So it seems Ontario ER waits are improving....

[wyly]

By writing a smaller number on their pay cheques.

I doubt you could do that in a legal manner it's discriminatory...a newly graduated Canadian MD gets full pay while a more experienced MD gets less?...once someone is accepted as an immigrant to Canada he/she is protected equally by the law...

plus there's the practicality of of it, setting up practice has expenses that are paid by the MD, receptionists, nurses, office, supplies, if you start reducing their wages they are going to find it very difficult if it not impossible to get by... I recall reading an article in our local Calgary paper a couple of years ago where a family MD gave up his private practice because he couldn't make ends meet with all the overhead involved on the amount he was paid...he quit and became an EMT, he said at the end of the day he had more cash in his pocket for fewer hours at work...

That can be done as well. We could also create new roles to offload the work. Or we could import physicians from other countries and pay them less.

again I don't think paying less will fly...how about free medical training in return for contractual service such as is done in the military, state pays for training MDs and Nurses who do not have the money for an education in return for x-amount of years service, they would work in communities where there are MD shortages or in walk-in clinics as family physicians until their educational debt is paid off...

The MDs do, I believe, have a say in how many doctors are put on the market in Canada.

it's a good question, that's the common assumption I don't know if that's the way it is or just our perception, I'll enquire...

I do recall being told by one friend how his department requested more MDs in his specialty and it had to be approved by the provincial government/health authority, so it may not be completely accurate the MDs make the decision...but that's in Alberta it may not be same where you live...

Edited September 20, 2010 by wyly

[Michael Hardner]

I doubt you could do that in a legal manner it's discriminatory...a newly graduated Canadian MD gets full pay while a more experienced MD gets less?...once someone is accepted as an immigrant to Canada he/she is protected equally by the law...

You could call it whatever you wanted to.

plus there's the practicality of of it, setting up practice has expenses that are paid by the MD, receptionists, nurses, office, supplies, if you start reducing their wages they are going to find it very difficult if it not impossible to get by... I recall reading an article in our local Calgary paper a couple of years ago where a family MD gave up his private practice because he couldn't make ends meet with all the overhead involved on the amount he was paid...he quit and became an EMT, he said at the end of the day he had more cash in his pocket for fewer hours at work...

None of these are insurmountable problems.

again I don't think paying less will fly...how about free medical training in return for contractual service such as is done in the military, state pays for training MDs and Nurses who do not have the money for an education in return for x-amount of years service, they would work in communities where there are MD shortages or in walk-in clinics as family physicians until their educational debt is paid off...

it's a good question, that's the common assumption I don't know if that's the way it is or just our perception, I'll enquire...

I do recall being told by one friend how his department requested more MDs in his specialty and it had to be approved by the provincial government/health authority, so it may not be completely accurate the MDs make the decision...but that's in Alberta it may not be same where you live...

Ontario.

[P. McGee]

again I don't think paying less will fly...how about free medical training in return for contractual service such as is done in the military, state pays for training MDs and Nurses who do not have the money for an education in return for x-amount of years service, they would work in communities where there are MD shortages or in walk-in clinics as family physicians until their educational debt is paid off...

The same idea has occurred to me, although I think that reducing or removing the burden of medical school debt would enable new doctors to get by on less money. It could also be argued that reducing wages somewhat might actually weed out some of those who go into medicine for the money and don't really care about the patients. On a related note, nurse practitioners can do a lot of the same work that doctors do, but generally work for less money.

[wyly]

The same idea has occurred to me, although I think that reducing or removing the burden of medical school debt would enable new doctors to get by on less money. It could also be argued that reducing wages somewhat might actually weed out some of those who go into medicine for the money and don't really care about the patients. On a related note, nurse practitioners can do a lot of the same work that doctors do, but generally work for less money.

the wages they receive I think is fair compensation for the years of training they go through...if you reduce wages what's the incentive for all those years and the debt they incur?...they might as well go into air conditioning or dentistry the return on the time invested and the dollars spent has a much better return...of all the MDs I've met over the years I have yet to meet one that went into it only for the money, no doubt there are some but we can't afford to lose them either...and how can we hold MD's to standards we don't submit ourselves to? we all strive to make as much money as possible in our chosen careers...

if we were to off load MD duties on nurses they will want to be compensated with higher wages for added responsibility, a nurse's wages here are about $60K per year...so it may not save any money but it may free up valuable MD time...

[Michael Hardner]

.and how can we hold MD's to standards we don't submit ourselves to? we all strive to make as much money as possible in our chosen careers...

And all sectors have cutbacks and external pressure put upon them, I would submit.

[wyly]

And all sectors have cutbacks and external pressure put upon them, I would submit.

I think you would grudgingly accept a wage freeze but not a roll back...I've been through a freeze but if someone told me my wages would be cut I'd be gone looking for a new job...

[Michael Hardner]

I think you would grudgingly accept a wage freeze but not a roll back...I've been through a freeze but if someone told me my wages would be cut I'd be gone looking for a new job...

I have accepted both, and there's really only one employer of doctors, so really the option is to strike. I didn't have that option, nor do many displaced workers. A freeze would be preferable, but actually all we care about is overall costs. I think we would be happier with more throughput from workers than either a freeze or a rollback.

[P. McGee]

the wages they receive I think is fair compensation for the years of training they go through...if you reduce wages what's the incentive for all those years and the debt they incur?

I was responding to a suggestion to fully subsidize medical training based on a commitment to work in needed areas, which would negate the debt part of the equation.

of all the MDs I've met over the years I have yet to meet one that went into it only for the money, no doubt there are some but we can't afford to lose them either

This may be more true of MDs because of the time commitment involved, but consider elder abuse by nursing home staff as an example of medical professionals who don't seem to be motivated by compassion for patients. In such cases I would think we can afford to lose those people. The connection I was making to wages is rather weak, which is why I wrote "It could be argued" instead of "I think..."

if we were to off load MD duties on nurses they will want to be compensated with higher wages for added responsibility, a nurse's wages here are about $60K per year...so it may not save any money but it may free up valuable MD time...

Nurse practitioners are somewhere in between a RN and a GP with respect to education time, responsibilities and earnings. For example they can write prescriptions and diagnose certain diseases.

[wyly]

This may be more true of MDs because of the time commitment involved, but consider elder abuse by nursing home staff as an example of medical professionals who don't seem to be motivated by compassion for patients. In such cases I would think we can afford to lose those people. The connection I was making to wages is rather weak, which is why I wrote "It could be argued" instead of "I think..."

okay, I agree...

Nurse practitioners are somewhere in between a RN and a GP with respect to education time, responsibilities and earnings. For example they can write prescriptions and diagnose certain diseases.

there's liability issues involved here...it's a minefield of dangers but one worth looking into...

[guyser]

there's liability issues involved here...it's a minefield of dangers but one worth looking into...

No different really than a Dr's.

Buy E&O and no problem.

[Smallc]

So, I just drove someone to the ER. I live in a rural area right now, and the 2 nearest hospitals, which are small community hospitals (with 14 and 26 beds, in order of closeness) which both have ERs, but do not have an in house physician 24 hours a day. The doctor is only called if necessary. So we bypassed those two hospitals and went to the regional health centre in out regional health authority. There is usually 1 resident doctor in the ER and at least one other resident of family physician elsewhere in the hospital to assist if needed. The wait time, as would be measured by the Ontario government? 70 minutes.

[Michael Hardner]

The wait time, as would be measured by the Ontario government? 70 minutes.

That's great.

Let's stop discussing these things with anecdotes, though, as tempting as that may be.

This is a system and needs to be treated as such by the managers, and by the consumers of services.

[Smallc]

Let's stop discussing these things with anecdotes, though, as tempting as that may be.

Why shouldn't I? Everyone else does.

[Michael Hardner]

Why shouldn't I? Everyone else does.

Be part of the solution, not part of the problem.