B.C.'s doctor drought

[Rwede]

Doctors in rural areas receive a Rural Retention Bonus for all their bills.

That does nothing to ease the shortage caused by the NDP's cutting of hospital spaces and freezing medical school spaces for a decade.

It is taking a long time to dig out from that, and with a growing and aging population in BC, we're struggling to keep up despite the positive moves made in the past 16 years to get more healthcare professionals into our system.

[hobbyguy]

Doctors in rural areas receive a Rural Retention Bonus for all their bills.

That does nothing to ease the shortage caused by the NDP's cutting of hospital spaces and freezing medical school spaces for a decade.

It is taking a long time to dig out from that, and with a growing and aging population in BC, we're struggling to keep up despite the positive moves made in the past 16 years to get more healthcare professionals into our system.

If you look at my post, it is not an NDP issue, it is not a Liberal issue, it not a party/partisan issue at all. It is really a failure of all politicians to look at the long term and properly manage the system without interfering.

The only two politicians that I can think of, in the last 15-20 years, that have even made a serious effort to come to grips with the SYSTEM management problems are Rona Ambrose and Jane Philpott. Unfortunately neither is involved anymore. They may have ruffled some feathers, but feathers need to be ruffled, the status quo has been a downhill slide.

[Queen K]

Oh Hobbyguy, when you can blame the NDP for everything, why dig deeper?

So now that the NDP are at the helm, I am interested to see how the Dr. shortage will be addressed.

[Cactusflower]

If you look at my post, it is not an NDP issue, it is not a Liberal issue, it not a party/partisan issue at all. It is really a failure of all politicians to look at the long term and properly manage the system without interfering.

The only two politicians that I can think of, in the last 15-20 years, that have even made a serious effort to come to grips with the SYSTEM management problems are Rona Ambrose and Jane Philpott. Unfortunately neither is involved anymore. They may have ruffled some feathers, but feathers need to be ruffled, the status quo has been a downhill slide.

I'm still trying to wade through that link you provided yesterday, but in the meantime I'd just like to add some anecdotal evidence. You probably recall my posts about my elderly neighbour, the one who ended up in the hospital for a few days after a fall in his home and a diagnosis of a chest infection. Well, I have some good news to report regarding the home care nursing services. Immediately after he returned home, Interior Health set up a program for him. The home care nurses visit twice weekly to change the dressings on the sores he acquired due to extreme swelling of his feet, and an occupational therapist comes once a week to help him with the exercise program that's supposed to improve his circulation.

So things seem to be looking up here in the Okanagan, anyway. Hopefully the same programs are being initiated all over the province. Chronically ill patients are much better off in their own homes being assisted by health care professionals rather than unnecessarily taking up beds in the hospital.

Oh, and BTW QK, beds ARE hospital equipment, are they not?

[Queen K]

They are, but most people don't think of the beds, they think of MRI machines or X-ray equipment and a million other things other than the humble bed.

And great to hear an up date on your neighbour. Did your neighbour have a GP Dr before this incident?

[hobbyguy]

Oh Hobbyguy, when you can blame the NDP for everything, why dig deeper?

So now that the NDP are at the helm, I am interested to see how the Dr. shortage will be addressed.

Given that it takes 10 yrs to train a physician... very little can be done. With retiring physicians outnumbering graduating physicians roughly 2 to 1, the situation will get a lot worse before it gets better.

The only realistic solution is to extend the reach of every physician through a team of other lower echelon medical folks, and to further extend the reach of physicians through innovations like tele-medicine. Physicians will have to become more like care managers.

That isn't going happen by top down decree. It would actually be counter productive to try to do it top down. Remember the great "reduce wait times" top down thing that was done a few years back? It di not stick, it cost a fortune, and we are still stuck with long wait times.

What has to happen is that the management of health care has to modernize, starting with a concerted effort to make Lean methodology work in the system. That transforms the health minister into a facilitator, coaching the system to find its own continuous improvements from the very knowledgeable and dedicated people within it.

[Queen K]

What about taking foreign trained doctors who have immigrated here and concentrating their new goals to getting up to speed in the Canadian health system? In some cases, I'll bet they have a lot to teach us.

[Hermes]

If medicine were treated by the BC government (and the tax payers) like dentistry or veterinary medicine, i.e. a competitive marketplace instead of a State monopoly and professional special interest group (medical association) we would have less of a problem.

I get most of my non-emergency medical care in Vietnam, India and Malaysia because I can't tolerate the lack of specialists and GPs in my home country. Plus there is the price issue. But for those who cannot travel - well, it is a major weakness of the very government I elected.

I can find a cannabis seller, a pharmacist, a carpenter, and a window washer. But finding a doctor who is taking new patients is a major task. There was a court case some years ago in Quebec where the judge said that of the province cannot provide timely medical care it MUST open up the marketplace. As much as I respect Tommy Douglas the CCF was fundamentally wrong (unrealistic). So we now have equal inaccessibility to medical care. Universal poverty of medical services.

I met a physician professor from Afghanistan who taught at University of Moscow who was driving pizza delivery because myself and other members of the public are not permitted to make up our own minds about which qualifications to accept when we choose a doctor. RCMP, convicts and otehr special groups can hire private doctors. Not the average Joe.

"We're from the government and we're here to help." I remember so well seeing in a firearms store in Nevada that T-shirt quote of Reagan's with image of a SWAT team bursting in the door. MSBC is a State and special interest group controlled mafia. ICBC and Liquor Control Board likewise. I would start the shut down every monopoly within 24 hours of being elected if I was in politics.

[Catsumi]

Wonderful! When can you start?

Also, do something about the dairy and egg marketing boards.

[hobbyguy]

The discussion of private versus public care provision is irrelevant. IF you look at care systems that are better at meeting the needs of the citizenry around the world, you find some that are public only, some that are a mix of public and private, and some that are largely private. (That's how far down the list we have fallen!).

The fact is that most family physicians operate as fee-for-service private businesses. Walk-in clinics are privately operated. Etc.

If you think you can get a change to the Canada Health Act to privatize the system, I would suggest you run for office and see how few votes you would get.

[Hermes]

The discussion of private versus public care provision is irrelevant. IF you look at care systems that are better at meeting the needs of the citizenry around the world, you find some that are public only, some that are a mix of public and private, and some that are largely private. (That's how far down the list we have fallen!).

The fact is that most family physicians operate as fee-for-service private businesses. Walk-in clinics are privately operated. Etc.

If you think you can get a change to the Canada Health Act to privatize the system, I would suggest you run for office and see how few votes you would get.

I both agree and disagree with you.

Multiple countries have two-tier systems. UK does for example. I am not suggesting entirely privatizing the system, but let's at least shorten the queues for all by the wealthier paying for services directly. My friends in Singapore and Switzerland are appalled that Canadians have a gun to our heads with regards to health care. Only recently have physicians offered the option of private pay. And I had to ask. It is not being advertised. I presume this change from 5 years ago is that some medical professionals are being inspired by the hope of the Cambie Clinic court case (Dr. Day).

Where I agree with you is that I suspect that most Canadians love the nanny state, preferring security over freedom. I know I do!

[Cactusflower]

What about taking foreign trained doctors who have immigrated here and concentrating their new goals to getting up to speed in the Canadian health system? In some cases, I'll bet they have a lot to teach us.

I'm glad you brought that up. It's something that has been asked many times in the past but there never seems to be an answer. Let's flood Adrian Dix's inbox with mail. It's time someone in government paid attention and started fast-tracking some of those immigrant doctors who are driving cab and delivering pizza.

As to your question about my neighbour, he has a GP but he also has agoraphobia, or something that won't let him leave his house. The only way he got to see his doctor was by falling down, not being able to get up, and having the ambulance come to his rescue. They took him to the hospital where he finally got to see his doctor.Thank goodness he bought one of those 'panic buttons' to wear around his neck. His doctor won't make house calls because he's in another city. My neighbour's been trying for years to get a local doctor, but so far no luck. He's certainly in no condition to sell his home and move to where the doctor is.

[hobbyguy]

The discussion of private versus public care provision is irrelevant. IF you look at care systems that are better at meeting the needs of the citizenry around the world, you find some that are public only, some that are a mix of public and private, and some that are largely private. (That's how far down the list we have fallen!).

The fact is that most family physicians operate as fee-for-service private businesses. Walk-in clinics are privately operated. Etc.

If you think you can get a change to the Canada Health Act to privatize the system, I would suggest you run for office and see how few votes you would get.

I both agree and disagree with you.

Multiple countries have two-tier systems. UK does for example. I am not suggesting entirely privatizing the system, but let's at least shorten the queues for all by the wealthier paying for services directly. My friends in Singapore and Switzerland are appalled that Canadians have a gun to our heads with regards to health care. Only recently have physicians offered the option of private pay. And I had to ask. It is not being advertised. I presume this change from 5 years ago is that some medical professionals are being inspired by the hope of the Cambie Clinic court case (Dr. Day).

Where I agree with you is that I suspect that most Canadians love the nanny state, preferring security over freedom. I know I do!

We do have a tiered system. There are lots of areas where we have private care functions. The rest is just squabbling over dividing lines.

[Jflem1983]

What about taking foreign trained doctors who have immigrated here and concentrating their new goals to getting up to speed in the Canadian health system? In some cases, I'll bet they have a lot to teach us.

I'm glad you brought that up. It's something that has been asked many times in the past but there never seems to be an answer. Let's flood Adrian Dix's inbox with mail. It's time someone in government paid attention and started fast-tracking some of those immigrant doctors who are driving cab and delivering pizza.

As to your question about my neighbour, he has a GP but he also has agoraphobia, or something that won't let him leave his house. The only way he got to see his doctor was by falling down, not being able to get up, and having the ambulance come to his rescue. They took him to the hospital where he finally got to see his doctor.Thank goodness he bought one of those 'panic buttons' to wear around his neck. His doctor won't make house calls because he's in another city. My neighbour's been trying for years to get a local doctor, but so far no luck. He's certainly in no condition to sell his home and move to where the doctor is.

I remember mom bought a car off a russian years ago. He was a doctor in russia. Car salesman here. Think this might be part of the problem

[The Green Barbarian]

*removed*