Thursday, 17 December 2015

More for Less!

    Everyone seems to know more about medicine today than the professionals.  Fortunately, I am now a  medical has-been so  can say anything I believe.  After all, my years of education and effort, lack of finance, lack  of security, not to mention lack of sleep,  and most of all, lack of certainty that I may eventually graduate, (not everyone who got in to medicine then came out with an M.D., you had to actually meet the standard) really doesn't matter, because doctors "make so much money".  This is, of course, how it appears in the eyes of the public, who are presented with misrepresented figures which sometimes look huge, since the physicians billings represents total revenue without considering the sometimes huge overhead, that often include several salaries, nurses, receptionists, equipment etc.  Gross incomes, presented deliberately without explanation serves to deflect attention from the greatly inflated salaries of the administrative group.   Most physicians have no pension,no sick benefits, no safety net if  ill-fate or misfortune befalls them and must provide for themselves those benefits that no civil servant would consider working without.  Now physician earnings are being seriously clawed back and there is no doubt that this will have an effect on physician supply and service.  So expect things to  change decidedly for the worst in the health care industry.

Let me point out the state of the Canadian Health Care system, using a report that the Department of Health has quoted itself: 

"With regards to international comparison, the 2014 Commonwealth Fund report on the health system performance of 11 countries ranked Canada 10th overall, indicated particularly low scores in quality, safety, access, timeliness, efficiency and equity.17 "
Commonwealth Fund, Mirror, Mirror on the Wall: How the Performance of the US Health Care System Compares
Internationally, 2014 Update.  Note the broad range of care in which we are at the bottom of the heap.

   The decline is, of course, a carefully guarded secret, the politicians see to that.   They want Canadians, to continue to think that they are still enjoying a 'world-class' health care industry, while the decline continues.
   Administridiots, with business training, are in charge now.  They really have no idea of what good medicine is, other than from  the economic point of view, and even then, often have little real insight.  They understand little about physician - patient relationships, and care less, unless, of course, they, their families, or their political friends are involved.   Things are different then.  I was the Chairman of a Department of Family Medicine, based out of a University Hospital, and not infrequently, would  get a subtle message that an important political figure or one of their family members was coming in.  Just to let me know, you know.  Not that any special treatment was being solicited, God forbid.  (Nod nod, wink wink!)   And , of course, when any of the  administrators or their families came into the department, they never failed, ever so tactfully, to let us know who they were.  So it's time to discard all that BS about everyone getting the same level of care.  It's just not so, and the people who crow most loudly about it are often the ones who are most demanding. 
   Soon, our already overburdened health care system,is going to be furthered burdened by twenty-five thousand Syrian refugees, at least some of them are refugees.   Physicians, who can't adequately cope with the already heavy patient load, and who are being treated in an unbelievably unacceptable manner, including unilateral claw-backs from government, are being asked by the same politicians to provide the coverage that the  politicians have so generously promised.  If physicians do that, they will deserve the consequences.  The government made a promise so they could look like 'good guys' , let them not fulfill it on the backs of physicians.
   I cannot help asking, where are the CMA and CPSO?


  1. What is happening to Canadian Health care today is no surprise to anyone who lived in and witnessed the decline in health care in Quebec for the last 40 years. La Belle Province was ahead of the curve and s harbinger of what was to spread to the rest of Canada! Today, Quebec is in the forefront of the legalization of marijuana and doctor provided death by injection. Look out Canada.

  2. Unfortunately as long as Health Care is perceived as an industry the situation will continue to deteriorate. The prognosis is grim, because health care is not an industry and cannot be successfully (from the patients point of view) be run as one.