created a guild lime structure to maximize work and income opportunities and then are angry they are worked to the bone.
I have relatives who are doctors in South Africa. They came here to do locums. Loved it. Generally healthy population, polite, educated patients, who had appreciation, and made off like bandits. Don't begruge the money doctors make (GPs make between 300 k and 500 k - I will not tell you how I know), as they can head to the USA at any time and make a little more (liabilility insurance reduces any windfall). Enlarge Medical Schools in Canada so Canadians can get in. This is far better than bringing in others, with poorer education and language skills.
This is utterly brilliant. I see my family doctor rarely, and right after she asks me how I am, I ask her how she is. I figured out a long time ago that Doug Ford doesn't give the tiniest little crap about public healthcare and is making life as miserable as possible everyone involved in it. Lessons about staffing should have been learned from COVID. They haven't. Lessons about time allotment per appointment should be obvious, yet aren't. Government paperwork takes an increasing amount of time when it should be streamlined. Every single consultant in healthcare should be fired. Healthcare is not a "Dale Carnegie" profession.
truth
I wish I had an answer. It’s doesn’t seem to be the management of demand by waitlist or denial of service administered by faceless government clerks. Private insurance companies in the US have the same system.
I think a major factor is unrealistic expectations laid onto physicians by the patients and encouraged by politicians.
Politicians of all stripes and civil servants who work for them are part of a system that rewards cowardice. They avoid all risks and put out policies where others take the brunt of the consequences. A prime example as I remember from Covid days was controlling access to grocery stores and enforcing mask mandates. This fell on 18 year old grocery clerks who had to take on the role of policemen and were cursed and spat upon as a result -,to the extent that anti spit shields were installed to protect the staff.
Similarly doctors are expected to say no to patients who have expectations of miracles or prompt service for free. I don’t see cowardly MPs or MPPs or being asked to explain to patients why they can expect to die on a waiting list.
Lets get more doctors. Lets get more nurses. Lets get more specialists
There is another side to this. I campaigned for the former minister of health in Alberta Jason Copping whom I thought was a very good minister. He said that he had gone to a conference in Copenhagen in the summer of 2022, A conference of various health ministers and health specialists. He said that one interesting thing he learned was that doctors in Europe are paid a lot less money than doctors in North America.