Cuts, Despair & Opportunity

Students must understand delayed gratification to succeed in school.

The best students go without food and rest.

They dream of ways to work longer and harder.

Top students use simple math: suffering now equals reward later.

Delayed gratification animates doctors. In some ways, it founds the core of our being.

Delayed gratification presupposes hope of tangible success: meaningful work, autonomy and respect, in a dependable career.

Cuts, Cuts and More Cuts

The early 2000s brought raises for doctors: pay back for a decade of ‘social contract’ cuts through the 1990s. Doctors’ incomes finally caught up with their inflation-adjusted incomes from the ‘90s around 2012.

Politicians called the catch up a gravy train. So they cut fees in: Continue reading “Cuts, Despair & Opportunity”

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Healthcare Crisis – Video

We cannot drain an abscess before we believe it exists. No one argues that Canada has the best healthcare system in the world anymore. At least no one who pays attention.

I want to hear what you think about the short video below.

In it, I look at our healthcare crisis through waits, patient leaving Canada for care and bureaucratic load. I offer solutions at the end.

Thanks for watching!

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Human Cost of Wait Times

Cool heads make hard choices for the greater good, in war. Innocent people die. Others survive. War is utilitarianism writ large.

Healthcare experts often sound like military.

“As for urgent patients in pain, the public system will decide when their pain requires care. These are societal decisions. The individual is not able to decide rationally.” So said a past VP Medicine from BC.

Here’s a personal story from someone in pain, shared with permission. Continue reading “Human Cost of Wait Times”

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Manage Doctors for Patient Benefit

knead-breadParents can try to control everything their children do, or let them run completely wild. Neither extreme works well.

Politicians can try to control everything in medicine, or let doctors run wild.

Just like parents, politicians tend towards one extreme or another. If we listen closely, most pundits assume doctors should be controlled.

How to Manage Doctors

I spend hours listening to healthcare opinionists: politicians, candidates running for office, administrators, consultants, bureaucrats, journalists, talk show hosts and concerned citizens. They all have different ideas on how to manage doctors. But none of them questions the need for management. Continue reading “Manage Doctors for Patient Benefit”

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How to Influence Council

influence councilLaugh tracks win debates.

Political talk shows, like Bill Maher’s, rely on cheers from the audience to boost the host’s views.

Applause directs viewers what to think. No one wants scorn for being out of line with what Bill Maher thinks.

Groups of doctors are no different. We think that we are thoughtful and deliberate, but applause changes doctors’ opinions, just like everyone else.

Influence Council

Almost 300 doctors will take a biannual pilgrimage to a giant basement in Toronto for the Ontario Medical Association Council meeting this weekend. Council delegates will consume tables of carbs and coffee listening to the OMA Board Report and other issues.

Delegates must sift hours of noise for buried scandals. Big issues can slip by in seconds. When delegates find something, they need to speak up. They need to convince the basement mob to think differently. Continue reading “How to Influence Council”

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Are Doctors Trapped in Their Careers?

New AdventureDread lies beyond fear and hopelessness. When we see only the certainty of something worse, we sink into a malaise and dread impossible to shake.

Country singers sell songs about heartache and loss, but no one likes songs of foreboding or panic.

Doctors in Ontario need a reason to hope again. They feel desperate. They have been attacked and slandered by government for the last 5 years. Draconian legislation threatens professional autonomy with Bill 41 (nee Bill 210). Docs feel abandoned and do not know who to trust. A malaise rests on doctors as dark as the 1990’s social contract years.

Reason to Hope

Doctors might appear to have it all. Doctors were born with an ability to endure gruelling education, and they get to help people for a living. Doctors never starve to death; only a few go bankrupt. But happiness requires more than a job, good food and a decent car. Continue reading “Are Doctors Trapped in Their Careers?”

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Dangers of an Executive Committee

Executive CommitteeIndiana Jones and the Last Crusade pivots around Indiana Jones’ relationship with his father.

During the first half of the movie, Indiana treats his dad with a mix of frustration and programmed obedience.

At one point, Indie sits with his dad and asks why they never talked.

Indie says that his dad taught him that he was less important than people who had been dead for 500 years. His dad insists that he was a great father: He gave his son independence.

The conversation heats up, and Indie’s dad finally closes his book. He leans back and says,

Okay, I’m here. What do you wanna talk about?

He stares at Indie: see the picture above.

Indie is at a loss for words. I….I don’t know, he says.

His dad says, Well alright then. We’ve got work to do!

Indie drops the topic, his dad stays convinced that he was a good father, and the movie continues.

Board & Executive Committee

We find Boards everywhere: hospitals, banks, medical associations and athletic clubs. Not all groups have Boards, but we all belong to groups governed by Boards. If we want our groups to perform well, we need to know a bit about the Boards that run them. Continue reading “Dangers of an Executive Committee”

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Doctors Need a Champion

superhero-kidMost people are too polite to tell you what they think. Even when it feels like someone was courageously honest, they still held back their strongest opinions.

This week, several dozen doctors met just west of Toronto to tell the OMA what they thought. It was one of many meetings booked across the province. Dr. Virginia Walley, OMA President, handled the questions and feedback.

Most docs pulled their punches and were polite. Even so, they offered bitter medicine. Continue reading “Doctors Need a Champion”

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