Hasten registration of foreign trained medical professionals

[ExFlyer]

3 hours ago, myata said:

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?

The system failed in the past 2 years when the hospitals, clinics and LTC etc were overwhelmed by a worldwide pandemic. Not systemic for years  (unless you say the past 2 years).

You were the one that wanted foreign credentials to be fast tracked. Now that Ontario is making the Nurses association come up with a plan,  you back off?  You are now questioning the foreign credentials when before, you wanted it accepted quickly?

You cannot have it your way back then and now question your assertions and demands.....or do you?

[myata]

19 hours ago, ExFlyer said:

he system failed in the past 2 years when the hospitals, clinics and LTC etc were overwhelmed

Bullshit. Just bull. A decade back a colleague from Switzerland was astounded having to spend eight plus hours in an ER with a broken foot in severe pain, a great epiphany of a great public health system.

Years back a personal friend with a head injury had to spend hours in ER before seeing a doctor or having scan witnessed first hand.

Want to sooth yourself with pandemic tales of "last two years" but of course! Like this land was ever short on heartwarming tales. Will it make things any better or rather, deteriorate any slower? Don't need a genius to see the obvious answer - looming right ahead.

[ExFlyer]

1 minute ago, myata said:

Bullshit. Just bull. A decade back a colleague from Switzerland was astounded having to spend eight plus hours in an ER with a broken foot in severe pain, a great epiphany of a great public health system.

Years back a personal friend with a head injury had to spend hours in ER before seeing a doctor or having scan witnessed first hand.

Want to sooth yourself with pandemic tales of "last two years" but of course! Like this land was ever short on heartwarming tales. Will it make things any better or rather, deteriorate any slower? Don't need a genius to see the obvious answer - looming right ahead.

Don't want to or need to "sooth" myself for anything.

As I have mentioned before, in ER, the most serious get treated first. Triage is done.

I was in Air Force search and rescue and spent a lot of time delivering to emergency departments. We landed the helicopter and the patients were transferred. We had to wait many times to get equipment back because the people we were delivering were less serious than someone already there. We have dropped off patients and they were the only ones in emergency. It all depends on the day, timing and what is going on. This has nothing to do with shortages, it has everything to do with the size of the emergency department and the personnel assigned to it and of course, the day. A pure hospital administration issue.

Hospitals get funding and they decide how and where to spend the funding. There is no hospital in the world that will staff for "just in case".  You are being over dramatic and clearly do not understand hospital function. You only see recent problems caused by pandemic issues and assume.

But you are changing your position. You wanted more foreign nurses (and doctors) to be pushed through and accredited faster and now, in Ontario, the Province has made the nurses responsible for coming up with a plan to do so. Rightly so. The nurses will decide who makes it and does not based on their own regulatory authority.

[myata]

4 hours ago, ExFlyer said:

You are being over dramatic and clearly do not understand hospital function.

This is the core of the problem, sure. You can only get what you accept. If you paid thousands each year and fine with getting just stay on the line, just sit here, just wait for your turn (a few more months/years) you've got it! If status quo is great as it is with minor insignificant fixes and some hundreds billions thrown (again) then so be it. Who are you trying to convince you got it already, packaged and delivered. A self-fulfilling prediction.

Edited September 9, 2022 by myata

[ExFlyer]

22 hours ago, myata said:

This is the core of the problem, sure. You can only get what you accept. If you paid thousands each year and fine with getting just stay on the line, just sit here, just wait for your turn (a few more months/years) you've got it! If status quo is great as it is with minor insignificant fixes and some hundreds billions thrown (again) then so be it. Who are you trying to convince you got it already, packaged and delivered. A self-fulfilling prediction.

Huh???

Your brain may be working but getting into post or print seems difficult for you.

What are you talking about??

I once again say, "You are being over dramatic and clearly do not understand hospital function.", let alone healthcare and it's intricacies.

[myata]

This is funny or maybe past that actually. You, a customer paid a hefty price, upfront, no warranties given. You get a crappy, sub par product .. or a bunch of emails, wait we're working on it. But look! Sure. You get what you're prepared to accept it's a fact no explanations needed.

[ExFlyer]

13 hours ago, myata said:

This is funny or maybe past that actually. You, a customer paid a hefty price, upfront, no warranties given. You get a crappy, sub par product .. or a bunch of emails, wait we're working on it. But look! Sure. You get what you're prepared to accept it's a fact no explanations needed.

WTF???

Brain  in gear but not getting  to the fingers for typing??

[myata]

St.. being slow is not an excuse, nor valid argument. There's nobody to convince. The law of entropy will do the job as it always does. Can't beat the Nature.

[SpankyMcFarland]

Another problem is the unattractiveness of family practice to Canadian graduates. They’re not joining the specialty in sufficient numbers with the result that the patients they would have seen now end up in the ER. I don’t see any reason why we shouldn’t rebalance the income gap between the high procedure crowd and GPs who have a far more varied field of work. If young grads want more support in their group practices in terms of NPs, EHRs, physician assistants etc., then we must make it a top priority to provide it for them. Lifestyles and physician expectations have changed; we must accommodate what is now expected urgently if we don’t the situation to get even worse. 

[myata]

20 hours ago, SpankyMcFarland said:

Another problem is the unattractiveness of family practice to Canadian graduates.

All are valid points here's a thing though: who's going to think about it and change anything? Who needs to? Why change anything in a system that is perfect (from some specific angles) as it is? With a few minor tweaks and some more billions thrown it'll happily print improvement reports and send "working on it!" letters for how long.. the eternity? (if it existed, in evolution)

[ExFlyer]

23 hours ago, SpankyMcFarland said:

Another problem is the unattractiveness of family practice to Canadian graduates. They’re not joining the specialty in sufficient numbers with the result that the patients they would have seen now end up in the ER. I don’t see any reason why we shouldn’t rebalance the income gap between the high procedure crowd and GPs who have a far more varied field of work. If young grads want more support in their group practices in terms of NPs, EHRs, physician assistants etc., then we must make it a top priority to provide it for them. Lifestyles and physician expectations have changed; we must accommodate what is now expected urgently if we don’t the situation to get even worse. 

I agree that graduating doctors are specializing instead of becoming a general practitioner in communities.

This was very clear to me during the pandemic. I have never seen nor heard of so many epidemiologist doctors. Every day, on every channel and every radio station there was a different epidemic specialist.

No graduate wants to be a GP and have an office with a steady stream of headaches, sniffles and boo boos. MY GP (thank him every time I go) is tired of the long hours and has to do clinic time to make ends meet.

Young graduates like the stratus of being a doctor and the hours they eventually get in hospitals. While it is said a doctor works long hours, fact is interns work long hours and the actual tenured doctors work reasonable hours. Yes, there are some that do a lot more, I will not argue that but, there are many that do office hours and some on call.

[myata]

2 hours ago, ExFlyer said:

I agree that graduating doctors are specializing instead of becoming a general practitioner in communities.

The system is in an autopilot mode and has been for who knows how long quite possibly from day one. It knows only two reactions: 1) aiii we're in a crisis!!! and 2) give us more billions! It doesn't understand anything else you say. Hip replacement queues, catastrophic shortage of GPs it doesn't speak that language, someone else has to (who?). And it looks like it doesn't need to.

[SpankyMcFarland]

5 hours ago, myata said:

All are valid points here's a thing though: who's going to think about it and change anything? Who needs to? Why change anything in a system that is perfect (from some specific angles) as it is? With a few minor tweaks and some more billions thrown it'll happily print improvement reports and send "working on it!" letters for how long.. the eternity? (if it existed, in evolution)

1. Improve the current system.

The government has to reallocate funds. If, say, dermatologists aren’t happy they can leave and GPs will do most of their work. I know a GP who did the UK Diploma in Dermatology. I’d trust him way ahead of many of the local specialists. The point is that no other specialist shortage causes such a crisis in the ERs. We simply can’t have it. 

 

2. Look at a mixed system. I think Canadians are becoming ready for a mixed health system, public and private. 

[ExFlyer]

13 minutes ago, myata said:

The system is in an autopilot mode and has been for who knows how long quite possibly from day one. It knows only two reactions: 1) aiii we're in a crisis!!! and 2) give us more billions! It doesn't understand anything else you say. Hip replacement queues, catastrophic shortage of GPs it doesn't speak that language, someone else has to (who?). And it looks like it doesn't need to.

Man!! Get over your "system" crap.

The doctors and nurses are people and they have the freedom to choose. To choose what they want to be, to do and where they want to do it.

Seems you are wanting to institute something to force them to go where you want them to.

[myata]

1 hour ago, SpankyMcFarland said:

2. Look at a mixed system. I think Canadians are becoming ready for a mixed health system, public and private. 

I tend to agree but what happens in the country is determined not so much by the needs of the population but those of the political elites. It's them who need to see and recognize the need for significant, meaningful change, and they simply have no incentives for that. It's safer and more rewarding for them to keep patching crumbling status quo for ... your guess is as good as mine. A system with no feedback from the reality cannot adapt - there are no reasons for it to.

[SpankyMcFarland]

19 hours ago, myata said:

I tend to agree but what happens in the country is determined not so much by the needs of the population but those of the political elites. It's them who need to see and recognize the need for significant, meaningful change, and they simply have no incentives for that. It's safer and more rewarding for them to keep patching crumbling status quo for ... your guess is as good as mine. A system with no feedback from the reality cannot adapt - there are no reasons for it to.

There are clear problems in Canada that have been brewing for a long time - healthcare, an uncompetitive telecom sector, unaffordable housing in major cities - that just don’t get addressed by politicians. 

[myata]

1 hour ago, SpankyMcFarland said:

that just don’t get addressed by politicians. 

The word is: "disconnect". No feedback from reality.

[ExFlyer]

3 hours ago, myata said:

The word is: "disconnect". No feedback from reality.

You are somehow endorsing or suggesting a communist medical system for doctors (and nurses). Become the doctor we want and go to where we decide??

We live in a free society. A person can become whatever they want and go wherever they want.

They are all general practitioners until the decide to specialize and take more training.

The reality is, doctors and nurses are public servants as they get paid by the public purse. They can do what they want where they want to do it. The other reality is, most do not want to work shift work. For instance, in Ontario, there is no "bonus" for shift differential for nurses.In Quebec, there is a 15% extra for shift workers working nights.

The issue of shortages is not new and will continue until you give them other options but you can never fore them to become what they don't want to be or work where they don't want to work.  Bonuses, benefits, bribery is the only way you will be able to get them to remote areas and to positions that are undesirable.

[SpankyMcFarland]

Like many aspects of physician behaviour, call flight - the tendency of doctors in high call positions to migrate to lower ones if they can - has been insufficiently examined but it’s up there with a related factor, expert support, and income as a key driver of physician distribution. Even before the cities become irresistibly attractive to young grads, call flight was working its magic and sending doctors towards the hubs. As my link on the situation in Fogo Island illustrated, rural GPs may not only be on 1 in 1 call, i.e. every night, for weeks, months or even years, but can also be in the surreal situation of referring sick patients to their own care in small hospitals. You’re basically talking to yourself on an official basis at that stage. This was bad enough in ye olden days when not much was expected of a medical man but today every practitioner is judged by the same standards which are impossible to keep up under such circumstances. So doctors tend to move to the cities and, even better, to the universities where they have lots of residents and experts around them and can become academics opining from their comfy chairs on the situation in places like Fogo. 

Edited September 13, 2022 by SpankyMcFarland

[myata]

2 hours ago, ExFlyer said:

You are somehow endorsing or suggesting a communist medical system for doctors (and nurses). Become the doctor we want and go to where we decide??

No. You're interpreting your misconceptions as something of mine. Wrong. Many factors determine people's intent to choose an occupation. An excellent service can be provided in a number (and growing) of ways. An intelligent society would be able to influence those to advance the goals it desires. For once, we're living in the 21st century while hoping that with rubbing and blowing solutions made for 18th and 19th would somehow keep working.

[ExFlyer]

12 minutes ago, myata said:

No. You're interpreting your misconceptions as something of mine. Wrong. Many factors determine people's intent to choose an occupation. An excellent service can be provided in a number (and growing) of ways. An intelligent society would be able to influence those to advance the goals it desires. For once, we're living in the 21st century while hoping that with rubbing and blowing solutions made for 18th and 19th would somehow keep working.

OK. How??

No, I am not interpreting your misconceptions at all. All I have heard from you is that there is a problem (which you seem to think is new and recent) and that everyone in the system is a failure.

Suggesting that the personel problem is 18th and 19th century is about the stupidest thing you have complained about so far.

You keep asserting shortages in outlying towns and villages and remote areas. How do you suggest this be resolved. Not more complaints, resolutions.

Schools have only so many seats, so many teachers (and the teachers have to be the doctors and nurses that twill  be taken away from hospitals).

Hospitals have only so many slots for interns and trainees and they need supervision by doctors and nurses taking them away form duties..

You speak as if this is an easy thing and that no one is trying to resolve the problem. It is easy to be a critic. While I was a trainee, my supervisor said, do not only come to me with problems, come with solutions too and I have used that as a mantra throughout my career.

So, you are complaining, calling the management, operators and schools of and government failures, what is your workable, logical and, affordable solution?

 

[myata]

12 minutes ago, ExFlyer said:

So, you are complaining, calling the management, operators and schools of and government failures, what is your workable, logical and, affordable solution?

First things first, could I get a modest compensation for that? Not even in the five digit range and for a few decades?

[ExFlyer]

10 minutes ago, myata said:

First things first, could I get a modest compensation for that? Not even in the five digit range and for a few decades?

Huh? So, your solution is pay?  More pay?

Here is the Ontario scale now.

https://www.ona.org/wp-content/uploads/2a-2021_hospitalhighlights.pdf

BC scale, 5th year nurse, about $90K.

https://www.ona.org/wp-content/uploads/2a-2021_hospitalhighlights.pdf

 

I go to a clinic regularly for infusions and there are many nurses there. All working for less than in a hospital. I asked them and the reason they work there is they do want to work shift work.

[myata]

12 hours ago, ExFlyer said:

So, your solution is pay?

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?

Edited September 14, 2022 by myata

[myata]

Who came up with these terms by the way? Why "CEO", what's common, like nothing except the paycheck of course? Why "mandarins" and "czars" does it still sound funny to you? Or maybe they create it for themselves, it reflect how they think - and act, and you're just hoping that it's only innocent fun?