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Hasten registration of foreign trained medical professionals


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54 minutes ago, myata said:

Yeah pay me for a solution, that just may work given the efforts and costs / results so far. You are correct though the current system is destined for a dead end and that's only a logical reality. There's every incentive for the happy management / unions duet to sing and press public for ever more dough (pseudo "CEO" salary in some cases in six digits range) while exactly zero, to improve the quality and service. And that's just a bad setting, from the outset. It engenders only one, obvious direction: ever more dough, ever less service, and so and very logically, a perpetual crisis. It's as bad as can be seen with a naked eye from miles away. How did we not figure it out yet?

Pay you? Why? You are just a complainer with no validity nor solution or even any ideas for anything.

Here we go again with CEO pay. CEO's are recruited and the pay scale is whatever the hospitals offer.  This does not matter in which corporation. The CEO gets paid what is offered and negotiated. And the fact you seem oblivious to what a CEO is only reinforces my in knowing you are completely ignorant of business and management.

While almost 50% of hospital operations go to salary already, the remainder is for all other costs and in particular the equipment.

Your solution is more pay but where does that money come from?? Less equipment, reduce equipment maintenance and therefore letting it break down?

When a public service organization gets a budget, decisions have to be made. A hospital gets $X and it has to do and pay for everything with that $X.  Pay is not adjustable, but equipment and maintenance is. Equipment fails, the money has to come from somewhere. Where does it come from?

I think you are a stay at home person and does not have any understanding or concept of business, labour, operations of anything. Just a complainer with no grasp of how companies, organizations, corporations and let alone public services work. Your responses are evidence that you have no idea of anything in the real medical (or business) world.

 

 

Edited by ExFlyer
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50 minutes ago, myata said:

You can have your default solution then. Good luck.

Your post, your complaints, ....your solution??

I have no solution. Never claimed to have on but did agree with the Ontario government to allow the nurses association to come up with one.  I am not dissatisfied with the medical system and it's staff and operations. I think they do an admirable job with the resources and finding they have.

You seem to think everything is archaic and it has become clear in your posts and retorts that you have no clue on the health care system function and systems.

I think you read news and jump on the bandwagon without understanding or realizing what is actually going on.

You seem to think that doctors and nurses can be plucked out of a top hat like a magician pulls a rabbit out.

The reality hammer has clearly missed you.

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3 hours ago, ExFlyer said:

I think they do an admirable job with the resources and finding they have.

No I advise you to figure out, is having to wait years for a routine operation still "admirable" or only "with the" (and a host of other reasons and excuses, system can produce those in a flash in contrast to top notch, always accessible and efficient services for the citizens). That confused quantum state can be a source of many conundrums.

Edited by myata
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Speaking strictly for my own corner of the world, we need to consolidate and make a stand where we can. Solo family practitioners should be a thing of the past and call should be at worst, say, 1 in 4 long-term. CMGs prepared to work on the front line and lead these rural groups should be fast-tracked for promotion at the university. They’re doing work of great value, after all, and it should be seen to be valued, not only financially. At the moment, the dept of family practice and indeed the whole medical school seem to exist mainly to sustain themselves despite their mission statements to the contrary. That must change. 

Edited by SpankyMcFarland
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2 hours ago, myata said:

No I advise you to figure out, is having to wait years for a routine operation still "admirable" or only "with the" (and a host of other reasons and excuses, system can produce those in a flash in contrast to top notch, always accessible and efficient services for the citizens). That confused quantum state can be a source of many conundrums.

WTF???

No excuses. Plain facts. You need to understand and cleary you are without the faculties to do so.

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One obvious pitfall from the UK to avoid when introducing a private system: don’t let the same surgeon control both a private and public list or the temptation to love one and hate the other will become unbearable. I saw this with two of my relatives waiting for hip replacements there: with a straight face Mr. Orthopod says, I can do you in 4 years time on my public list or next week on my private list if you hand over thousands in cash. It’s an invitation to extortion. The problem gets even worse if the doctor is paid on a salary on the public side and fee for service privately. Surgeons start disappearing early from their public posts, sometimes at 8 am, leaving the residents in charge - a common enough scenario in Ireland and the UK. 

Edited by SpankyMcFarland
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42 minutes ago, ExFlyer said:

Plain facts.

Not sure on what planet. You paid a contractor for a fence in four weeks. The time comes, no fence, the union is picketing for more dough and the CEO needs a raise and an annual bonus. Of course you'll be perfect understanding and reaching for the wallet (again and again, for ...??).

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47 minutes ago, SpankyMcFarland said:

Surgeons start disappearing early from their public posts, sometimes at 8 am, leaving the residents in charge - a common enough scenario in Ireland and the UK. 

Absolutely, a real problem that requires novel solutions. For example, private doctors could use public equipment in hospitals (with stuff, etc) provided they perform a minimum number of public services and a bonus system for improvements. Then it's only a matter of managing service times with pretty much known and predictable demand (outside of pandemics), hardly a rocket science in this century.

Edited by myata
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2 hours ago, myata said:

Not sure on what planet. You paid a contractor for a fence in four weeks. The time comes, no fence, the union is picketing for more dough and the CEO needs a raise and an annual bonus. Of course you'll be perfect understanding and reaching for the wallet (again and again, for ...??).

I am on a real planet. You clearly have not a clue on how business works, let alone how management get their jobs. CEO's do not build fences.

2 hours ago, myata said:

Absolutely, a real problem that requires novel solutions. For example, private doctors could use public equipment in hospitals (with stuff, etc) provided they perform a minimum number of public services and a bonus system for improvements. Then it's only a matter of managing service times with pretty much known and predictable demand (outside of pandemics), hardly a rocket science in this century.

You seem to think that you can tell or force professionals to do what you want.

Hate to burst your bubble but you cannot.

Hospitals already over book their equipment so where do you think "private" doctors would fit in?? Surgery rooms are also overbooked.

You are so uninformed and so simple minded, it is a wonder how you get through your day.

http://www.andreweifler.com/how-hospitals-work/

 

I can no longer debate with fool. Bye.

Edited by ExFlyer
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4 hours ago, ExFlyer said:

Hospitals already over book their equipment

You're fighting a lost battle here because there are facts. It works in insurance based system (3 times more Americans satisfied with healthcare than Canadians), and it works in many countries. So it is possible. And if it's possible and yet does not exist (here) then there have to be reasons. Why we are talking about eternal cliches and not real reasons? For that, there have to be reasons too.

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There's a very close great analogy here: Soviet Union. A great place in general but nothing works as it should. And the cause is simple, even trivial: no incentive.

So we have a capacity problem? Yes there are solutions, this 21st century ones. But effective solutions are not limited to talking heads talking to death of boredom about horrors of private, nor constant crying for more public money, nor outrageous executive compensations and bonuses without any connection to delivered service. All of that is / was Soviet Union. Congrats: almost there.

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  • 2 months later...

I’ve noticed that Canadian politicians and senior medics are much keener to talk about the bright future of rural recruitment that awaits us rather than the dismal record of a past we’ve just been through. For example, my local med school hired a chief who was going to work wonders on this issue. Alas, not only did he screw up on that, he never publicly admitted the province was doing ever worse while he was in charge.

This is a common enough situation. So what to do? An annual scorecard on rural recruitment and retention should be produced and the Dean of Medicine should then be invited to discuss the results. If we are going to fail at this - and there are many reasons beyond the control of med schools for this trend - we should at least be kept up to date on the magnitude of our failure. Not much to ask. 

Edited by SpankyMcFarland
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Is this not a real country anymore? How can we rely on foreign this and that, in core areas of social services as a long term policy? Can we not just figure out how to make it work here? Between governments (public service), schools (PS), hospitals (public) and practitioners. Is it really high calculus - or just lazy, entitled and carefree no matter what public bureaucracy?

No we can't - the unavoidable conclusion.

Edited by myata
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On 9/14/2022 at 5:00 PM, myata said:

You're fighting a lost battle here because there are facts. It works in insurance based system (3 times more Americans satisfied with healthcare than Canadians), and it works in many countries. So it is possible. And if it's possible and yet does not exist (here) then there have to be reasons. Why we are talking about eternal cliches and not real reasons? For that, there have to be reasons too.

Per capita, the US spends twice as much than Canada on health care.

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2 hours ago, Aristides said:

Per capita, the US spends twice as much than Canada on health care.

Let's clarify: as taxes with no choice paying for inefficient, permanently stressed system? Comparing costs without taking into consideration quality and choice is meaningless. This smacks of socialism already, you can only get one brand of car but it's half the price.

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  • 2 weeks later...

Some suggestions for the improvement of our system, from two physicians:

1. Increase spending on primary care. Australia is a great country to compare ourselves with: big, sparsely populated, similar expectations from the public. 

Quote

Our roots lie in shallow ground. No amount of individual effort can make up for the lack of systemic support for family medicine over the past decades. In Canada, just 4.7 per cent of current health care expenditure goes toward primary care, defined as general outpatient care. By comparison, Australia spends 11.5 per cent.

Spending on primary care pays for itself many times over. Access to a family physician has been shown to decrease hospitalizations, emergency department use and re-admissions. Patients with continuity of care have better health outcomes, and report better quality of life.

 

2. Team-based models of GP care. The Brits are way ahead of us on this. 

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And we’ve long known that we need transformation of primary care systems, not just more money. Team-based models like Alberta’s Primary Care Networks and Ontario’s Family Health Teams must be supported and expanded.

 

3. Much more long-term care.

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Our aging population needs access to long-term care.



4. A national EMR. Why on earth hasn’t this happened already? 

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A national electronic medical record would improve patient care and decrease administrative burden.

 

5. Licensing reform. One of my hobby-horses. Not sure about the second one, though, as a more level playing field may merely increase the supply of docs to already popular places. 

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Streamlined licensing pathways for foreign-trained medical professionals and national licensure for physicians would partially alleviate our work force crisis.

 

And a good conclusion. 

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Politicians need to stop crushing the remaining family physicians with unrealistic demands, and start focusing on solutions. It’s time to tend to the roots before the tree topples in the storm.

 

https://www.theglobeandmail.com/opinion/article-dont-blame-family-doctors-for-the-current-health-care-crisis/

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  • 4 weeks later...

I’m not exactly the biggest fan of Pierre Poilievre but he had some interesting things to say today about reviewing the credentials of IMGs more quickly and, very important, assessing their skills more as individuals rather than on their country of origin. Not much detail is available on his speech yet.

Quote

"Health care, after seven years of Trudeau, is worse than ever," Poilievre said. "I understand why premiers are frustrated with the damage he's caused."

Poilievre said a government led by him would pursue three health-care priorities: shorter wait times, more doctors and nurses and "faster approvals for new cutting-edge treatments and medication."

He also vowed to work with the provinces to fast-track foreign-trained health professionals.


https://www.cbc.ca/news/politics/trudeau-health-care-deal-1.6715534

 

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I think the medical establishment is finally changing its attitude to foreign doctors:

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The Royal College of Physicians and Surgeons of Canada is making it easier for internationally trained specialists to work in Canadian hospitals as it responds to the country’s doctor shortage, and to complaints that some of its policies discriminate against people with overseas medical degrees.

 

 


For Poilievre this is a good campaign topic for the general public and a great one in immigrant communities where many IMGs are unable to practice their profession:

Quote

 


 

 

Edited by SpankyMcFarland
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2 hours ago, SpankyMcFarland said:

where many IMGs are unable to practice their profession:

And we have no way of knowing, even less confidence in the quality of their training standard. And would "hastening" improve the situation with quality, if not access? If one could see a doctor quicker, but the outcome, less certain, would it be a gain or otherwise? Let's guess: it depends on how we count and who's counting! So we'll just have to find out. Give it a few decades.

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2 hours ago, SpankyMcFarland said:

I think the medical establishment is finally changing its attitude to foreign doctors

But then again, back to the origins: what's wrong with training sufficient numbers of high standard specialists here? Where is the conundrum that squarely beats decades of hard efforts and public megabillions thrown at it? Where could we find an Einstein or Galileo, to figure out this bureaucratic pickle?

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2 hours ago, myata said:

But then again, back to the origins: what's wrong with training sufficient numbers of high standard specialists here? Where is the conundrum that squarely beats decades of hard efforts and public megabillions thrown at it? Where could we find an Einstein or Galileo, to figure out this bureaucratic pickle?

Nothing but if we decided to do it today it would cost a fortune and would have no effect on our manpower shortfall for decades. It is part of the long-term solution. 

Edited by SpankyMcFarland
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2 hours ago, myata said:

And we have no way of knowing, even less confidence in the quality of their training standard. And would "hastening" improve the situation with quality, if not access? If one could see a doctor quicker, but the outcome, less certain, would it be a gain or otherwise? Let's guess: it depends on how we count and who's counting! So we'll just have to find out. Give it a few decades.


IMO it would be a gain and could be a big one if we assessed them properly. For no doctors at all to be better than doctors, they would have to be terrible. The medical colleges are not accountable for the people who suffer harm and death because they can’t see a doctor. In my province orphan patients are now 25% of the population, an intolerable situation. We need to think more about that growing minority of neglected Canadians.

Edited by SpankyMcFarland
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One example I’ve quoted before - experienced non-consultant IMGs in the UK. Take a surgeon as an example. This person might have been training more than ten years over there, going from post to post and only surviving in their career because of their competence. We’ve been lucky enough to employ many of these people. They are far more experienced than Canadian grads emerging from residencies who have done much less surgery on their own. 

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Our health systems limit doctor and nurse salaries.  Many Canadian doctors and nurses have moved to the US over the decades for better pay.  This is what can happen with socialism.  Their pay is determined by the government, it isn't decided by the market.    In the USSR and Cuba they had to ban people from being able to freely leave the country without the government's consent because people with high ability would leave.  We've all heard of Cuban athletes defecting etc.  We all have seen the many eastern European hockey players come to North America after the fall of the USSR.  Doctors are no different.  But in Canada, they are free to leave, as they should be, but we can create incentives for them to stay (like higher pay) and disincentives for them to leave (like having to pay back some of their subsidizes university tuitions).

Edited by Moonlight Graham
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