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Physician political orientation

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1 hour ago, adhominem said:

Yes, many young MD applicants are likely to be liberal. On top of that, there is no denying that academics (i.e. those who run medical schools and admissions committees) are far more left-leaning than the general public. The massive liberal bias within academia is well documented in several countries. I am quite convinced these circumstances lead to a selection bias for incoming students, though I am not aware of whether or not it has been documented. It is hard to imagine that a conservative influenced answer would be looked upon favorably by interviewers chosen by liberals when majority of the candidates are going to be delivering a more liberal answer. 

That might be true only if you think there are "liberal" or "conservative" answers. Not everything fits some a priori ideological lens. Now of course if we're talking about things like abstinence-only policies or being against harm reduction, then perhaps you're right. 

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Oh yes, because an intelligent voter clearly would not have voted conservative... This sort of comment proves my point about liberal bias.

We're talking about Doug Ford here. He's a proven liar who never accomplished much of anything in public office, has "succeeded" only by inheriting a business (of questionable current health), and was the enabler in chief of his late brother's alcoholism, drug use, consorting with gangs, and general nastiness. He's not someone that's ever taken responsibility for much of anything and is more inclined to promise the moon but offer no way to pay for it. 

Anyway the last time the PCs were in power in Ontario they sold off a toll highway for basically nothing, made a mess of electricity regulation, and cut inspectors and basic infrastructure resulting in NOT building any subways and people dying from contaminated water in Walkerton. I am delighted to see the end of an increasingly tired and self-involved Liberal government, and equally delighted not to live in Ontario. 

Edit: Doug Ford is also evidently pro-vaping so that makes him a tool. 

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2 hours ago, A-Stark said:

That might be true only if you think there are "liberal" or "conservative" answers. Not everything fits some a priori ideological lens. Now of course if we're talking about things like abstinence-only policies or being against harm reduction, then perhaps you're right. 

We're talking about Doug Ford here. He's a proven liar who never accomplished much of anything in public office, has "succeeded" only by inheriting a business (of questionable current health), and was the enabler in chief of his late brother's alcoholism, drug use, consorting with gangs, and general nastiness. He's not someone that's ever taken responsibility for much of anything and is more inclined to promise the moon but offer no way to pay for it. 

Anyway the last time the PCs were in power in Ontario they sold off a toll highway for basically nothing, made a mess of electricity regulation, and cut inspectors and basic infrastructure resulting in NOT building any subways and people dying from contaminated water in Walkerton. I am delighted to see the end of an increasingly tired and self-involved Liberal government, and equally delighted not to live in Ontario. 

Edit: Doug Ford is also evidently pro-vaping so that makes him a tool. 

You realize the PCs are doing an amazing job so far right? You have to be mega biased to even suggest they've been average. In fact, I would have given Ford a disapproval rating despite voting PC and give him a strong approval right now. Ohip+? Freezing public sector admin wages? Hiring freeze? Calling Drs to come negotiate asap to repair the harms done from Wynne? And there's still more.. they're doing a fantastic job.

Also Ford is one guy, the PC cabinet is another. Literally any single cabinet minister right now has more talent than the whole NDP party did combined. And you have to let go of the Mike Harris thing dude... it was so long ago. Other PC govs have been way more fair to doctors across Canada. Harper was more fair to Drs than Trudeau has been. And that's why a majority of doctors voted for PC. 

 

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14 minutes ago, medigeek said:

You realize the PCs are doing an amazing job so far right? You have to be mega biased to even suggest they've been average. In fact, I would have given Ford a disapproval rating despite voting PC and give him a strong approval right now. Ohip+? Freezing public sector admin wages? Hiring freeze? Calling Drs to come negotiate asap to repair the harms done from Wynne? And there's still more.. they're doing a fantastic job.

Also Ford is one guy, the PC cabinet is another. Literally any single cabinet minister right now has more talent than the whole NDP party did combined. And you have to let go of the Mike Harris thing dude... it was so long ago. Other PC govs have been way more fair to doctors across Canada. Harper was more fair to Drs than Trudeau has been. And that's why a majority of doctors voted for PC. 

 

In what way has Harper been more fair to doctors than Trudeau? Salary wise?

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4 minutes ago, brady23 said:

In what way has Harper been more fair to doctors than Trudeau? Salary wise?

There are federal healthcare transfers. Trudeau cut down the rate of increase that Harper established. 

Then of course there's the tax nonsense which is a whole other story.

 

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11 minutes ago, medigeek said:

There are federal healthcare transfers. Trudeau cut down the rate of increase that Harper established. 

Then of course there's the tax nonsense which is a whole other story.

 

Yes, I've heard about that!

Are physician taxes also higher with Trudeau? (I know there have been limitations imposed on incorporation, income splitting, and ability to join FHTs for new FM grads), but are there any other issues?

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2 minutes ago, brady23 said:

Yes, I've heard about that!

Are physician taxes also higher with Trudeau? (I know there have been limitations imposed on incorporation, income splitting, and ability to join FHTs for new FM grads), but are there any other issues?

Income tax is higher. Income splitting has gotten harder among other corp benefits Drs have had - and this has been by far the most damaging. The FHT/FHO thing was done by the Wynne liberals so hopefully it's something the Ford gov rolls back (assuming the OMA makes a solid proposal for it).

Left leaning governments simply don't want doctors to make more money and view it as immoral. The more left you go, the more they hate success. 

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3 minutes ago, medigeek said:

Income tax is higher. Income splitting has gotten harder among other corp benefits Drs have had - and this has been by far the most damaging. The FHT/FHO thing was done by the Wynne liberals so hopefully it's something the Ford gov rolls back (assuming the OMA makes a solid proposal for it).

Left leaning governments simply don't want doctors to make more money and view it as immoral. The more left you go, the more they hate success. 

Thank you! I definitely respect a lot of Liberal policy, but not when it means taking almost half of physician pay and not finding alternate ways to recoup this money that can support the social programs Liberals support (i.e. Hydro One employees don't need to be making 500k+, and if they want to keep it limited to physicians, they shouldn't be targeting FM specifically when you have professions that benefit from technology advancements like ophthalmology who can do 20 cataract surgeries and bill 2x as regular doctors in the same time)

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1 minute ago, brady23 said:

Thank you! I definitely respect a lot of Liberal policy, but not when it means taking almost half of physician pay and not finding alternate ways to recoup this money that can support the social programs Liberals support.

Generally speaking, Liberal social policy is good. But yeah they have zero respect for doctors and many of them are either not pro-business or worse.. they're anti business (which the entire NDP party is). 

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As someone recently in medical training and on the conservative side, it may seem like a lot of people are left leaning.  Myself, I remember having to parrot leftist dogma to blend in and not rock the boat during small group sessions in PBL and especially the sessions on "social determinants of health".   To say anything else would make you seem like a bigoted dinosaur.

 

Once you are out in practice however, you will find a lot more people on the conservative bent.

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8 hours ago, regular said:

As someone recently in medical training and on the conservative side, it may seem like a lot of people are left leaning.  Myself, I remember having to parrot leftist dogma to blend in and not rock the boat during small group sessions in PBL and especially the sessions on "social determinants of health".   To say anything else would make you seem like a bigoted dinosaur.

 

Once you are out in practice however, you will find a lot more people on the conservative bent.

I’m curious how one can be on the “conservative side” when it comes to SDH, please elaborate.

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One example would be something like the general teaching of addictions as being completely a disease and nothing to do with the individual's life choices etc.  To disagree even slightly in class would likely have you shamed and ostracized right away.  In a way, some of these issues were presented similar to climate science where you have to agree completely or you're labelled a denier.

Another example would in relation to topics regarding women's health and abortion.  I am totally prochoice on this issue but a couple of my Catholic friends felt judged and patronized for their assumed beliefs on this subject during small group PBL sessions.

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Well I mean life choices only go so far when it’s addiction, and it’s too easy a cop out I think to blame it all on that. What led them to make those choices? Lots of people in medicine come from privledged backgrounds and can’t relate to patients and their issues and therein lies the main issue. I’d say half of my elementary school class was low income, their friends were bad infiences, their parents didn’t really care to parent them on good behaviour because they themselves did the same, and then the cycle continues, including drugs. Those are a lot of factors to go up against to all of a sudden to be the first to change when growing up as a kid to tennager years with no good role model. I think we should be able to be open on some issues though and be able to discuss without feeling ostracized from friends as you say. But at the end of the day, we’re supposed to be helping the person overcome their problem. Empathy is the main key I think, and once we start losing that, that’s when the more conservative side tends to come out. That’s why I like the MMI, it teaches you to consider all the aspects, and have a more balanced approach, not just one side or the other.

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On 7/4/2018 at 2:39 AM, medigeek said:

There are truck loads of them in literally every single field. I'm not saying literally "do nothing" but that they certainly do not earn their 6 figures.

Don't you think this applies to physicians too then? If the physician is claiming competitive compensation based on the current market, shouldn't the Hydro One exec be able to claim equivalent compensation to his peers in the private sector?

I've worked in biomedical research in the public sector (academia). I definitely think most profs/PIs definitely earn their pay. Especially considering what they have to get through in order to get a position : increasingly long PhD and post-doc (more often post-docs) with no guarantee of a position down the road. No truck load of slackers in this sector : it's publish or perish, with a large majority in the latter category.

I agree with you that an efficient public sector should be a priority and that some salaries are excessive. On the other hand, indiscriminate cutbacks create a culture where people are overworked and the means to provide adequate services are lacking. This then heightens the perception that government is inefficient (and that people are not doing their jobs or are lazy/overpaid). If you're of a cynical bent, you might even argue that conservatives enact these indiscriminate cutbacks because they know this plays into their hands all too well...

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5 hours ago, IMislove said:

Well I mean life choices only go so far when it’s addiction, and it’s too easy a cop out I think to blame it all on that. What led them to make those choices? Lots of people in medicine come from privledged backgrounds and can’t relate to patients and their issues and therein lies the main issue. I’d say half of my elementary school class was low income, their friends were bad infiences, their parents didn’t really care to parent them on good behaviour because they themselves did the same, and then the cycle continues, including drugs. Those are a lot of factors to go up against to all of a sudden to be the first to change when growing up as a kid to tennager years with no good role model. I think we should be able to be open on some issues though and be able to discuss without feeling ostracized from friends as you say. But at the end of the day, we’re supposed to be helping the person overcome their problem. Empathy is the main key I think, and once we start losing that, that’s when the more conservative side tends to come out. That’s why I like the MMI, it teaches you to consider all the aspects, and have a more balanced approach, not just one side or the other.

Well.. there's a very big difference between the guy who has no fun in life aside from smoking weed, snorting coke here and there or using the less harmful opiates vs the guy shooting up with dirty needles from the alley. I mean the difference is pretty simple. The former you feel bad for as should any reasonable person. He's developed a disease that wasn't entirely his fault, and really... even if it was, so what? The latter however keeps presenting with a giant mrsa abscess, endocarditis and his nice HIV/hepC package. He then leaves AMA from the ICU to shoot up only to be brought back in on an OD. Do you really feel bad for him? 

1 hour ago, TheSalmonMousse said:

Don't you think this applies to physicians too then? If the physician is claiming competitive compensation based on the current market, shouldn't the Hydro One exec be able to claim equivalent compensation to his peers in the private sector?

I've worked in biomedical research in the public sector (academia). I definitely think most profs/PIs definitely earn their pay. Especially considering what they have to get through in order to get a position : increasingly long PhD and post-doc (more often post-docs) with no guarantee of a position down the road. No truck load of slackers in this sector : it's publish or perish, with a large majority in the latter category.

I agree with you that an efficient public sector should be a priority and that some salaries are excessive. On the other hand, indiscriminate cutbacks create a culture where people are overworked and the means to provide adequate services are lacking. This then heightens the perception that government is inefficient (and that people are not doing their jobs or are lazy/overpaid). If you're of a cynical bent, you might even argue that conservatives enact these indiscriminate cutbacks because they know this plays into their hands all too well...

Well physicians bill a relatively small rate for their service compared to other professionals. It just so happens they can do a high volume in a day's worth of work. Not sure how you can reasonably compare that to other professions. 

PhDs also decide their own fate when they pursue a path with little financial reward. Also, it's really the nature of their field. But in the end, they don't accumulate med school loans either and make money TAing through grad school and as post docs. Not to mention failure to publish =/= loss of human life, unlike medical errors. 

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6 hours ago, regular said:

One example would be something like the general teaching of addictions as being completely a disease and nothing to do with the individual's life choices etc.  To disagree even slightly in class would likely have you shamed and ostracized right away.  In a way, some of these issues were presented similar to climate science where you have to agree completely or you're labelled a denier.

Another example would in relation to topics regarding women's health and abortion.  I am totally prochoice on this issue but a couple of my Catholic friends felt judged and patronized for their assumed beliefs on this subject during small group PBL sessions.

You are so brave, brother. MAGA!!

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33 minutes ago, medigeek said:

Well.. there's a very big difference between the guy who has no fun in life aside from smoking weed, snorting coke here and there or using the less harmful opiates vs the guy shooting up with dirty needles from the alley. I mean the difference is pretty simple. The former you feel bad for as should any reasonable person. He's developed a disease that wasn't entirely his fault, and really... even if it was, so what? The latter however keeps presenting with a giant mrsa abscess, endocarditis and his nice HIV/hepC package. He then leaves AMA from the ICU to shoot up only to be brought back in on an OD. Do you really feel bad for him? 

Well physicians bill a relatively small rate for their service compared to other professionals. It just so happens they can do a high volume in a day's worth of work. Not sure how you can reasonably compare that to other professions. 

PhDs also decide their own fate when they pursue a path with little financial reward. Also, it's really the nature of their field. But in the end, they don't accumulate med school loans either and make money TAing through grad school and as post docs. Not to mention failure to publish =/= loss of human life, unlike medical errors. 

Actually no the first example could lead to the second, hence not a difference just an evolution of their problem. They don’t have to be mutually exclusive. And again what happened to lead the coke head to do that, hence addiction, not realy a choice at that point either. Hence the empathy part and hopefully it doesn’t degrade, but then there is the all mighty compassion fatigue. People should know that medicine entails these things, I know my previous jobs have had times you wanna baby your head against the wall, but then eventually with enough perseverance you can see change. Too bad most people going into medicine that is their first real adult job, Hence seeing things not workout isn’t just exclusive to medicine.

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1 hour ago, medigeek said:

Well physicians bill a relatively small rate for their service compared to other professionals. It just so happens they can do a high volume in a day's worth of work. Not sure how you can reasonably compare that to other professions.

I don't see why you couldn't compare, unless you're implying physicians are just more efficient than others...? $/act is just an alternative way of determining compensation ; if a bricklayer charged per brick layed he'd also be doing a high volume of acts in a day's work.

In the end, wouldn't you agree that the market determines compensation, whether it's $/act or salary?

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1 hour ago, IMislove said:

Actually no the first example could lead to the second, hence not a difference just an evolution of their problem. They don’t have to be mutually exclusive. And again what happened to lead the coke head to do that, hence addiction, not realy a choice at that point either. Hence the empathy part and hopefully it doesn’t degrade, but then there is the all mighty compassion fatigue. People should know that medicine entails these things, I know my previous jobs have had times you wanna baby your head against the wall, but then eventually with enough perseverance you can see change. Too bad most people going into medicine that is their first real adult job, Hence seeing things not workout isn’t just exclusive to medicine.

They don't have to mutually exclusive but most drug users also don't end up shooting dirty needles repeatedly :) So clearly there is a distinction and one person makes the choice to do so whereas the other abstains. 

You're taking the black and white approach. Where everyone's either good or bad. All drugs are either good or bad. And there's no case by case. 

10 minutes ago, TheSalmonMousse said:

I don't see why you couldn't compare, unless you're implying physicians are just more efficient than others...? $/act is just an alternative way of determining compensation ; if a bricklayer charged per brick layed he'd also be doing a high volume of acts in a day's work.

In the end, wouldn't you agree that the market determines compensation, whether it's $/act or salary?

Well the closer you go to a free market, the more physician services are compensated (USA) grossly. It just so happens the middleman is so big there that overhead is simply too high. This has made doctors increasingly into employees and soon all their doctors will make less than Canadian ones if we're looking at post-overhead income. 

But yes I know what you're saying and I more or less agree. 

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Uhh you mean you’re taking the black and white approach lol? I was arguing against that exact approach. You can most definitely look at it case by case. In terms of dirty needles I guess it could come down to : income, desperation, again bad habits from growing up, so many different reasons to get to where they are. I’d say it can be a lack of choice really, in some cases, not all, but some. 

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38 minutes ago, medigeek said:

Well the closer you go to a free market, the more physician services are compensated (USA) grossly. It just so happens the middleman is so big there that overhead is simply too high. This has made doctors increasingly into employees and soon all their doctors will make less than Canadian ones if we're looking at post-overhead income. 

But yes I know what you're saying and I more or less agree. 

Right, except it isn't exactly a free market in the US if supply (of doctors) is artificially limited by the state, essentially by limiting the number of spots in residency and blocking the opening of new medical schools. So a proper free market should drive physicians' wages down if it weren't for state intervention and lobbying by the AMA. At lest that's the Milton Friedman argument, which I think makes a lot of sense.

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