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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 
6 hours ago by AfroMaestro
All Five Eyes Countries Formally Accuse Russia of Orchestrating NotPetya Attack
All the countries part of the Five Eyes intelligence-sharing alliance — the US, the UK, Canada, Australia, and New Zealand— have made formal statements accusing the Russian Federation of orchestrating the NotPetya ransomware outbreak.
The UK was first to pin the attacks on Russia, earlier this week, when Foreign Office Minister Lord Ahmad said in a press release that an intelligence agency part of Russia's military had created and deployed the NotPetya ransomware in Ukraine, from where it accidentally spread worldwide.
The UK's statement caused a stir, but the country didn't stand alone for long, as the next day, February 15, the White House came out with a similar announcement.
The attack, dubbed “NotPetya,” quickly spread worldwide, causing billions of dollars in damage across Europe, Asia, and the Americas. It was part of the Kremlin’s ongoing effort to destabilize Ukraine and demonstrates ever more clearly Russia’s involvement in the ongoing conflict. This was also a reckless and indiscriminate cyber-attack that will be met with international consequences.
gov2.0  politics  security  privacy  russia  usa  uk  canada  australia  ukraine  ransomware 
yesterday by rgl7194
Indigenous Women’s Stories and Experiences in Canada (Mar 4)
"Join Indigenous scholar, Candace Brunette (Mushkego Cree) as she leads a panel of local Indigenous women in the discussion of Indigenous women’s stories and experiences in Canada."
crhesi  radar  events  indigenous  women  canada 
3 days ago by jamesshelley
Bomb squad detonates hazardous material from North Vancouver lab
The RCMP’s explosives disposal unit squad was called in to blow up a volatile substance left in a North Vancouver government lab Tuesday.
According to District of North Vancouver Fire and Rescue Services assistant chief Jim Bonneville, staff at Environment Canada’s Pacific Environmental Science Centre on Dollarton Highway came by a bottle of a chemical that had been left on a shelf and called a private hazardous material removal firm to come retrieve it.
article continues below
But the substance had sat so long, it became dangerous, and hazmat staff said it was unsafe for them remove it.
“In this case they had to get a hold of the manufacturer because the product had crystallized and apparently is very unstable and explosive when it’s in a crystallized form,” Bonneville said.
“They said, ‘We can’t take that and nobody will take it. You’ll have to dispose of it with the bomb squad, basically.”
Though it was just a small amount, first responders and government agencies took the substance seriously, Bonneville said.
“Just to put it in perspective, it was a 100-millilitre bottle and there were only 30 millilitres in it, so hardly anything, really, but it was still recommended to dispose of it the way the RCMP did,” Bonneville said.
Canada  laboratory  discovery  response  explosives 
3 days ago by dchas
Canada Modern
Canada Modern is an archive of modernist Canadian graphic design focused on the period 1960—1985. It was conceived and produced by Canadian creative director Blair Thomson in 2017 and is the culmination of a long held ambition to curate a comprehensive national cache, whilst simultaneously addressing the absence of any such resource on a singular (red) thread.
design  canada  art  archive 
4 days ago by jpkoudstaal
Twitter
RT : Today in history: The maple leaf becomes the official emblem of as the new ational flag is launched on 15…
Canada  from twitter
4 days ago by jbfink

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