B.C.'s doctor drought

[Urbane]

Lots are actually. Lots of South Africans especially. Every place I’ve worked at has had a wide ethnic range, with international doctors full of storied careers across the globe. Doctors come from all over the world to work here in Canada. While people on these forums moan and whine about immigrants, I’m celebrating the contributions they are making, and hard work they are doing for us and our country.

I see a difference between foreign born doctors coming here and former ISIS fighters. Don't you? Do you really hear a lot of people "moaning and whining" about doctors coming here from other countries? I don't. I think the overwhelming majority of Canadians want foreign born doctors to come here.

[The Green Barbarian]

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[flamingfingers]

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[flamingfingers]

|Urbane wrote:

I think the overwhelming majority of Canadians want foreign born doctors to come here.

I spent a decade overseas and experienced care from doctors there. Most of them had at one time or another studied in England or the US but their credentials allowed them to work in their home countries. There were no reciprocal agreements to allow them to practice in other countries, despite their Western education. Canada needs to make it easier for these doctors to credential and do what they do best.

Anyone suggesting a person with a medical doctor's qualification is "an ISIS fighter" is pretty well off their perilous rocker.

[Queen K]

All I want is for foriegn doctors to be given all supporst necessary to be able to practise to or above Canadian standards, which ever comes first.

I didn't follow the ISIS logic, but I'm sure someone will explain it.

[flamingfingers]

All I want is for foriegn doctors to be given all supporst necessary to be able to practise to or above Canadian standards, which ever comes first.

I didn't follow the ISIS logic, but I'm sure someone will explain it.

Foreign-born doctors need to be given all out support to gain Canadian licensing.

If you didn't follow the ISIS logic, ask GB - he will mansplain it to you in great detail, ok?

[Urbane]

I didn't follow the ISIS logic, but I'm sure someone will explain it.

A poster suggested that some people were "moaning and whining" about immigrants and I replied that there's a big difference between doctors and former ISIS fighters. There is a controversy right now about former ISIS fighters being allowed into Canada so some people might be "moaning and whining" about THOSE immigrants but might NOT be "moaning and whining" when it comes to other immigrants such as doctors. It's not just former ISIS fighters though. Some are concerned about the vetting process in general.

[d0nb]

We shouldn't be stealing much-needed doctors from other countries, rather we should train our own. Take the bureaucratic shackles off and allow health care professionals to practice their craft. Doctors need to know that they will be able to do the research and offer the treatments that will make it unnecessary for them (or their patients) to flee the country. The WBFN couldn't even get a private clinic off the ground - more's the pity. People from other countries should be coming to Canada for medical care, not the reverse.

Perhaps we could start by removing conditions from federal medicare funding. Let the provinces innovate - let in some fresh air.

[Queen K]

Are we stealing Drs or are they free to immigrate here? If they've come to have a new life, how is that stealing?

[Urbane]

Perhaps we could start by removing conditions from federal medicare funding. Let the provinces innovate - let in some fresh air.

We either do that or we keep doing what we're doing and see the surgical wait lists get longer and longer and longer . . .

[d0nb]

Send us your privileged, your educated, your huddled doctors yearning to breathe free.

Of course the wealthy, and those who have been the beneficiaries of expensive educations are not property, and are free to live and work wherever they please, but to the people of the countries they leave behind, it can feel like a betrayal, even theft.

Canada should continue to welcome them, but not use them to compensate for not having a system in place to produce our own.

[gordon_as]

Dix and his 1990s gang of bozos are the reason BCers can't find a family doctor.
.

Not agreeing with you , just pointing out that the Liberals had 16 years to improve the situation.
Has it gotten better , or worse ?

[hobbyguy]

Perhaps we could start by removing conditions from federal medicare funding. Let the provinces innovate - let in some fresh air.

We either do that or we keep doing what we're doing and see the surgical wait lists get longer and longer and longer . . .

Their are only 5 conditions that I am aware of: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447685/

1. Public administration. This frequently misunderstood condition does not mandate public delivery of health services; most care is privately delivered. It represents a reaction to the high overheads associated with private insurance when the system was introduced,16 and it requires that the health care insurance plan of a province “be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province”15 and its activities subject to audit. This administration can be delegated, as long as accountability arrangements are in place.
2. Comprehensiveness. Coverage must include “all insured health services provided by hospitals, medical practitioners or dentists, and where the law of the province so permits, similar or additional services rendered by other health care practitioners.”15 (Insured dental services are defined as those that must be performed within hospitals; practically, less than 1% of dental services so qualify.)
3. Universality. The plan must entitle “one hundred per cent of the insured persons of the province to the insured health services provided for by the plan on uniform terms and conditions.”15
4. Portability. Provisions must be in place to cover insured people when they move between provinces, and to ensure orderly (and uniform) provisions as to when coverage is deemed to have switched. The details are worked out by interprovincial agreements. Although there are some irritants, in general, out-of-province care incurred during short visits (less than 3 months) remains the responsibility of the home province, which can set limitations (e.g., refuse to cover elective procedures). Out-of-country care is reimbursed at the rates payable in the home province. Since these rates are considerably less than what would be charged in the United States, Canadians leaving the country are strongly advised to have supplementary travel health insurance.
5. Accessibility. Provincial plans must “provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly, whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons.”15 Other provisions require that hospitals and health providers (usually physicians) receive “reasonable compensation,” although the mechanisms are not defined

All aspects of health care delivery are in the hands of the provinces and territories with the exception of some indigenous health care delivery. The CHA (Canada Health Act) actually only guarantees universal health care insurance, not delivery of services.

The federal government actually has a very "light" hand on the reins of health care delivery. We actually have 13-14 different systems independently managed, with is both an advantage (one size fits all is avoided) and a disadvantage (lack of coordination and cross pollination).

There are areas of health care delivery where federal laws and regulations do get in the way, and need to be updated/modernized. But those are neither tied to health care funding nor within the CHA. They show up in other areas like onerous privacy requirements that make tele medicine tricky and places like that.

The primary problem is a lack of a modern management system that permeates and coordinates (without being prescriptive) health care delivery. The system is set up around a hospital/institution/physician care system that worked fine with the range of care available and the demographics of the 1950s. It still works very well for acute care, which is what it was set up for, but is now clogged with chronic care patients who can be better cared for in other settings and at a lower cost to boot.

You see the beginnings of that in the report that Rona Ambrose commissioned - the Naylor report - and that Jane Philpott (a physician as health minister - what a novel concept!) started to implement. The one section of that report that I know has been implemented (on drug costs) will save Canadians $13.5 billion over the next decade, and actually improves health care outcomes by making prescriptions more affordable (fewer patients not filling prescriptions because of cost reasons).

There is lots to be done. Those of us with chronic conditions will have to adjust to a different kind of care, but it will be more convenient, more effective, and better for us - even though it will not be physician based, but physician managed.

To get there, we need a modern management system led by the federal government. Modeled on Lean methodology, where the solutions come up from the bottom as continuous improvement, not top down. There are no "silver bullet" solutions, it is a whole bunch of small changes and innovations that will naturally streamline and make the delivery of health care faster, more efficient, and more responsive to patient needs.

[The Green Barbarian]

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[The Green Barbarian]

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