Hasten registration of foreign trained medical professionals

[herbie]

On 8/18/2022 at 2:32 PM, ExFlyer said:

Bill Gates was sure important in the tech world  but doctors save people lives every day. Very very few coders can save lives and do surgery.

In my last post I pointed out just how techs can make the doctors and surgeons more efficient. That doesn't lower standards or steal doctors from the Third world that needs them even more than we do.
Like for example why does my amazon order get from Toronto to the boonies in northern BC in 48 hours when lab results often take more than a week to get to the clinic one block away? When both places are on the same network it shouldn't take any longer than sending a file to my home NAS!

[ExFlyer]

18 minutes ago, herbie said:

In my last post I pointed out just how techs can make the doctors and surgeons more efficient. That doesn't lower standards or steal doctors from the Third world that needs them even more than we do.
Like for example why does my amazon order get from Toronto to the boonies in northern BC in 48 hours when lab results often take more than a week to get to the clinic one block away? When both places are on the same network it shouldn't take any longer than sending a file to my home NAS!

Don't much care about your lab tests. Even less about bill gates.

[SpankyMcFarland]

1 hour ago, myata said:

But even that wouldn't be the full answer. What is missing in this system is a customer. Someone who can make a meaningful choice and aim for the best outcome, not be feed whatever is available. In such a system improvement is really a rare event.

Patients are in no position to be customers but that role could be delegated in the system to, say, GPs if we had capitation across the country.

On a more general note, I think a chief nursing officer is one small step in the direction of a more coherent national health care policy. 

https://www.ctvnews.ca/health/canada-names-new-chief-nursing-officer-reinstating-role-to-advise-on-health-crisis-1.6038568

 

 

Edited August 25, 2022 by SpankyMcFarland

[myata]

16 hours ago, SpankyMcFarland said:

On a more general note, I think a chief nursing officer is one small step in the direction of a more coherent national health care policy. 

I would argue that we don't need a more coherent policy, or it's not the top priority. The priorities are: accountability; efficiency; quality and access. This is not some sacred national cow. It's a service paid for 100% by taxpayers that needs to perform with quality and stability to modern standards. Otherwise, what's the point?

[myata]

The debate of public / private is completely beyond the point. Why are we framing it this way, for decades? Who benefits from gross oversimplifications instead of addressing real and present issues? There's one obvious answer: status quo complex, the bureaucracy.

In a hypothetical health services market provided by multiple quality providers regardless of ownership publicly financed or insured customer would have a choice based on quality; cost; access standards and service. They could recover costs for services under standard, or agreed terms of access. And with 100% public no competition no market we have no choice. We have to pay the asking price (through our taxes) and accept the outcome whatever it is because status quo bureaucracy can make any promises and talk about reforms forever but it just cannot improve anything in the reality.

[herbie]

Because most people are so stuck on simple ideas as solutions they won't even think. Privatize, privatize... duh. We can't fix things! Throw it away....

don't matter if there's a nursing shortage, private clinics won't have to pay nurses as much. People will rush to train as nurses if we pay them even less....

besides we won't have to think anymore about the problem, only of how to pay the bill.

[myata]

15 hours ago, herbie said:

Because most people are so stuck on simple ideas as solutions they won't even think. Privatize, privatize... duh.

There was an example in this very thread, where a routine operation years on a public waiting list was done in three weeks. It doesn't mean "privatize everything" or throw away. But it means that it can work, a fact and shouting "horror private" won't do anything to change it; and if it still wouldn't work after decades of near crisis condition and throwing uncounted public billions (what trillions already?) 'fixing for generation' there has to be a reason. So thinking, objective and independent is called for but where can it be found, here?

15 hours ago, herbie said:

We can't fix things! Throw it away....

What if you have a watch that shows you wrong time, or with a huge delay or both no matter how much $$$ you throw into fixing it? What do you do with a watch that stubbornly refuses to work as you want and need it to?

Edited August 26, 2022 by myata

[ExFlyer]

On 8/25/2022 at 5:19 PM, herbie said:

Because most people are so stuck on simple ideas as solutions they won't even think. Privatize, privatize... duh. We can't fix things! Throw it away....

don't matter if there's a nursing shortage, private clinics won't have to pay nurses as much. People will rush to train as nurses if we pay them even less....

besides we won't have to think anymore about the problem, only of how to pay the bill.

Are you saying it is about money for the medical personnel? pay them more and they will stay??

On 8/26/2022 at 8:01 AM, myata said:

There was an example in this very thread, where a routine operation years on a public waiting list was done in three weeks. It doesn't mean "privatize everything" or throw away. But it means that it can work, a fact and shouting "horror private" won't do anything to change it; and if it still wouldn't work after decades of near crisis condition and throwing uncounted public billions (what trillions already?) 'fixing for generation' there has to be a reason. So thinking, objective and independent is called for but where can it be found, here?

What if you have a watch that shows you wrong time, or with a huge delay or both no matter how much $$$ you throw into fixing it? What do you do with a watch that stubbornly refuses to work as you want and need it to?

I am happy to say that my friend, who basically lived as an invalid for almost 2 years is happily walking about now, thanks to being able to pay for the hip replacement.

Private health care in Canada is not new but has been there for a very long time.

 

[myata]

58 minutes ago, ExFlyer said:

Private health care in Canada is not new but has been there for a very long time.

Exactly. It's not about sticking a cliche, crying horrors but making things work. The bureaucracy doesn't know and forgot how to make things work and so it sticks to cliches and horrors. Naturally. Why bother? Nothing changes (for it) anyways.

[ExFlyer]

29 minutes ago, myata said:

Exactly. It's not about sticking a cliche, crying horrors but making things work. The bureaucracy doesn't know and forgot how to make things work and so it sticks to cliches and horrors. Naturally. Why bother? Nothing changes (for it) anyways.

I am not defending but I do have to say, having worked in a bureaucracy for a number of years, it is not the tasks, work, effort, skills, or  people that are the problem, it is actually a demand for "transparency" that creates the bureaucratic mess.

Everything that happens or, is proposed or, done etc has to be so documented and reviewed and approved that it takes so long and requires so much administration it takes forever. The level of frustration by the people that actually have to do the work is overwhelming and things naturally slow right down over even come to a halt.

An example. A city hospital emergency department.... All you hear are the 6, 8 10 hour wait for help. Thing is, 10, 20, 50 people come in. They have to register to get the information (a lot of it to ensure you are who you say, you are entitled to hospital care etc etc). Then you get triaged. Then you sit and wait your turn. Triage prioritizes the issues. If you are waiting 6 hours, chances are your boo boo is less serious than the ones in front of you. Then , if later in the evening or at night, whatever you have may need specialization and there may only be one doctor to see you or, one has to be called in. Hospitals do not have full staff on 24hrs per day. So,you wait some more. Everything that is done to you or with you is fully recorded, verified and validated. It all takes time and personnel. 

My daughter was a senior nurse in emergency department for a while and would tell horror stories of people with head aches, scrapes and cut fingers screaming at the staff. She knows that everyone waiting was under the impression their injury was the worst but facts were, 50% should not have even been there. She left not because of the work, but of the abuse from patients.

Edited September 2, 2022 by ExFlyer

[herbie]

4 hours ago, ExFlyer said:

Are you saying it is about money for the medical personnel? pay them more and they will stay??

No I'm stating the obvious. Private companies pay less, and you're not going to recruit more nurses by lowering wages.

[ExFlyer]

24 minutes ago, herbie said:

No I'm stating the obvious. Private companies pay less, and you're not going to recruit more nurses by lowering wages.

What is obvious? Who is lowering wages??

Many reasons why nurses go private. Less hours. No shift work, lower patient count and on and on. I am not sure wages are lower. My daughter has been recruited and was offered much more but her investment in the system made her stay where she is (pension).

[myata]

4 hours ago, ExFlyer said:

I am not defending but I do have to say, having worked in a bureaucracy for a number of years, it is not the tasks, work, effort, skills, or  people that are the problem, it is actually a demand for "transparency" that creates the bureaucratic mess.

At the core of the issue is a simple thing: disconnect. From the reality. No feedback. If you are in a business and there's high demand for your product, you'll go out of your way to make corrections and improvements to meet it. It just makes sense for you. If you are a public hospital CEO / bureaucracy and the demand for services is growing, you ask for more dough and do nothing. Why? Nothing would change for you if you did.

5 hours ago, ExFlyer said:

An example. A city hospital emergency department.... All you hear are the 6, 8 10 hour wait for help. Thing is, 10, 20, 50 people come in. They have to register to get the information (a lot of it to ensure you are who you say, you are entitled to hospital care etc etc). Then you get triaged.

This is no calculus. Throughput, throttling issues are ubiquitous and solutions known for decades. The question is other though: do you have any incentives to think about the problems and deliver working solutions? Do you have to deliver working solutions or only ask for more dough instead of solutions? Is CEO salary and bonuses dependent on meeting service standards, with maximum wait times? There. If there's no incentives to change, even a perfect solution won't do anything.

[ExFlyer]

17 hours ago, myata said:

At the core of the issue is a simple thing: disconnect. From the reality. No feedback. If you are in a business and there's high demand for your product, you'll go out of your way to make corrections and improvements to meet it. It just makes sense for you. If you are a public hospital CEO / bureaucracy and the demand for services is growing, you ask for more dough and do nothing. Why? Nothing would change for you if you did.

This is no calculus. Throughput, throttling issues are ubiquitous and solutions known for decades. The question is other though: do you have any incentives to think about the problems and deliver working solutions? Do you have to deliver working solutions or only ask for more dough instead of solutions? Is CEO salary and bonuses dependent on meeting service standards, with maximum wait times? There. If there's no incentives to change, even a perfect solution won't do anything.

You are saying they ask for more money and do nothing? Are they getting it? You are aware that a hospitals largest expense is wages? 

You are implying there are solutions? Do you actually think that all hospitals in Canada have not been thinking of solutions? Do you have some you wish to share with all hospitals?

 

 

[myata]

4 hours ago, ExFlyer said:

You are saying they ask for more money and do nothing? Are they getting it? You are aware that a hospitals largest expense is wages? 

Nothing new. This is important. Same wages can do different things if things are done differently.

4 hours ago, ExFlyer said:

You are implying there are solutions? Do you actually think that all hospitals in Canada have not been thinking of solutions?

Not implying but that's quite possible, if their environment, operational practice and tradition give them no incentives to seek and find working solutions, instead of asking for more dough to throw at a system that hasn't changed since 1960-s. And then, if one or two hospitals in Canada found working solutions, had no queues and great service standards, how would we know that? Would we even know, why?

[ExFlyer]

2 hours ago, myata said:

Nothing new. This is important. Same wages can do different things if things are done differently.

Not implying but that's quite possible, if their environment, operational practice and tradition give them no incentives to seek and find working solutions, instead of asking for more dough to throw at a system that hasn't changed since 1960-s. And then, if one or two hospitals in Canada found working solutions, had no queues and great service standards, how would we know that? Would we even know, why?

Nothing new? Meaning what??

I really think you believe no one is trying anything to make hospitals be more efficient or better serving and I think you are naive.

I think you believe it is one person (CEO) that makes all the decisions in a hospital and you could be no farther form the truth.

Hospitals have departments and all departments have committees and boards that make decisions on support, effectiveness and efficiencies as well as patient management and crisis.  These groups inform the hospital board and management of their issues and potential solutions.'

Every member of the hospital staff is concerned with efficiency, effectiveness  and patient care and they do all they can to make it better.

If you think there has been no progress or system improvement since the 60's, you are in Rumpelstiltskin mode. I am very sure that if you, or anyone, has better solutions, they would adopt them in a heartbeat.

It is very easy to criticize. It is not so easy to come up with a better way, especially if you are not fully aware of all (and I mean all) the intricacies of running a very complicated, technically advances and life saving processes and procedures. A hospital is not a manufacturing plant or food processing plant or factory where improvements are based on product sales.

.

[myata]

16 hours ago, ExFlyer said:

I really think you believe no one is trying anything to make hospitals be more efficient or better serving and I think you are naive.

This sums pretty well what I think. Talking, reports and asking for ever more public dough in ever deepening crisis does not count as "new". Obviously.

There is a reason for that too and it's quite simple too: detachment. No feedback. No incentives for positive change. You simply cannot have intelligent adaptation to the reality aka "working solutions" without that. Not a chance. Doesn't exist in the nature.

[myata]

A recent poll (CBC - Angus Reid) shows that Canadians are half as likely to be satisfied with healthcare than Americans. Clearly setting the discussion in terms of public - private vs. quality, performance and efficiency is little more than a fetish. Is it a fetish or a very expensive to the public service that has to work with high quality and flawlessly for its owners and customers - the citizens? Can entrenched Canadian bureaucracies construct and provide such services?

[ExFlyer]

On 9/4/2022 at 8:21 AM, myata said:

This sums pretty well what I think. Talking, reports and asking for ever more public dough in ever deepening crisis does not count as "new". Obviously.

There is a reason for that too and it's quite simple too: detachment. No feedback. No incentives for positive change. You simply cannot have intelligent adaptation to the reality aka "working solutions" without that. Not a chance. Doesn't exist in the nature.

So, Ontario has just told the nurses college to develop plans to more quickly register internationally educated professionals. They complained so now they need to put up.

The Province should also drop this on the doctors as well.

It is easy to complain, now find a solution and be responsible for it.

 https://ottawa.citynews.ca/local-news/ontario-gives-ok-for-nursing-college-to-expedite-international-nurse-registration-5789082?utm_source=SND&utm_medium=Facebook&utm_campaign=AutoPilot

[myata]

1 hour ago, ExFlyer said:

It is easy to complain, now find a solution and be responsible for it.

A typical bureaucratic plugging the holes pseudo-solution that will result in even further deterioration of quality. If you cannot expedite provisioning of quality services for decades, what kind of bureaucratic order / paperwork would instantly add necessary resources in a flash? Obviously it doesn't exist. Expedition will come at the expense of quality but who cares, the holes will plugged even if for a short while.

This is a systemic, conceptual crisis and nothing short of a serious reorganization of the service from up to the bottom would and can fix its inherent problems. Just one question: why, why we call those people "CEO" as if they have anything, even within lightyears remotely related to private, competitive business? This is where the problem begins, its origins are: near accomplished disconnect from reality. No meaningful feedback. The system likes to work for itself it doesn't need patients, all those pesky people are only inconvenience to it, nuisance. So let's throw at it a few more public billions and relax quality standards. Let's see if that will produce a miracle. What can we do.

[ExFlyer]

19 minutes ago, myata said:

A typical bureaucratic plugging the holes pseudo-solution that will result in even further deterioration of quality. If you cannot expedite provisioning of quality services for decades, what kind of bureaucratic order / paperwork would instantly add necessary resources in a flash? Obviously it doesn't exist. Expedition will come at the expense of quality but who cares, the holes will plugged even if for a short while.

This is a systemic, conceptual crisis and nothing short of a serious reorganization of the service from up to the bottom would and can fix its inherent problems. Just one question: why, why we call those people "CEO" as if they have anything, even within lightyears remotely related to private, competitive business? This is where the problem begins, its origins are: near accomplished disconnect from reality. No meaningful feedback. The system likes to work for itself it doesn't need patients, all those pesky people are only inconvenience to it, nuisance. So let's throw at it a few more public billions and relax quality standards. Let's see if that will produce a miracle. What can we do.

This is exactly as it should be. The body that controls the nurses should be the ones authorizing foreign nurses.

How can you even think the government authorizing and forcing foreign nurses into the system without the nursing organization approval.

The government is giving the nurses control. The proper thing.

The action by Ontario government is the proper step to getting more nurses into the system.

I am baffled by your post and what it is supposed to mean.  You are getting what you have been complaining about.

[myata]

17 hours ago, ExFlyer said:

to develop plans to more quickly register internationally educated professionals

That's a direct quote. "More quickly register" instead of: begin understanding and addressing (no quick fixing!) systemic, long standing, day one problems. Do you see the difference? Can you anticipate the outcome already?

Edited September 8, 2022 by myata

[ExFlyer]

1 hour ago, myata said:

That's a direct quote. "More quickly register" instead of: begin understanding and addressing (no quick fixing!) systemic, long standing, day one problems. Do you see the difference? Can you anticipate the outcome already?

I hope you are aware that nursing schools have been full with students for many years.

Many do not make it the full 4 years. Some choose not to stay in the profession for numerous reasons and one major reason is the shift work (as my professional nurse for a long time tells me).

Using the term "systemic "is unfounded. schools have been graduating nurses as fast as they can.

[myata]

34 minutes ago, ExFlyer said:

Using the term "systemic "is unfounded.

Of course it's founded in the factual reality: the system is and has been in a perpetual crisis for years. The system is not working. Someone is responsible for this system, been claiming outrageous compensations for it for decades, and it's not working as it should as we, the owners and customers require it to work, for decades. So what now, blow on it, read a spell, fast track foreign claimed credentials with unknown validity, quality, or even authenticity in two months and see what happens? Where in the world those professionals are coming from? Are those countries where quality and authenticity can be confirmed with confidence? Or just blow on it and see what happens?

[SpankyMcFarland]

On 8/24/2022 at 8:51 PM, herbie said:

In my last post I pointed out just how techs can make the doctors and surgeons more efficient. That doesn't lower standards or steal doctors from the Third world that needs them even more than we do.
Like for example why does my amazon order get from Toronto to the boonies in northern BC in 48 hours when lab results often take more than a week to get to the clinic one block away? When both places are on the same network it shouldn't take any longer than sending a file to my home NAS!

In my province we persisted with an archaic health records system long past its sell by date until it underwent a massive cyberattack. Over the decades, security was only one of the ways it became unfit for purpose. The company did not show enormous interest, let’s say, in our suggestions for improvement of the lab module. I suspect they were banking on the fact that it would be huge trouble for us to change to another vendor. 

https://www.cbc.ca/news/canada/newfoundland-labrador/nl-opposition-meditech-cyberattack-1.6251420

So, speaking strictly for NL, we are not optimally organized on information systems. 

Edited September 8, 2022 by SpankyMcFarland