Canadian doctors want YOUR views on healthcare

[wyly]

Well, mistakes will always happen. There`s a trade-off in any system. You can spend twice as much money to reduce the number of errors from .2 % to .1 % but is it worth it ?

I can't see reducing the standard any more than what it is...we have lesser trained personnel already, nurses and emt's and I'd rather not have either one making a decision that could a affect a family members life...I'm not even 100% confident in the MDs we have now, as you say mistakes will always happen, reduce the education and more mistakes will happen...

in the US they allow Specialist MDs to practice without passing their final exams, would you want a surgeon or oncologist that's never passed his/her exams working on your wife, child or you, hey what's .1%?...

[Michael Hardner]

Would you still say that if a family member of yours got a bad diagnosis which led to severe complications or death because the person they went to see wasn't a fully trained doctor?

No. That`s why we don`t ask such people to design the system.

Again, I`m just asking. It`s quite possible that we overtrain people for some jobs in the medical system. Don`t you think ?

Health care is one area where we cannot compromise on quality. People that are sick already have enough to worry about without also wondering whether the person they are seeing can tell a lymphatic cyst from a cancerous tumor. The solution to our health care system is most definitely NOT to reduce the quality and education of the people staffing it.

`we cannot compromise on quality` is kind of meaningless. Quality is designed into the system, and costed out. If we`re going to look at the system more closely, then we have to have open discussions about such things.

[Michael Hardner]

I can't see reducing the standard any more than what it is...we have lesser trained personnel already, nurses and emt's and I'd rather not have either one making a decision that could a affect a family members life...I'm not even 100% confident in the MDs we have now, as you say mistakes will always happen, reduce the education and more mistakes will happen...

in the US they allow Specialist MDs to practice without passing their final exams, would you want a surgeon or oncologist that's never passed his/her exams working on your wife, child or you, hey what's .1%?...

Well, using that logic, what is .05 % ? or .01 % ? And who is talking about surgeons ?

What is the rate of error of primary care family physicians today in Canada anyway and how has it changed over the last ten years ? I would be surprised if you could find a source on that.

[wyly]

No. That`s why we don`t ask such people to design the system.

Again, I`m just asking. It`s quite possible that we overtrain people for some jobs in the medical system. Don`t you think ?

`we cannot compromise on quality` is kind of meaningless. Quality is designed into the system, and costed out. If we`re going to look at the system more closely, then we have to have open discussions about such things.

quality is something I don't want to see changed unless it's to improve it...

one issue heard of is wages, a number of MDs find the wages received as a family MD too low and decide a few more years of school and they're into the much better wages of specialists...but if we increase the family MD wages at what point does that reduce the number of MDs who go on to be specialists? it's a catch 22....

then there is the issue of female MDs, most MD students now are I believe women, and being women many take themselves out of the workforce to raise a family, is this something that will balance out in time or does it leave us short MDs all the time...

but as true metis posted Canada has more MDs and Nurses per 1000 than the US so do we really have a problem or is it media hype?...

or are we just not making optimum use of personnel available?...

[bush_cheney2004]

...but as true metis posted Canada has more MDs and Nurses per 1000 than the US so do we really have a problem or is it media hype?...

Not unless your only comparisons are constantly to the USA, which has terrible healthcare and "uncertified" doctors!

Edited December 19, 2010 by bush_cheney2004

[Pliny]

yes...I could tell a number of anecdotal stories involving my own family where the MD missed something obvious, I can't imagine someone less knowledgeable being trusted...

But...But...we have the best MDs in the world. How could they have missed something obvious?

[Bonam]

No. That`s why we don`t ask such people to design the system.

Again, I`m just asking. It`s quite possible that we overtrain people for some jobs in the medical system. Don`t you think ?

`we cannot compromise on quality` is kind of meaningless. Quality is designed into the system, and costed out. If we`re going to look at the system more closely, then we have to have open discussions about such things.

Sure, we are having an open discussion. Unusually, I agree with wyly, if we are gonna make any modifications to quality, it should only be to improve it.

I do not embrace the narrative of an aging population that must be supported and cared for by an ever shrinking number of productive people. Rather, I am of the opinion that technological improvement in medicine will continue to allow people to live longer and healthier lives, and that as part of living such lengthened lives, people will both want to and need to work longer to support themselves. The economy will continue to grow, the money spent on health care will continue to grow, the medical technology in use will continue to advance, and training and knowledge that medical personnel receive will continue to broaden, and the quality of health care will continue to improve. The research of today already holds the promise of drastically increasing the human lifespan, and the economic model of people retiring at 65 and receiving free health care for the remainder of their lives will not continue perpetually, and once that begins to change so too will the funding crisis of our health care systems.

[Michael Hardner]

quality is something I don't want to see changed unless it's to improve it...

I guess that would mean we need to start by measuring quality, hm ?

one issue heard of is wages, a number of MDs find the wages received as a family MD too low and decide a few more years of school and they're into the much better wages of specialists...but if we increase the family MD wages at what point does that reduce the number of MDs who go on to be specialists? it's a catch 22....

then there is the issue of female MDs, most MD students now are I believe women, and being women many take themselves out of the workforce to raise a family, is this something that will balance out in time or does it leave us short MDs all the time...

but as true metis posted Canada has more MDs and Nurses per 1000 than the US so do we really have a problem or is it media hype?...

or are we just not making optimum use of personnel available?...

I guess we need to gather and publish statistics.

[Pliny]

Again, I`m just asking. It`s quite possible that we overtrain people for some jobs in the medical system. Don`t you think ?

I do. I think we overtrain mainly because there is too high a percentage of people getting trained that aren't particularly suited to the profession. Too many are being trained that are there for status, self-importance or parental importance or economic security.

There is also overtraining in order sustain quotas. Quotas are a means of protecting economic status.

`we cannot compromise on quality` is kind of meaningless. Quality is designed into the system, and costed out. If we`re going to look at the system more closely, then we have to have open discussions about such things.

We compromise on quality because of the above considerations. Minimal standards are designed into the system rather than a search for quality.

Quality is only evident in results. It is isn't evident in procedure, education or rules. We can establish rules, procedure and education but they may have nothing to do with having a healthy population and everything to do with having a well-managed sick population.

WE certainly do have to have open discussions but they are often only about protecting the turf. The system must change but only minor tinkering is allowed mostly to do with the economics of health care and not the efficiency or quality of delivery. Apparently, that should not be a part of the discussions.

[wyly]

I guess that would mean we need to start by measuring quality, hm ?

I guess we need to gather and publish statistics.

the more I think about the more I'm convinced the problem is mostly media driven, we like to hear ourselves complain...we have excellent healthcare we're among the longest lived people on the planet and we do it for a reasonable amount of cash, roughly on par with other leading nations...

the only real issues I see is a shortage of family MDs and poor response time in ER's...and the ER's response times could be reduced significantly with 24 hr walk-in clinics staffed with family MDs...

[Michael Hardner]

the more I think about the more I'm convinced the problem is mostly media driven, we like to hear ourselves complain...we have excellent healthcare we're among the longest lived people on the planet and we do it for a reasonable amount of cash, roughly on par with other leading nations...

the only real issues I see is a shortage of family MDs and poor response time in ER's...and the ER's response times could be reduced significantly with 24 hr walk-in clinics staffed with family MDs...

Again, we don't really know because ER times are sparsely reported. The government doesn't like to self-report on performance. Now CIHI isn't giving out the stats anymore and no one seems to have even noticed.

The shortage of family MDs has been going on for years now. See if you can find a report on that one too.

[Michael Hardner]

We compromise on quality because of the above considerations. Minimal standards are designed into the system rather than a search for quality.

Quality is only evident in results. It is isn't evident in procedure, education or rules. We can establish rules, procedure and education but they may have nothing to do with having a healthy population and everything to do with having a well-managed sick population.

WE certainly do have to have open discussions but they are often only about protecting the turf. The system must change but only minor tinkering is allowed mostly to do with the economics of health care and not the efficiency or quality of delivery. Apparently, that should not be a part of the discussions.

The patient-taxpayer needs to be the main stakeholder in open discussions as they are the ones who are poorly represented now.

We seem to be worried about reducing quality, yet nobody is concerned about the fact that baselines for quality are poorly reported or even unknown.

[wyly]

Again, we don't really know because ER times are sparsely reported. The government doesn't like to self-report on performance. Now CIHI isn't giving out the stats anymore and no one seems to have even noticed.

well I think we both know the reason for that...

The shortage of family MDs has been going on for years now. See if you can find a report on that one too.

but it's not an unknown problem everyone is aware of it, problem is how to solve it and is anyone looking into the problem? and if they are why are they not telling us or is it because no one pressing hard enough for an answer?...

[Michael Hardner]

but it's not an unknown problem everyone is aware of it, problem is how to solve it and is anyone looking into the problem? and if they are why are they not telling us or is it because no one pressing hard enough for an answer?...

If nobody is looking into it, then the government (as the sole legal provider of healthcare) has the responsibility to look into the problem. This must be so, otherwise they would be pressing for a solution.

[wyly]

If nobody is looking into it, then the government (as the sole legal provider of healthcare) has the responsibility to look into the problem. This must be so, otherwise they would be pressing for a solution.

I agree, so are you going to vote for in the next election, the government who refuses to tell you what you want to know or someone else?...

[Smallc]

Ok, but most complaints are pretty basic. I`m just suggesting that the system could be re-thought, is all.

That's what Nurse Practitioners and some RNs are being used for. NPs are in short supply though.

[Michael Hardner]

I agree, so are you going to vote for in the next election, the government who refuses to tell you what you want to know or someone else?...

I will vote for someone else, but there is a low chance that healthcare performance will become a major issue.

[wyly]

I will vote for someone else, but there is a low chance that healthcare performance will become a major issue.

so ultimately the voter is responsible, they let the politicians get away with it...

[Michael Hardner]

so ultimately the voter is responsible, they let the politicians get away with it...

That's what I think. There's a thread on here about whether TV conversion to digital will play into the election.

[pfezziwig]

I don't think anybody's called for a total or near total privatization. Just an option. Which is hardly a fringe minority view, more like a majority.

I agree, that's just a scare tactic for public sector lobbiest, a fairly successful tactic for many years. Hopefully they won't think up one equally good in the years to come as we wise up to this disception or dare I say hopefully voters will actually wise up and support politicans who propose we live within our means?

[wyly]

I agree, that's just a scare tactic for public sector lobbiest, a fairly successful tactic for many years. Hopefully they won't think up one equally good in the years to come as we wise up to this disception or dare I say hopefully voters will actually wise up and support politicans who propose we live within our means?

there's another scare tactic from the private sector lobbyist, that we aren't living within our means...we're actually quite competitive with other countries is regards to amount spent per person and average lifespan attained...the country that fails miserably is that champion of private medical care the usa...

[bush_cheney2004]

...the country that fails miserably is that champion of private medical care the usa...

Doesn't seem to bother Canadians of means who prefer not to wait in queue, patriotically. When their asess are on the line and they grow tired of waiting, we know where to find them....just ask PM Chretien.

Edited January 6, 2011 by bush_cheney2004