Quebec's Sad Doctor Fiasco

The latest round in Quebec's ongoing doctor fiasco is the news that doctors from Ontario are still facing roadblocks despite the bilateral agreement signed between the two provinces that was supposed to allow each province to recognize the other's professional accreditation and thus pave the way for elimination of the inter-provincial barrier.

This week it was revealed that the five Ontario doctors that applied to work in Quebec still can't get the green light despite the four month old agreement which remains blocked by red tape.

In the meantime, since August 1, doctors from Quebec are free to cross the border into Ontario and start practising immediately. Already close to one hundred Quebec doctors have made the move towards Ontario.
This has infuriated some opposition politicians who have demanded that Quebec withdraw from the agreement rather than take remedial action.

This reaction would border on hilarious, were it not not so sad. Quebec could certainly withdraw from that agreement, but even if they did, that wouldn't preclude Ontario from continuing to honour Quebec credentials. It would then become the worst of both worlds, with Quebec doctors leaving for Ontario and no Ontario doctors allowed in. Our politcos aren't too bright.

Despite what we hear on the news, Quebec does not really have a doctor shortage. Really.

There are more physicians per capita in Quebec than any other province (except Nova Scotia): 215 per 100 000, compared with 179 in Ontario and 166 in Alberta.

Quebec's real problem is the type of doctors that we have.

Although there is an appalling shortage of family medicine doctors, the other specialties are so over-represented that the government is restricting licenses (PREMS) and has actually frozen the hiring of new specialists. For some reason the mainstream press refuses to report that aside from a few specific specialties and family medicine, the government isn't hiring doctors.

When it comes to finding a family doctor, twenty-five percent of Quebeckers are out of luck. Estimates vary as to how many family doctors are needed to fill the gap, but the figure of 700 does sound reasonable.

Why the extreme shortage in family doctors?

Mismanagement. For years the government imposed such harsh conditions, that it drove doctors towards other specialties or worse, out of the province.

First by imposing a salary cap. Doctors could earn so much and no more, regardless of how many patients they saw. It led to the ridiculous situation where GP's were working only three out of four weeks, having maxed out their renumeration, leaving patients in the waiting rooms and doctors twiddling their thumbs. This policy has since been rescinded.

Second was the policy that attempted to blackmail doctors into working in the backwoods of the province, where the doctor shortage was critical. Doctors who set up shop in urban areas were paid less than their counterparts in the sticks. This policy remains in force.

Third, the actual remuneration is inferior to that offered outside Quebec. Quebec has always counted on the language and cultural barriers to keep doctors at home.
The majority of graduating doctors in Quebec are unilingually French (except McGill grads) so few of them, upon graduation, have the option to take up residencies outside the province.
This is why that up to now, it's the Anglos who were leaving, but it is changing as Francophone doctors wise up and learn English.

What to do.....

The answer is much simpler than you could imagine.- Increase the amount of family doctors trained.

Require each of Quebec's medical schools to accept a proportion of their applicants based on a contract that streams them towards becoming a family doctors. Applications to medical schools are so overwhelming, that given a choice between being a family doctor or no doctor at all, applicants would jump at the opportunity.

Secondly, regularize pay and conditions. Quebec could still pay less, but it's got to be more reasonable.
Family doctors are the best investment that the government can make. Their offices are small and extremely efficient compared to the burdensome CLSCs, who's level of care leaves much to be desired, not to mention expensive emergency room visits that could be handled in the doctor's office. Experienced family doctors are a health system bargain, they see more patients a day than any other specialty, with some practices of more than 5,000 patients!

For towns and cities outside the urban hubs, it would be smart to make it worthwhile for doctors to come, instead of bitching and moaning. A free home and office facilities would be a start. The government should allow communities to directly subsize doctors if they want to do so.
It would cost a small town of 20,000 just $5 person to offer a $100,000 yearly bonus to a doctor to set up shop. Believe me, there would be a stampede to the hinterland.

Remember in the real world the carrot is always better than the stick.

Chickens Come Home to Roost for Passport Canada

The blame for the sad affair that kept Torontian, Suaad Haji Mohamud, a Canadian citizen from returning from Kenya because both Kenyan and Canadian consular personnel didn't believe that she was the person portrayed in the photo can probably be blamed on her Canadian passport picture:


In all honesty, would you let her through if it was your decision at the border?

Here is some of her other ID.


Both her OHIP card and her driving license, where she is wearing a hijab are impossible to match to the picture on the left.
However in the ID photo where she isn't wearing the hijab, even though her hair style is different, clearly resembles the picture on the left.

Instead of banning smiles from passport pictures, officials might want to consider banning hijabs instead.

But this being Canada........

Hydro-Quebec Boss Unlikely to Survive Scandal

Had Thierry Vandal quickly apologized and taken responsibility for his lack of judgement in the donation scandal now swirling around him and Hydro-Quebec, he might have survived, but like Martha Stewart, he's going to pay the price of the coverup which is presently going on.

Hydro-Quebec's decision to give $250,000 to Collège Notre-Dame, to upgrade it's sports facilities, is appalling enough, considering that the school is Mr. Vandall's alma mater and of which he just happens to be the president of the board of directors, but defending the gift is beyond the pale.

The BS that is pouring forth from the Hydro-Quebec building on Rene Levesque Street in Montreal exposes the fact that the princes who run the public corporation are unaccustomed to account for their actions and their sad attempt at public relations is as laughable as it is pitiful.

Our advice to you--Better get professional spin doctors in ASAP, but it may already be academic.

When the story first broke in La Presse, a Hydro-Quebec spokesman François Taschereau, denied that Mr. Vandal was involved in the decision to give the donation. This lie was corrected the next day when the corporation realized that the truth would probably come out and so Hydro-Quebec then admitted that the president might have been in the loop.

The spokesman then defended the donation to the private school by pointing out that the sports facilities funded by Hydro-Quebec would be available to the public when school was out for the summer. He went on to say that Hydro had already approved a similar request for upgrading facilities at another school, but refused to name the facility, nor the amount pledged. Arghhh!.......

If that is true, the donation to the other 'school' was no doubt an attempt to make the first donation seem legitimate.

Marcus Tabachnick, Lester B. Pearson school board's director, commented that when he approached Hydro Quebec for a donation to its Pearson Electrotechnology Centre, something Hydro-Quebec would certainly be interested in considering the shortage of electricians, Hydro's response was- "We don't fund schools"

A greater issue here is why does Hydro-Quebec give out donations, or provide sponsorship money for public events ?

Come to think of it, Why on Earth does Hydro-Quebec sponsor the Zambonis that clean the ice between periods at the Montreal Canadiens hockey games at the Bell Centre? Advertising is meant to encourage people to use your product instead of competitors. Hydro has no competitors. Could it be that the Zambonis are part of a package that includes an executive box, one that Hydro bosses can use for their personal benefit?

The company is a state monopoly with the mandate to produce and sell electricity for the benefit of Quebeckers, so what business do Hydro executives have donating money that belongs to taxpayers?

That's the job of the government.

If the education department wanted to fund Collège Notre-Dame, they could do it themselves, full well in the knowledge that they'd have to face the consequences of their decision to fund a private institution in Parliament or at election time.

Just because Hydro-Quebec makes money for the government, doesn't give it the right to spend money as they see fit.

How would the public feel if Revenue Quebec started doling out money to their favorite private schools or paint up the Zambonis in the Bell Centre with a big "REVENU QUEBEC" logo, after all, they also raise a lot of money for the government?

Mr. Vandal will likely not survive the scandal.

With the opposition parties screaming for his head, Jean Charest has no political upside in defending Mr. Vandal.

For Vandal it's resign or be fired.

Not to worry, there's probably a huge golden parachute waitng for him.

General Amherst versus Lionel Groulx

Another idiotic French versus English controversy has erupted with independent Montreal city councillor Nicolas Montmorency, of the Rivière-des-Prairies-Pointe-aux-Trembles district, saying that since the city is officially French, it's street names should be too.
Aside from that, he also wants that the name of Amherst street be changed, claiming that recognizing General Amherst is akin to having "Adolf Hitler Boulevard in Germany."

In 1760, during the Seven Years War, General Jeffery Amherst was commander-in-chief of the British forces that conquered Montreal. In 1763, during the Pontiac rebellion (which pitted the British against the local Indians), it was suggested by Colonel Henry, in an exchange of letters with Amherst, that smallpox might be employed as a weapon for the racial extermination of the Indians. General Amherst was favorable to the idea. Read a defence of Amherst in the Montreal Gazette.

"The culture and history of Montreal's English should not be unjustly represented by someone overtly in favour of the extermination of a people," reads Montmorency's city council motion.

Not for one minute am I going to defend Amherst's actions, nor attack the idea of changing the street name, but starting a debate on the subject opens a whole can of worms, one that can't be helpful to French/English relations.

The city is just recovering from the fiasco wherein the proposed name change of "Parc Ave." to "Robert Bourrassa Ave." (after the late Premier) was met by a furious backlash in the city's Greek community and which ultimately led to the city backing down.

Montreal is perhaps unique in that many street names represent rival historical figures of both English and French heritage. Some of these figures are nothing less than demons to militants on the other side. Perhaps the best example of this is are the Montreal streets 'Wolfe' and 'Montcalm' which are located back to back and honour the two generals who led the opposing English and French forces at the Plains of Abraham. Ironically the streets lie adjacent to Amherst St.

Most Montrealers are mature enough to let sleeping dogs lie. Better to accept the differences and go on with life.

Upon examination, there's are a lot of other streets named for historical figure that if judged by today's standards would also be eligible for a name change.

Lionel Groulx (Metro station and street name) is the one that is at the top of the list. A priest who is proudly remembered for his spirited defence of the French Canadian nation during the first two-thirds of the last century. Unfortunately his brand of nationalism included a virulent case of anti-semitism and a belief in the fascist doctrine that was then currently in vogue in France and Germany. He preached for a racially and religiously pure Quebec. Groulx argued against the immigration to Canada by Jews, Mennonites, Mormons and other non-Catholics.

In his book L'Appel de la race (The Call of Race,) he taught that;

"the children of ethnically mixed marriages suffer from a form of schizophrenia because they are inhabited by two different souls."

Although apologists argue that his views should be seen in the context of a time when the Catholic Church was also espousing these views, it remains an open question as to whether it is appropriate to continue honour him.

Come to think of it, does Henri Bourassa, also a rabid anti-Semite, deserve a street named after him?

"Indeed in 1905 in the most vituperative anti-Jewish speech in the history of the House of Commons...Bourassa urged Canada to keep its gates shut to Jewish immigrants."- Canadian Encyclopedia

How about James McGill. Shouldn't being a slave owner, preclude one from the honour of an eponymous street name?

I'm sure we can go down the list and find, that judged by today's standards, a great deal of our heroes, who's names adorn city street signs, would not pass muster.

Do we really need or want a 'Truth and Reconciliation' commission concerning street names.

I don't think so, but there are those still spoiling for a fight.

Gabrielle Dufour-Turcotte des Jeunes Patriotes du Québec has entered the fray with an online petition advocating the changing of the name of Amherst street. This thick-witted organization hasn't had an original thought since it's inception, but rises to action every time a good confrontation can be found.

The best comment on the controversy was made in a letter to the editor in the French language daily, Metro Montreal;

Change English street names? I am tired of this nonsense. It's University Street and not Université because it's adjacent to McGill University, which also goes for McGill College.

Eliminate the name of Jeffrey Amherst because he was a "scoundrel", according to Gabrielle Dufour-Turcotte des Jeunes Patriotes du Québec? Fine, if we also remove the name of anti-Semite Lionel Groulx from the metro station and the streets that bear his name.

Yes, it's ridiculous, like the endless desire of some of us to eradicate any evidence of the presence and history of the anglophone population of Montreal. Remember that we are not the enemy and that Montreal is ours too.

-John Ronald

A Reply To Those Anti-Canadian Health-Care Ads Playing on American TV

By now you've seen those frightening TV commercials describing patient disasters attributed to the Canadian health care system. It's awfully unfair (but highly effective) to highlight anecdotal disaster stories to shape public opinion. I have no doubt that if someone tried, it wouldn't be particularly difficult to come up with a similar TV advertising campaign depicting American health-care disaster stories that would be equally frightening.

Now the Canadian health care system is not running TV ads defending itself, as rivals would do in a political campaign. That's because it's no skin off our collective Canadian nose what Americans think of our health care. If Americans are dumb enough to fall for a fear campaign, so be it. Apparently Willie Horton type ads shouting "Boo-SOCIALISM!!" at viewers is all that it takes to get people off health care reform.
It seems that fear factor is as effective today as it was thirty years ago in the Dukakis/Bush advertising war.

If I was to run a rebuttal TV ad that promotes the benefits of Canadian style health care, by telling an anecdotal experience, it might go something like this;
By the way the story in my commercial is also 100% true, it concerns my mother's Canadian health-care experience that happened this very week.

My mom is 85 years old and lives alone in a condo in the west end of the city on Montreal. She is independent, lucid and in relatively good health. She still drives and is completely autonomous. About 10 years ago she had bypass heart surgery and has been monitored quite effectively by her GP and cardiologist.

Monday night at about 3 AM she awoke to a crushing pain in her chest. At first she put it off to a panic attack but finally realized that it was serious.

She dialed 9-1-1 (Yes, we have 911 service in Canada) and spoke with a dispatcher who tried to ascertain the problem.

"I'm not well and I need to go to the hospital, my chest hurts!"

"YES Ma'am! we'll be there within ten minutes.

The dispatcher was wrong, the 'state' run 'socialist' ambulance was there within five minutes. They checked her vital signs, gave her oxygen and placed her on a stretcher and tucked her into the ambulance. With lights flashing, they raced to the hospital and arrived there within another seven or eight minutes.
At the hospital an emergency team was waiting for her at the door. The ambulance drivers turned her over to the care of the hospital staff, wished her good luck and left.

COST FOR THE AMBULANCE- $0.00

She was instantly ushered into a cubicle in the emergency room where a team led by a staff doctor stabilized her heart (which was beating dangerously slowly.) She was administered various drugs and had a temporary pacemaker implanted in a vein in her leg.

COST FOR THE EMERGENCY ROOM TREATMENT- $0.00

She was sent up to the C.C.U (Coronary Care Unit) where she spent a couple of hours under excellent and dedicated care. In the morning she underwent a diagnostic angiogram test to determine if the heart-related arteries had any blockages. An hour later, a heart surgeon came by her bed and explained that the blockages were not serious enough to warrant bypass surgery, but told her that she did need to have a pacemaker implanted in her chest to regulate her heartbeat.

COST FOR THE ANGIOPLASTY- $0.00

COST FOR THE CONSULTATION- $0.00

The surgery was to take place that same day, probably at 12 noon, but the CCU nurse warned that since she was stable, the procedure could be pushed back in the case of an emergency. In the meantime she was given constant medical supervision and about 11:45 she was informed that the surgeon was involved in an emergency procedure and that her surgery would indeed be delayed---until 4:30PM.
At 4PM the nurses slid out the device that connected the diagnostic wires to a monitoring device and slid it into a portable unit, without disturbing my mother. A very nice and polite orderly wheeled her down to the elevator for the trip to the operating room accompanied by a CCU nurse who brought her into the operating room and handed her off.

I waited patiently for the procedure to be completed in the family room opposite the CCU where she was to be brought back after the surgery.
I used the complementary Internet and telephone to check my email and to keep in touch with family and tell them about the surgery.

COST FOR THE OPERATING ROOM- $0.00

COST FOR THE PACEMAKER- $0.00

COST FOR THE SURGEON- $0.00
COST SURGICAL TEAM- $0.00

COST OF DRUGS- $0.00

Sixty minutes later, my mom was delivered back to the CCU, the pacemaker safely implanted in her chest. She would stay in the CCU to be monitored until the doctors were satisfied that she was stable and that the pacemaker was functioning correctly. Fifteen minutes after she arrived a technician arrived with a portable X-ray machine to take a picture of the heart.

COST OF CHEST X-RAY- $0.00

In the morning I came by and found that my mother was doing well and was transferred out of the CCU and was resting in the Recovery room, again under excellent, although less intense care.
A doctor examined my mother and deemed her ready to be discharged. The nurses advised her that they would be forwarding her file back to her cardiologist.

TOTAL COST OF ALL TREATMENTS -$0.00

COST OF A NEW LEASE ON LIFE- PRICELESS!

Now as commercials go, it would be a beauty, but does it reflect reality?
Probably not, everything went too perfectly. In fact, I couldn't imagine any health care system in the world performing better. But I do believe that this story is a lot more representative of reality than the depictions that are shown in TV ads presented by the US health care industry.

How would the American health care system handle my mom?

• A whopping ambulance bill.
• A bunch of useless and unnecessary tests meant to ward off malpractice suits with the secondary benefit of driving up the bill.
• A recommendation to have bypass surgery, medically justified but completely unnecessary, all with the intent to maximize profits for the hospital and the surgeons.
• An extra long stay in hospital to 'insure' that the patient is fine. More useless tests and prescriptions.
  

But all this would happen only if my mother had good insurance or was rich.
If not, I wonder? What if she was one of the uninsured?

Should Canadian medicare be a model for the USA. Probably not.

There are a lot better systems being practiced in countries all over the world, but at any rate, it doesn't really matter.
Given the fierce fight and the massive amounts of money being spent to frighten and misinform Americans, there is no chance reform will happen.

Here in Canada we are looking to improve, let's hope we are are not as entrenched and invested with what we have, as our neighbours to the south are.

Can we change for the better? Hopefully.

After all, we did manage the roll over to the metric system.