Wednesday, March 05, 2008

Canada needs more doctors.

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12 comments:

jessica said...

Once I went to my doctor's to have stiches and then later removed. She told me that I could have just done it myself.
I felt really bad- like I was wasting her time or something.

So yes, we do need more doctors!!

jessica said...

have them removed*

Sorry. I normally do have good grammar.

comrade said...

The CMA is lobbying for a fund to "enhance the lives of healthcare providers"? Talk about self-serving.

Healthcare providers aren't exactly disadvantaged members of society here.

Vitum Medicinus said...

You say self-serving like it's a bad thing (I can tell from your tone of voice :) ). The CMA is a professional association. Professional associations exist in great part to increase the quality of the lives of their members - I'm happy to see the CMA is indeed fulfilling this objective.

However, the CMA is one of those rare professional associations that also looks to improve the lives of others, especially patients (ie. every Canadian). And by increasing the quality of lives of its members, the CMA is doing just that.

How? Well, first of all, I'd agree that physicians (but not all health care providers) are not financially disadvantaged...once they have been working for several years. But when you take into consideration work hours, benefits (none, for most family doctors), stress levels, workload, personal time, lack of resources, overhead, amount of responsibility, and government bureaucracy, they are indeed at a disadvantage compared to many other professions.

If you want to include all health-care workers, just ask any nurse who wants to work full-time, but has to work 3 part-time jobs instead (with no benefits) because no full-time positions are available, or who has to work night shifts until her seniority is in the millenia range.

Or ask a resident facing an average debt of $158,000.

That being said, while the CMA is indeed serving its physician members, a happy doctor makes for a happier patient.

Think of it this way. You are driving and are hit by a drunk driver, and taken to the nearest trauma centre. The first person who looks you over is likely a medical resident. Do you think they will provide you with better care if they are completely unstressed? Or would you prefer them to feel burdened by the stress of a massive debt that they can't afford to pay back (which is the case for many residents), overwork, little free time, and have all those things on their mind when they are treating your injuries?

I'd argue that by enhancing the lives of their members, the CMA is indeed self-serving...but that's a good thing, because ultimately, that will benefit the Canadian public.

comrade said...

First, let's agree that there are many structural issues at work in our healthcare system that the CMA has rightly identified as objects of criticism. The bureaucratic and regulative failings (i.e. the nurse with 3 part-time jobs, the poor scheduling of debt repayments for residents), however, aren't at issue here since I object solely to the CMA lobbying for a fund to improve the quality of life of healthcare professionals.

Clearly the CMA is indeed a professional association, but it's not "just" a professional association. It's a self-regulative body that's entrusted with a great deal of responsibility that would otherwise be taken up by a government institution. Further, it claims to represent the interests of patients. To lobby for self-serving ends is a betrayal of the trust that Canadians [rightly and necessarily] place in the medial community.

Now, it certainly seems plausible that enhancing the lives of CMA members will benefit the public, but the question is whether using government funds to do so would benefit the public more than any other use of those funds would. Public spending is all about tradeoffs. It's not enough to simply be worthy -- every program is funded at the expense of another worthy program. There's been no case made here as to why improving the quality of life for healthcare professionals should be prioritized over education, social programs, other medical funding, etc.

Finally, if it's indeed demonstrated that the most efficient use of public funds would in fact be such a healthcare providers fund, why should the public's concern be enhancing their "quality of life"? The chief concern is, in fact, the quality of care. If, for example, instead of enhancing the stressed resident's quality of life, we could achieve the same total efficiency improvement at half the cost by sending him to therapy, it seems only right to do so and invest the cost savings where needed elsewhere to improve the quality of life of people ever so much more in need of it than medical professionals.

Vitum Medicinus said...

"If, for example, instead of enhancing the stressed resident's quality of life, we could achieve the same total efficiency improvement at half the cost by sending him to therapy..."

Preventative medicine usually costs less and is much more effective than treating the ensuing problems. Should it even be ethically permissible to allow a condition to progress to the point of needing treatment, when it can be prevented in the first place?

Anonymous said...

Canadians have a common misconception that physicians are "rich". The truth is that there are many specialists and very experienced gp's that make a hefty salary. However, the majority of physicians make an average salary with very little benefits and a huge amount of responsibility. I don't think it's fair that some doctor's make as much as an electrition does. The doctor has to deal with very unhappy patients all day and occasionally all night. Canadians and people in general need to get their facts straight. WE ARE NOT ALL MAKING MILLIONS EACH YEAR! I know there'll be some smart ass commenting on my grammar but I don't care. I went through 9 years of post secondary to get where I am. I don't need to prove my intelligence by crossing my t's and dotting my i's. I love my job and I love helping people. But, it just sucks helping someone with a potentially fatal illness and instead of receiving gratitude we get the cold shoulder.

Also, to add to this argument, there are Canadian trained doctors leaving Canada everyday for a large increase in pay and benefits in the US. So I would argue that by improving the standard of living for physicians would help keep many such doctors who left this country and fled south. So to put this simply for the guy arguing against it. Increasing the standard of living would increase the amount of doctors staying in Canada. Which would in turn increase the amount of doctors IN Canada. Which would then increase the effectiveness of our health care system.

And by the way, your proposition of giving residents access to therapy is hysterical. That would be way less effective. It would be a complete waste of money. Instead of doing that why don't we scrap some things that are a drain on our economy and are completely useless like troops in Afghanistan. Or, how about we decrease the standard of living of government officials. We would free up plenty of money to fund many programs. I mean, the governor general and prime minister don't need to be eating thousand dollar meals and staying in thousand dollar hotel suites and flying first class everywhere. Why are the doctors are always considered the greedy ones?

comrade said...

First of all, I never proposed giving residents access to therapy. I stated that IF giving residents access to therapy would improve Canadian health care for a cost lower than that of improving the benefits of health care professionals, then that would be the more efficient use of our limited tax dollars.

I'm not saying that increasing the remuneration paid to doctors wouldn't prevent many from leaving for the US. I'm not saying that that wouldn't increase the effectiveness of our health care system. That all seems very likely. I have two concerns:

1. Doctors having a conflict of interest in lobbying for a increase in benefits under the guise of "improved care".

2 Even granting such an improvement in care (while maintaining that there's a problem if doctors are lobbying for it), the all important question is whether it's the most EFFICIENT means of improving health care. If an alternative measure (eg. therapy) could provide the same resulting improvement in health care at a lower cost, then that is clearly the better solution.

Also, please note that I never said anything about doctors making millions. My point was solely that doctors are not even close to being the most vulnerable or disadvantaged members of our society, so our tax dollars would be better spent elsewhere if improved health care can be more cheaply achieved.

comrade said...

And Vitum, your point on preventative medicine is well made (though it seems a tangent from the other questions here). Clearly our medical system has to do a much better job of preventative medicine, though at least we're not at the American level of emergcare.

As to whether it's ethical to allow a preventable condition to arise in the first place, I'd suggest that it would have to be on a case-by-case basis. Hypothetically, if preventing a certain disease had a cost of a million dollars and treating it had a cost of fifty cents, waiting to treat seems perfectly acceptable. If, however, we add the idea that the disease will cause extreme agonies of pain before it can be successfully treated for fifty cents, the idea of spending a million to prevent it becomes much more palatable. It's a balancing test: the severity of the ailment plus the costs of treatment must be weighed not only against the ailments of others, but also against the non-medical social ailments, solutions to which are ultimately funded from the same public pocket.

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