A possible solution to the family doctor shortage | About That
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- čas přidán 14. 12. 2022
- A recent survey suggests 20 per cent of Canadians do not have a family doctor, which can make getting timely lab tests and referrals to specialists nearly impossible. But what if you could get everything you need under one roof? Andrew Chang talks with Dr. Danielle Martin about health teams and why they could be an answer to our doctor shortage.
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I’m a newly graduated doctor, born and raised in Ontario. I studied in Ireland, graduated with honours and passed my Canadian boards on my first go. I applied for family medicine residencies this year and was turned away…didn’t even get interviewed. I had no choice but to work in the UK, which has its own doctor shortage. The longer that I’m away from home, the less likely I’ll return. If universities/politicians continue to put up barriers for Canadian IMGs, then they’ll loose out on very good doctors to other countries
Good grief, how ignorant of Canada bureaucracy. Yours is a sadly too-common story. This kind of nonsense has been going on for decades and resulted in a severe family doctor crisis.
My dear brave colleague, thanks for speaking up.
I can share the story of IMGs who sell their souls to get into Canadian residency and practice in Canada.
God have mercy on those who play with the life of patients and IMGs to keep their faces and....
My old dr was so good and he moved to the uk
This isn't news. It is and always has been all about the funding.. our health care (aka drug cartel priorities) is rationed.
My brother in law is a Consultant who graduated from the UK, he was planning to work in a hospital in BC ....because my sister is Canadian and the amount of delay was mind blowing for him to come to Canada. I don't believe what our politicians say and people who work in the system are causing all this and complaining we have shortage...there are a lot of qualified physicians out there and in Canada to ease the pressure off our healthcare... its just that Healthcare Don't Care....
Tbh this is old thinking. I lived in Denmark and any doctor I walked into had instant access to any medical history I had in the country. Anything. And the data format was the same everywhere in the country. THAT should be the question. How to format the medical data so any doctor can see anyone anytime and completely understand their history and what they need. Also, whenever I had a prescription, it was attached to my SIN number (Danish equivalent called CPR). I could walk into any pharmacy in the country and they could get that prescription from my SIN number. They could also see any prescription I’ve ever had in the country. So could ANY doctor I spoke to. Instantly.
They also want to do this with dental.
I get the family doctor talk, but honestly it’s the wrong conversation. And this is just medicine. This digitization applies to SO MUCH ELSE in our social services.
That sounds absolutely frightening. you don't even need a doctor, you just need a computer to determine what drug to give you according to what Pharma prefers for their profit line! No thanks, I prefer real health care from my Naturopath.. there's always the hospital emergency in case of a car accident.
Love it! And you're right; I've experienced similar sharing of patient details in other countries. It's sick that your information shows up when you apply for life insurance, but doctors seem to not have access to the same records. 🤪
Yes we trust the system and medical records, NOT a single doctor or a particular clinic.
@@snowbird6855 this right here is exactly why Canada isn’t able to modernize its public systems. In Denmark, the percentage of young voters is something like 80%. In Canada, it’s less than 30%. The only people that vote here have no idea how modern systems work and this makes them extremely susceptible to misinformation and a ripe target for anyone trying to gain their support through quack wedge issues. This guy doesn’t understand anything about the maintenance and representation of data, and a human doctors use and role of that data. He wouldn’t be able to understand how we could also use this data to extrapolate huge value. He’s also a minority, BUT, he’s almost definitely from the only demographic that ACTUALLY VOTES IN CANADA. So to be honest, it’s the fault of every smart person in Canada that doesn’t vote. The blame can’t be put on this guy, he doesn’t know what he’s doing, but he almost definitely excercise his right to vote. We have far too many smart people in Canada to excuse people like him driving change for the future. A politician would NEVER develop any system or fund anything their voting base doesn’t support or understand, and our actual voting base has no clue how anything modern works.
@@chrisbabb3973 true, politicians can’t fix the healthcare system, they don’t have a clue!!! The ones who can , prefer not too for their own benefit!!!
I am a Canadian and left 17 years ago to study medicine abroad and practiced in the US for 12 years. I recently returned to Montreal to open a private medical clinic. There are thousands of people like me that Canada is NOT using. If they mount a campaign to call on these expats to return and make it easy and incentivize them, it will be a huge blow to the current shortage. Plus the US has trained and tested these physicians so Canada did not spent almost anything, a win-win situation.
Canada needs to enhance it's public health infrastructures, not siphon more resources towards the private sector.
This is ironic as hell. I'm moving to Montréal this week, and I couldn't find a family doctor for 1,5 years while living in Ontario. Are you currently taking new patients?
Wow...I knew an Italian trained doctor who moved to Toronto who was prevented to practise as if Italy had stoneage medical training. He is now a manager for a food chain.
@cmauro7912
Even in the US you got to pass the equivalent exams and repeat residency all over again.
I want to make sure I understand this. You say a "private medical clinic" in Montreal. Are you saying the patients pay for care cash, privately outside of the Quebec provincial system?
The federal government must make it mandatory for provinces to provide at least 2 general check up appointments for people without family doctor.
Why I need to pay the same taxes and getting almost no care.
I used to get a complete check-up every 3 years or so at a private clinic, but now that's illegal. I've been on a waiting list for a family doctor for over 6 years. So I pay a fortune through my taxes for medical services that I cannot receive, and I am not allowed to pay from my pocket for the services I need. I am totally screwed by the system.
Canada won't have this problem if they made it easy for competent foreign Mds to practice when they arrive but instead you see them in the Uber services and other jobs when they could be saving lives 🤦
The government does not want 1,000s more doctors submitting 100,000,000s of billing codes to insurance. The government is happy for the most vulnerable, who can't jump through the hoops of finding a new doctor or waiting hours in a walk-in clinic or ER, to fall through the cracks.
@@MedicalAutonomyProject terrible
My family doctor definitely does not know me. She is too rushed.
I'm 65 early next year, went through 4 dr so far.retired or too busy now so passes me off to a new dr.raising my granddaughter..allergies to pain killers and pass kidney stones very frequently..this dr makes me go to emergency dept to deal with my extreme pain. Not impressed
Mine too! It’s like a transaction now. Timed and only 3 concerns. 😢😮 Sad! Plus I travel 30 mins to see them.
@@deborahstone9696
Find a good Naturopath. Kidney stones are easily dealt with by taking a supplement called chanka piedra.
My family doctor tried to send me back to the reproductive endocrinologist who already botched my saline sonohistogram for....... another saline sonohistogram. After refusing to send me to an OB-GYN. Oh, and I'd developed medical anxiety going through a high risk pregnancy with a poorly healed C section scar because of the initial botched saline sonohistogram done by the RE she was trying to send me back to. Because she's too lazy to make a referral for me. Which I asked for before and after the needlessly high risk pregnancy. When I fired her, her response was "the kids too?". She was hoping to get rid of the high maintenance neurotic patient she created and keep the easy kids. I will never forget that she is a hero, smarter than me and my moral superior, though.
You all clearly have no idea what a family doctor goes through in a day. Seeing a patient is only half the battle. The other half is the mountain of paperwork that goes on behind the scenes that they have to do to provide care to 1000's to the point that they can't even enjoy a weekend.
With the number of doctor's reducing their practice size and dropping out from burnt out, one day you will be eating your words when your family doctor quits and you will be grateful for one minute of a family doctor's time if you even have one. 20% more are expected to quit in the next 5 years.
There is a reason why most do not accept new patients. There are political reasons why you can't spend an hour with your doctor in an 10-hr day with a doctor who has 1000's to serve due to the shortage. If you want such great attention get a personal, private doctor and pay $400 a visit as you would a lawyer. You paid nothing. You are lucky to get what you get. We all pay taxes so that's no excuse either. Blame the system not your doctor. If you don't like the way medicine is run, talk to your MP. Until the politicians change how healthcare is funded, things will only get worse. Doctors are in need of support with the heavy load of administrative responsibilities they have. The healthcare system is crumbling on the backs of family doctors despite their best efforts because there is little support from the Ministry of Health.
You Canadians are so entitled and ungrateful when it comes to healthcare. Come across the border where you may actually have to pay and you will be grateful for what you have there that helps out everyone, even the unemployed. If you can do a better job, when don't you spend 10-12 years of your life after high school and write endless exams and maintain your license only to get crapped on by patients like this. You can't and you won't so never ever complain when you can't do it yourself. Go to a rural developing area, where people wait all day in line for a minute if a doctors time without a complaint.
If you have a family doctor, you'd better be good to them so they don't quit and leave you doctorless. Your choice.
10 years without a family doctor here on Vancouver Island and I was born and raised here. WHY do we continue to move so many people to this country until we fix this problem?! As well, my trust in the regular medical system and any docs/nurses I have seen in the past few years has been shattered.
as a solo practictioner, the fees go to paying rent, medical supplies and equipment, staff before you are paid. Nurse practioner costs have escalated with the shortage and costs of medical supplies but the payment from government has continuously decreased. The government does not want to run clinics and pay salaries because it costs alot to run clinics. Most family physicians spend 60% of their time on adminstrative work which is exhausting, this leaves less time for patient care and then there is the time to run the business side of the practice. Reviewing charts and results from 1500 to 3000 patients everytime they have a test or go to hospital or another facility takes time and it is unpaid under the fee for service model. The government hasnt allowed physicians to join the FHO system in Ontario because it costs them more so there is no pay for the admin work, only $35 per patient you see in the office. Alot of services and procedures are no longer covered.
If it was profitable, family physicians would not be leaving in their droves. The ontario government is to blame for the failures. The OMA is usesless in negotiating with government. They need to put up the clinics, hire the staff and pay physicians salaries but they wont do this because running clinics cost too much. So the publish the amounts to say how generous they are to physicians.
Been using walk in clinic for about 5 years. Not because it’s impossible to find family doctor but because it’s IMPOSSIBLE to schedule appointments. Earliest appointments are usually a week away and you end up waiting 2hrs to actually see the doctor for 10min. We need to reduce wait time. And also idk where they find receptionist, but I’m amazed that doctors offices can always manage to find the most ill tempered people for that role.
Not having a family doctor is a big problem, but it is only part if the problem. In my case, I do have one, but being able to see him is mission impossible. Firstly, you cannot get an appointment by Internet like in other Western countries. Then, when you call the clinic and finally get to speak to someone, you cannot get an appointment simply because "your doctor hasn't given us his schedule". This happens in Montreal.
Same, I was so happy to finally get a family doctor in 2018. I've literally seen her once since, my first visit only. Since then, she's been on maternity leave, or we had quick virtual calls during covid, but no where near the level of care described in this video. I get that i'm young and healthy, but still. I find it more frustrating to see my family doctor than before, when I relied on walk-ins.
Some of us have no choice. In New Brunswick there are more than 70,000 people on a waiting list for a family doctor. My husband’s doctor recently left the province. In rural NB, we are left at the mercy of the existing health care. If I wake up one morning with acute pain , or a bladder infection, I have no choice but to go to emergency. There are no daily drop in clinics.
You can start figuring out some basics for yourself instead, such as consuming a litre of pure cranberry juice per day for 2-3 days eliminates the infection. Another tip; you get far better care from a Naturopath. Not cheap but worth it.
Drive to Maine with your credit card. If one of my kids get sick right now I would strongly consider driving to Buffalo to avoid the 24 hour misery wait in the local ER.
I just Googled New Brunswick Walk-in Clinic Locations, and I found 20+. ??
@@snowbird6855CZcams needs to add a laugh react 😂😂
This is laughable. I went for years to a “community”/team based clinic and I never received this level of service. In fact I was treated more like a piece of office furniture than a patient.
Wow..... with all the immigration in every province, there's NO physician coming to Canada? Oh yeah.... I remember now..... they're forced to drive Uber to survive. 😔
But I do love the community health centre concept. It's probably what family doctors aim to do, but rarely accomplish.
Moved to Saskatoon in 1977 & immediately joined the Saskatoon Community Clinic. The clinic was part of the start of Medicare in Canada. My first doctor was a Dr. Fisher who left the clinic to teach family medicine at the Royal University Hospital here in Saskatoon.
During the pandemic I've had three different doctors/health professionals but always had continuous care at the clinic.
One part of the problem/solution is much better utilization of other healthcare professionals. For example our pharmacists are greatly underutilized: they can and should be prescribing for minor ailments and optimizing and renewing prescriptions independently. This in turn would reduce the number of unnecessary "emergency" visits to our overcrowded EDs and urgent care centres. And free up physicians to manage more complicated diagnosises.
Obviously this is a multidimensional problem requiring a multidimensional approach - there's no one solution, we need multiple changes/implementations to happen in unison to help our suffering healthcare system.
Medical schooling is very expensive and accessible to a small percentage of the population. It should be made easily accessible to everyone. There are probably many Canadians that are smart enough and have the ability to be great doctors but can’t afford, or would qualify to go to medical school because of life and financial circumstances. The government needs to find a way to change this. If you come from a low income demographic you could be a great doctor but never be able to follow that path because of the way things are set up right now.
THIS!
Complete BS. Medical school positions are 3/4 subsidized as it is in Canada and it's very inexpensive compared to some countries. A motivated and intelligent candidate will easily get loans when they get accepted and will be be able to pay their loan back in a few short years.
The barriers are not financial, it's the very stiff competition to get accepted for the fewer than needed positions that's the problem. If the candidate has less than a 95% grade average from their undergrad degree in sciences, don't bother applying. If you're indigenous or a person of colour, a little less will do.
@@snowbird6855 , so first to that I would say it should be free. Feds can subsidize 100% to fix this problem. They spend way more on the military. Secondly they do need to create more spaces and places for the education. As this population continues to grow this problem will continue to get worse. I would even argue that privatization or partial in the system would allow for an influx of money and keep medical staff from going south to earn more than they can up here. Definition of insanity is doing the same thing over and over and expecting a different result. What we are doing right now obviously is not working. That’s a fact.
The number of residency positions is the limiting factor, not medical school spots.
I don't understand how the government doesn't see that preventative care is way cheaper in the long run. I am very lucky to be one of those patients in a family health team.
I found it interesting when he said that these multi-disciplinary team based health Centers are more common in more rural areas because I was watching/listening to this I was like “I feel lucky that my hometown in Alberta has something like this”. My childhood family doctor retired and I was glad I was able to become a patient of my parents new GP. Easier than finding a family doc in the city I live in now. ~50 minute drive to see a doctor isn’t that bad.
My family doctor did know me. I rarely went to visit her so I was kind of shocked about how much she remembered. She knew my friends and asked how they were doing when they moved to another area. It was a wife and husband team, so they took turns if they needed time off. It was actually pretty great, but she retired with the pandemic. Now I am at a clinic of multi doctors. My experience is not great. My son's records were missing so I was told he will have to get his vaccines again. I wait on hold for 30+ minutes to try to make an appointment. I miss my family doctor.
I feel this, I don’t like how many people I have to see.I hate doctors and I really only got o them for my son when he’s sick. I still don’t trust doctors tho and it’s hard as a mom. So when I have to go around seeing 3+ people it’s hard for me to gain trust as I’m super anti social and introverted it’s hard for me to just be passed around person to person like that
I've been on a waiting list for a family doctor for over 6 years. Around 20 years ago the Quebec government decided there were too many doctors, so they provided incentives for doctors to retire early and cut the number of spaces available in medical schools. Given that there is now a shortage of both doctors and nurses, has the government been increasing the capacity of medical and nursing schools? Also I hear that doctors waste a lot of time filling out forms and doing other paperwork. If they work in hospitals or clinics, are there administrative assistants who can help them out with all the paperwork so as to free up their time to care for patients?
The number of medical school spots has never ever been the limiting factor, but they love to make you think that. The limiting factor has always been the number or residency positions and funding. We could have 1000 new doctors who already have degrees and passed Canadian medical exams in residency positions tomorrow morning if we (the government) wanted.
'Given that there is now a shortage of both doctors and nurses'
Back in Oct 2021, your provincial government was trying to force nurses to get the jab, and were told they would be suspended without pay if they didn't get it. Many nurses decided they would rather quite.Then the Quebec government backtracked on that thereat. They then decided to try and get the nurses to be tested 3 times a week, but the nurses still refused and many started to quite. I don't even live in Quebec and I know this, because every province had reports about it. Reports said that almost 22,000 doctors and nurses were facing suspension. And now more recently (Jan 17, 2023), more than 90 of the 115 nurses at a Hospital in Montreal were threatening to quit en mass over mandatory overtime requirements.
my family doc was forced to retire during covid as he was already in his late 60s but he was my doctor from when i was born in 2000 , was a great guy hope he's healthy and happy also hope i someday get another GP like Dr. Marsh
My Gyn was pressured to give up her practice, and joined another. My PCP was pressured to leave his practice as well. They were pushed out since they were both near 70 and they were volunteer faculty with this particular major medical center.
Faculty pays 15% of their billings to the medical center, volunteer faculty pays less and are not wanted.
This is pie-in-the-sky and gives a false sense of efficiency, this is a bureaucratic problem. The government has placed too much responsibility on doctors to do due diligence for them, i.e. drivers medical evaluations each year for young able bodied patients, doctors note requirements from employers, allowing the restricting of certain medications being prescribed by walk-in clinics and an unreasonably long period of time to accredidate professionals compared to other countries.
I’m a Canadian Internal Medicine Resident training in the US and the Royal College of Canada won’t see my residency as equivalent unless I do an extra year of training and redo my Internal Medicine boards for $5k plus. The Canadian system does need standards but the idea that they need to put barriers up preventing Canadian citizens that want to come home with American board certification is ridiculous.
CBC needs to look into why during a health care shortage that the government and Royal college have barriers against physicians trained in the US practicing in Canada.
Can't you do a fellowship and that will add the extra years needed to qualify for Canadian Royal College qualification?
I've heard it's the same for physicians coming even from the UK or Ireland.
It doesn't make sense. People need access; nitpicking over small details is costing people their lives.
Who tf cares if one country prefers a slightly different procedure or has some different data systems? You can learn that while practicing and in the mean time people get the help they need.
@@thepanda9782 Training is longer in UK/Ireland IIRC, but they need to redo Canadian boards. It doesn't make too much sense though as they'd have to sit UK boards anyways with low pass rates (notorious).
Or at least, there should be more resources to helping said doctors pass Canadian boards etc but seems to be no path, just "do your Canadian boards" and pay enough to have your credentials transferred.
It’s impossible to find a family doctor. The children ICU is full. The hospital emergency are over capacity. What is going on?? This government needs to give us a solution 😢
Our gouvernement in Quebec is pay for it or suffer waiting to get a doctor. In fact our gouvernement is now telling people that children do not need a yearly check up. This is really happening if you can believe it.
@@mg79277
They don't need a yearly checkup. I never had one until I was 21. The checkups are there to facilitate the next vaccination they want to give.
It's very simple and nobody wants to talk about it. Either the system is under-funded, or the funding is going places it should not (i.e. corruption). Canada does not underfund relative to other G10 countries but we are the bottom of the pack for quality.
@@snowbird6855 The children of high socioeconomic status hockey mommies do not need annual checkups because their moms will notice something wrong and take them to the doctor. The most vulnerable kids with dysfunctional parents will fall through the cracks without annual checkups.
Canada graduates almost 3000 doctors per year. About 15% (450 doctors) of Canadian graduates move to the US every year because the pay is better.
1 in 4 Canadian health care workers is a first generation immigrant to Canada. Without immigration Canada's health care system would be unworkable.
This teams system is a good idea, it is already in use in many places, it is not a new idea.
The root problem is supply. Canada has higher entrance standards than the US. Canada could increase medical school capacity and produce more than 3000 doctors per year.
I know of a few cases. Studied out of Canada. Passed all the Canadian exams. Looked for a job in alll of Canada 7 months. No job!!!!. Left Canada went back to Australia. Got a job right away
Never had a family doctor my entire life in Canada. Have just used the walk in clinics. Haven’t seen a doctor in over 6years. And now that I have to see a doctor can’t find one. All those taxes and not a single benefit on my favour.
Long relationship?? Wtf, I just need attention the clinic history should be available for all clinics so you wouldn’t get stuck with one slow option it’s 2022 no 1800
Back home, most of the time no need family doctor referral to see specialist. If we have skin problems, then go to dermatologist, if we are pregnant, we go maternity hospital without family Doctor’s referral like dental care. It save patients time and Taxpayers money as well. Sometimes I just go to see family Doctor to get referral. Hope get rid of referral system and patient can make an appointment with specialist directly.😊
I had to fire my former family doctor because she repeatedly blocked access to an OB-GYN even after I had a documented ultrasound abnormality. She indirectly caused a horrific high risk pregnancy that was totally needless and could have been extremely costly, not to mention dangerous.
@@snowbird6855 getting MAiD is not easy/straight forward at all. I have patients in a PCU waiting months. Some pass away before their schedule. Please don't throw around "opinions" as facts if you lack the knowledge.
@@snowbird6855 And here I was thinking I am having a well intentioned conversation with someone of at least average intellect. Well, that's on me, you fooled me.
I had a family doctor for 5+ years and did not have this kind of care. My husband's grandfather blew out his gallbladder with an impacted stone so our genius family doctor told my husband who was having several gallstone attacks a year that it was ok to wait to have his gall bladder out. She also refused a prescription that would have inhibited gallstone formation. Sure enough my husband got an impacted gallstone and pancreatitis. All this happened during covid. Thank god it wasn't during a wave. There was a news story from the states of a man with gallstone pancreatitis being turned away from hospitals during a covid wave and dying.
Also my experience! My family doctors treats my visit like I’m a walk-in.
Most people in Toronto go to the large walk in Clinics that have popped up in the last 20 years when they dont have a doctor.
My family doctor practiced in one of the very first ones ever developed in Toronto (its over 60 years old).
about 10 years ago they moved into a new building that's the size of a large rural hospital. Its now packed to capacity.
I also dont have a family doctor anymore once I moved, even though I kept going to my old doctor for years when major issues happened.
But Canadians get what they deserve. They dont keep politicians accountable.
Most people are not interested in politics or issues when they arise, or have anything to say to the government. And the other half are new Canadians who are just happy to be here and are even more clueless.
I would say these issues have been brewing for over the past 10 years and close to 15 years in Toronto.
There were warnings raised at least 15 years ago… But it wasn’t critical yet so many Canadians didn’t pay attention and politicians didn’t care….
Same in Quebec. At least years ago when couillard and barrette were in charge.
@@carlyar5281 15 years is about how long it takes to train an experienced specialist.
0:56 There are virtually NO walk in clinics in my city. I was recently attacked by a cat and suffered several deep bites. I have a family doctor but he's off sick and it's a sole-doctor clinic. Health Connect told me to get antibiotics ASAP, so I called around the city, looking for a walk-in clinic. There were quite a few listed on Google, but when I called them they said they hadn't been walk-ins for years. A few places actually said on their automated system that due to cutbacks, they could no longer employ someone to answer the phones, and to make an appointment online...so clearly also no longer walk-in clinics. The one place I found that _is_ still a walk-in told me that the doctor there wont treat animal bites. That receptionist told me to go to Urgent Care, which is something I have been trying to avoid because of the wait times and COVID.
The Group Health Centre in Sault Ste. Marie was set up this way when I was a child. I loved the services there. If I was ill I could have a walk in type appointment. I had specialists available to me. They had ultrasound, dental and pharmacy all under one roof. The best part - they all shared my files. They were started in 1963. When I left Sault Ste. Marie and couldn't find a similar clinic in a larger community I was very surprised.
I had to fire a doctor in a practice like this because she repeatedly refused to send me for an OB-GYN consult, even after I had a needlessly high risk pregnancy she indirectly helped cause. Also, it was impossible to get a same day appointment for my kids. The Boomers who have no life can be on the phone as soon as the phone lines open and they are booked solid with boomer ingrown tonails while my kids with fevers are out in the cold. Yes, you read that right, the "walk-in" clinic requires an appointment.
Why to go through with so many people to get to the bottom of problem. Isn’t it a waste of time and money.
What a waste!! a patient coming in a medical center or community medical center, the first medical stuff he should be able to see is a doctor's! Not so many stuffs who do not have qualify for first diagnosis,,,this practice is waste too much money in the wrong direction! Have more doctors service patients directly!!
You're talking over her, let her speak.
In Quebec you can’t even go to a walk in clinic. It’s absolutely awful how broken the system is. I just had a baby and wouldn’t even be seen after giving birth. My baby and I are not followed by anyone. A nurse can give her vaccinations and weigh her that’s all the follow up we get.
That’s nuts!. I am from Canada and live in the US and have NEVER had a problem seeing an MD. Even at UCLA which is super busy
Good.. take your and your families health into your own hands. Profit motivates the sick care system and your health is definitely not their priority..
I was denied follow up by the OB-GYN after a C section.
Did you try the CLSC?
As a senior citizen born here in.Canada, I don't understand what has changed in the past few decades. I NEVER had a problem finding a family physician in my 20's, 30's or 40's and I've lived in 3 provinces. I am really frustrated with the reporting on this subject. WHAT IS WRONG WITH OUR HEALTH CARE SYSTEM???? Not enough spaces in mefical schools? No monetary incentive? Is the paperwork too complex and time consumimg for doctors?
What is it? Can't SOMEONE get to the bottom of this morass?
Record breaking Immigration. Same crisis for housing as well.
Family physicians are burning out and leaving the profession or are switching to working in a different area of medicine. The reason they are leaving typical/traditional family practice is because the current model is that of a small business. So like any small business they have overhead to pay (rent, supplies, staff wages etc.) but their income is controlled by the provincial government. They get paid a certain amount per appointment and they cannot bill the province for more if the appointments run long. They also cannot bill for multiple appointments with the same patient on the same day. This is why the appointments are limited to a strict in our time because they are trying to get through so many patients in a day. I additionally there are more demands being put on family doctors and in terms of paperwork and records. If you’re running a business and your costs are going up, you end up having to increase your prices to cover the cost of your business. If you do not then you end up going out of business. The cost of running a family medicine practice continue to increase. The demands from the public in terms of population increase, and increasing patient number of patients with complex conditions is putting more of a strain on the existing supply of family doctors as more people are competing for a limited resource. But the income is restricted by what the provinces will pay for the services provided. It’s a business model that is set up for failure.
So as a result family doctors are leaving the profession because they cannot keep keep going (burnout), and medical graduates see what’s going on and they are choosing to go into other fields and avoid family medicine. So while increasing the number of medical school spots is a good thing, if they’re actively choosing to avoid family medicine it will not solve this shortage.
Well, our population has grown and the number of family doctors are declining so it’s just simple math. Plus provinces have cut health care funding for years ! And senior citizens keep voting in conservative government.
As for solutions, improving/modernizing the fee for service system is vital. There are other funding models that exist but I don’t know of any examples of off the top of my head. Providing additional supports for family practices/family medicine be important. The administrative burden is huge and there needs to be support for operating family practises if we are going to keep this business model. Multidisciplinary practices, with family doctors, nurse practitioners, nurses and other allied healthcare providers has also been one that improves healthcare outcomes for patients, and reduces the demand on the system.
The best people to ask are the family doctors themselves.
Dear google what is the health care problem in Canada.
Spend less time of facebook and watch some news.
There are remote doctors available. I used for my grandfather 3 years ago before he passed away. It was a remote screen visit with a doctor from British Columbia
I moved to within Ontario and I am struggling to find a family doctor since my move in 2020. I called most of the doctors/ clinics, no one is accepting patients. They don’t even have wait list. I do get phone consultation from my current family doc who is located 3 hours away. But it is really inconvenient if I need to see the doc in person. Also even if you have family physician, it has been really hard to catch hold of family physicians when you need them the most. I don’t know what has changed in past two years that has put all of us in this unorganized state of healthcare.
I moved from one part of the city of Toronto to another and I had to keep going back to my old doctor when anything major came up... that was almost 7 years ago.
Tip; when a new walk-in clinic opens that's usualy a new family practice that will evolve from it so go there and sign up but be careful. Always look up the education and credentials of the doctor first. I only will go with one who did both their undergrad and medical training in Canada so that I know they had to compete at the highest level to get their spot in medical school (not paid their way in) and can communicate well in English.
Where are these mythical family doctors that know their patients? She has an extremely rosy view of how GPs practice.
I have one. I live in Hamilton and my doctor is under the team-based model. My first and only doctor for the first 35 years of my life retired, but a new one took over her practice. I'm very lucky that I have only had two doctors in my life, and that they both knew/know me. It definitely helps when providing care.
Nah, this is pie in the sky - limited referrals. Doesn’t pay thebills
Before one doctor handled all this what the reporter is now having to see so many different people...each costing Healthcare salaries. How did seeing a health professional, previously family physician, get so splintered and convoluted?
I spent 1 1/2 years at an extended care facility. I got a GP assigned to me, who is still my GP. I also have a cardiologist and a Urologist. Personally, I blame the Provincial Colleges for the Dr. shortage. I was extremely lucky.
This is Scary!
You let a pharmacist decide on your medications?!
Agreed. Terribly scary
I believe the doctor said they work with the pharmacist to adjust the medications accordingly. The doctor still writes the prescription.
In Canada, it takes at least 5 years to become a pharmacist. The pharmacist who filled an emergency prescription for me has a doctorate. When it comes to any medication I have always trusted the pharmacist's knowledge as that is what they are educated in.
Yes pharmacist are extremely knowledgeable about how medications work and adverse effects but they can't not diagnose or manage medical conditions. It's dangerous to have a pharmacist acting like a medical doctor. They will soon realize they are in way over their head. They need to stay in their lane!
Something that has come to mind is the wonder of possibly some people choose to not go into medicine because of the sky-high tuition costs and that's partially why there are fewer doctors available. My GP took his well deserved retirement last November at 70y/o after spending nearly 5 years trying to find someone to take over his practice with no avail. Unfortunately where I live, we also have a couple hundred people fighting for 25 same-day clinic appointments every single day.
Love your program!
It only makes sense to treat the patient holistically. If a patient can only tell the doctor one symptom per visit, a diagnosis can take years rather than weeks. It's like trying to describe an elephant by only talking about one body part.
I’d be interested to know why this model isn’t a prevalent in urban settings… The effects of the doctors shortage is just as noticeable in cities as it is in smaller centres. Yes there are more service available but the care is just as much of a patchwork.
Agreed 👍
I've been looking for a family doctor for more than 5 years and the Quebec health system is so broken that no one answer my calls or provide me with advice!
Add in metal health services and I would say this is as close to perfect as you can get.
It used to take 2 years of hands-on training in a hospital to become a RN. In the UK, it takes just 5 years to become a physician. In Eastern Europe, they save costs by allowing patients to book with specialists directly. There are many ways to solve this issue without the pie-in-the-sky approach of (very expensive) team practice. Patients do not want to see 5 people in a visit. They want to see their doctors! Why can't practical ways to save money -- while allowing 10 minutes per visit, which is all that is sought -- be considered? It takes too long for doctors and nurses to be trained. There should be a shorter, less expensive, programs for people who intend to become family or general practitioners.
You seem to be confused. Canada requires family doctors to make these referrals to create barriers for patients so less money is spent.
Ridiculous comment. This was a scenario. Everyone is not in need of a social worker. They use a team approach here. 5 years to become a doctor is not long.
Hi Andrew, me and my family are fans of your videos summarizing important issues. However, lately, I have noticed the turnover of new videos increase, but the quality of research decrease. Like today's video on Canada Post's Deficit. There's just not enough research into, for example, the different expenses of Canada post, is labour cost the biggest cost? or is it property costs? What are the proportions between them? What's the number of employees and their salary compared to other low-cost delivery companies.
Please do more of well researched videos like this one.
Good luck!
Should open large offices that evaluate each patient then send them to appropriate sources. X-rays.stitches.broken bonecast etc.
I am originally from Montreal, Quebec where we had a Family doctor Dr. Jean-Louis Chartrand who knew my parents medical history and we the children were also his patients He knew us all by our first names. But, when I moved away friom Quebec to Ontario. it was a whole different story in the beginning to find a good family physican. I was lucky to meet Dr. R.P. Davis who became my family doctor until he retired. The G. P's today don't take any interest in their patients, they don't even listen. No confidence in them these days. Today's G. P.' s only interest is the Money...
This team effort has a lot of promise. I wonder if the simple case study could have benefited with a walk through of the intake processes. Getting the initial details correct might alter the entire process. Given this is a case study and not a real person I'll elaborate on the study in a slightly sensitive manner. I could see someone living alone with few supports as someone who drinks too much. The high consumption of liquids might be aggravating the urination problem and the excess sugars from the alcohol could have a similar amplification with any diabetes. However, without seeing how the intake occurs, it is hard to see the team shine as a whole. Getting a 50 year old man living alone to admit to excessive drinking could be difficult. The intake staff may need a considerable number of skills to direct a variety of patients towards the correct treatments. Having the patient's details correct might result in a diagnose of drink 6 beers a day not 24 and cut down any excess sugars before the team manages a metformin prescription. This is the second episode of About That I've seen and they are excellent. Thank you for taking the time to provide explanations about the state of Canada today.
It’s not only the alcohol consumption but also fast food consumption. Empty carbs provide no nutritional value. If he doesn’t have friends or family, he probably has depression too.
Thank for the video
In Quebec the public system has completely collapsed
Private clinics are on every street corner and this system of private clinics
has been fully embraced in Quebec.
The genius idea was supposed to be good for the public sector as it would free up doctors for those who couldn’t afford the private doctors.
End result...
Doctors are leaving the public sector for more money less hours.
Just genius yes?
Do most people have insurance coverage to be able to access the private clinics?
Have Canada government ever consider a health care model that we have in Vietnam that you have many smaller specialized hospitals in a region with a good walk-in clinic with a quick checks and test options that can be done in one day and reduce the need of family doctors?
this is nice to have but i also feel like i called into a call center and i get transfer to 12 people before getting one person to really help me. i would have to experience this to really say if i personally would like this.
Provincial Ministers of Health can solve most health care access problems with good legislation :
--such as arranging for Canadians educated in foreign medical schools to return to Canada and enter local residency training programs.
There is no leadership in provincial health care.
None at all
RS
Canada
I have a family doctor but only see a health practitioner. I like going to a walk-in clinic because l can actually see a doctor.
Education should be adjusted as well to suit the modern times. Children and students should be taught about diseases and when to seek medical help or what are the urgent symptoms and what are the things we can do at home prior to seeing a doctor.
I only go into the walk-in clinic when I have a cough that won't go away, which is typically get the anti-biotics and walk back home. but I have my family doctor for the major stuff, my family doctor is who got me my diagnosis of bipolar disorder and multiple sclerosis. If I never had my doctor I don't know where I would end up.
Being a Family Doctor and doing those investigations/relationships is unaffordable - we know it's all about the bottom line at the end of the day.
Yup. When I had a family Dr. he did his best to get me out of his office as quickly as possible - I am unaware of any attempt by him to investigate any long-term cross-diagnoses or specialists.
I honestly believe that my family Dr. was much more interested in "gaming the system" to get as much money as possible from the government while serving the patient as little as possible.
Also, my family Dr. went on 3 week vacations without having a backup for his patients to go to. The system is too stressed for the medical boards to put pressure on Dr.'s to do what is correct and best for the patient.
Finding a family doctor is difficult. Finding a good one is harder, you need to really know what to look for.
You figured out why there was never enough residency positions for the expanding and aging population! $$$$$$$
I was denied student loan to finish my 5 year of medicine, I was aiming to become a physician, to support myself I went into realstate while in school. Eventually I abandoned the idea of becoming a doctor. I'm now sell houses.
can they have CNS NP as the family provider?and to do telehealth ?
I really hope that health teams can solve the doctor shortage problem, the lack of family doctor in particular. My husband and I are very lucky to have a family doctor who's an epitome of what a physician should be: approachable, competent, efficient, down-to-earth and caring, really caring. He's the only doctor who finds time to give his patient the result/s of a lab test by he himself making the phone calls to give his patient speedy feedback. Some doctors I've encountered here seem to be in a pedestal, very hard to reach and refuse to answer questions although such queries are very much related to the current health issue of their patients. Moreover, he sends the requested prescription to the pharmacy nearest my residence when there is no need for me to see him in person for a consultation. This saves me time and car gasoline. I also have an equally caring internist who is very thorough in finding out what ails me. He tries to look beyond the symptoms, thus, healing not only the physical illness but what contributes to it. Bonus is that he answers my questions, making me feel that I am a person to be respected and cared for(given my senior age), not merely an elderly patient and so to my mind, he's a son to be cherished. I wish you can find a family doctor as well as an internist like mine.
I would love to see this type of health care in Interior BÇ
Me toooo
I'm in Peru visiting my new family doctor :) great and quick service. EMR scans & lab tests all done in the same day.
Peru is a small market but eventually the pharmaceutical industry will control it too.
Bighandgestures, ok, got it - necessary? Effective? Distracting?
Hey I'm visually impaired too, I can't drive either so I feel ya! Anyways living on Van Island is the land where there are no Drs. 😭
How about big companies like Walmart, shoppers drug mart , Costco , …., who have pharmacies, have doctor’s clinics too!!! Costco has pharmacies, eye exams clinic, hearing clinic, why not a doctor clinic!!!! Government should work with them on this!!! It is cheaper for them to run a clinic than an doctor to open an office on their own!!! Also how about a provincial pharmacy system that keep records of all your medications received so any doctors you are visiting can have access to Have an idea of your past medical conditions! When visiting other doctors, they always ask what medication are you taking!!!! They don’t ask about you medical history!!! Any doctors you are visiting for fist time, will know your health Conditions by seeing your medication that you are taking!!!
Who cares if you recommend other care, if all of it costs a fortune. $105 per session for help. Who can afford that. Even have to pay $100 plus for eye tests.
$105 is a fortune?
@@shauncameron8390
Its a lot of money to some people Shaun. Maybe not for you. Consider yourself lucky right ?
Walk-in clinic wants you now to make an appointment...what's the point of "walk-in" then? I can't find a doctor, 80 yrs old. My Dr. suddenly retired and left us all hanging. I was very sick a month ago and had to go it alone. Called Healthcare Canada to find physician, told had to get my medical records, which cost me $170.00 and file is incomplete but have to send some form that I "release my doctor" for Healthcare to try and find me another doctor. No end of rigmarole...
You can file a complaint that they are charging unreasonably high fee for your records.
Love this program. Access to medical services is such an important issue (especially with an aging population). Thanks for bringing this solution to light and is something we should all be focused on and asking for.
That's funny. This program isn't posted to find or offer solutions, it's just paying the salaries of those who made it. The whole point of pharmaceutical industry control is to facilitate the goal by creating a crisis then codifying what treatment is acceptable according to their profit margins. It can be managed via computer and online "visits". Why do you think ivermectin was kept away from us when dozens of countries had it available over the counter?
There shortage of doctors in my city and in United States. Many are not accepting new patients because they are overwhelmed with patients. Doctors have retired. My new primary doctor left and had to find a new primary doctor but had to have a reference from my head pharmacist to get a new primary doctor. Walk in clinics are overwhelmed here and in United States. A new State Texas medical college is being built in Tyler TX near my city. State and city hoping new doctors, specialists and nurses will fill the shortage but many go to big cities for more pay. My area pay less. Hospitals here have lost many nurses for low pay and many going to big cities for better pay.
What the heck is this lady talking about? Government set up family health teams and put the doctors on a salary ( a juicy salary at that) thinking this would save cost. What ended up happening is that the doctors started working as civil servants and their patients had to wait weeks for a regular appointment. The doctors got paid wether they saw 10 patients a day or a week. The government quickly realized that this model wasn’t working so they stopped funding this model
1) it starts at medical schools, they are overcharging and underfunded. First year is a waste of time except for MSK and neuro and also developing study technique. 2) There's a lack of residency programs and government funding. The public is not aware and not requesting a fix to this, and therefore the politicians are not aware. Residencies are underpaid, so only sadomasochistic students will go into medical school knowing they will be underpaid less than minimum wage during residency. 3) Corporations/investors are buying up practices and lobbying regulation making it harder and harder to operate private practice.
The biggest problem is lack of residencies which puts the squeeze on medical schools. Residencies need more funding to afford preceptors and attending physicians to train residents. There's plenty of paying patients to cover the costs between, just a lack of residency training positions. Government needs to step up and stop funding wars and instead ease the squeeze on residency positions.
Her glasses are so fire
I don't understand why things are so difficult here...
The cost of med education has sent the message that graduating doctors isnt a priority. Private schools are under fire for misleading applicants/students about their chances of success at that school and other facts about the education. So again the message is, ppl should just go away and solve their own problems.
The issue I have experienced living in Edmonton and being with more than 1 chronic illnesses, is that they tend to put these "clinic" centers deep in the suburbs.
2 problems I have directly encountered more than once was
A) people like me who are now on LTDI or CPP Disability don't earn enough money to own a vehicle and live in a house in the suburbs. We live in Central areas and rely on public transportation or often cabs because the bus ride there is extremely difficult if you're very ill. I have paid $80.00 round trip to find out that all of the available services are specialists and treatment itself is completely out of my budget...which brings me to
B) if they know you have some kind of insurance policy, they start off with telling you that they can offer X,y,z and additional services and often this is after they have asked explicitly the details of your coverage. Then they tell you that you must enroll with each specific specialist right up front. If you say, I cannot commit to all these different specialists because of expenses and travel time, they will pressure you with "we only provide these services if you are willing to all of our treatment plan or we will not enroll you ".
If, which in the first year of being on LTDI I did enroll at LifeMark as referred by a walk in Doctor, they did everything I said above. They completely gave me a ridiculous schedule and max out ALL my medical coverage on my insurance including treatments that have caps or a frequency I.e. once every two years etc. I never got better, I actually got worse and I was completely bankrupt. I couldn't afford it anymore than walk in clinic Dr.s .
My health continued to deteriorate and I was get 2 to 3 or more years of wait- listed to see actual specialists out of the hospital. It basically took me to get much sicker before I was sick enough to be refered to the hospital specialists.
Now 5 years later, I have had a Afib multiple hospitalizations because my health keeps crashing. But they don't really keep you in the hospital to actually get better.
This is ridiculous. We they, the government and other organizations start thinking of privatization or semi-privatization, this is what it looks like. The clinics are available to people on a higher pay class and may have health issues but aren't chronically ill. It was like going to a high pressure gym that also happens to have a massage, Physio therapist and chiropractor. That's all great if those are your issues but that isn't medical care.
Great in theory, but exactly where in Canadian cities are they going to provide all this new infrastructure proper care early enough in low income areas or central areas? They cannot.
This idea needs to be reworked to actually accommodate chronically ill people.
Your example 50 year old man, off work for 10 years, due to an injury, with possible: diabetes, prostate and hormone issues, is going blind and is developing a heart condition;
Cannot afford or do such a treatment plan that rigorously. And mostly likely cannot afford to travel back and forth.
This isn't realistic. We need more Family Doctors that are willing to forgo fancy buildings and boardrooms.
That's the problem and that is the solution.
Canada should start to use immigrant doctors asap like Germany does. There are thousands of doctors in Canada and they are doing Uber or delivery lol While Germany and other European countries are giving 1-2 years of training to the foreign newcomer doctors and then integrating these immigrant doctors. Canada is just wasting its own qualified labor.. ridiculous..
Most family Doctors today do not take the time to get to know you. Marcus Welby is long gone.
We have exactly the same problems here in Austria 🇦🇹, EU. I am aGP seeing 100 patients a day.
Nurse practitioners would be helpful, but they seem to be denying these professionals reasonable workloads and pay in the maritimes
They are not the same as family physicians and actually end up costing the system more because they spend longer with patients and refer out too much.
Nurse Practitioners would be a good family doctor replacement because they can also do everything that the family doctor now does.Doctors have kept their practices in a closed shop environment . They were extremely slow in allowing chiropractors, midwives to share medical roles. 80% of ER admissions were probably sent to ER by their family doctors. Family doctors seem to work a four day week at least at the clinic I used to go to before my doctor closed her practice. There are about 10 doctors listed but not one seems to work full time.
1 word privatize
haven't seen my family doctor in years always a weeks long waiting list - so what's the difference?
The difference is the walk in clinic doctor can fob you off, tell you to go to your family doctor!
Unless the patient is a woman, where everything is caused by stress. The ideal is great, but having had a family doctor for many years, they never gave a damn and gaslighted me for symptoms that eventually led to a diagnosis years later.
Totally
That’s awful. Yup it’s all in your head ya da ya da. I’m not confident about doctors anymore. I feel they’re just in it for the salary and social status. I’m sure there are a few great doctors out there but it’s hit and miss it seems.
Vote!
So your solution after talking for 10 mins is to go to a community center? And you couldn’t fit that in the first few minutes of the clip instead of wasting viewers time talking about yourself.
I've never had a problem finding a family doctor in the city I live in. Is this a small city or rural problem?
You are probably not a high maintenance patient. They cherry pick easy patients, which they are not supposed to do.
Primary care providers should have a wide knowledge of differentiation diagnosis and updated evidence-based approaches to rule in and rule out the differentiation diagnosis. The next step is to refer the patients to the other team members or the specialist. As a physician who is not practising in Canada, my previous family physician had a cylindrical view and less knowledge of new medications. As a result, the circle starts not in the best direction. Patients don't have enough knowledge of medicine to understand the shortage and question it. The quality of life of many patients is not considered in some health protocols. The best example of ignoring the quality of life would be endometriosis and the PCOS protocols.
When a health system is set up to provide pharmaceutical industry profits and not health outcomes of the patients, what do you expect? Why do you think ivermectin wasn't allowed here? I prefer consulting with my Naturopath because he cares about my health and has non pharma options for most issues. It's no coincidence that I'm 66, in perfect health, not on any meds and vax free.
What about the childern mutilation??
Send more kids to university for M.D.s.
Social influencers aren't helping anyone.
I use Urgent Care if its an infection since my insurance covers that. I solved this overall problem by finding a Functional Medicine Physician/PCP and I pay out of pocket. I'm age 72 and I have four serious Autoimmune Conditions so I have no other real choice. My husband has some cognitive decline and a serious physical/neurological issue called CMT. We HAVE to have good care at age 72 and age 77- our lives depends on this kind of high quality of care.
I haven't been to the doctor in 20 years