What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Friday, March 16, 2007

Doctors Deal Offers CPR

A cowboy friend of mine observed many years ago “opinions are like &ss h%les, every ones got one”. The editorial “Doctor Deal offers CPR” in Thursday’s Calgary Herald (March 15/07) exemplifies his position!
The editorial starts out with the position “The two-year proposed contract between the Alberta Medical Association and the province is good for doctors. It’s even better for Albertans, who have been paying the price with their health for Alberta’s Physician shortage. Well, at least they got that last part right, but it pretty well ends there. The writer goes on to give advice to the doctors “Physicians should listen to the A.M.A.’s recommendation and ratify the deal”, now here is the clincher for the doctors “because all Albertans, especially new ones, need and deserve their own family doctor.
Now, keep in mind that I am retired, so I really have no axe to grind other than as a senior, I will likely have to be more dependent on our health care system as time goes on; but my doctor friends are largely approaching my age and they keep me pretty well informed as to what’s happening---------and it’s not pretty.
Consider the following:
1) Rental rates in Calgary have jumped five to six times the 4.5% increase offered.
2) Every business window has a “Help Wanted” sign in the window. Good luck at finding good office help at a 4.5% increased wage.
3) Other office costs, taxes, etc are increasing at a rate equal to or greater than 4.5%.
4) Office expenses for a family doctor doing fairly comprehensive patient care and management run at least 45% of billings. This means that take home pay for family doctors may actually decrease during this two year period with the proposed agreement.
5) A.M.A. negotiations since 1969 (the introduction of Universal Healthcare) has kept up with inflation approximately one third of the time and is largely responsible for the steady decrease in available family physicians.
6) At present, there are areas that family physicians can work outside of the healthcare system. Botox shots, varicose vein treatments, other cosmetic treatments, specialist extenders,etc, provide better revenue for time spent than running a family practice. Even working within the system, we can do much better working as walk-in clinic docs, hospitalists, and Regional health clinic docs; and have a much better home life.
The bottom line will be that we will see a continuing erosion of the availability of family docs.
The editorial states that Alberta physicians, with this contract will be “among the highest in the country, and tied only with New Brunswick”. Good Grief!!!! What does a house cost in New Brunswick? What does it cost to run an office? Surely this editorial was the work of a high school student given a chance to be “Editor for a day”!!!
The final insult to family docs was the statement “There is no shortage of students who want to be doctors. The Medical faculty had U.of C.’s highest entrance grade last fall, at an average of 89.1%. Everyone else was turned away, even those with slightly lower grades who might make wonderful family doctors”. What the!!!!???? Are they saying that you don’t have to be as intelligent to be a family doctor?? The editorial then goes on to say “As long as admission is restricted to the intellectual elite, provinces such as Alberta will have trouble attracting and retaining family physicians”. I think the writer really does think that family physicians are not the intellectual elite and that specialists are!!!!
Here is a news flash, Mr/Ms editor.The last time I looked at the breakdown of medical students, family doctors came primarily from the middle one third of the class and specialist came primarily from the lower third and upper third of the medical class. Specialists coming from the upper one third were more likely to go into research areas. Focusing on one aspect of medicine is often viewed as being easier than being a generalist, which requires a good knowledge of a wide spectrum of medical fields. Specialists spend four to five years of additional training in their specific area, and they certainly should be the authority in that area; but it does not mean that they are more intelligent. In any case, the statements were dumb and demeaning, and certainly won’t entice talented medical students into choosing family medicine.
For those who may be interested, here are some of the real determinants used by medical students when choosing their area of medicine: (not necessarily in order of priority).
1) Primary area of interest.
2) Years of training required
3) Cost/ability, to continue studies
4) Remuneration in practice
5) Marital status
6) Family status (children)
7) Availability of residency training
8) On call status during training and after graduation.
9) Expectation of home-life and personal time after graduation
10) And finally, in some cases the “milk of human kindness” aspect.
11) If some docs are reading this, you can add more, but ability is NOT the issue!
So there you have it, doctors of Alberta. This brilliant editorial suggests you ratify this proposed agreement. If I were a voting member of the A.M.A., my vote would be an unequivocal NO! ---------for the good of all Albertans, and the right of every Albertan to have a family physician.


Blogger Rosie said...

I took his comment to mean people who get into medical school being the intellectual elite, not specialists. Its sure hard to get in. I've seen people with straight A averages having to apply 2-3 times before they got into medicine. Some gave up. Very able people, there's just no room for them. I always wanted go to medical school and sure think I'm smart enough, but never made the grades. Seeing my friends who are in now, I know I could have kept up with them no problem.

Guess I'll settle for the "oh, you're not a REAL doctor" doctoral degree.

16/3/07 7:14 PM  
Blogger Al said...

Sorry, Rosie, your being kind. I didn't include all of the inferences, but here is another that infers the brightest become specialists.
"If your brilliant, and you have invested considerable time and money in medical school, your going to choose a highly paid specialty to match your talents---" I would think the corollary is that if you dumber,and invested considerable time and money in medical school, you'd better get out there and be a family doc, cause you don't have any talents.
The point of my blog entry is that the medical profession shoud probably not take any advice from an editorial writer that is this clueless!

17/3/07 4:24 PM  
Blogger Rosie said...

point taken.

17/3/07 9:01 PM  

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