MicrobiologyMan Posted August 21, 2009 Report Share Posted August 21, 2009 http://www.cma.ca/index.cfm/ci_id/53559/la_id/1.htm Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 $150,000 before tax is somewhat above poverty level but if you have 3 or 4 kids, it does not go that far really Link to comment Share on other sites More sharing options...
ploughboy Posted August 21, 2009 Report Share Posted August 21, 2009 $150,000 before tax is somewhat above poverty level... You really do have a knack for understatement: Low income cut-offs, per StatsCan: http://www12.statcan.ca/english/census06/reference/dictionary/tables/table18-family20.htm Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 A single mother earning $65,000/yr with 2 kids is burdened with enormous debt, student loans, mortgage, car, home repairs, schooling for kids, she cannot get out from under it. Double the income, add a spouse and 2 kids, another car or two, add on some vacations, it ain't easy. To earn t hat kind of money, forget about private school for the kids, winter vacation, country cottage.....I am not talking about having food, shelter and clothing, I am talking about a basic lifestyle, we expect, I expect to maintain for myself and future family..and to be in FM where I need to devote min. tyime to my patients only b/c I am a mini-factory who requires a high turnover just to cover my expenses and then make a living for my family, leaving aside RRSP, the nes tax saving plan, the educational reserve, etc., I don't think so. I cannto afford to be in FM b/c I want to serve my patientsd and yet have a life outside of the office. Link to comment Share on other sites More sharing options...
bnface Posted August 21, 2009 Report Share Posted August 21, 2009 A single mother earning $65,000/yr with 2 kids is burdened with enormous debt, student loans, mortgage, car, home repairs, schooling for kids, she cannot get out from under it. Double the income, add a spouse and 2 kids, another car or two, add on some vacations, it ain't easy. To earn t hat kind of money, forget about private school for the kids, winter vacation, country cottage.....I am not talking about having food, shelter and clothing, I am talking about a basic lifestyle, we expect, I expect to maintain for myself and future family..and to be in FM where I need to devote min. tyime to my patients only b/c I am a mini-factory who requires a high turnover just to cover my expenses and then make a living for my family, leaving aside RRSP, the nes tax saving plan, the educational reserve, etc., I don't think so. I cannto afford to be in FM b/c I want to serve my patientsd and yet have a life outside of the office. ya, this will be the situation.....if you have *zero* financial management skills. the thing that always makes me laugh is looking around at my classmates and realizing how much they suck at managing their LOCs...i do fear for them Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 I have financial management skills, admittedly only as a student, but I manage to live effectively on air. The business aspects of the pracrice of medicine are extremely important. For example, if I were to go into FM, I would only go into a polyclinic with a group of doctors and perhaps no others in FM, so I build up my practice from patients of other doctors in my polyclinic. The building would be owned by us, so that while we are paying rent, we are increasing equity every month. And I would have my practice divided so I amalso building up a practice in another area, while renting out my office to a specialist who uses schedule is coordinated with mine. I understand. And I don't intend to enter the prwctice of medicine to enter poverty, although I would like to be able to afford to devote one mo. a year on international pro bono humanitarian medical work.So, yes we need to understand money, the business of the practice, have a good team of professionasls to assist us and also be smarter than our professionals so the tail does not wag the dog...and we able to give to our kids the education and lifestyle we want for them. Link to comment Share on other sites More sharing options...
ploughboy Posted August 21, 2009 Report Share Posted August 21, 2009 To earn t hat kind of money, forget about private school for the kids, winter vacation, country cottage.....I am not talking about having food, shelter and clothing, I am talking about a basic lifestyle I suspect we come from different backgrounds and assumptions. Don't want to start a fight, but I feel that private school, winter vacations and a cottage are very much over and above "basic lifestyle". Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 Well lerts explore this. I come from poverty, we arrived in Canada with zero money. And this lasted for a long, long time. We lived in apartments you would not go near. And I went to a private school, trilingual, I took private lessons in anotherr language, private piano lessons, ballet since a child.....all subsidized. I will give my children the same education I received on society but I will gladly pay for these privileges as you would see them as being. True, I never had winter vacations or a cottage and as physician I certainly will not live in the standard I was brought up, I will live much better and will deserve to. And if I make decisions about my practice that will effectively lead to relative poverty in terms of lifestyle, shame on me, I will deserve that exactly. My pagtients will receive what they deserve and so will I. I will not practice assembly line medicine, I will choose anareas where I can tresat my patients as they deserve and I with my family can live as we expect. If you think that is expecting too much, well, that is your opinion, not mine. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 Well said brooksbane. Doctors deserve what they get. I sure am not going to be one of them. I will find a way to achieve my goals in practice, humanitarian work, and lifestyle without compromise. It won't be easy but it is defiinitely doable, but not in FM at this time. They need leaders with our thought processes and greater experience. Glad to meet you. Amen. Say no to assembly line medicine. Illness is not a commodity with which to measure worth, as is the case now. Doctors are idiots. We don't know how much bargaining strength we wield. Instead, we fight amongst ourselves. Family docs whine about specialists making more, and specialists insult the skills of family docs. I say they should unite and demand that both sides get paid far more. Those who write the cheques would have no way out - they'd have to comply. Doctors are idiots. Link to comment Share on other sites More sharing options...
medordie Posted August 21, 2009 Report Share Posted August 21, 2009 Amen. Say no to assembly line medicine. Illness is not a commodity with which to measure worth, as is the case now. Doctors are idiots. We don't know how much bargaining strength we wield. Instead, we fight amongst ourselves. Family docs whine about specialists making more, and specialists insult the skills of family docs. I say they should unite and demand that both sides get paid far more. Those who write the cheques would have no way out - they'd have to comply. Doctors are idiots. I don't think the government will pay you more money to see less patients. Get paid far more? I'm all for it(!) but it seems tax dollars are limited so where will the money come from, who will it be taken away from, for docs to get it? Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 capitation Link to comment Share on other sites More sharing options...
medordie Posted August 21, 2009 Report Share Posted August 21, 2009 Not all docs in Canada are paid by fee for service these days. My understanding was that capitation was already being used in the Ontario family health team compensation models? It would still depend on how much you could get per patient, not just 'capitation'. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 correct, plus we get into patient load, ideally the patient makes a 'small' payment per visit that is set in accordance with what may be affordable for the poorest patient. I guess I am talking about seriously tinkering with the existing model for the benefit of all that has been explored by the powers that be. There has been an ongoing discussion on this topic in Private Clinics Discussion. Link to comment Share on other sites More sharing options...
medordie Posted August 21, 2009 Report Share Posted August 21, 2009 I've seen the private clinic discussion. Personally I disagree with the idea of co-payment as I don't think it will do much to improve the system or patients health, it will primarily benefit doctors. You yourself said a person making $65000 (which by the way is WELL above the Canadian average) can't get out from under the burden, so having to pay a copayment to a doctor already making triple that income for a visit is just not appropriate, IMO. Personally I don't want to practice assembly line medicine, but I like a fairly quick pace so seeing a large volume of patients doesn't bother me too much. That's also how some specialists make big money, high volume. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 I hear you. There are other models in other specialties. TeleRad or in PMR, having your clinic(s), having your PTs, doing Workmen's Comp also, in polyclinic(s) setting is an excellent business model for excellent medicine, with high fees. I cannot consider FM b/c I don't want to starve, lol, relatively speaking, but want to give my patients all time they really need. Meanwhile, step at a time, lol, I need to get into medicine. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 Family medicine is for "fools and angels" a family practioner just claimed on CNN in the US moments ago! She blamed med schools (in US anyhow) to a degree where the stu8dents are trained by specialists and the students are not exposed to doctors who are excited by primary care. She claimed FM is not valued in terms of money, the lowest paid and least valued, although the need is huge. She went on to point out that by valuing FM, the savings down the road are HUGE b/c if you trest the patients well at the start, you reduce the downstream consequences and ultimately save big bucks otherwise spent in the health care system. Link to comment Share on other sites More sharing options...
jdai Posted August 21, 2009 Report Share Posted August 21, 2009 Primary care is pretty important, yes. It's cheap to treat people at the primary care level, but much more expensive per person when their problem gets bad enough to need to go to a hospital. Not to mention that the person will be sicker at that point. Primary care is all about prevention afterall, and they always stress prevention over intervention at the med school. I thought the exposure to family med so far has been good. However, everyone in my class is aware that financially speaking, a family doctor is not as well compensated as other specialties, and despite what you believe, that is still an important factor to why people choose to specialize than be a family doc. As a future family doc, I'd like to see more government subsidization on overhead costs for family practice and clinics, or maybe more tax breaks. This helps entice more people wanting to go into family, without increasing how much they are relatively paid. Link to comment Share on other sites More sharing options...
A-Stark Posted August 21, 2009 Report Share Posted August 21, 2009 This is why doctors have to unite and form a union. Who else will the government employ to replace us? Nobody. We have far more bargaining power than we realize, but it will only work if we are unified. Eh? I believe we already have one. Link to comment Share on other sites More sharing options...
ploughboy Posted August 21, 2009 Report Share Posted August 21, 2009 Well lerts explore this...[deletia]...If you think that is expecting too much, well, that is your opinion, not mine. Not the response I expected, but given your background I'm more than a little puzzled at why you're maintaining that an individual with an income over twice that of the median income for a Canadian *family* is impoverished. The compensation of FPs vs specialists is a reasonable topic for discussion. However, crying that you're going to be poor if you go into family medicine is -- quite frankly -- an untenable position. Cheers, pb 1) median Canadian family income in 2006 was $70 400. http://www40.statcan.gc.ca/l01/cst01/famil106a-eng.htm Link to comment Share on other sites More sharing options...
A-Stark Posted August 21, 2009 Report Share Posted August 21, 2009 Family medicine is for "fools and angels" a family practioner just claimed on CNN in the US moments ago! She blamed med schools (in US anyhow) to a degree where the stu8dents are trained by specialists and the students are not exposed to doctors who are excited by primary care. She claimed FM is not valued in terms of money, the lowest paid and least valued, although the need is huge. She went on to point out that by valuing FM, the savings down the road are HUGE b/c if you trest the patients well at the start, you reduce the downstream consequences and ultimately save big bucks otherwise spent in the health care system. The US example is irrelevant here, not least because Canadian med students encounter lots of family docs early on - our family med interest group's events are quite popular at that. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 pb, I understand what you are saying, and i f I have to live on twice the median incoome for a Canadian family, I will and of course, won't starve, nor will my family. This is the worse case scenario but tenabler or untenable, I consider it as relative poverty, professional poverty perhaps to coin a phrase, and in my search for a productive and fulfilling professional and family life life, I have my goals, professionally, financially and with regard to family, and I will do my best to achieve them with the absolute minimum of conpromise or no compromise if possible. And as I see it now, FM is out for consideration as an option. unfortunately. Link to comment Share on other sites More sharing options...
A-Stark Posted August 21, 2009 Report Share Posted August 21, 2009 Well lerts explore this. I come from poverty, we arrived in Canada with zero money. And this lasted for a long, long time. We lived in apartments you would not go near. And I went to a private school, trilingual, I took private lessons in anotherr language, private piano lessons, ballet since a child.....all subsidized. I will give my children the same education I received on society but I will gladly pay for these privileges as you would see them as being. True, I never had winter vacations or a cottage and as physician I certainly will not live in the standard I was brought up, I will live much better and will deserve to. And if I make decisions about my practice that will effectively lead to relative poverty in terms of lifestyle, shame on me, I will deserve that exactly. My pagtients will receive what they deserve and so will I. I will not practice assembly line medicine, I will choose anareas where I can tresat my patients as they deserve and I with my family can live as we expect. If you think that is expecting too much, well, that is your opinion, not mine. Relative poverty? What BS. I didn't go to a private school, never had a cottage, and winter vacations meant driving to Ottawa for Christmas. And I come from a physician family. By any relative measure, all full-time physicians are in the top 1% of income earners in Canada. Link to comment Share on other sites More sharing options...
future_doc Posted August 21, 2009 Report Share Posted August 21, 2009 The US example is irrelevant here, not least because Canadian med students encounter lots of family docs early on - our family med interest group's events are quite popular at that. That is a breath of fresh air to receive. Now how do we increase their income while allowing them to take the time the consider necessary to devote to their patients? Welcome back to Canada. Link to comment Share on other sites More sharing options...
A-Stark Posted August 21, 2009 Report Share Posted August 21, 2009 And how effective have they been? Considering that the provincial associations directly negotiate fee schedules with provincial governments, I'd say they're fulfilling their function properly. Doctors' strikes tend not to be very successful, though. Link to comment Share on other sites More sharing options...
bnface Posted August 21, 2009 Report Share Posted August 21, 2009 Considering that the provincial associations directly negotiate fee schedules with provincial governments, I'd say they're fulfilling their function properly. Doctors' strikes tend not to be very successful, though. a doctors strike is the stupidest thing that one could do. all public respect, confidence, and backing would be lost. Link to comment Share on other sites More sharing options...
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