Make it easier for doctors to practise here
A recent letter about investing outside Canada to get new doctors struck a loud chord with me.
My daughter is a physician practising in the United States, having gone to medical school outside of Canada due to limited placements in B.C., and subsequently completing a fellowship in Boston.
As a parent, I had hopes that despite the physician shortage in many disciplines, my daughter could find an avenue to practise in B.C.
Through my work within the Lower Mainland health authorities, I was acutely aware of the recruitment difficulties to fill physician vacancies. In this context I had a discussion with a physician-recruitment group to learn about existing recruitment practices.
It seemed that efforts were focused on job fairs where health agencies across Canada competed against each other for physicians. I also learned that for a B.C. graduate of a foreign medical program to practise in B.C. they would have to find a physician mentor at a B.C. hospital for a year with the graduate receiving no income.
Since most medical students accumulate substantial student loans that need payback after graduation, this is an untenable situation. I discussed potential opportunities for B.C. health authorities to form strategic alliances with medical programs outside Canada to create a pathway for B.C. and Canadian medical students to practise in B.C.
I suggested that health authorities had several opportunities to train our homegrown students in a Canadian medical environment, starting with hospital rotations in third and fourth years of medical school and also during residency years.
I also suggested that through such strategic relationships, health authorities could address quality concerns, often cited for foreign-trained physicians, but additionally allow them to influence these medical students to pursue training in areas of projected physician shortages.
And the bonus would be that Canadian medical students at foreign programs pay completely for their education as their programs are not subsidized by the B.C. or Canadian taxpayer, as are Canadian programs.
Importantly, B.C. medical students have family in B.C. communities that can help mitigate the high living costs that make it unaffordable for physicians to locate here. It has been 12 years since my discussion, and it seems like 12 lost years. How many more will it take?
John Little
Victoria
Private-public partnership needed
As a patient intervenor in the Cambie case, I was disappointed in Friday’s decision by the B.C. Court of Appeal to keep the door shut on private health care.
That, regardless of the fact that we already have private health care.
It was not a surprise in a province where ideology trumps common sense.
And it’s not a surprise that this critical issue is going to the Supreme Court of Canada and before the Canadian people.
A national conversation, with focus and deadline, about the role of private health care is long overdue.
This is what I would ask you to consider with an open mind: private health care is not black or white, as the debate is framed today.
A national conversation leading up to the Supreme Court’s ultimate decision needs to focus on a public-private partnership.
A partnership where the handshake works together to create, or in this case to reform, a badly broken system. The current polarized debate is not useful.
Indeed, a public-private approach is not the panacea to fix the health-care crisis in Canada, but along with other ideas, we’d be moving in the right direction.
This is not something new. There are European countries that already have a dual system that works together with insurance plans, where people are not left out.
We can’t keep doing the same thing year after year and expect different results. We deserve better health care.
Bill Currie
Victoria
Be careful with rush to privatization
The deluge of pro-privatized medical care opinions on the editorial (coincidentally right after the courts rejected it) is expected but delusional.
In recent decades the privatization of long-term care and the race to the bottom for staffing costs, caregivers and four-person rooms was similar. We have seen the result recently.
Be careful what you wish for.
Max Miller
Saanich
Where is logic in fighting private health care?
Re: “Court rejects private care; surgeon says solutions must be found to long waits,” July 16.
This decision wades deeply into legal hair-splitting. Let’s bring the issue back to some simple practicalities.
It seems that in Canada it’s fine to have a private health-care system working alongside public care for: eye health (optometrists); dental health (dentists); musculoskeletal health (physiotherapists, chiropractors, massage therapists); mental/emotional health (counsellors); hearing health (audiologists); nutritional health (dietitians); foot health (podiatrists); skin health (cosmetologists) — and no doubt other areas.
But any suggestion of a dual private/public care system for anything else health-related — such as surgery — is out of the question. Where is the logic in this?
And just to turn the focus in a slightly different direction, it seems most British Columbians have no issues with a dual public/private education system working alongside each other that often involves a subsidy to the private system.
Yet the idea of considering that a similar model might successfully be applied to health care, even without any subsidy to the private side, is almost heresy. Again, where is the logic in this?
Anne Heel
Saanich
Two-tier medical system can cause financial woe
Just for the record: The largest single cause of bankruptcy in the United States is medical-related, according to MSNBC.
Let’s not rush into a two-tier system.
Ray Maddocks
Sidney
Change the system, do not replace it
Re: “Fix health care with a dual private system,” letter, July 16.
I have to suppose that there is an unknown number of doctors lurking in the shadows ready to come into private practice, or that there is something in the present system that prevents doctors performing all the services that they could.
As for the latter, doctors have long been complaining that the built-in bureaucracy takes time away from their actually practising. Why are they not heeded?
But if the number of doctors is finite and there is not a hidden number of surgeons, etc. ready to act if allowed to practise privately, then, it is must be true that doctors from the present finite group serving those that can afford to pay for their services will indeed reduce the waiting list and those waiting will move up in the line, but what will be the advantage as there will be fewer doctors to treat them (their numbers being reduced by those working privately, whether full- or part-time)?
Given that England, one of the countries with a public/private system, is suffering from both a doctor shortage and unacceptable wait times just as Canada is — some cases are sent by the NHS over to France for treatment — would it not be better to listen to the suggested solutions of our doctors and medical practitioners themselves?
From what I have read and heard, it would be better to restructure the system in the way that medical practitioners themselves have been urging rather than throwing money into a system that, if not already wrecked, is certainly sinking.
Has the medical health system in Canada become so cumbersome that change is impossible?
William Thompson
Victoria
See if retired MDs will return
One possible solution to the current shortage of family doctors might be to entice doctors back to work that prematurely retired due to the pandemic.
Most doctors, myself included, enjoy doctoring. Less enjoyable is all the hassle of running a small business — staffing, rent, administration, etc.
If the government provided staff and facilities, perhaps in a portion of the urgent care centres, some retired doctors might be tempted to return to part-time salaried employment.
I was a general practitioner for the first 15 years of my career, subsequently I specialized in dermatology, with clinics in Victoria and Nanaimo.
March 2020 was an interesting month for me. I turned 65. The pandemic arrived. I “burnt out.” In consequence I had to sell and close both my Victoria and Nanaimo clinics at short notice.
Now, after a two-year break, I am opening a new dermatology clinic in the Stadacona Centre on Fort Street.
It is incredibly difficult. Staffing and supply-chain issues frustrate every step. However, needs must, as I have two offspring with five years to do at university.
As a dermatologist, I prefer to run my own clinic. But if a family doctor retired prematurely, I might be tempted to take a part-time salaried post, if the government provided adequate staff and facilities.
Dr. Julian A. Hancock, FRCPC Dermatology
DrSkinlaser.com
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