Frustration builds up among Canadian family doctors

Faced with an aging population requiring increasingly complex care, overwhelmed Canadian doctors are feeling more and more frustrated by their inability to properly serve their patients' health needs, a national survey of physicians reports.

In the survey of more than 20,000 doctors and doctors-in-training from across the country, 75 per cent reported that inadequate funding of the health care system and an under-supply of physicians and other health professionals, along with paperwork and bureaucracy, are curtailing the amount and level of care they want to provide patients.

While that attitude was expressed by all the specialties, it is perhaps most pronounced among family physicians, simply because of their number and the nature of their practice, said Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada.

Almost half of Canada's roughly 60,000 doctors are family practitioners, and it's usually the specialty seen most often by patients, he said.

"I think the frustration remains related to just the capacity within the family medicine community to address all of the needs of the population," said Dr. Gutkin, whose organization conducts the triennial survey jointly with the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada.

"Physicians in most communities across the country are doing their best to try to see as many patients as they can," he said.

"But still many of them have had to ... limit the number of new patients they can take. And we have community after community with patients who are unable to access a family physician for themselves or for their families. "

Read the rest of the story here

A related story about Calgary doctors can be read in here

Does Halifax get its own Mayo Clinic?

Liberal Leader Stephen McNeil's remonstrations in the legislature this month condemning a year-old memo from some Capital District Health Authority physicians proposing a new, doctor-driven, private-public, "Mayo Clinic-like" hospital facility in metro were an emblematic example of the sort of backward, stick-in-the-mud attitudes and reactionary, tunnel-vision thinking that keep Nova Scotia an underachieving backwater.

McNeil trotted out the customary boilerplate about defending the sacrosanct public health care system from the evils of profit motive or market accountability, trotting out the old FUD (Fear, Uncertainty and Doubt) about privatization of health care delivery leading to (horrors!) - two-tiered health care, with NDP leader Darrell Dexter chiming in with his labour-union constituency's pet trope about private hospitals and clinics supposedly luring doctors and nurses away from the public system.

The 2006 memo, reportedly authored and signed by Capital Health surgeon Robert Stone, lays out a concept for clinics or centres that "should not be staffed by 'unionized' personnel

It would focus on providing endoscopy; breast health services; prostate therapy; various other diagnostics; orthopedic surgery, other same-day surgeries, and executive preventive health - all procedures that do not require the facilities of a fully-equipped and staffed, acute-care surgical hospital.
For which there is a strong demand that isn't being met in a timely fashion by the current public system, and which helps keep waiting lists long for other, more complex surgeries and treatments.

It's just, plain inefficient and a misuse of scarce resources.

Read the full story here

York University needs to improve Medical Education

Originally designed as a feeder school for the University of Toronto, York University has managed to break away, except when it comes to medical students who are still forced to leave after completing their undergraduate degrees.

According to York University’s mission statement: “We promise excellence in research and teaching in pure, applied and professional fields.”

Since York’s founding in 1959, however, a strong emphasis has been placed on the arts and fine arts, while future doctors have moved on to other schools for further education.

Canadian universities do not have enough medical schools to keep up with the growing need for professional doctors.
Only four medical schools have been created in Canada since 1959, and only one since 1968. During this same time, the population of Canada grew 178 percent from 18 million to 32 million.

According to the Canadian Medical Association Journal, the average general practitioner in Canada works 51.4 hours per week.
From 1979 to 2003, the average Canadian workweek dropped from over 34 hours per week to around 33 hours per week.

Despite doctors working over 50 hours per week, many Canadians still have a hard time trying to find family doctors and wait times at hospitals have increased dramatically.

Meanwhile, Canada has seen a reversal of the brain drain of the mid 1990s, which saw its peak with around 1.5 percent of Canadian doctors leaving Canada to work in the United States, according to the Canadian Institute for Health Information.

Fortunately, 2006 was the third year in a row that saw a brain gain, with 238 doctors returning from abroad and only 207 leaving.
This only represents 0.05 percent of Canada’s 62,307 practicing physicians, which is not nearly enough of an increase to significantly affect hospital wait times, overworked doctors or the lack of family physicians.

The average age of doctors in Canada continues to increase, reaching 49 in 2006, with only 23 percent of doctors in Canada being under 40 and 19 percent being over 60.
The need for young doctors has never been greater, and in order to fill this need Canada needs more medical schools.

Most of the schools York competes against, including the University of Toronto, McMaster University, the University of Western Ontario and the University of Ottawa, all have quality medical schools.

York has managed to compete with and often surpass the big established programs with its business and law faculties, now it needs to do the same with a medical school.

After all, shouldn’t an interdisciplinary university strive to give their students everything that is possible, instead of simply taking the easy route and sticking to what they know best?

Source: Excalibur

Two great stories about Canadian health care professionals

Here are two interesting stories I came across, about two Canadian health care professionals who have been active elsewhere in the world to share knowledge with their local health care professional counterparts.

Both are on their own, unique mission:

The first is Dr. Laura Louie, a naturopathic doctor from Vancouver, who set up an acupuncture clinic for HIV infected people in Thailand.

"It's Tuesday morning and Louie is only a few days off the plane from Canada when she arrives at the Mae On Clinic, bright and early so she can consult with head nurse Unchalee Pultajuk before the patients start arriving for the weekly HIV-acupuncture clinic."

"........Patients move from the acupuncture beds to a chair where a Tui Na massage completes their treatment. The traditional Chinese massage is done with bare hands -- "with healing, touch is so important"

The second is Dr. David Chaulk, a pediatrician from Alberta, who teaches Yemeni health care professionals the advanced knowledge from Canada and to help them catch-up.

“When I first arrived in Yemen and began teaching it was easy to have a feeling of superiority — for lack of a better word,” Chaulk said. “As Canadian physicians we have far better education, far superior training and more experience."

"..........You see two children to a bed, two patients with one intravenous infusion going to both patients and extremely malnourished, dehydrated and dying children that would be in intensive care units in Canada lying on a bed, being cared for primarily by the parents and with no monitoring equipment or any type of modern medical devices..........."

Enjoy reading the full stories (just click on their names)

Premier Nova Scotia wants to allow more private competition in health care

Rodney MacDonald, Nova Scotia's Premier, should be applauded for his openness to a greater role for private competition in health care.
In his recent state-of-the-province address, he said specifically that the provincial government was moving towards a greater role for the private sector in the delivery of publicly funded health services.

For far too long, Canada has been out of step with the rest of the industrialized world in its steadfast opposition to tapping into the competitive market for solutions to our health care woes, to the detriment of both patients and taxpayers alike.

Consider for a moment what Canadians receive in return for this steadfast commitment to the status quo.
Among the 28 developed nations that have universal health insurance programs, Canada ranks third in age-adjusted health care spending as a percentage of GDP.

At the same time, Canadians endure relatively poor access to physicians and medical technologies, while wait times for health care in Canada are not just unacceptably long but are among the longest in the developed world.
Perhaps a closer look at why other countries are getting more for less is in order.

Among the world’s 28 most developed nations that have universal health insurance coverage like Canada, the majority allow private providers to deliver publicly funded services.

All of the nations that outperform Canada across several measures of mortality related to health system performance (Australia, Sweden and Japan) employ private competitive providers in the delivery of publicly funded health care.

Allowing private hospitals to compete for the delivery of publicly funded care is a proven policy that would improve the state of Medicare for all Canadians.

Premier MacDonald’s willingness to sit down and take an honest look at those policies that have worked so well elsewhere in the developed world, bodes well for both patients and taxpayers in Nova Scotia.

Read the full story here

IT solution makes Jewish General Hospital in Montreal more efficient

At Jewish General Hospital in Montreal, you won’t hear the buzzers triggered by patients’ call buttons, and you won’t hear the public address system paging doctors.

Physicians and nurses now carry wireless telephones that work over the hospital’s computer network.
Call buttons with voice capabilities are linked to the phone system, so a patient in need can let an assigned nurse know what the problem is right away rather than just ringing a buzzer at the nursing station.

"It means better response to patients’ needs and it means doctors waste less time," says Stephen Rosenthal, the hospital’s associate director of medical informatics.

In the past, Dr. Rosenthal explains, the usual way to reach a doctor was to page him or her via the public address system. This added noise in an already busy environment where patients need quiet. The doctor being paged had to find a telephone to call back, and by that time the person at the other end might be unavailable.

Cellphones weren’t an option because of potential interference with some sensitive medical equipment, Dr. Rosenthal says.
But the wireless IP phones serve the same purpose: Calls can now go directly to the doctor, eliminating the paging and telephone tag.

Jewish General first tried a wireless phone system in its emergency room, using older technology, then switched to a voice over IP (VOIP) network and expanded throughout inpatient areas about a year ago. This past summer it was extended into outpatient clinics as well.
Put together by IBM Canada Ltd. and Symbol Technologies Inc., the system now supports about 100 phones for physicians, nurses and administrators.

Read the full story here

Editor's opinion:

"This is a great example of how technology can make communication processes in the hospital more efficient. It will reduce time which can be better used to serve patients. More institutions in health care and hospitals should adopt initiatives like this to cut costs.

There's a task for IT companies to promote their solutions and cater to the health care industry."