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This U.S. doctor is moving to Canada. Find out why. | Emily S. Queenan MD | KevinMD
..I knew that Canada had largely resolved the problem of delivering affordable, universal care by establishing a publicly financed single-payer system. I also knew that Canada’s system operates much more efficiently than the U.S. system, as outlined in a landmark paper in The New England Journal of Medicine. So I decided to look at Canadian health care more closely.

I liked what I saw. I realized that I did not have to sacrifice my family medicine career because of the dysfunctional system on our side of the border. In conversations with my husband, we decided we’d be willing to relocate our family so I could pursue the career in medicine that I love. I’ll be starting and growing my own practice in Penetanguishene on the tip of Georgian Bay this autumn.

[Really here for the comments though]
While there are the obvious benefits to the Canadian system (billing) be mindful of the changes beginning to take root. Ontario is in a terrible financial situation and the system as it exists is unsustainable. Health care in this country is going to change dramatically over the next decade, likely leading to a two-tiered system (the fact that Canada is the only western nation where private medical care is actually illegal is absurd). The provincial budgets are bursting at the seams and the new Liberal government is sticking to their guns and holding the line on physician's fees. The 3% claw back this year is the first of what will be many reductions across billing codes. There is simply no other way to pay for the ever increasing demand on the system, and the now record numbers of doctors practising in Ontario. In this country unfortunatley as a doctor you are very much at the mercy of the government, despite the deceiving label of "independent contractor."
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I'm a family doctor here in Ontario. I think hospitals and ERs here in Canada do a pretty decent job dealing with true emergencies (heart attacks, strokes, major trauma, etc) at little cost to patients other than the ambulance ride. But for everything else, in general, the system is woefully inadequate. "What can wait" is a pretty broad category. In my fair city, wait times are over a year to see any psychiatrist, and likely just on a one-off basis. Psychotherapy and counseling aren't funded at all for mental health care if not performed by a doctor, and psychiatrists are inaccessible and too overburdened to do much other than tinker with meds. Waits to see a shoulder surgeon locally average about two years. Waits to see dermatology are about a year as well no matter the acuity. Rheumatology doesn't accept any new patients at all. Chronic pain clinics or consultants don't really exist locally and all prescribing of narcotics falls upon poorly trained and equipped family docs. The grass is always greener. And stealing a quote from Ms. Thatcher, "The problem with socialism is that eventually you run out of other people's money".
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I am working with Health Force Ontario -- do not need to retake board exams, but rather practice under limited supervision for a year. Excellent organization (an agency within the provincial government) -- I highly recommend for any physician interested in moving north.
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I work in both systems. Canada has some good advantages. Start with malpractice being a fraction of the US (I pay $750/mo with some of it rebated back) and fear of lawsuits is minimal. This allows you to practice more 'clinically', and you can actually send suspected appendicitis to the OR without a CT via the ED (the ED won't CT either). Billing is fee for service. You need a billing number, patient number, provincial health plan fee code and ICD 9 code (no decimals, just the 3 digit code) with 99% payment within 2 weeks. You can do it yourself, it is that simple. The physicians are much more organized, and provincial medical association negotiates the fee schedule on your behalf just like a union. There are no PA's, a few nurse practitioners. DO's are not allowed in my province, only MD's.
One of the downsides are the lack of technology. Outpatient CT is about 3 mo wait. MRI is 6-12 month wait. Pacemakers are limited (in my province). There are only 4 cath labs in the province, 3 are in major cities, one per city. Getting things done for patients is often difficult. Most OR's are on a waiting list. Elective Hip surgery is about 3mo - 1 yr. A referral to a gastroenterologist took 6 months for an appointment to open. But, as an upside, the people are used to waiting, so they rarely complain. (BTW - no satisfaction crap either). And, if you prescribe a lot of narcotics, get used to doing things much differently. Canadians are a tough bunch of polite people.
Also, because healthcare is free (actually you do have to pay a monthly fee) it is over utilized. The primary care docs are overwhelmed by demand, many have closed their practices. The ED's are bombarded by colds and coughs, or chronic problems that should be managed by a primary care.
You will make more money in Canada, but you will be heavily taxed. If you are a US citizen, you will be taxed again on your Canadian income. The cost of living is much higher in Canada.
These are a few of the differences I have found.
Medicine  Canada 
26 minutes ago by AfroMaestro
Who’s sharing their clinical trial results?
FDAAA 2007 is a law that requires certain clinical trials to report results. After a long wait, it effectively comes into force from Feb 2018. The FDA are not publicly tracking compliance. So we are, here.
health  science  research  medicine  transparency 
9 hours ago by GranoblasticMan
Amy Holden Jones on Twitter: "There are always debates and we welcome them. Doctors are threatened. I’m glad. They are the third leading cause of death and hospitals are overbilling humans in pain. Patient safety activists are in my corner and I’m fin
> There are always debates and we welcome them. Doctors are threatened. I’m glad. They are the third leading cause of death and hospitals are overbilling humans in pain. Patient safety activists are in my corner and I’m fine with that.
media  TV  controversy  2018  medicine 
yesterday by porejide
‘I could hear things, and I could feel terrible pain’: when anaesthesia fails | News | The Guardian
Anaesthesia remains a mysterious and inexact science – and thousands of patients still wake up on the operating table every year.
guardian  anaesthesia  medicine 
3 days ago by nxg
Plague of Frogs | West Hunter
For a few years the herpetologists were concerned yet happy. Concerned, because many frog populations were crashing and some were going extinct. Happy, because confused puppies in Washington were giving them money, something that hardly ever happens to frogmen. The theory was that amphibians were ‘canaries in a coal mine’, uniquely sensitive to environmental degradation.

...

It took some time for herpetologists to admit that this chytrid fungus is the main culprit – some are still resisting. First, it was a lot like how doctors resisted Semmelweiss’ discoveries about the cause of puerperal fever – since doctors were the main method of transmission. How did this fungus get to the cloud forests of Costa Rica? On the boots of herpetologists, of course.

The second problem is Occam’s butterknife: even though this chytrid fungus is the main culprit, it’s just got to be more complicated than that. Even if it isn’t. People in the life sciences – biology and medicine – routinely reject simple hypotheses that do a good job of explaining the data for more complex hypotheses that don’t. College taught them to think – unwisely.
west-hunter  scitariat  reflection  stories  troll  lol  science  low-hanging  occam  parsimony  bio  medicine  meta:medicine  ability-competence  explanans  disease  parasites-microbiome  spreading  world  nature  environment  climate-change  hypochondria  academia  questions  epidemiology 
3 days ago by nhaliday
As we age, cancer rates go up as immune system winds down | Ars Technica
Finally escaping immune control—not getting two hits—is what causes disease.
articles  health  diet  cancer  aging  ImmuneSystem  medicine  science 
3 days ago by xer0x
"I would like to subscribe to zoology facts"
"[–]punstersquared 22 points 11 hours ago

Cows have 4 compartments to their stomach, 3 forestomachs and 1 true stomach. They're basically giant fermentation vats on legs. [...]"
veterinary  medicine  zoology  cow  bird  horse  stomach  bursa-of-fabricius  from notes
3 days ago by aidan
As we age, cancer rates go up as immune system winds down
Finally escaping immune control—not getting two hits—is what causes disease.
medicine  science  cancer  health  articles 
3 days ago by mikael

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