SHAME! Our 'Health Care" is the pits in comparison. :(

[guyser]

Could you explain how population density has any correlation whatsoever to number of doctors?

Remember that the shortages aren't in the boonies but in Toronto, Vancouver, Montreal and Ottawa, very highly populated areas.

I never linked the two. I think you have me confused with someone else.

The CMA says it is outside the GTA were the problem is most acute. I know that Orangeville, Huntsville and places like that are the problem areas, not Toronto.

[punked]

Why?

Economies of Scale. The higher population density makes it easier to have access to care and to train those who give care.

[Argus]

I bet the MDs in France are paid a lot less than ours are. They make a good income, but nothing compared to the US. And our physicians compare themselves with the US.

Good guess, but wrong.

http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/

[guyser]

It has a lot to do with it.

A country like France or Germany has the density that makes economies of scale efficient. But you are right, more Doctors supposedly leads to better distribution and addresses the shortage.

There is a reason the Northern School of Medicine does not demand MCAT's for admission. Upon graduation you will serve the north for a specified term.

[Argus]

hospital shortage is a factor, if there are few rural hospitals those rural patients will go to the already maxed out urban hospitals...our newest hospital cost $1 billion, how many of those do you think a province can build without complaints of tax increases...we can't afford to build billion dollar hospitals all over the province, the population density isn't large enough to support it...

The Ottawa region hasn't seen a new hospital in my lifetime. In fact, the Ontario government has closed 2 hospitals here.

And people don't travel from the boonies to get into our hospitals. Wait times are normally quite a bit lower in rural hospitals.

[Argus]

wait times for surgery are dependent on the number of facilities, surgeons could easily do more surgeries to ease wait times but OR time is limited...my daughter recently had a major elective surgical procedure, she waited a year for the surgery not because the surgeon couldn't do it sooner but because he was limited to a fixed amount of surgical days, a facility/bed shortage...

Well then, here's an idea... how about we build enough facilities to match the need?

[punked]

Well then, here's an idea... how about we build enough facilities to match the need?

Good idea that costs money though.

[Wayward Son]

There is a reason the Northern School of Medicine does not demand MCAT's for admission. Upon graduation you will serve the north for a specified term.

There is no requirement for NOSM students to serve the north for any period of time. The idea is select students who are more likely to want to work in northern and rural environments.

[Wayward Son]

And where are those physicians going to do their internships and residencies when they graduate?

Graduating medical students are free to apply to residencies anywhere they wish. Most will be accepted (and accept) to Canadian spots, some in the US (and a small number in residencies elsewhere). The number of residency spots in Ontario increased inline with the increase in medical school spots, so while some Ontario medical school graduates are going to accept residencies outside of Ontario, those are generally replaced by a similar number of applicants accepted to Ontario residencies from medical schools outside of Ontario.

[guyser]

There is no requirement for NOSM students to serve the north for any period of time. The idea is select students who are more likely to want to work in northern and rural environments.

I will take your assertion as the truth. . I am repeating what my girlfriend was told when applying to Med-schools around the country. ( I wanted her to move and live up there-there being anywhere north of Orrillia)

[Wayward Son]

I will take your assertion as the truth. . I am repeating what my girlfriend was told when applying to Med-schools around the country. ( I wanted her to move and live up there-there being anywhere north of Orrillia)

It is a rumor that is believed by many - probably most - pre-meds. I personally feel that it would a good idea (although how does one tell a graduate who goes into a specialty residency that they must work in the north when there may only be a couple openings for that specialty in the country and none of them in the north).

The main advantages that Northern Ontario has for NOSM include 1) most students are from Northern Ontario or other rural areas 2) While in medical school you make professional connections - if you go to NOSM those professional connections are going to be in Northern Ontario and 3) many do residencies in Northern Ontario which provides further professional connections and gives you a leg up on job openings in the area.

[guyser]

It is a rumor that is believed by many - probably most - pre-meds. I personally feel that it would a good idea (although how does one tell a graduate who goes into a specialty residency that they must work in the north when there may only be a couple openings for that specialty in the country and none of them in the north).

The main advantages that Northern Ontario has for NOSM include 1) most students are from Northern Ontario or other rural areas 2) While in medical school you make professional connections - if you go to NOSM those professional connections are going to be in Northern Ontario and 3) many do residencies in Northern Ontario which provides further professional connections and gives you a leg up on job openings in the area.

Thanks for the reply.

Question though, NOSM isnt a spot one goes for a specialty disignation is it? Afterall, they are capped at something like 60 applicants or so?

I have always felt one way to ease Dr shortages is to relieve them of debt in return they are employed where the shortage is for a pre-determined number of years. So if one wants to be a GP and do it for free then they get posted in Timmins, Red Lake or the like for 5 years. Chances are, plenty of applicants would say yes, the life in the north would generally integrate into their lives and they would stay. Of course I am presuming most apllicants would have some sort of affinity to the north , someone like me for instance, who if I were younger may well have decided thats the ticket for me.

Edited December 5, 2012 by guyser

[Argus]

Economies of Scale. The higher population density makes it easier to have access to care and to train those who give care.

I know all about economies of scale I just don't see it in this case. Doctors are trained in universities. Are you saying the universities need to be bigger? They intern in hospitals. Hospitals tend to be as large here as elsewhere. Accessing care does not seem to be a problem related to distance but to the number of doctors available. You supply X doctors and nurses per X population regardless of how spread out that population is. Is it really cheaper to pay for ten hospitals in Toronto then ten hospitals spread across a distance in rural areas? The only way economies of scale would enter into things would be if we had small hospitals scattered around which were under-utilized, but we don't. Nor has anyone demonstrated that smaller, rural hospitals cost more to operate on a per patient level, than large urban hospitals.

[Argus]

Good idea that costs money though.

I don't know anyone who wouldn't be willing to pay more to improve health care response times.

I do know a lot of people who think merely spending money to increase the salaries of health care professionals (our usual methodology) is not likely to help.

[wyly]

residencies are limited, students can choose the field of medicine they would like to specialize in and where they would like to do it but the hospitals also have a choice of who they will accept and what specialties they will offer to those who they select...

as to assigning graduates to remote regions...good luck not many young mds once they've lived in a big urban area want live in the boonies....

maybe as a contractual exchange, free education time in hillbilly land they may do it for a short period....I think most would find other ways to pay for their education, as it is now our medical educational system is at full capacity with paying students....

[Bryan]

There is no doctor shortage in Canada. We've got more of them now than we ever have, a large number of them out of work and unable to find a job in the profession.

Doctor numbers in Canada at all-time high

The number of physicians in Canada is at an all-time high and rising, according to new data, suggesting the much-discussed doctor shortage may be improving.

Between 1980 and 2010, the number of physicians in Canada increased by 87.1 per cent, finds the study, Supply Distribution and Migration of Canadian Physicians, 2010, released Thursday by the Canadian Institute for Health Information.

During this time, there were variations in the number of physicians per province. While the number of doctors increased 182.5 per cent in Alberta, the North West Territories experienced a 20.9 per cent decline in physicians.

In 2010, there were 203 physicians per 100,000 Canadians versus 151 in 1980.

http://www.cbc.ca/ne...da-report.html

The Unemployed Doctor Show

Have scalpel, will operate for food? It's not quite that bad, but a growing number of young doctors, who have spent years in school and a mountain of money on their training are having trouble finding jobs. This week on White Coat, Black Art, we explore the parodox: highly-trained, well-educated MDs who can't find work, while you can't find a family doctor and there's no geriatrician to look after your aging parents. You can chalk it up to bad planning, but it may have an impact on your healthcare.

http://www.cbc.ca/wh...d-doctor-show/

The real issue, as already explained in this thread, is geography. Allocating resources over such a large expanse of land that is so sparsely populated is a logistical nightmare.

Edited December 6, 2012 by Bryan

[Wayward Son]

Thanks for the reply.

Question though, NOSM isnt a spot one goes for a specialty disignation is it? Afterall, they are capped at something like 60 applicants or so?

I have always felt one way to ease Dr shortages is to relieve them of debt in return they are employed where the shortage is for a pre-determined number of years. So if one wants to be a GP and do it for free then they get posted in Timmins, Red Lake or the like for 5 years. Chances are, plenty of applicants would say yes, the life in the north would generally integrate into their lives and they would stay. Of course I am presuming most apllicants would have some sort of affinity to the north , someone like me for instance, who if I were younger may well have decided thats the ticket for me.

NOSM has 64 spots each year for 1st year medical students.

They also have probably 50 or 60 new residency spots each year. Most of those are GP spots (and GP+1, where the +1 is ER, anesthesia etc), but there are also residencies in specialties such Internal medicine, anesthesia, peds, OBGYN, general surgery. They don't have some of the more specialized residencies - which makes sense as places that are more rural would be better off having a general internal medicine specialist then say someone who further specializes into cardiology or oncology.

However, the students graduating from NOSM have no obligation to apply to NOSM residencies, nor does NOSM have any obligation to take students who went to NOSM over applicants who went to other medical schools. Two of the three people I know who have graduated from NOSM went to a NOSM residency in family medicine and I anticipate they will work in Northern Ontario. The other took a speciality residency spot in another province and will be specialized enough that he will most likely have to remain in a very large city.

As for the debt relief plan for working in underserviced areas, I am all for such plans. I believe that some communities that are underserviced have offered debt relief etc, but I believe that in those cases the funding for such falls on those communities. If the government was more serious they could get something going themself to help solve the problem.

[bush_cheney2004]

The good folks over at the Wait Time Alliance have highlighted a well known health care system metric that remains troubling to them:

Medical wait times up to 3 times longer in Canada

Canadians wait longer in hospital emergency departments than people in other countries with publicly funded health-care systems, according to a new report.

The Wait Times Alliance’s annual report card, called "Time to close the gap," said 27 per cent of Canadians reported waiting more than four hours in the emergency department compared with one per cent in the Netherlands and five per cent in the United Kingdom.

http://www.cbc.ca/news/health/medical-wait-times-up-to-3-times-longer-in-canada-1.2663013

Cue comparisons to U.S. health care in 3...2...1...

[monty16]

Our government has control over our health care system by funding it. Therefore, the Harper government is in the process of defunding it and consequently making it bad enough that the people will go along with it's destruction. It's a slow process because what they are doing must be hidden from the people as much as possible.

But even with that happening it's still rated higher than the failed US system.

No improvements to our system will happen until we get rid of Harper. If we don't then he will be able to accomplish his goal with another 4 year majority.

[Argus]

Our government has control over our health care system by funding it. Therefore, the Harper government is in the process of defunding it and consequently making it bad enough that the people will go along with it's destruction. It's a slow process because what they are doing must be hidden from the people as much as possible.

No improvements to our system will happen until we get rid of Harper. If we don't then he will be able to accomplish his goal with another 4 year majority.

I love the blitheful ignorance of the fact health care is a provincial responsibility! That really adds so much credibility to your opinion, monty! And, of course, ignoring all factors other than funding, despite the fact we spend more than most countries, is a wonderful added touch which will cause much mirth among those who read your opinion. I see, now, the brilliance of your wit and wisdom, where before I saw only laughable lack of knowledge and insight! Kudos to you!

[Shady]

I love the blitheful ignorance of the fact health care is a provincial responsibility! That really adds so much credibility to your opinion, monty! And, of course, ignoring all factors other than funding, despite the fact we spend more than most countries, is a wonderful added touch which will cause much mirth among those who read your opinion. I see, now, the brilliance of your wit and wisdom, where before I saw only laughable lack of knowledge and insight! Kudos to you!

Judging from his other posts, I'm pretty sure he's just trolling. But it's hard to know for sure.

[monty16]

I love the blitheful ignorance of the fact health care is a provincial responsibility! That really adds so much credibility to your opinion, monty! And, of course, ignoring all factors other than funding, despite the fact we spend more than most countries, is a wonderful added touch which will cause much mirth among those who read your opinion. I see, now, the brilliance of your wit and wisdom, where before I saw only laughable lack of knowledge and insight! Kudos to you!

My point was about funding so you must be confusing me with somebody else.

And you think we spend more on health care than other countries? Duhhhhhhhhhh! Some already know the US spends nearly twice as much per capita than we do.

Laughable isn't a word to explain your kind of drivel!

[monty16]

Judging from his other posts, I'm pretty sure he's just trolling. But it's hard to know for sure.

You need to read his posts carefully before you jump at the opportunity to attack me personally again.

[Argus]

My point was about funding so you must be confusing me with somebody else.

And you think we spend more on health care than other countries? Duhhhhhhhhhh! Some already know the US spends nearly twice as much per capita than we do.

Laughable isn't a word to explain your kind of drivel!

You're so funny! You know how easily the numbers can be verified and have slyly chosen to make the reader discover how inane your supposed claims are! I approve of your encouraging others to do the basic work of proving how ignorant your opinions are! It will serve to educate them in how to disarm internet blowhards in the future!

In fact, we spend more per capita than France, Germany, and even Sweden! But of course, we get less for it because of the enormous salaries we pay throughout the health care field and because of bureacratic incompetence on the part of the provinces. But you knew that, didn't you, you brilliant man!

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita

Edited June 8, 2014 by Argus

[monty16]

You're so funny! You know how easily the numbers can be verified and have slyly chosen to make the reader discover how inane your supposed claims are! I approve of your encouraging others to do the basic work of proving how ignorant your opinions are! It will serve to educate them in how to disarm internet blowhards in the future!

In fact, we spend more per capita than France, Germany, and even Sweden! But of course, we get less for it because of the enormous salaries we pay throughout the health care field and because of bureacratic incompetence on the part of the provinces. But you knew that, didn't you, you brilliant man!

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

Referring to me as an internet blowhard is a personal attack. Again!

I referred to the US when I said their system costs nearly double ours per capita and that is fact. If some of the better universal health care systems in the world out perform ours on cost then that's saying something for universal health care.