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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 (382)

Kim

You already made that decision. The OMA will remain forever your "union". You have no rights under the labour act, but you must pay dues and you may not negotiate directly with government.
June 19, 2017 | Unregistered CommenterEklimek
As stated by DrK, MDs now have occupational roles, not professional ones.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
" Rise of the 4 day a week Doctor fuels National shortage of GPs as ' millennial' medics choose to work part time".( Daily Mail).

....part of this is because of generations Y and Z and millennial starting to come through not wanting to work the hours that many of the baby boomers and generation X want to work.

In Canada Generation Y were born between 1972-1992 with generation Z 1993-2011.

Generation X were born 1966-1971.

The baby boomers born 1946-1965.

The differences regarding the generations between the UK, Canada and the USA being related to the fact that US troops returned earlier from Europe after a WWII than did the Canadian troops...the baby boom started immediately at the end of WWII in the U.K.in 1945-6.
June 19, 2017 | Unregistered CommenterAndris
Kim,
It is said that physicians are terrible at making investment decisions because they are too busy to do the necessary research groundwork themselves.
The same thing seems to hold true for medical political decisions.

I suggest that physicians also tend to be very trusting. They find someone who they believe knows what is going on and attach their trust to that individual or organization.


You must do your own homework.
You must be a critical thinker.
You must understand that the decisions you make in medical politics will affect you and your patients.
You must understand the upside and the downside.
You must think longer term and beyond your own immediate needs because the decisions you make now in your best interests may turn out to be quite different over the longer term.

Do not be too busy to look up and out.
Understand that academic leaders have their own bias. They can't help it.
June 19, 2017 | Unregistered CommenterMerrilee Fullerton
and I should add, Kim,
that the deal last summer was no "deal".

The problems in health care are big. They will not be solved by blaming the providers and squeezing access. The volume of services required is just too big.
June 19, 2017 | Unregistered CommenterMerrilee Fullerton
as an aside, if we are becoming employees we will also be on the sunshine list,

https://www.thestar.com/life/health_wellness/2017/06/19/ontario-doctors-go-to-court-to-keep-billing-information-secret.html

The top 100 OHIP billers took in a combined $191 million in 2012-13, according to data supplied by the ministry. The highest biller alone claimed more than $6 million, while the second- and third-highest billers each claimed more than $4 million. Nineteen doctors received payments of more than $2 million each.
June 19, 2017 | Unregistered Commentereklimek
DrK

All physicians billings will be made public. That deal is resolved.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
Andris there is no mention of the fact that there are probably 60% women now in the GP workforce who work fewer hours and retire earlier. I'm sure the same effect can be seen here in Canada.

Given the very poor work conditions many docs are just leaving to Australia and New Zealand. No new exams need to be written if you are a licensed GP in the UK.



"I fear this gender imbalance is already having a negative effect on the NHS.

The reason is that most female doctors end up working part-time — usually in general practice — and then retire early.

As a result, it is necessary to train two female doctors so they can cover the same amount of work as one full-time colleague."

http://www.dailymail.co.uk/debate/article-2532461/Why-having-women-doctors-hurting-NHS-A-provovcative-powerful-argument-leading-surgeon.html


http://www.dailymail.co.uk/news/article-4612430/Rise-4-day-week-doctor-fuels-national-shortage-GPs.html
June 19, 2017 | Unregistered CommenterCanary in a Coal Mine
Oh dear, say it it ain't so. Working conditions and employee hours are being discussed.

Pandora's box is opened. As the MoHLTC takes a more direct role, more responsibility for working conditions and outcome will be uploaded.
June 19, 2017 | Unregistered Commentereklimek
Yes working conditions will become an issue if one becomes an employee and works for the LHIN.

37.5 hours a week, six weeks vacation, pension, double time on holidays, ten sick days a year, and no more than 20 patients a day.

You're right the government has opened a pandora's box because who in their right mind would continue to operate a FFS clinic in that environment.

At some point there will be so many restrictions on how to run one's FFS clinic that it won't be economically possible to do so and those clinics will close leaving the primary care system in disarray. There are still 55% of family docs working on FFS in Ontario.

Blame the public who voted in the Liberals and the physicians who voted for this agreement.

The other big change in the UK according to the doc I spoke with on the weekend is that many GPs are heading into private focused practices for derm, sports medicine, etc.

One can see the primary care system is already coming apart at the seams. We're running volumes now that normally we'd see in the winter months. No one has an FP or they can't get in to see their FHNOT doc on a timely basis (< 2 weeks).
June 19, 2017 | Unregistered CommenterCanary in a Coal Mine
The closest parallel is not the teachers, but the airline pilots working contracts, with their monitoring of hours worked, and shifts allowed, and restrictions when off work (drugs and alcohol monitoring,etc).

The old days are gone.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
As central moves to get lots in place before the 2018 election, watch for more special groups being selected to receive centrals resources. MDs are not on that list.

Enough small but vocal groups with benefits can swing elections.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
Not really because the airline pilots don't own the means of production whereas we do. A pilot doesn't own the airplane, the hanger, or hire his co-pilot and flight attendants. As a FFS physician we lease the facility, pay for supplies, and hire/fire the staff.

The two economic models will not be compatible unless the government takes over the financial running of these clinics which we know won't happen. So then either the clinic will shut down because of too much regulation or the government will have to set them free to operate similar to private schools in the province.

Take your pick but you can't have it both ways.
June 19, 2017 | Unregistered CommenterCanary in a Coal Mine
Cicm

The last 5 years have given warning. Few docs in the "have not" specialties in FFS will continue. Leases will not be renewed. Staff are not affordable. None will apply for hospital privileges without clinic support paid by the hospital.
June 19, 2017 | Unregistered CommenterEklimek
CICM

Central can have it both ways. It owes the pot of money, and all the rules. It has shown that.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
Mfo, they can have it both ways until we end of like the NHS with an exodus of docs, terrible working conditions, and a rapidly aging population.

It can't have it both ways because as Eklimek has pointed out the FFS clinics which comprise 55% of FPs in the province will just shut down. Many specialists will close up shop as well.

At that point a doc will either leave the province, retire, change careers, or apply for a LHIN job, but if you don't have facilities for 50% of the FPs in the province to transition to, the primary care system will implode.
June 19, 2017 | Unregistered CommenterCanary in a Coal Mine
The vacuum left by the absent FFS will be filled by ersatz providers. Judging by the referrals I receive, there is a shift of care to specialists. When they fail to back stop the public there will be a mortality uptick. It is a bad omen when I make a diagnosis of a DVT referred for leg pain, query sciatica. It will get worse.
June 19, 2017 | Unregistered CommenterEklimek
CICM

This is not about health care. This is about power and social engineering. A growing proportion of society is being persuaded someone is to blame for their issues.
June 19, 2017 | Unregistered CommenterMovingforwardOntario
today's running

http://www.torontosun.com/2017/06/20/wynnes-liberals-tracking-for-minority-status-in-next-election-poll

Best on the Economy

1. Patrick Brown (42%)
2. Andrea Horwath (17%)
3. Kathleen Wynne (13%)

Best on Trust

1. Patrick Brown (30%)
2. Andrea Horwath (29%)
3. Kathleen Wynne (10%)

Best on the Health Care

1. Andrea Horwath (30%)
2. Patrick Brown (28%)
3. Kathleen Wynne (13%)

Best on the Environment

1. Andrea Horwath (30%)
2. Patrick Brown (25%)
3. Kathleen Wynne (12%)

Best on Education
1. Patrick Brown (32%)
2. Andrea Horwath (22%)
3. Kathleen Wynne (18%)

Best on Infrastructure

1. Patrick Brown (37%)
2. Andrea Horwath (16%)
3. Kathleen Wynne (15%)
June 20, 2017 | Unregistered Commentereklimek
Back to opioids
http://www.cmaj.ca/content/189/18/E650.full
CMAJ May 8 p 383-4

Systemic barriers include the lack of timely access to alternative safe, effective and affordable multimodal pain treatments. There are long waiting lists to access multidisciplinary pain clinics and pain management specialists, and few community-based self-management programs.
...

health care professionals receive inadequate education about chronic pain in undergraduate, residency and continuing professional development programs.10 Current funding models do not account adequately for the time required to address patients who present with the complex interaction of chronic pain, sleep and mood disorders and, in some cases, substance abuse.
June 20, 2017 | Unregistered Commentereklimek
"China has become a world heavyweight in manufacturing synthetic drugs, which have flourished in a country with a giant chemical industry, industrious organized criminal groups and borders busy with trade.

But choking off the supply of Chinese-made drugs, including laboratory-made opioids fuelling a fentanyl overdose crisis in North America, will be difficult enough that countries suffering the effects of Chinese-made drugs would do better to persuade their own people not to consume them."

http://www.theglobeandmail.com/news/world/dont-count-on-china-in-fentanyl-crisis-cutting-demand-is-key-un/article35418275/
June 22, 2017 | Unregistered CommenterCanary in a Coal Mine
"China has become a world heavyweight in manufacturing synthetic drugs, which have flourished in a country with a giant chemical industry, industrious organized criminal groups and borders busy with trade.

But choking off the supply of Chinese-made drugs, including laboratory-made opioids fuelling a fentanyl overdose crisis in North America, will be difficult enough that countries suffering the effects of Chinese-made drugs would do better to persuade their own people not to consume them."

http://www.theglobeandmail.com/news/world/dont-count-on-china-in-fentanyl-crisis-cutting-demand-is-key-un/article35418275/
June 22, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM

Thanks for the article.

“At the end of the day, it’s a consumer market.”

Let's stop vilifying doctors trying to help patients with problems for which no other treatment is available?
June 22, 2017 | Unregistered Commentereklimek
http://www.canadianhealthcarenetwork.ca/physicians/discussions/opinion/a-road-map-for-the-next-12-months-50226

A road map for the next 12 months

Written by Stephen Skyvington on June 22, 2017 for CanadianHealthcareNetwork.ca


Stephen Skyvington
Now that the Binding Arbitration Framework has been ratified by Ontario’s doctors, I’d like to focus on something I believe is sorely missing in all this—namely, a strategy.
Many people—doctors included—confuse strategy with tactics. So, let me help clear up some misconceptions. Bus shelter advertisements, tweets, rallies at Queen’s Park—all those are tactics. A strategy, on the other hand, is the plan you come up with to help you find the path to victory. Tactics are the things you may or may not choose to use to implement that strategy.
With me so far? Good. The other thing I’d like to point out is that in order to run a successful campaign of any kind—be it a public relations campaign, an election campaign, or a campaign to convince someone to support something (or not)—you need to do the following three things: educate, motivate, activate.
With this in mind, here is a four-point strategic plan that Ontario’s doctors and the Ontario Medical Association should seriously consider using as their road map when dealing with the Wynne government over the next 12 months:
Inform Kathleen Wynne and Dr. Eric Hoskins that you will not be returning to the negotiating table until after the next provincial election. Simple rule of thumb. You can’t negotiate with bullies, nor should you. Just because the Liberals are desperate to reach a deal with the OMA doesn’t mean we should accept whatever table scraps the government is willing to throw our way.
Begin reaching out to the leadership of both the New Democratic Party and the Progressive Conservatives. It doesn’t take a rocket scientist to figure out that someone other than the Liberals is going to form the next government. With this in mind, it’s essential for the leadership of the Ontario Medical Association to begin building bridges now—before next year’s election—with both Andrea Horwath and Patrick Brown.
Implement Operation “Take the Wind Out of Wynne’s Sails.” Fact: Ontario’s doctors have the power to bring any government to its knees. Clearly, the best use of the next 12 months would be to actively campaign against Kathleen Wynne and other Liberal candidates in every riding across the province. Forget job action. Political action is a much more powerful weapon.
Launch an aggressive public relations campaign to explain all this to both your membership and the people of Ontario. Here’s where the educate, motivate, activate part of the strategic plan comes into play. In order to get the province’s doctors and their patients onside, the OMA needs to hire someone with the expertise and courage to come up with an advertising campaign that tells it like it is. No more confusing messages. No more playing nice. The Wynne government has screwed up health care and needs to be brought to account for its actions.
Sounds simple, doesn’t it? That’s because it is. If we band together and help those who’ve been charged with the duty of getting it right, then there’s nothing we can’t accomplish on behalf of Ontario’s doctors and their patients.
But in order to win, one must first find the path to victory and then find a way to get on that path as soon as possible. One thing you can’t afford to do is waste any more time playing “footsie” with those who have already shown by their actions that they’d chop off one of our arms or legs without so much as a second thought.
Premier Wynne and her band of bullies and charlatans don’t deserve our co-operation or respect. The reborn Ontario Medical Association, however, does.
Stephen Skyvington is president of PoliTrain Inc., former manager of government relations for the Ontario Medical Association, and currently an adviser to DoctorsOntario, a grassroots physicians’ organization.  Twitter @SSkyvington.
Opinions expressed in this article are those of the writer, and do not necessarily reflect those of CanadianHealthcareNetwork.ca or its parent company.
June 22, 2017 | Unregistered CommenterStephen Skyvington
Fun on Twitter . . .

Stephen Skyvington‏ @SSkyvington 8m
8 minutes ago


More
Operation “Take the Wind Out of Wynne’s Sails.” Let's actively campaign against Kathleen Wynne and other Liberal candidates in every riding.


Stephen Skyvington‏ @SSkyvington 7m
7 minutes ago


More
"Take the Wind Out of Wynne's Sails." Ontario's doctors: Forget job action. Political action is a much more powerful weapon. Are U with us?



Stephen Skyvington‏ @SSkyvington 5m
5 minutes ago


More
To help defeat Kathleen Wynne and the Ontario Liberals go to http://www.doctorsontario.ca  and take out a membership or make a donation today!



Stephen Skyvington‏ @SSkyvington 1m
1 minute ago


More
No more playing nice. Premier Wynne has screwed up health care and needs to be brought to account for her actions. Time to toss them out!
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June 23, 2017 | Unregistered CommenterStephen Skyvington
Back to opioids

"The Associated Press reported Sunday that 33 people were affected by drug overdoses during the previous week, and another four died.

Cyclopropyl fentanyl is chemically similar to the narcotic fentanyl, which is used to treat severe pain. This is the first time cyclopropyl fentanyl has been reported in Georgia, and it is not known how it affects the human body, as it is not intended for human or veterinary use.

U-47700 is a painkiller that is seven-and-a-half times stronger than morphine.

Both of the drugs are highly dangerous and should not be handled, according to the press release. They can be inhaled or absorbed through the skin and are extremely toxic, even in low quantities."

June 13th, 2017
http://www.timesfreepress.com/news/local/story/2017/jun/13/deadly-fake-percocet-identified-synthetic-drug-seven-times-stronger-morphine/433187/
June 24, 2017 | Unregistered CommenterEklimek
Dr. K,

I think he wrote this one specifically with you in mind.

http://shawnwhatley.com/relativity/
June 27, 2017 | Unregistered CommenterCanary in a Coal Mine
No issues. Under the plan, high billers reined down. No other major corrections.
June 27, 2017 | Unregistered CommenterMovingforwardOntario
cicm thanks for the notice. Here is my response.

--------------------------------------------------------

Your solution is ” good-faith consensus between traditionally tribal factions”.

Trick question here, how long does it take to record the 20 minute EEG that is reimbursed for the same fee as when Ronald Reagan was President of the USA? (Answer 20 minutes.)

Cataract surgery required inpatient hospitalization before the Berlin wall fell. it is now day surgery and about 15 minutes in the OR. The fee remained about $400. If you do 25 in an afternoon how much do you bill? ( Answer – more than a geriatrician bills in one week)

The first commercial CT was 1974. CT was a vague imprecise image and it took all the computing power then available. (Do you remember the IBM XT in 1982 had 5¼ inch floppy disk drive with a 10 MB Seagate ST-412 hard drive?). Ignoring entirely increases in technology, how long does it now require to undertake and interpret a CT or MRI?

The evolution of novel and experimental into readily and commercially available is accompanied by cost alignment. The point of this is that medical services and the fees applicable have distorted “value” of the specialty.

In dividing up a single physician budget bone among dogs of different specialties you may expect honor, gentlemanly behaviour and generosity. It has not been my experience that all have been prepared to share good fortune.
June 27, 2017 | Unregistered Commentereklimek
"New Brunswick has made public how much it pays to each of its doctors.

The province released the names of physicians along with the amounts each received in payments for providing medically insured services last year.

In doing so, it has joined a growing list of jurisdictions that is turning to public disclosure of such data."

http://www2.gnb.ca/content/dam/gnb/Departments/tb-ct/pdf/OC/upmpl-lnvpm.pdf

https://www.thestar.com/news/gta/2017/06/27/new-brunswick-joins-growing-list-of-provinces-who-reveal-how-much-they-pay-doctors.html

http://globalnews.ca/news/3555516/new-brunswick-medical-professionals-paid/
June 28, 2017 | Unregistered Commentereklimek
Interesting statistics about Canadians seeking medical care outside of Canada in 2016....Ontario led the way with 26,533 followed by BC at 15,372 and Alberta at 9087.

Surprisingly the largest group was for ENT at 2.1% , not surprising was orthopaedics at 1.9%.
June 29, 2017 | Unregistered CommenterAndris
See Fraser Institute
https://www.fraserinstitute.org/sites/default/files/leaving-canada-for-medical-care-2017.pdf

non-emergency medical treatment outside Canada.

In some cases, these patients
may have needed to leave Canada due to a lack
of available resources or a lack of appropriate
procedures or technologies. In others, their
departure may have been driven by a desire to
return more quickly to their lives, to seek out
superior quality care, or perhaps to save their
own lives or avoid the risk of disability."


(I note the lowest rates seem to be in select provinces.)
June 29, 2017 | Unregistered Commentereklimek
Dr. K - you had a 10 MB hard drive? Lucky!
June 29, 2017 | Unregistered CommenterExecutive Lead Blogger
Congratulations, Dr. F! (I think).

https://ipolitics.ca/2017/06/28/ontario-pcs-choose-candidate-in-kanata-carleton/
June 29, 2017 | Unregistered CommenterExecutive Lead Blogger
Thanks ELB!
My nomination campaign was successful.
On to the next mountain to climb.

As for snarky comments in the public sphere, c'est la vie.

We carry on.

Thanks to all of you for your contributions here

AND

Best Wishes to All of You for a Happy Canada "150" Weekend!
June 29, 2017 | Unregistered CommenterMerrilee Fullerton
yes, congrats, best of luck.

Time to put on the flameproof attire and ignore the trolls.

Does good politics ever make for good government?
June 29, 2017 | Unregistered Commentereklimek
Realist,
Congratulations on winning the nomination.
Now to win the provincial election.
June 29, 2017 | Unregistered CommenterCanary in a Coal Mine
The Wynne government hydro plan

"The Ontario Society of Professional Engineers, a non-partisan body, which represents the province’s engineers, says it has crunched government hydro numbers from 2016 and they show that 7.6 terawatt-hours of clean hydro went down the drain that year. That’s equal to the amount required to power 760,000 homes – or $1 billion worth of electricity – said the group’s past president Paul Acchione.

“This represents a 58% increase in the amount of clean electricity that Ontario wasted in 2015 which was 4.8 terawatt hours,” he said. “All while the province continues to export more than two-million homes’ worth of electricity to neighbouring jurisdictions for a price less than it costs to produce.”

Acchione said the province is wasting the power through a practice called “curtailment.” It means that when the province’s hydro generators produce power consumers don’t need, and it can’t be exported, they have to dump it.

“It’s when we tell our dams to let the water spill over the top, our nuclear generators to release steam to their condensers and our wind turbines not to turn even when it’s windy,” he said. “The numbers...show that Ontario’s cleanest source of power is literally going down the drain because we’re producing too much of it.”

http://www.torontosun.com/2017/06/29/1b-worth-of-energy-wasted-last-year-engineers
June 30, 2017 | Unregistered CommenterEklimek
From

NUPGE

The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 370,000 members. Our mission is to improve the lives of working families and to build a stronger Canada by ensuring our common wealth is used for the common good. ~ NUPGE

"Serious problems with privatization in Britain are as easy to find as mosquitoes in a swamp. They range from hospitals facing bankruptcy because of P3 privatization scheme debts to the government being overcharged by more than $200 million for contracted out correctional services.

But instead of learning from mistakes made by British governments, too many Canadian politicians seem determined to copy them."

https://www.nupge.ca/content/britains-doctors-link-underfunding-privatization
June 30, 2017 | Unregistered CommenterEklimek
Re: Illinois budget crisis

Thanks for posting CICM...I just found about this last night. While I'm not the most dialed in person in the world, I have to wonder why this long-festering issue has been flying below the media radar for so long?

Surprised that the current Federal administration hasn't manipulated the story into a convenient 140 word e-message to highlight the failure of the state's previous Democratic governor and (of course) the absence of assistance from the former POTUS.

Of course there is material of more substance for the current POTUS to tweet about: (low MSNBC Morning Joe ratings, Crazy Mika, bleeding facelift)...right?

All the more reason to love our country! Happy Canada Day weekend, everyone.

Now it's time to hunt down one of those Tim Horton Nanaimo bar donuts!

#Canada150-what-a-country
June 30, 2017 | Unregistered CommenterExecutive Lead Blogger
Back to opioiods


"Dear North Carolina Medical Board Licensee,

Yesterday, Governor Roy Cooper signed the Strengthen Opioid Misuse Prevention (STOP) Act of 2017 into law. This legislation aims to reduce the supply of unused, misused and diverted prescription opioids in North Carolina, and the resulting patient harm and deaths associated with them.

The STOP Act contains multiple strategies with various effective dates, including:
Limits on the number of days of opioids that may lawfully be prescribed upon initial consultation to patients with acute pain (no more than a five day supply) and following surgeries (no more than a seven day supply)
A requirement that prescribers review the patient’s 12-month history with the NC Controlled Substances Reporting System (NCCSRS), before issuing an initial prescription for a Schedule II or Schedule III opioid or narcotic, and subsequent reviews every three months as long as the patient continues on the drug. NCMB offers a streamlined NCCSRS registration process on its website. Use this visual guide to find it
Faster reporting of prescriptions to NCCSRS by pharmacies that dispense controlled substances (within one day versus the former requirement of three days), as well as financial penalties for pharmacies that fail to correct missing or incomplete information.
For a detailed summary of the STOP Act provisions and the effective dates of specific provisions (some provisions are effective tomorrow), click here. The full text of the STOP Act is available here.

Finally, although the STOP Act places no limitations on prescriptions for chronic pain, licensees who treat patients with chronic pain should continue to exercise their best medical judgment to deliver care that is consistent with current accepted standards of care. For information about NCMB’s efforts to encourage safe opioid prescribing, visit www.ncmedboard.org/safeopioids.
June 30, 2017 | Unregistered CommenterEklimek
Coming to rural Ontario,.....a health care desert.

"Rural Georgia is dying"

http://www.cnn.com/2017/06/30/health/rural-hospitals-medicaid-cuts-health-care/index.html
We already have the name of the highest paid Ontario doctor and it is Dr. Eric Hoskins.

His salary plus office overhead will easily surpass $6 million and he likely only sees a handful of patients a year.

Can the Toronto Star please publish his gross income for all to gawk at.


http://www.thestar.com/news/queenspark/2017/06/30/ontario-court-orders-end-to-secrecy-around-names-of-highest-paid-mds.html
R:

Really nothing to report. Holiday season for Central. Hospitals cutting staff. It seems no one cares.
July 3, 2017 | Unregistered CommenterMovingforwardOntario
"The OMA has released a breakdown of how 48 physician specialty groups voted on new rules of engagement for contract negotiations with the province — and to the surprise of no one who follows Ontario medical politics closely, radiologists and cardiologists were among the minority who opposed the deal."

http://www.thestar.com/news/gta/2017/07/03/oma-vote-breakdown-shows-which-types-of-doctors-rejected-framework-deal.html
The OMA Chairs for District 5 and 11 representing some 20,000 doctors have resigned. I guess they didn't want to swallow the Liberal Kool-aid that the rest seem to have swallowed.

http://www.torontosun.com/2017/07/04/doctors-quit-toxic-oma-tired-of-being-liberal-tools
There must be a way for diverse voices to be heard in this type of organization. Been there...done that....
Thing is, much better solutions would be grown if diversity of thought were championed. Instead, there is a predetermined end point and everyone must fall in line. How well is that working? How well has that worked for the OMA?

I've heard it said from OMA ranks..."we'll never please certain groups of people...they are there to object...that's all they do"...

I suggest that the OMA has been politicized and it will become even more so in its current structure as time goes on. There is an element of danger in always believing in one's own righteousness all of the time.
July 4, 2017 | Unregistered CommenterMerrilee Fullerton
R:

Medicine is solely a political beast in Ontario.It is not about health care. It is about getting the monies from central. What the OMA doesn't get is the deals are already cut. Social justice causes, and small group vote buying is how the distributions will be based. "Technical" based fees are going to take big hits in fees.

Those who plot out the future need to carefully review their options, and make their "life" decisions to stay or go. Things have peaked for many MDs.
July 4, 2017 | Unregistered CommenterMovingforwardOntario

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