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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)

http://m.torontosun.com/2017/07/04/meaningful-change-needed-at-oma

Sounds familiar...takes me back a decade....

How things change but remain the same.
July 4, 2017 | Unregistered CommenterMerrilee Fullerton
"Dr. Holland said he has not been paid for any of the eight people he has helped to die."

https://www.theglobeandmail.com/news/national/payment-complications-turning-canadian-doctors-away-from-assisted-dying/article35538666/

Really? Was it worth it, in publicity, to add this task to those of physicians.
July 4, 2017 | Unregistered CommentermovingForwardOntario
"The need for over 300 OMA staff must be independently reviewed.
In the fall, the OMA announced plans to implement a code of conduct policy to allow it to report members for investigation to the College of Physicians and Surgeons of Ontario (CPSO), the doctors’ regulatory body, which would threaten their ability to see patients.
The policy would not apply to OMA staff, board directors or executive.
The organization ignored our passed motion to survey membership on this policy before implementing it.
A board member and others within the organization have already submitted formal complaints against over 40 doctors to the CPSO.
Freedom of speech being a cornerstone of democracy, physicians have a wide array of opinions and deserve to be able to voice them, without fear."
July 4, 2017 | Unregistered CommenterMerrilee Fullerton
Taste of the future from the NHS mothership...Daily Mail article 'patients forced to beg NHS to fund cataract and hip surgery'.

Many of the treatments were previously routinely available on the NHS, but local health trusts ( equivalent to our LHINs) are now rationing procedures to meet financial targets.

Sad to see the re decline of the " new" OMA.....Jean Cocteau stated that a revolution's purity can last 2 weeks...then it goes down hill....those resigning are preserving their integrity.

Orwell's cautionary tale Animal Farm that the key scene is when the pigs reserved the eating of apples for themselves alone , telling others that it was necessary in order for them to be able to carry out their supervisory duties...had the other animals stood up to the pigs when they kept the apples to themselves it would have been OK.

The supervisory pigs in the upper strata of the bureaucracies of government and of the health care system such as the LHINs and of the OMA are determined to keep the apples to themselves and to deprive those that they deem to be unworthy of them.
July 4, 2017 | Unregistered CommenterAndris
And here's an update from quasi-governmental agency front that fro some reason has gone relatively unnoticed over the long weekend:

Metrolinx $500-million sole-sourced contract broke the rules, company claims
Siemens has complained to the government over the transit agency’s decision to issue a non-competitive vehicle contract to Alstom.
Fri., June 30, 2017

https://www.thestar.com/news/gta/transportation/2017/06/30/metrolinx-500-million-sole-sourced-contract-broke-the-rules-company-claims.html

A rail manufacturer has challenged Metrolinx’s decision to issue a $528-million sole-source contract for vehicles to run on Toronto-area rail lines, claiming the non-competitive deal violates government procurement policies as well as international trade agreements.

In a letter to Transportation Minister Steven Del Duca, the president and CEO of Siemens Canada, a Germany-based corporation, said the company was “extremely disappointed” with the provincial transit agency’s decision last month to purchase 61 light rail vehicles (LRVs) from Alstom without allowing other companies to submit bids. Alstom is a French company.

***

Public competitive procurement good. Backroom sole sourcing bad. Sole sourcing for over a half a billion dollars...priceless. This makes ORNGE/Dr. Chris Mazza look like a lemonade stand tip jar heist!

There are rules for a reason - if this plays out to be true, the whole board governors and chief executive officer has to go. Simple.

http://www.metrolinx.com/en/aboutus/board/board_of_directors_bios.aspx

No end of embarrassment for any sitting government...even more so when it is on the brink of an election run up!
"But it’s not just manufacturing where there’s a problem. Overall business investment — the lifeblood of any jurisdiction’s long-term growth — has slumped.
Business plans to invest $50.9 billion in Ontario this year, down from $53.8 billion before the recession.
Sluggish business investment and manufacturing, at a time of growth next door in Quebec, suggest the reasons for the slump are specific to Ontario.
The high cost of doing business is a major factor."

http://www.torontosun.com/2017/07/04/ontarios-economy-a-house-of-cards
The difficulty associated with totalitarian government management are showing in many areas. The current government (since 2003) has greatly altered the practice of liberal democracy in Ontario. It is splitting into the rulers,and the serfs. The rhetoric, not reality, rules.
July 5, 2017 | Unregistered CommenterMovingforwardOntario
And the same thing has begun federally,....probably because there is the same backroom guy in Ottawa from Dalton's regime. Identity politics seems to be the name of the game.
"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." Mfo


Nothing will hasten that decision more than another four years of Liberal rule.

http://www.theglobeandmail.com/news/national/ontario-survey-shows-rise-in-support-for-liberals-a-year-out-from-election/article35550089/
Good catch, CICM! I was just about to post as well.

They LIBs are rising in the polls - the mind absolutely boggles.

I am frightened to predict a hard number on how many more `feel good`(for now) announcements will it take to get them re-elected!
"The problem is we have a health care bureaucracy that is trying to preserve the health care monopoly for their own benefit.

Who owns control of the patient's body, the patient or the state?" Dr Brian Day

Great interview.

http://vancouversun.com/news/local-news/dr-brian-day-on-the-strong-public-health-system-we-could-have
Don't expect the Liberals to lose. Lots of small group vote buying is going on. Internal polls are much closer than the public ones. They will pull out the "two tiered" health evilness.That generally can gather in another 1/3 of the voting populations om their side. There will also be a lot of targeted feelgood federal money for Ontario. LHINs are being advised to control the dissenters.
July 5, 2017 | Unregistered CommenterMovingforwardOntario
Wynne is busy buying votes with the voters' own money...more accurately the tax ayers' money ...OPSEU received a surprise 7.5% raise...the government has just wrestled the supposed strongest Union in the province ( the OMA) to the ground and will be doing a victory dance up to June 2018.

I'm noting a bit of a problem on the real estate side of the equation just as it becomes recognized that the Ontario expconomieconomic has become increasingly dependent on the booming real estate sector....people are walking away from real estate deals leaving their deposits behind...one of my patients remodelled his old home in Barrie and has already moved to a new home only to find that the real estate market has gone flat and that the offers on his old home have evaporated.

He's sweating ....one suspects that he's not alone.

The air released from the Toronto real estate balloon has led to its release well outside of Toronto.

There is many a slip between the cup,and lip....one hopes that a few banana peels are tossed in front of Wynne by the opposition and that a political climate change occurs between now and June 2018.
July 5, 2017 | Unregistered CommenterAndris
We have 23% of the Ontario working population directly or indirectly working for government. They and their spouses will vote Liberal. Add in all those on the various social assistance entitlement programs who will also vote Liberal.

The fire fighters will be out campaigning for the Liberals and the two tier health care bogeyman will be trotted out at the right time. It is not inconceivable that Wynne could pull off another 4 years.

Mfo.....how do the LHINs identify their dissenters?

As it is I gather that the OMA has already given a list of 40 for the CPSO for investigation ( promoting the recent resignations ofthe chairs of Districts 5&11?)....some of us had better check under our cars before we switch on the ignition.

In the mean time Bills 41,84 and 87 are in place and about to be rolled out and be imposed for maximum political impact ....any idea yet about the timing? I'm getting impatient, bring them on!
July 5, 2017 | Unregistered CommenterAndris
Andris, you'll know if you're on the list of OMA subversives when a "random" CPSO audit request shows up in your mail box.
True enough canary.
July 5, 2017 | Unregistered CommenterAndris
There are internal lists of those whom offer "disruptive behavior" attitudes. There will be little need to use these lists. Since where and how one practices will be determined by the LHINs need, they merely will not assign you a spot based on the internal list. No need to file with the CPSO. Those 40 MDs filed with the CPSO are through the OMA system which needs to clear out those trying to stop the buyout by the MOHLTC.
July 6, 2017 | Unregistered CommentermvingForwardOntario
After the collapse there will be a post mortem ...the 40 will likely be perceived as heroic figures, those who saw saw that the emperor was stark naked.
July 6, 2017 | Unregistered CommenterAndris
There will not be a collapse. Just an acceptance of mediocre. Free mediocre is better than excellence for those whom needs it. Social justice for all - not justice, social justice to avenge the past injustices.
July 6, 2017 | Unregistered CommenterMovingforwardOntario
One can only hope this deficit funding approach works. It is quite amazing how much debt is piling up at the provincial and federal levels. As for MDs, certainly, the old times "freedoms" are gone. LHINs are just beginning to stretch their muscles, relatively soon positions for MDs within each LHIN will be controlled by the need to have permission to practice from the LHIN. Changing the government will not reverse this.
July 7, 2017 | Unregistered CommenterMovingforwardOntario
<< relatively soon positions for MDs within each LHIN will be controlled by the need to have permission to practice from the LHIN>> - MfO

Interesting comment - I suspect that this interface with hospital professional staff privileging and credentialing is inevitable at some point.

Is anyone at Central looking at what legislative and regulatory changes need to be made for this to occur?

Alternately my alter ego would comment that no one is even looking at this because:

a) it is too hard
b) it is not on anyone's radar
c) it would take longer than a single election cycle
d) all of the above
e) none of the above
Let's see if I got this right.

The LHIN can assess the medical service needs of its region,

calculate the number of providers that meet these needs in all areas,

direct the service providers to the specific sites,

with infrastructure available to enable the activity of said providers.

Oh my, Friday afternoon is usually a humourless day. Today is certainly exceptional.

Or are you pulling my leg?
July 7, 2017 | Unregistered Commentereklimek
Nice summary, Dr. K. Let's see if I can offer an answer (always subject to external validation or correction, of course...I ain't perfect).

Q1. The LHIN can assess the medical service needs of its region,
A1. In principle, yes. This will depend on the health planning abilities of the leadership and staff of each individual LHIN. Among 14 entities of anything, there will always be variation.

Q2. Calculate the number of providers that meet these needs in all areas,
A2. While LHINs do have a health human resources mandate, I am not aware of any LHINs that have published any current state plans for their areas. At best (and this is not a "slight" against the LHINs - there are no agencies in Ontario that have an accurate handle on the health human resources requirements) each LHIN could probably develop a high-level range for each specialty based on population needs for their overall geographies in relatively short order.

Q3. Direct the service providers to the specific sites.
A3. Presently, I do not believe that LHINs have the mandate to direct this and I am not aware of any short or mid-term plans to assign this responsibility to them.

Q4. (with) infrastructure available to enable the activity of said providers.
A4. Capital planning (buildings and major clinical modalities like CT, MRI and PET - which I interpret by what you mean as infrastructure) remains the sole responsibility of Central. LHINs presently only have a local validation role.

Again, I welcome any corrections to the above-noted responses.
ELB

The capital investment sites will primarily determine the service provider distribution. Patient service centres, imaging tools, operations rooms. All LHIN duties.
July 7, 2017 | Unregistered CommenterMovingforwardOntario
MfO,

I was under the impression that once whatever capital investment selection criteria is applied (i.e., political, highest needs, etc.), the rest is managed by capital branch.
Sounds much like Stalin's 5 year agriculture plan of 1928-32....the creation of the Kolhoz collective farm system ( LHINs ) which required the extermination of the Kulaks ( private self employed medical practitioners) , the introduction of fixed agricultural prices, the introduction of forced labour, the introduction of quotas, ...each time a quota was met it was raised....all of which led to famine and the deaths of millions.

Central planners defy free market forces, inevitably creating price distortions , generating disequilibrium and shortages ....Von Mises pointed out that the idea of central planning sounds reasonable that it is hard to see why any intelligent person would oppose it thinking that central planning is a mere extension of individual planning which everybody does.

" The champions of socialism call themselves progressives, but they recommend a system that is characterized by rigid observance of routine and by a resistance to every kind of improvement. They call themselves liberals, but they are intent upon abolishing liberty. they call themselves democrats, but the yearn for dictatorship. They call themselves revolutionaries , but they want to make the government omnipotent. They promise the blessings of the Garden of Eden, but they plan to transform the world into a gigantic post office. Every man ( and woman) but one a subordinate clerk in a bureau"...( sounds like a good base for your stump speeches come election time Realist) .
July 7, 2017 | Unregistered CommenterAndris
From the Chair of District 5 and 11

On Tuesday, we resigned as chairs of the two largest Ontario Medical Association (OMA) districts, having represented nearly 20,000 physicians in District 5 (GTA, Dufferin, Muskoka, Simcoe) and District 11 (Toronto). The reason is there has not been meaningful change at the Ontario Medical Association and it has taken drastic measures to silence dissenting opinions.

Here are the critical structural changes we believe are needed to transform the organization from one that is ideologically aligned with the Ontario government, to one that will truly advocate for Ontario’s doctors and patients.
The key reason the OMA is not accountable to its membership is its annual $70 million in mandatory membership dues. It is the only medical association in Canada where all doctors must pay in full and have no choice in who represents them. The government legislated in 1991 that if doctors don’t pay their dues, they will deduct the amount from doctors’ billings and give it to the OMA. The OMA will never bite the hand that feeds it in this relationship.

Moreover, there is a profound lack of transparency on finances, and our efforts to rectify this through motions at OMA council were blocked from being submitted. The original intent of the mandatory dues was only to support negotiations with the government, yet it now funds a bloated bureaucracy. OMA officials can make a lot of money through honorariums if appointed to multiple committees (there are nearly 100). The end of mandatory dues was supported by two-thirds of Ontario physicians in two independent surveys.

Prominent OMA staff and board members have used the organization as launching pads into government-funded organizations. We had put in motions at May’s OMA council meeting for the OMA to refund dues from physicians who ceased to be members, and for OMA staff and officials to sign agreements to not work for the government for a period of five years after leaving the OMA. The frequent adversarial nature of relations between the government and doctors requires that there are no conflicts of interest, specifically the promise of government jobs.
Both of our motions are supported by member surveys of doctors, but unlike previous years, the two-day council meeting was filled with inordinately long committee reports — essentially a filibuster. Time ran out, and council never heard our motions.

Administrative OMA staff are beholden to the corporation, not the elected physician representatives. As such, their interests are often at odds with what is best for physicians and health-care reform. The need for over 300 OMA staff must be independently reviewed.

In the fall, the OMA announced plans to implement a code of conduct policy to allow it to report members for investigation to the College of Physicians and Surgeons of Ontario (CPSO), the doctors’ regulatory body, which would threaten their ability to see patients. The policy would not apply to OMA staff, board directors or executive. The organization ignored our passed motion to survey membership on this policy before implementing it.

A board member and others within the organization have already submitted formal complaints against over 40 doctors to the CPSO. Freedom of speech being a cornerstone of democracy, physicians have a wide array of opinions and deserve to be able to voice them, without fear.

Even with new leadership, only significant structural change will allow for meaningful, democratic reform at the OMA. It has a long way to go to achieve genuine transparency and accountability. Transplanting its umbilical cord from the provincial government to the medical profession would sharpen its ability to fight against future government policies that prove ruinous to patient care. There must be a fully independent forensic review of the OMA.Until then, we will continue to advocate for Ontario healthcare, independent from the OMA.

It is sad that we had to go public with this after our attempts to address the concerns internally were simply met with more intimidation and bullying. It would have been easier to remain silent, but positive change can only come if we are vocal and shed light on behaviour that is unacceptable.

Many physicians have already shared the details of their CPSO complaints with us. For those who have not yet, please do get in touch. You can email to our attention at ConcernedOntarioDoctors@ to connect with us. Everything will be kept strictly confidential. Please feel free to send this message to your colleagues. Always know that you are not alone. We know it is a scary and stressful time, but please never forget that you have many colleagues who are sadly in the same boat and even more who are here to support you through all of this.

We all need to take a stand together to ensure such aggressive measures to silence free speech are stopped and that going forward, we all feel safe expressing our opinions openly. The only way this can be achieved is if all of us continue insisting on a fully independent forensic review of the OMA. There is strength in our unity. Thank you for your continued trust and support.
ELB:

You are correct, but the initial decsions by the LHINs will be picking the "Winners and losers" by the now common political process, not based on want, based on politics.

One thinks the frustrations being expressed by Concerned Ontario Doctors, is a sign, a block of MDs are getting they have lost. Still good pay,but widgets doing political bidding of central.
July 7, 2017 | Unregistered CommenterMovingforwardOntario
Sad to hear that the distribution of medical doctors will not be by merit , by market forces, but by the decisions of the LHIN planners...those that suck up to the petty LHIN bureaucracy will prosper...presumably the "diversity" of health care providers will be a factor....does each LHIN have the politically correct distribution of genders, pigmentations, sexual orientations, disabilities, races, belief systems ?...of course those providers who have diverse / contrary political/ philosophical opinions will become hot potatoes and shuffled away to the LHIN versions of Siberia.
July 8, 2017 | Unregistered CommenterAndris
Andris one only need look at a recent OCFP job posting to see what is coming:

Here are some qualifications that will help guide the current selection process:
• Represent a diversity of practice and payment models with specific emphasis on solo practitioners;
• Are currently, or recently practiced, in the following regions that coincide with one or more LHINs: Erie St. Clair, North Simcoe Muskoka;
• Are female;
• Are early in their career (0-10 years);
• Have experience working with vulnerable and complex populations, including Inner City, / Homeless, recent Immigrants, Aboriginal populations, and Addictions;
The naturopaths are claiming they are medically trained and have started a PR campaign to advertize their alternative facts.

Meanwhile the medical profession has one hand tied behind its back in trying to fight this quackery in that a public rebuttal by an individual physician could be met with a complaint to the College. It was Smitherman, the health minister with no post-secondary education, who allowed all these placebo vendors to become regulated in the first place which was a big mistake.

Where is the OMA on this file. They should be out front and centre defending this battered profession.

http://nationalpost.com/health/naturopaths-not-real-doctors-despite-video-claims-they-are-medically-trained-critics/wcm/50717969-36c6-46eb-848e-6be9e9f8237f
OMA should be out front on the Naturopaths BUT only to say that they will not endorse nor endorse them as the Naturopaths have been vetted by the MOHLTC and hence any issues arising from the Naturopaths belong to the MOHLTC.

KISS principle on everything.............MWs, LHINs, wait-times, ER efficiencies, etc
July 8, 2017 | Unregistered Commentergfraser
How can quackery and hocus pocus be vetted?

KISS ( keep it simple, stupid) is very much a free enterprise principle...there is a virtue in simplicity...as Schumacher put it " any intelligent fool can make things bigger, more complex....it takes a touch of genius and a lot of courage to move in the opposite direction".

Our central planners have taken the essentially simple and straightforwards and concocted the present increasingly complex intertwining health care labyrinth that requires navigators and a huge unwieldy bureacracy to manage it....they perceive the enslavement of the medical profession as a necessary step, the final solution, in the creation of a statist health care nirvana.

Orwell predicted that the state would try to enslave the people...it would seem that the medical profession will be the first , of many, to experience that boot grinding in its face "forever".

Bills 41, 84 and 87 are just the first of many with more to come ...they should take their place amongst the pantheon of swear/ curse/ profanity words...." Oh! 41, 84,87!"...the Chinese Bing Fa ( Arts of War) have already taken #36...to run away...which the wise should do.
July 9, 2017 | Unregistered CommenterAndris
DrK

Justice versus "social justice".

We are moving from the use of legislation and regulation to try to assure individuals rights and earned privileges can be protected, to the "social justice" rulings where groups of interested parties can determine, outside of the legal structure, why your individual rights will be stripped away.

Comrades, enjoy utopia.
July 9, 2017 | Unregistered CommenterMovingforwardOntario
Mfo

I have no objections to supporting the disadvantaged. My perspective is, however, one that crystallized many years ago and is reinforced by my job. It may not entirely coincide with the current social policy. Current policy seems born insulated from significant economic downturn and external threat. It is, borrowing from our leader, a "sunny days" attitude yet to face adversity.

Policy set in motion without an overall plan based on solid evidence seems more wishful thinking targetting electoral favour. Much activity is being generated without accountability for adverse outcome. We are in heady times brimming with enthusiasm for policies that seem very similar to previous failed efforts.

I hope I am wrong. But this seems familiar and I wonder why this time will be any different. It looks like a political fire sale in responsible policy making. Anything and everything is being offered to whitewash the current problems in health care, as well as elsewhere.

https://www.thestar.com/news/gta/2017/07/10/patients-whose-emergency-surgeries-are-delayed-have-higher-risk-of-dying-canadian-study-shows.html

“Global hospital budgets in an era of constrained public financing force surgical departments to strive for maximum efficiency; most optimize utilization of operating rooms and staff at maximum capacity for elective surgery, while assiduously avoiding any unbudgeted activity.”
July 10, 2017 | Unregistered CommenterEklimek
DrK

I suspect very few of us disagree with responsible support of those less fortunate. The difficulty remains how much resources transfer is needed, and wherest to get the resources. This deficit funding strategy to develop social planning not based on evidence is quite worrisome. It really seems to be driven by the desire of those in power to engineer what they believe we should become.
July 10, 2017 | Unregistered CommenterMovingforwardOntario
"It really seems to be driven by the desire of those in power to engineer what they believe we should become." - mfo

I never suspected you to be so gullible. Is it not more likely that policy is driven, not by such lofty goals, rather merely seduction of the electorate to reinstate the incumbent by masking the problems with plausible aspirations.

This is just a well decorated power struggle.
July 10, 2017 | Unregistered Commentereklimek
Imagine, self-organized nursing care was less expensive in this case:

https://beta.theglobeandmail.com/opinion/learning-from-the-dutchs-neighbourhood-care-model/article35641577/?ref=https://www.theglobeandmail.com&service=mobile
July 11, 2017 | Unregistered CommenterMerrilee Fullerton
"He and fellow nurses were frustrated by the growing bureaucracy of health delivery and how nurses had less and less time for nursing. So they organized themselves in small, self-managing teams to compete with existing home-care organizations."
July 11, 2017 | Unregistered CommenterMerrilee Fullerton
I saw this...it definitely speaks to "overall value" and "meaningful outcomes" as opposed to "overall cost" to the system. Melds nicely with the CIHI report today tha 22% of all seniors in long-term care could really be supported at home with better community care.

The model looks attractive but I doubt that in our current "age of accountability" anyone from Central would transfer funds (even through a LHIN) to a group of self-organized staff to self-organize without having to complete an agreement and submit a phonebook's worth of next-to-useless-that-no-one-is-going-to-look-at quarterly reports.
July 11, 2017 | Unregistered CommenterExecutive Lead Blogger
R

The system isn't going to change. There are so many managers at Central, we need managers to manage the management.
July 11, 2017 | Unregistered CommenterMovingforwardOntario
New OMA relativity committee is being led by a radiologist. The board is obviously not interested in relativity. By the time they're done, we'll learn that radiologists are making 10 times less rather than the 10 times more they are currently making in comparison to others doctors.
July 12, 2017 | Unregistered CommenterJim
The OMA is done. Central has figured it out, and enlisted the right players within the OMA.

MDs in Ontario will do as they are told. Still, good incomes, but widgets. It has submitted to authouritarian government. Resistance is futile.
July 12, 2017 | Unregistered CommenterMovingforwardOntario
"By the time they're done, we'll learn that radiologists are making 10 times less rather than the 10 times more they are currently making in comparison to others doctors."-Jim

Hi Jim. Why do you say that?
July 13, 2017 | Unregistered CommenterMerrilee Fullerton
http://www.health.gov.on.ca/en/common/ministry/orgchart.pdf

This org chart just keeps expanding right along with Ontario's debt.

Anyone know why three of the four associate chief medical officer of health positions are vacant?
July 14, 2017 | Unregistered CommenterCanary in a Coal Mine
"Ontario Premier Kathleen Wynne basically has little choice now. Hoskins and Bell are just too easy targets for the mess that they've made of health care and the way they've badly misread physicians passion for protecting their patients. The differences are irreconcilable."

http://www.huffingtonpost.ca/sohail-gandhi/irreconcilable-differences-for-hoskins-and-ontario-doctors_a_23022820/
July 14, 2017 | Unregistered CommenterCanary in a Coal Mine
CICM

Nothing will change before the election. Central is doing well against the doctors. The pending contract is cost neutral, with the overbillers being cut. The OMA is happy to attack it's own members.
July 14, 2017 | Unregistered CommenterMovingforwardOntario
"Anyone know why three of the four associate chief medical officer of health positions are vacant?"-ELB

Good question.
July 14, 2017 | Unregistered CommenterMerrilee Fullerton
"Canada placed third from the bottom in a major new study of health care in 11 affluent nations, a score that reflects this country’s poor performance on measures such as infant mortality, access to after-hours medical care and the affordability of dental visits and prescription drugs.

Canada’s ninth-place finish is a slight improvement over 2014, when the Commonwealth Fund, a New York-based private research foundation, put Canada in 10th place, ahead of only the United States."

http://www.theglobeandmail.com/news/national/canada-ranks-third-last-in-study-of-health-care-in-11-rich-countries/article35692286/
July 14, 2017 | Unregistered CommenterCanary in a Coal Mine

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