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Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 

 

 

 

 

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Wednesday
Jun072017

Understand the Implications of the "Framework"

It is shocking to me that Ontario physicians would be encouraged by the OMA or any other group to be supporting a deal with so many MAJOR pitfalls for the profession and for Ontario patients as this one.

It is WORSE than the tPSA that was voted down not so long ago with such extraordinary upheaval.

Let me be more accurate, the pitfalls are not just potholes, they are huge sharp cliffs in this case. There is a trap being set for Ontario physicians and apparently not even our own leadership can see it. The Wynne government is using Ontario physicians as part of its campaign, offering them an election goodie right before the potential of a snap summer election which may come sooner than you think...The Wynne government, after cuts to care and causing so much upheaval, is trying to deliver Ontario MDs on a silver platter and the OMA is complicit.

I will post some of the information put out by Concerned Ontario Doctors and from DoctorsOntario after this plea to think critically about the serious and dangerous ramifications of this potential "framework" not only to physicians but to Ontario's patients.

There are really four areas of concern that jump out from this contract which are more than unsettling:

1. One of the Ontario Medical Association's own negotiators is linked through family to a very vocal activist group. This in itself should have been recognized as a potential conflict of interest. This is extremely relevant since this conflict of interest puts into question the motivation for at least several contentious aspects of this potential agreement.

2. Tying arbitration to economic conditions in Ontario is murky. Although the government will say that Ontario is doing better than most other provinces in Canada with its GDP growth, this is a relative comparison and in no way indicates an overall positive econonomic picture here.

Ontario has a huge debt burden that threatens credit ratings and as it sells off revenue generating entities like Hydro One, drives up energy costs, and makes it harder for businesses to thrive, the current government is creating greater challenges for the economy for years to come. In addition, an aging population will have an effect on productivity. This too will have an impact just as need for care begins to surge. Make no mistake, tying binding arbitration to the economy is a major flaw in this agreement.

3. "Perpetuity"--any contract that requires those involved to be bound in "perpetuity" should be looked at with a special lens. Physicians must be aware that binding arbitration that is flawed by being tied to the economy, which is a problem in itself, will now be linked to other requirements that will be in "perpetuity"....items that because of this deal cannot be renegotiated.This is a major downfall and should outweigh any positive in this agreement.

4. After four years without a contract and major cuts to patient services, and being treated disrespectfully, physicians must not accept the Wynne government's newest election ploy. The Wynne government is luring physicians and the OMA with promises of  binding arbitration but the binding arbitration described  is so badly flawed that it will result in serious ramifications for doctors and patients now and in the future.

It will result in an agreement silencing physicians without any recourse. Legal counsel has confirmed that No Strike and No Job Action becomes effective immediately upon ratification, not later. The Liberal government and the OMA negotiating team with Steven Barrett will have silenced physician voices forever thereafter.

Ontario physicians and the OMA are being duped.

 

 

Reader Comments (587)

Andris,
Thank you for sharing your experiences. You deliver them in a very matter of fact way. I imagine that is one way to cope with them.
You remind me that whatever is gained can so easily be lost without.
June 12, 2017 | Unregistered CommenterMerrilee Fullerton
Thanks Merrilee ....in the meantime OPSEU's 36, 000 members are voting on that 7.5% with NO demands for concessions and no mention of the state of the Ontario economy.
June 12, 2017 | Unregistered CommenterAndris
DrK

Back to opiods. Increasing the dependency ratio, more social assistance, by more publicly funded workers. More tax on the middle class.
June 13, 2017 | Unregistered CommenterMovingforwardOntario
And in the heels of this 7.5% raise for OPSEU workers,
MDs will bite on "binding arbitration" frought with pitfalls and the possibility of some wobbly kneed Charter Challenge.

More evidence that the prior OMA board and executive were completely "out to lunch" in recommending acceptance of the governments tentative offer.

It will be very difficult for the Ontario government to claim bankruptcy after handing out raises to everyone else in the public sector.

Binding interest arbitration has worked out very well for the police and firefighter unions. No reason it can't work out well for the doctors.

Doctors will not strike so the loss of the ability to strike is meaningless.
June 13, 2017 | Unregistered CommenterERDOC
ERDOC...
You've missed the point!
Squeezing Ontario doctors is the reason why the Liberals can afford to hand out more to others.
Handing out more to others does not mean more for MDs.

Other issues I have with the BARF is that it doesn't solve anything...it won't improve income for MDs because of the economy condition,
It won't improve access for patients because the volume of services required will continue to grow without appropriate increase in utilization funding.
More rationing in different guises will likely result.
And it doesn't solve government's budget planning issues.
It's a lose-lose-lose... except potentially for the Liberal gov't to trot out the doctors holding their little string just before they announce a snap election.
June 13, 2017 | Unregistered CommenterMerrilee Fullerton
More news from the NHS mother ship...article in Daily Mail... ' Cut price doctors will see you now: 3,000 assistants ( " associate physicians") with just 2 years training to work as GPs ( FPs) and hospitals'.

These " doctors on the cheap" will be increased to 3,000 by 2020 and earn a third of a medical doctor's salary...a 1000 will graduate each year after 2020.

The concept of physician associates originated in the USA and was introduced into the UK's NHS on a small scale in 2013 ( 300 ) .....they will take over the "easy" cases , the young, leaving the serious and long term illnesses in the hands of the regular members of the medical profession....as it is the British NHS is hiring them from the USA.

At our clinic we have had 4 UK graduating MD 's clerking with us , they are leaving next week to go back to the UK to graduate in July...3 are Canadian born...the story they give of conditions in the UK 's NHS are horrible and they are eager to get out and get back to Canada....they were warned that they might be jumping from the frying pan and into the fire and advised to get qualifications that could allow them to expand their global options.

Soon these hellish conditions are to come to Ontario?
June 13, 2017 | Unregistered CommenterAndris
You will have lost the ability to speak out.
And that's a bad thing for a civilized society.
June 13, 2017 | Unregistered CommenterMerrilee Fullerton
Here you go Andris:
https://www.google.ca/amp/www.dailymail.co.uk/news/article-4601346/amp/3-000-cut-price-physicians-work-GPs-hospitals.html
June 14, 2017 | Unregistered CommenterMerrilee Fullerton
I'm not saying it's perfect , but to demand interest arbitration before negotiations and then turn around and reject it won't sit well with the public and media.

We can still protest , we just cannot strike.
Individual job actions and deciding what services are provided (or not) are options.

I think most physicians are getting tired and just want to move on.

"More rationing in different guises will likely result." - for sure but they cannot claw back billings to pay for extra services.

Until the public is ready for a private healthcare option the status quo will continue
June 14, 2017 | Unregistered CommenterERDOC
ERDOC,
You will not achieve what you think you are achieving. It's tough to watch.
June 14, 2017 | Unregistered CommenterMerrilee Fullerton
I said it about the FHTs, I've said it about eHealth...I've said it about most of the bureaucratic "transformation" efforts by the Liberal government to date...they have not resulted in overall improvements for patients or front line providers...(MDs or others) and they have not resulted in lower costs.

Please tell me one thing the current government has done in health care that has successfully created improvements for physicians and patients while costing less and while creating sustainable improvements for ALL patients long term. One thing.
June 14, 2017 | Unregistered CommenterMerrilee Fullerton
"I think most physicians are getting tired and just want to move on."-ERDOC

and there you have it.

Just when you could have been in a position to make significant change for the betterment of patients, providers, and the "system".. "We're tired".

Don't say I didn't tell you.
June 14, 2017 | Unregistered CommenterMerrilee Fullerton
R

It has turned into an autocratic political system, where the widgets do as they are told.
June 14, 2017 | Unregistered CommenterMovingforwardOntario
Mfo,
It sure looks that way and one wonders if the increased acceptance of socialism and communism by the younger generation has something to do with lack of willingness to stay in the fight for the long haul and confront the autocratic leaders?

Are we witnessing the early warning signs of "democratic deconsolidation" in this country and in particular in Ontario?

"Support for autocratic alternatives is rising, too. Drawing on data from the European and World Values Surveys, the researchers found that the share of Americans who say that army rule would be a “good” or “very good” thing had risen to 1 in 6 in 2014, compared with 1 in 16 in 1995.

That trend is particularly strong among young people. For instance, in a previously published paper, the researchers calculated that 43 percent of older Americans believed it was illegitimate for the military to take over if the government were incompetent or failing to do its job, but only 19 percent of millennials agreed. The same generational divide showed up in Europe, where 53 percent of older people thought a military takeover would be illegitimate, while only 36 percent of millennials agreed."

https://www.nytimes.com/2016/11/29/world/americas/western-liberal-democracy.html


"According to the study, just over half of millennials (55 percent) believe communism was and still is a problem, compared with 80 percent of Baby Boomers and 91 percent of elderly Americans. Only 37 percent of millennials have a “very unfavorable” view of communism, while 57 percent of the rest of Americans do."

http://thefederalist.com/2016/10/17/survey-finds-high-support-communism-among-millennials/
June 14, 2017 | Unregistered CommenterCanary in a Coal Mine
I think this is one of the 'bigly' problems of our time,.....complacency.

A comment on an NYT article yesterday stated that if there is a silver lining to the election of Trump in the USA it will be the coming realization that democracy cannot be just left on auto-pilot with the hope that it will survive into the future.
.

"There still isn’t a lot of cross-country, longitudinal data about attitudes to democracy. Perhaps the last years are an anomaly. Or perhaps new evidence, taking into account the shift from 2012 to date, will show a continuation of the trend. Many of these questions will be answered in 2017-19, when the World Values Survey conducts its next round of surveys. So it’s important to keep an open mind and to avoid panic.

But the opposite of panic is not calm; it is complacency. And complacency has been the dominant response of Western elites to the looming threats of Brexit, of Donald Trump and of the rise of illiberal politics. The comforting assumption that the past will remain a reliable guide to the future — that countries would not vote for extreme candidates when they never have before, or indeed that core norms of liberal democracy wouldn’t come under attack where democracy has always been “the only game in town” — hasn’t worked out very well so far. Now is the time to stop being complacent."

Yascha Mounk is a lecturer on government at Harvard University, a fellow in the Political Reform Program at New America, and a fellow at the Transatlantic Academy of the German Marshall Fund. Roberto Stefan Foa is a principal investigator of the World Values Survey and fellow of the Laboratory for Comparative Social Research.

https://www.washingtonpost.com/news/wonk/wp/2016/12/08/yes-millennials-really-are-surprisingly-approving-of-dictators/?utm_term=.fab5b643a04a
June 14, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM:

My experience with the youth, is they fall into two distinct groups. Those who wish to save the world, and actively participate; and a growing group who believe they are "owed" support.

I'm enthralled by the active participants, although sometimes it confuse me, I'm worried by the "owers" who believe someone else owes them their support.

I still travel through the province, and find in some areas of the province, large groups of the population are moving over to social assistance,both by need,and desire. It is worrisome. Too much globalization, too fast. It is overwhelming a large segment of society.

Sorry about the downer.Long day dealing with MOHLTC errors.
June 14, 2017 | Unregistered CommenterMovingforwardOntario
And yet in my corner of the world contractors cannot find reliable help despite offering starting wages for basically general labour at $21 to $23/hr.

I have two business cards from patients who own their own contracting firms with the instructions to send any young able bodies who can operate a shovel, show up on time at 7AM, have no substance abuse issues, and can leave the smartphone in the truck.

I've only given two people the contact info in the last 8 weeks. Many students already have summer jobs but many I just can't send because of one issue or another.

Excessive pot consumption during the week is a real problem in our unemployed and it isn't even legal yet.
June 14, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM:

Sadly,I can't disagree.

Something has changed. I believe it is the belief in "entitlement". I'm here, I'm entitled.

I find the youth who are working, are getting angry. I'm worried.

The BA agreement will be interesting. It should be voted down. It will not be. "Peace in our time". What will follow is more MAiD. MDs as the state's agent for processed non life.
June 14, 2017 | Unregistered CommenterMovingforwardOntario
Yes it looks like the BA will be accepted.

Sadly it does look like we're throwing in the towel and agree with both you and Realist that over the long-term it is a bad decision for both physicians and patients.

But we do live in a functioning democracy, at least for now, so I will respect the outcome of the decision. Time will tell if the profession has made the right decision.

Possibly for the younger generation becoming an agent of the state in terms of rationing care, promoting MAID, etc. all the while working in a harmonious team will be seen as patriotic.

I'm not sure those at the other end of life will see it that way.
June 14, 2017 | Unregistered CommenterCanary in a Coal Mine
Self sale, voluntary slavery, was not uncommon in ancient times, where, for sheer survival of oneself and ones family during hard times.

What excuse is there for the medical profession to enter into a slave contract?

Is it sheer apathy, the lack of self esteem, the lack of courage, the fear of responsibility , hypegiaphobia?

Intelligent people are often more anxious ....ignorance may well lead to bliss and intelligence may well lead to anguish.

If the profession votes yes to self enslavement , then it will be one of the saddest moments in the history ( 2400 years, going back to Hippocrates 460-370 BC) of our once proud and self confident profession.
June 14, 2017 | Unregistered CommenterAndris
Don't despair, friends.

A little nuclear bomb is being faxed and emailed to all Ontario docs first thing tomorrow morning.

Hopefully, the OMA will over react and people will change their votes from yes to no for the BARF.

Might be an entertaining final couple of days.

Cheers.

Yer favourite spin doctor
June 14, 2017 | Unregistered CommenterStephen Skyvington
This is being faxed and emailed to all Ontario doctors within the hour...




Fool me once, shame on you.
Fool me twice, shame on me.


[picture of McGuinty holding Wynne's hand after she wins Liberal leadership]


It all comes down to trust.
For Ontario’s doctors, the question isn’t whether the tentative Binding Arbitration Framework is good enough (it isn’t), or whether the Ontario Medical Association should begin negotiating a new Physician Services Agreement before the next election.
No, the real question for the province’s doctors is whether or not we can trust Premier Wynne to work with us to build a better health-care system here in Ontario.
Ontario’s doctors have been without a contract for the past three years and counting. During that time, Premier Wynne and her health minister Eric Hoskins have stolen over $3 billion from us, while misleading the public about our remuneration.
That’s bad enough. But what the premier is about to do is even worse. Understand that if we ratify the tentative Binding Arbitration
Framework, Premier Wynne will very likely tell the people of Ontario that she’s reached an agreement with the province’s doctors and call an early “snap” election.
If she and the Liberals triumph and form another majority government, you can bet your bottom dollar they’ll tear up this agreement and go back to vilifying doctors and making us scapegoats for a broken health-care system that’s unsustainable and in need of innovation.
Premier Wynne has played the OMA for fools by dangling binding arbitration in front of them like a carrot. But we can stop the premier from prevailing by voting against it by June 17.
To cast your ballot, go to the BigPulse voting link: www.bigpulse.com/m47104/intro.
And don’t forget, if you’ve already voted in favour of the Binding Arbitration Framework, you can change your vote. The last ballot submitted is the one that’s tallied.


Don't get fooled again.

#DOCTORSagainstBARF

A message from DOCTORS AGAINST THE BINDING ARBITRATION FRAMEWORK AGREEMENT
June 15, 2017 | Unregistered CommenterStephen Skyvington
<<Premier Wynne will very likely tell the people of Ontario that she’s reached an agreement with the province’s doctors and call an early “snap” election.>> - SS

On May 31, 2017 CBC Queen's Park/Provincial Affairs reporter Mike Crawley tweeted:

Premier @Kathleen_Wynne rules out calling an early election, commits to fixed election date of June 7, 2018 #onpoli

Source: https://goo.gl/yzkyIn

Now, while I wouldn't put it past any politician to go back on their word, wouldn't the consequence of making a commitment and then recanting in the context of something so fundamental as calling a snap election would have some serious credibility implications, no?
June 15, 2017 | Unregistered CommenterExecutive Lead Blogger
Everything's lining up for an early election.

Remember, those very embarrassing trials are coming up this September.

She really needs to get the election out of the way now, or they'll have no chance at all.

Docs accepting the tBARF is the last piece of the puzzle.
June 15, 2017 | Unregistered CommenterStephen Skyvington
"calling a snap election would have some serious credibility implications, no?"-ELB
June 15, 2017 | Unregistered CommenterMerrilee Fullerton
I hope that the Premier calls a snap election...I hope that she has the same advisors that Theresa May listened to.

Polls , as Theresa and Hillary discovered , can turn on a dime.
June 15, 2017 | Unregistered CommenterAndris
“Beware of Greeks bearing gifts” goes the timeless saying.

Doctors are now in their fourth year without a contract with the Ontario government, and have seen billions of dollars in unilateral cuts to the patient services they provide during this time."


http://www.torontosun.com/2017/06/15/government-oma-deal-is-a-trojan-horse
June 17, 2017 | Unregistered CommenterCanary in a Coal Mine
“Beware of Greeks bearing gifts” goes the timeless saying.

Doctors are now in their fourth year without a contract with the Ontario government, and have seen billions of dollars in unilateral cuts to the patient services they provide during this time."


http://www.torontosun.com/2017/06/15/government-oma-deal-is-a-trojan-horse
June 17, 2017 | Unregistered CommenterCanary in a Coal Mine
The governmental Greeks promised the medical Trojans that there would not be any Greek surprises inside the 2017 Wooden horse as occurred in 2012.
June 17, 2017 | Unregistered CommenterAndris
potential lucrative contract for Goldblatt should there be a yes vote, which I believe is likely.
Well, it will make bargaining with the OMA that much easier for government since the economy is going to be somewhat slow for quite a while.
It's unfortunate that Ontario MDs seem "tired of waiting". Gov't was counting on that I suspect.
June 17, 2017 | Unregistered CommenterMerrilee Fullerton
Quebec now has a better credit rating than Ontario
June 17, 2017 | Unregistered CommenterMerrilee Fullerton
"Framework" ratified
June 17, 2017 | Unregistered CommenterMerrilee Fullerton
What a pity....the profession helped to close the gates on the abbatoir ( a term now forbidden for me to use on the HealthcareNetwork site).

The whole thing rhymes with Lenin's statement that " capitalists will sell us the rope with which we will hang them"...the OMA membership just voted to give the government the rope.

Lenin's other statement comes to mind " give me four years to teach the children and the seed that I have sown will never be uprooted"....the seed was sown in the educational system and within the medical schools...it has taken root.
June 17, 2017 | Unregistered CommenterAndris
Andris I believe you are correct about the seed being sown right back into the secondary school system. I'm sure we'll never see the data but it would be interesting to see what fraction of students and residents were part of the small number of docs who actually voted.

I'm not sure of the total number of docs in Ontario but it would appear only a third of docs actually cast a vote? Ontario doctors are a complacent bunch and have got the government and deal they deserve. At least now it is clear as day as to the future conditions one will practice under in Ontario.
June 17, 2017 | Unregistered CommenterCanary in a Coal Mine
It will be fine. Steady incomes,defined jobs,distributed as Central needs. Comrades, all will be fine. Trust us. We know what is best. No lineups for MAiD.
June 17, 2017 | Unregistered CommenterMovingforwardOntario
When the penny drops, when our colleagues whine....I will have little sympathy....they either voted yes or did not vote at all...it seems that only around 13% of the whole voted No.

The public will get the health care system that they voted for; the medical profession will have to tolerate the work conditions that they voted for.

I graduated in medicine 50 years ago....medical historians will record that it was a golden era for both medical doctors and their patients.
June 17, 2017 | Unregistered CommenterAndris
Andris your generation benefited from and practiced under the era which followed the Flexner Report. High quality, science-based medicine, controlled predominantly by physicians.

Today medical historians will mark as the end of the Flexner report era where we now have medical education and the practice of medicine fully state controlled. Physicians within 10 years will be no different than teachers with much of their professionalism and independence gone forever.

This is not what we signed up for but possibly it is what the younger generation desires,....state intervention at every point in their lives in return for entitlements from cradle to grave.
http://en.wikipedia.org/wiki/Flexner_Report

What I don't understand is how I keep meeting medical graduates who have such huge debt loads (especially those who have gone offshore to gain their degree), often in the ballpark of $200K plus, who will simply not be able to pay those debts off until very late in life especially if entering family practice or other low paying specialties.. Sadly practical economics does not seem to have been taught to these young socialists graduating today.


Another very sad story in the Globe today of a young Ontario medical graduate who killed himself because he could not get a residency position. Here we are allowing in foreign born IMGs, many of which have very questionable skills, and our own Canadian-born and trained cannot even obtain a matched residency position. Something is very wrong with this system.


"Tragic case of Robert Chu shows plight of Canadian medical school grads

Each year, a growing number of students do not get matched, putting the hundreds of thousands of dollars that provincial governments invest in educating and training future doctors at risk"

http://www.thestar.com/news/canada/2017/06/17/tragic-case-of-robert-chu-shows-plight-of-canadian-medical-school-grads.html
June 17, 2017 | Unregistered CommenterCanary in a Coal Mine
How bloody sad!

The faceless government health care bureaucracy guards its rules and regulations preventing a bright young medical graduate , who passed all the exams required , from taking that final step....even as the system needs more interchangeable widgets...the system , quite deliberately designed a system that does not have enough training slots for newly formed widgets...Canada has fewer MDs per population, than any of the global top rated health care systems...even with the increase of 650 doctors yearly to 2025 ....the number of doctors in Canada will rise from 2.1 : 1,000 to a dizzying 2.2 : 1,000....the top rated health care systems such as those in the EU have 3.4 : 1, 000....our ideological mothership, the U.K. has 2.8 : 1,000.

June 17, 2017 | Unregistered CommenterAndris
I attended a very interesting wedding tonight for a Millennial and one of the siblings is a GP trainee in England. What she told me reveals the NHS is on the verge of collapse.

1. They are now paying new medical school grads 10,000 pounds to apply to family medicine because no on wants to enter the profession.

2. Family docs are being paid 60K to 80K pounds year yet if you you locum you earn 100 pounds/hour so all the new FP grads are just doing locums rather than entering full-time practice.

3. British born and trained FPs are fleeing the system and moving permanently to Australia and New Zealand where there is a shortage of FPs.

4.. The British government is so desperate for primary care widgets they have started to train nurses to become physicians assistants who will act as FPs.

5. British FPs are now sued at a higher rate than ob/gyne.

This Canadian born doc has passed her Canadian exams recently and could work here as a FP, but says she will also head to Australia or New Zealand to start her career.

When I asked her where the NHS will be in a decade she said gone. Very few services will be covered and everything visit will have a co-pay.

Canadians have no clue that their cherished monopoly health care system is about to head down the same pathway as the NHS.
June 18, 2017 | Unregistered CommenterCanary in a Coal Mine
The fact that GB is so far down the road suggests Ontario has a long way to go before the MoHLTC becomes completely overwhelmed. I doubt Ontario has a more demanding or discriminatng population.

Fact remains only those in the system by emploment or illness see the problems. Far more OPSEU members lobby the government effectively for more trivial concerns affecting residents.

It wont change openly for many years. The insidious provision of necessary care off the government books is a growing industry. Government wont attempt to stop it.
June 18, 2017 | Unregistered CommenterEklmek
Typo in authour name above. Yes, it is who you think it is.
June 18, 2017 | Unregistered CommenterEklimek
So the NHS is bribing to entice young grads to enter a profession where they will be abused and sued....one of the 4 UK medical grads ( 3 born in Canada) that spent time with us the last few months stated that an UK McDonalds employee earned more than she would....they are horrified by UK conditions....I gather that after graduating this July they have to work for 2 years within the NHS system before they have the paperwork that allows them to escape.

I had mentioned in a previous posting that the graduating Canadian FPs with the highest marks were going to become nomadic locums in Canada ( and elsewhere) rather than setting roots.

The U.K. Mothership leads the way.

The British NHS WILL collapse as will our own increasingly dysfunctional health care system ....and all the healthcare bureaucrats and all the MBA's won't be able to put Humpty Dumpty back again.
June 18, 2017 | Unregistered CommenterAndris
Watch the UK. Labour party now is advocating seizing housing,for the good of the public, soon o come to GTA, GOA.

http://www.bbc.com/news/uk-40319515
June 18, 2017 | Unregistered CommenterMovingforwardOntario
What I did not understand and wanted to verify first before posting is that to become a GP in Britain it is now a 5 year process post-medical school.

For those of you in practice long enough to remember the one year rotating internship these Brits do a 2 year rotating internship, called Foundation Training, and then apply to a specialty such as family medicine, surgery, etc.

Only after completion of the two foundation years one then does 3 years of family practice training.

This seems like an insanely long process to become a family physician, in fact it is 3 years longer than what our Canadian programs require, but I do think the foundation years are a good idea.

If I was to revamp post-medical school training here in Canada I'd institute a one year rotating internship again followed by your specialty training. Family practice would be two additional years for a total of 3 years like the American programs.

Here's the link showing 5 years to become a family doctor. The government is getting essentially a few extra years of cheap labour it would seem.

http://www.rcgp.org.uk/training-exams/becoming-a-gp/how-to-be-a-gp.aspx
June 18, 2017 | Unregistered CommenterCanary in a Coal Mine
I could get rich very quickly if this scheme was instituted in Ontario. It is just more evidence of the desperation of those running the NHS.


http://www.independent.co.uk/news/health/gps-drugs-take-away-elderly-patients-care-homes-doctors-nhs-incentive-a7767071.html
June 18, 2017 | Unregistered CommenterCanary in a Coal Mine
Canary : that two year business before our UK graduating Canadian have to do "before they get their papers" before they can think of Canada ( or the world) must be the foundation years....if the 2 & 5 years spent were educational it would be one thing....instead it's the government driving into the ground as cheap labour .

Mfo, that Corbyn ( of the silver spoon.) demand to seize the property of the " rich" prompted me to write that piece earlier on this thread on how the Soviets did it with their communal appartments with its 9 square meters per person.


It does not take much imagination to see a mini LHIN of the near future sending in social workers to assess an elderly person living in a bungalow , noting that it was way larger than the recommended 9 square meters, directing the ' needy' to be relocated there in the name of social justice, with the client relocated to her hellish government 9 square meter allocation within her original home or in a dilapidated nursing home....it was done in the Soviet era.

An aunt of mine had a home ( a flat) with many rooms, Soviet military officers took it over with her limited to her own room having limited access to her own kitchen ...eventually they drove her out and she literally dug a shelter for herself in the rise/ hedge on the other side of the road ...happily with the collapse of communism she was able to return to her appartment which I visited just prior to her death.

Nothing is unthinkable.
June 18, 2017 | Unregistered CommenterAndris
Mfo your observation that the urban hipsters are angry about the current housing situation was spot on. Many, with a few glasses of wine at the wedding, were more than willing to speak their mind.

It would seem that for the average 30 year old in the GTA or GVA the choices are to rent, purchase a condo, or leave altogether which is typically not possible due to career aspirations. Most do not want to raise a family in a condo so renting a duplex seems to be the plan for the foreseeable future.

Once this demographic comes to to vote en mass it will be interesting to see their views on housing and health care. I doubt that a maintaining a single payer system at all costs will be part of their core values.

Just wait until they realize that not only can they not afford a house likely until their kids are off to college, but that the cost of child care will deplete any savings they might put towards purchasing a house in the future.

Politics is about to get a lot more divisive in this province.
June 18, 2017 | Unregistered CommenterCanary in a Coal Mine
DrL/CICM:

With the BA now set, all that needs to occur is the binding contract, fixing incomes,and locations of practice through the LHINs and subLHINs. It will provide,overall,less money, than what would occurred if the claw backs had not occurred. Central has "flatten the curve", and the MDs will live with it.

The 10 year plan. The MD widgets are owned.Now just need to be fairly redistricted across the province. A binding contract with binding arbitration, taking into consideration the economic needs of the province. Comrades,we have achieved nirvana. The committess appointed by central will lead us well.

As for seizing housing: you want home health care, you house your personal care worker,and their family in your house with 4 bedrooms. You want personalized home care, you can keep it by housing exchange,and stay out of the ED. Otherwise, line up for the widgetized ED care.

Those with defined benefit state provided pensions ) teachers,health professionals,etc), in for a shock as the Soviet system rolls out.

"Vertical" condo living for the newer graduates in health.

Central will achieve social justice (note not justice,social justice as central sees fit).

The plan for central, is excellent.
June 18, 2017 | Unregistered CommenterMovingforwardOntario
The deal with the doctors, even if wildly successful on either side, is a trivial matter. The level of health care provided is professionally to be considered. The CPSO must become much more involvd as "employee" status is entrenched. The ramifications are significant.

Whereas before the standard of care was a professional matter, it will now become an occupational expectation. In case the distinction is unclear, the LHIN "told me to practice here" will become a defense.
June 18, 2017 | Unregistered CommenterEklimek
This ordeal was nothing but an exercise in futility. Even with binding arbitration, we will not get a better deal than what was offered to us last summer. Then what becomes of the OMA?
June 19, 2017 | Unregistered CommenterKim

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