Foreign doctors take up more medical residency spots as Canadians struggle to get in - "Canada has an acute shortage of doctors — a staffing crisis that is expected to get much worse in the years ahead as the number of residency positions on offer fails to keep up with rapid population growth. Despite those challenges, roughly 1,000 Canadian doctors who went to school abroad are turned away every year because they can't get residency spots in Canada, according to a CBC News review of medical school data. Physicians are required to go through a residency in order to be licensed to practice. Canadian doctors who want to come home to work are routinely told it's not possible because resources are limited and there are only so many residency positions to go around. But the medical schools that run residency programs still find room for foreign nationals from countries like Oman, Kuwait and Saudi Arabia — people who frequently have no intention of staying here to work over the long term. All of this is done with Ottawa's blessing. The federal government has exempted medical schools from immigration laws that require Canadians get priority for a job. Critics maintain that dismantling the foreign "visa trainee" program — which gives several hundred residency spots to non-Canadians — would free up positions so more homegrown doctors can work here in Canada and help chip away at the physician deficit... Typically, foreign trainees are contractually required to go home when their residency is over. The Saudi government and the state-owned oil company Saudi Aramco — two of the entities that pay the way for some visa trainees — demand they leave Canada once their residencies are complete. That means precious Canadian residency spots are wasted, critics maintain. These foreign residents are not being permanently deployed to physician-starved rural and remote areas or hanging their shingles in a province like Nova Scotia — where 142,000 people, roughly 14 per cent of the population, are on a waiting list for a family doctor. IMGs, by comparison, are Canadian citizens or permanent residents who generally want to live and work in the country they call home... Ivy Lynn Bourgeault is an expert on health care human resources and a professor at the University of Ottawa. She's studied the visa trainee issue and has found that Canadian taxpayers actually foot part of the bill for foreign residents. About 70 per cent of the funding comes from abroad while the rest comes from public funds, according to Bourgeault's data."
Damn conservative governments underfunding healthcare!
When you need to treat medical degrees from all foreign schools as equivalent in order to not be "racist"...
Randall Denley: The private health-care scare doesn't work anymore. Someone tell Ontario's opposition parties - "The whole public-private health-care debate in Ontario, and the rest of Canada, is a bit of a farce. Most Ontario hospitals are not-for-profit entities, not owned by the government. Doctors’ clinics are mostly owned by doctors. Much X-ray and blood test work is performed by the private sector. We have a system of public payment and private provision. The latest announcement from the Ontario government is more of the same. That’s only controversial to people whose ideology tells them that anything done by the public sector is good and anything by the private sector is bad. It’s not a line of thinking that will fix Ontario’s health-care supply shortages."
The left hate profit more than they love good outcomes. Ergo the common demand that nothing essential to life should be sold for a profit and the demand to destroy capitalism since people still die from a lack of these things. Because clearly, efficiencies don't exist and all gains go to profit because of "greed", and alternatives to capitalism will automatically be better than it
Why immigrants like me don’t stand a chance at owning a home - "As of 2021, it is estimated there are more than 13,000 internationally trained doctors in Canada who aren’t working as doctors, according to the Internationally Trained Physicians’ Access Coalition. My mother is among them."
AGAR: A reckoning for Canada's healthcare system - "Consider a comparison with Germany. The Calgary Herald reported, “Canada has 10 times as many health-care administrators as Germany, even though Germany has twice the population of Canada.” Germany is rated one of the best universal health care systems, while we are near the bottom. Germany has more doctors and nurses and more equipment. Where do we spend our money? “Canada has one health-care administrator for every 1,415 citizens. Germany: one health-care administrator for every 15,545. Even accounting for Canada’s vast land mass and that each province and territory runs its own system, the discrepancy doesn’t make sense.”... “Canada ranked worst out of the countries studied that had data available when it comes to the percentage of patients who waited two months or more for a specialist appointment (30% in Canada but just 3% in Germany) and worst again when it comes to the percentage of Canadians (18%) who waited four months or more for elective surgery compared to best in class Germany (0%).”"
Healthcare professionals, paramedics and other first responders. What vibes is the city currently giving you? : r/askTO - "I'm a family doctor, overall vibe is people are suffering, resources are stretched and healthcare at the primary care level is falling apart.
1. Social issues are increasing; I have so many patients in precarious housing/employment situations. Many of my patients, if evicted or lose their job can't afford new rental prices so they'll end up homeless. Similarly, a large number of my appointments are related to social issues I have no ability to deal with.
2. Specialty services are fucked. Doug Ford shares a huge chunk of blame but physician specialists and hospitals are also responsible. Mental health is the most obvious one; we don't have enough therapy programs and psychiatrists have 1-2 year waits. Psych won't follow patients and generally offer shit recommendations for family doctors. If anything, specialists are cherry picking easy patients for longitudinal care while abandoning complex patients. For example endocrinologists will see stable type 2 diabetes patients every 3 months but the type 1 with terrible blood sugars... follow up every 6 to 12 months. Specialists of all types are refusing to see patients and punting work back to family doctors which is increasing burnout amongst primary care physicians. A common example: I refer a patient to a neurologist for migraines, neurologist replies back "we don't deal with migraines, only XYZ" or you refer to gynecology and they reply back with "we don't deal with endometriosis or fibroids, please refer elsewhere". Now we have to waste more time sending referrals.
3. Social services are being heavily abused. More and more patients are requesting disability/medical leave from work for non-health issues. After taking over the practice from the previous doctor I'm seeing so many people who previously qualified for ODSP, disability tax credits when they never should have.
4. Immigration is fucked; my clinic takes on refugee patients but I'm seeing far more illegal immigrants - people who overstayed visas but refuse to leave. I'm also generally seeing far more elderly patients who immigrated to Canada in the last 4 years but can't speak english. It's my duty to treat people regardless of their background but I can't help but feel bad for Canadians who were raised here, paid their taxes for decades but can't access primary care.
5. Lastly, while not exclusively an issue limited to Toronto, family medicine is dead. I strongly believe this is the last generation of family physicians. The damage that has been done is irreversible. Expect nurses practitioners and pharmacists to take over primary care in the next 1-2 decades. The new cohort of family physicians will go into hospital care like emergency medicine, palliative and hospitalist."
Alberta health care reforms have system on verge of collapse - "Last November Alberta Premier Danielle Smith announced a massive overhaul of the province’s public health care system — Alberta Health Services (AHS)... the number of for-profit surgery clinics for hip, knee, and cataract operations, which are covered by Alberta Health, continues to expand but we have no idea if those clinics cost the government more, shortened waiting lists, or provided good care. Research from Parkland Institute in 2023 found that, while the volume of surgeries performed by these clinics had increased 48 per cent from 2018-19 to 2022-23, that increase came at the expense of the public system. Surgical volumes in public hospitals dropped 12 per cent over this same period as funding and health-care workers were diverted to the private CSF stream. In the meantime, pharmacists are given diagnosing and prescription privileges at the expense of the government and nurse practitioners are allowed to set up shop, some with private pay. They are chewing away at the edges of health care while ignoring the major problems and expect us to be satisfied."
How dare she destroy healthcare in British Columbia, Ontario, Newfoundland and everywhere else in Canada!
Left wing logic - an overloaded public system transferring cases to the private system is bad, because public good and private bad. And everything needs to be seen by a doctor, even simple cases pharmacists and nurse practitioners can handle, because that means the government will pay more for healthcare and more spending is always better and if high spending doesn't lead to good results it means even more money is needed
Why are left wingers so scared of change?
AMA president sounds alarm as Alberta hospital wait times rise
From December 11 2023. Clearly, Danielle Smith's reforms were so damaging that in just a month, they managed to destroy the healthcare system
Jerome Gessaroli: B.C. public health is being hijacked by woke agenda - "In analyzing the document’s language, critical functions – including population-level disease monitoring – are eclipsed by vague, unmeasurable, politically-laden concepts. Social justice terminology appears almost as often as health-care terms. Words like equity appear 44 times, climate 41, and reconciliation 34 times, while key health terms like disease prevention and influenza are mentioned far less. Politically contentious terms like colonialism and supremacy appear 19 times. Overall, there are 380 health-care terms and about 320 social justice-related terms in the report... One of the report’s principles is “Health Equity and Anti-Racism.” Here the document says, “Many of the determinants of health, such as income, education, housing … and natural environments, are shaped outside of the health system… [Health equity] …involves challenging and changing the values, beliefs and practices that maintain social and economic inequities, including racism and other forms of oppression.” In plain terms, this means that achieving health equity requires changing social and economic systems that create wealth inequality, racism, and oppression — quite the set of unargued assumptions, and quite the ask! It’s safe to say these goals are outside both the purview and pay grade of our medical professionals. Later, the report claims that “anti-colonial, anti-racist, intersectional, and equity-driven approaches to public health governance” are key to addressing the systems that maintain inequities... Apart from signalling that the ministry has adopted progressive values, these ideas also carry potential adverse consequences. For example, the report says that “evidence-informed decision-making” includes not only scientific data but also First Nations knowledge and lived experience. Instead, evidence-based decisions should rely on scientific data and proven health practices. Including cultural wisdom or personal experience introduces subjectivity, which may undermine evidence-based practices. One could reasonably question whether the ministry’s support for decriminalizing personal amounts of hard drugs and providing free opioids and harm-reduction paraphernalia to addicts is partly influenced by “people with lived and living experience,” a priority population in the report’s parlance, than by sound, scientific evidence. The negative consequences of opioid diversion and reduced street drug prices are well documented. Public health plays an essential role in monitoring infectious diseases, promoting vaccination, informing the public on disease prevention, ensuring universal standards, and addressing emergency preparedness and health-care system improvements. All decisions should be guided by scientific evidence and best practices."
'Anti-racist' doctors would put social justice over medical expertise - "A working group under the auspices of the Royal College of Physicians and Surgeons of Canada believes training future doctors should concentrate more on social justice and anti-racism than “medical expertise.”... As Dr. David Jacobs, president of the Ontario Association of Radiologists, tweeted so succinctly of the idea, “This is bonkers.”... One section of the report, titled “De-centering medical expertise,” called for a shift away from medical expertise to values such as anti-racism, anti-oppression, shared humanity and the ever more ubiquitous concept of decolonization... Jacobs noted that most doctors were too busy to worry about the diversity, equity and inclusion (DEI) agenda. “In daily practice, (DEI) is barely given a nod. We are overwhelmed by the volume of patients that need care on a daily basis,” he said in his statement. “Our work has bled into our evenings and weekends leaving very little time to think about what seems to be both a political and academic exercise. You can imagine the chaos that would ensue if patients were queued based on perceived oppression as opposed to the acuity of their medical condition.” DEI is trying to change medicine from a discipline that cares for patients to one that champions social justice causes, Jacobs added. “The vast majority of physicians have entered the field in order to care for others,” he continued. “There is an abundance of empathy and kindness among my colleagues. (DEI) has tried to piggyback on these noble traits and impose a social justice agenda that is driven by only a handful of activist physicians.” Jacobs said DEI was a divisive ideology that painted people as either victims or oppressors in order to rebalance power which focuses on “social justice and equity of outcomes as opposed to empathy and excellence of outcomes.” Before DEI, the goal in training doctors was to be kind and competent, but with DEI, doctors are also being “tested for ‘purity of thought.’” The DEI movement has now infected most of Canada’s universities, government institutions and schools. Should anyone stand up to this “progressive” movement the results can be devastating... “Beyond the obvious worrisome impact on patients, there is also an impact on physicians’ freedom of expression and thought,” he said in his statement. “(DEI) is governed and policed by a small unelected and unaccountable group that is using the authority of universities and medical governing bodies to establish what is acceptable and what is unacceptable thought.” Medicine should return to embracing respect and partnership with patients, Jacobs said, and “strongly reject those who would try to weave their political and social agenda into the doctor-patient relationship.” The halls of academia appear to have long fallen to the charlatans of DEI, but if the medical establishment has also succumbed then we are all in for a taste of bad medicine."
A woke takeover is coming for Canadian physician training - "these woke wünderkinder are busy building their careers — not on evidential research about disease, because that is an arduous, snail’s-pace affair — but instead, by soul-searching over the pervasive white supremacy they deem is baked into modern western medicine, and the oppressive patriarchal Enlightenment notions (read: modern science) that fails to recognize the contributions and value of Indigenous knowledge. Today, CanMEDS is undergoing an ideological makeover before our very eyes, one that marks a complete departure from the empirical basis for medical practice... the pontiffs who are championing the impending CanMEDS revolution are calling for the decentring of medical practice away from traditional evidence-based medicine in favour of foregrounding virtues of social justice activism; at once demanding that Canadian doctors regurgitate critical race theory and prioritize patients’ lived experiences. This inevitably greenlights a patient’s inalienable right to dictate unilaterally their desired treatment — informed by, well, Google searches. The CanMEDS protagonists, it transpires, are led by a colleague of mine, Ritika Goel, assistant professor at the University of Toronto. On X she self-identifies as a “South Asian woman. Family doctor and Activist. Immigrant and Settler. Mom of two. Tweets on health, politics & social justice.” Some will inevitably read this and recoil, nervous about the intersection, say, between politics and life-and-death decision-making. Of the other nine members of the CanMEDS Anti-Racism Expert Working Group, four are Black — translating to a representation rate 10 times the national proportion. And then there is the other elephant in the examination room: one-third of Canadians are white men; yet on this committee, not a sausage. Naturally, it will be argued that for inclusivity, diversity and equity to succeed, these self-appointed grandees must actively exclude white males. This effectively silences the disquieting voices of the patriarchy, unifies the monotonous narrative, homogenizes opinions and demands everyone nod in acquiescence. Democracy, free thought and, perhaps most crucially, the recognition of merit be damned. Very soon, then, CanMEDS will become “Can’t MEDS.” They don’t like it, you see: the deeply colonial, evidence-based practices that prop up systemic societal prejudices in the West. Some of the more unhinged statements on record stretch as far as the editor-in-chief of the Canadian Medical Association Journal (CMAJ), Kirsten Patrick, whose editorial declaimed as far back as March of 2021, “I am writing today to state categorically … that systemic racism exists in Canadian society and within its health care systems,” and went on to pledge, “I will work to further an antiracism agenda at the journal.” These are deranged, unsubstantiated assertions. Just in July, a CMAJ article appeared whose sole intellectual contribution to medicine was to scathe governmental bodies for funding research focusing on South Asian populations because the studies weren’t conducted by a posse of doctors with the correct skin tones. For the three female authors, it’s blindingly apparent that far too many white doctors are unconscionably imposing their systemic racism upon a victimized ethnic community. In their words, “White … senior authors in leading medical journals … can misrepresent White academics as experts on South Asian health.” This is monumental bigotry, of course, and constitutes the acceptable face of modern racism in Canada in 2024. Indeed, such unconcealed prejudice is emblematic of left-leaning intellectuals who have imbibed the sacramental wine of the antiracist ideology, a demented religion espoused by proponents such as Ibram X. Kendi — now widely discredited for his academic financial improprieties — and the perilous White Queen of critical race theory herself, the cashmere-clad Robyn DiAngelo. These academics urge the guileless listener to look past their unashamed champagne authoritarianism and embrace the toxic tenets of their cultish belief system, beliefs such as the mythical White Fragility that is the title of DiAngelo’s bestselling book. White fragility is a Catch-22 concept that reinterprets a white person’s denial of their own racist beliefs and behaviour as de facto evidence of racism. Any normal Canadian would instantly call this out as a buffoonish bear trap. The fact that DiAngelo reportedly bills US$20,000 (C$27,000) per hour for her insights is merely a sideshow; move along, people: nothing to see here. The distillation of these facts is to realize that Canada is now on a trajectory to prioritize a doctor’s social justice and political activism over their competence in anatomy, physiology, pathology, biochemistry and medically informed intuition. D’Souza pointed me to a recent embarrassing discovery that emerged in the esteemed New England Journal of Medicine, no less, which declared with some considerable vigour that apartheid, the segregation of racial groups into different cohorts, for the purposes of teaching physicians was “the future” of medical school training. I’m lost for words. What this means for everyday life in Canada is a “physician class” that will be expected — and likely required — by their governing body to prioritize social engineering over and above their knowledge of medicine. Patients who present as, let’s say, arthritic seniors, will need to be evaluated for their social status and privileges at least in parallel, if not ahead of, an assessment of their symptoms. These pensioners might well also be subjected to cross-examination about their current gender identity. No joke: in a 2022 interview for the College of Physicians & Surgeons of Ontario, Alex Abramovich, a transgender man, urged colleagues to discuss pronouns with longtime patients: “Gender identity can change over time … I think it’s important to also let long-time patients know that you are open to speaking about changes in their gender identity.” D’Souza, whose new book Lost & Found: How Meaningless Living is Destroying Us and Three Keys to Fix It launches today, told me that a large number of doctors — nobody knows quite how many — have already complained to the Medical Post, a physicians’ periodical, only to be gaslit by the establishment elites, dismissing these as a troublemaking minority who fail to grasp the true intentions of the new CanMEDS framework. No, these doctors understand perfectly well; mercifully, they are unwilling to acquiesce without a fight. With only four months left to go, the machine that is reimagining CanMEDS seems like an unstoppable juggernaut, slated for implementation beginning in January next year. It will fall to workaday Canadians, doctors not least among them, to resist. A lucky few could, of course, deploy emigration parachutes. Pessimists might welcome our increasingly permissive euthanasia provisions, MAiD, as an existential blessing in disguise. What is certain is that in Canada, in 2025, there will be nowhere left to hide from the social justice reinvention of medical practice."
Murray Mandryk: Feds, provinces now share health-care funding urgency
Fundamental reform isn't needed and more money is always the solution
Reduce wait times by allowing patients to seek care of out of country - "It’s no secret that if you need elective surgery in Canada, you’d better be prepared to wait for a very long time... Canada is not the only country to be plagued with such issues. Some European nations have had to deal with long wait times, as well. The difference is that they were able to resolve the problem. Part of their solution came from what’s called the “Cross-Border Directive.” This policy allows European patients to seek treatment in any EU member country and get their medical expenses reimbursed at a level equivalent to what their national health insurance plan would have covered. Like most policy innovations, this directive emerged out of necessity. In the early 2000s, many British citizens found themselves struggling with long medical waitlists. But through their membership in the European Union, some saw an opportunity to address the delays... Thanks to the Cross-Border Directive, over 450,000 EU residents sought treatment in another EU country in 2022 alone. This policy has brought about a significant reduction in wait times, but it has another noteworthy side effect: it helps reduce the overall cost of individual ailments, both to the patients who suffer from them and the states that pay the bills. This is because the longer a health problem goes untreated, the more the treatment will cost, due to an increased risk of complications. The longer people wait, the more likely it is that their intervention will need to be more invasive (and thus riskier) and will also require more resources to perform. But the effect on spending is not the only one that needs to be considered. Health issues can have an adverse effect on government revenue, as well. While elective treatments are not considered urgent, the ailments they hope to treat can still have an effect on our lives. For example, some of the people on waiting lists are workers who are unable to do their jobs, or who are forced to reduce their workloads, due to the pain they’re experiencing. Some are even on worker’s compensation. Even looking at it solely from a revenue standpoint, it should still be in the state’s best interest to get those workers the treatment they need so they can start paying taxes again. Letting them obtain the required medical attention out of province or out of the country — for the same price the system would pay domestically — should be a no-brainer. Let’s not forget just how many Canadians can’t get the treatment they need within the recommended timelines. In 2019, 30 per cent of patients needing a knee implant were unable to receive it within the recommended 26-week period. By 2023, that number had climbed to 41 per cent. Similarly, the proportion of patients needing hip replacements who couldn’t get them within the established time frames rose from 25 per cent to 34 per cent over the same period."
Just as with school vouchers, left wingers will claim this is diverting public money to foreign pockets
Release Canadian health care from the chains of government monopolies - "Why is it so hard to fix health care in Canada? It’s not for a lack of trying. Many reports, commissions, task forces and consultants have tried. However, this great country has not been able to achieve what many people believe is the crown jewel of its identity... In 1961, Prime Minister John Diefenbaker asked Hall to head a royal commission of inquiry into a potential national health service... It was not to be state medicine; rather, it was to be based “upon freedom of choice, and upon free and self-governing professions and institutions.” That system never came to exist. At present, the provinces and territories each operate their own health services with support from the federal government, notwithstanding the trend to contract surgical care to private facilities — and it’s not working. Each agency operates independently, responding to a myriad of great ideas with “we already do that.” The feds don’t trust the provinces and territories, and the provinces and territories don’t trust the feds. Heck, the various alphabet soups of federal departments and agencies don’t trust each other. Meanwhile, one-fifth of the country lacks basic access to a primary-care clinician. Other countries in our peer group, such as the Netherlands and Denmark, ensure that over 95 per cent of their citizens have a regular primary-care provider and can access one. It’s not working for health professionals either. Data sharing is onerous, even for the most basic medical supplies. There’s no digitized Google or Amazon of health care in Canada to show what supplies are available — no communication with the workforce about shortages. Health workers pick up the pieces and inform blank-eyed citizens that there’s a shortage of chemotherapy drugs. Perform that task, day in and day out, and then ask why doctors and nurses feel disillusioned. Paying them more won’t make them feel better when the only way they find out about a drug shortage is when the pharmacy phones. Why? This is the tough part. We look to governments, federal, provincial and territorial to fix it. Politicians and their multitude of starry-eyed apparatchiks that come and go every few years take great joy in rearranging the deck chairs. Over the years, some have even tried to overlay structures like regional health authorities to put some distance between them and their political authorities, but it never lasts; the pendulum always swings back to more politics, and the only thing politicians do is throw more money at it and reinforce the status quo... Wonder why health care is incapable of reform? Look to the constitutional foundations that divide the spoils among the political victors. Because of the constitution, if you win an election, you’re in charge of health-care delivery. If you want to fix health care for the generations, get it out of the hands of politicians. Luckily, there is a middle ground that steers clear of both privatization and our current state-controlled health care, which leaves much to be desired. Canadians must revisit the Hall commission’s recommendations and return to a publicly funded health insurance model, resourced by the provinces, territories and the federal government, accessible through licensed providers and accredited institutions. This would allow the innovative individuals and organizations hindered by our failing government monopolies to deliver a variety of modern health-care options that meet local needs. A return to the principles of the Hall report could chart a course between the endless debate over public versus private health care, allowing service providers to innovate within the boundaries of a publicly funded insurance program — Medicare for the 21st century. The solution to our health-care crisis lies not in spending even greater sums, but in having the courage to tackle the system’s core flaws. The middle way would focus on prevention and accountability by returning to the elegance of the Hall commission’s insurance model and getting governments out of the business of delivering health care. That’s what progress looks like."
Libs of TikTok on X - ".@TorontoMet's medical school is reserving 75% of its spots for DEI admissions and is allowing DEI applicants to be considered even if they are below the required minimum GPA score. DEI doctors… this won’t end well…"
Canada's newest medical school to reserve 75% of available seats for black, indigenous and equity-deserving applicants. : r/canadian
Clearly, poor doctor performance will be due to insufficient funding. Of course, many people claimed that doctors don't need to be the best - just good enough. This left wing cope comes up all the time and probably ties into their hatred of success and satisfaction with mediocrity (see also: degrowth)