working conditions of ontario doctors

[Rock*]

Putting even paramedics and medical assistants in as filters before seeing a doctor can do marvels in increasing the amount of pts. A doctor sees. In the US, physician assistants can be licensed to do minor surgeries and prescribe medications for about 86-100k/year, which makes regular family visits cheaper and more accessible. Honestly, during the flu season 2/3rds of the patients who visit a GP either have a cold, a flu, or strep throat. Most of these people can be treated with the ol' "take an aspirin and call me in the morning" treatment while the strep throat pts can get a throat swab to be sent in for testing and a prescription for some penicillin. It hardly takes more than 7 years of medical training to do these things. For anything more difficult, the physician's assistant or medical assistant can just push the case up to the doctor (who is on site to supervise and handle the other cases).

[quickdraw_mcgraw]

I would tend to disagree about the duties of PA's performing minor surgeries. The only state that I could find minor surgery specifically listed as scope of practice for a PA was Arizona.

 

But then think about it, a PA is a senior medical student who gets paid. H&P's, write orders, do little procedures. All without much knowledge or responsibility.

[Alastriss]

It's not at all clear to me that this is a good thing. Who wasn't going to the doctor? Does this average reflect that a subpopulation just stopped getting health care entirely? Were people waiting until their illnesses became much more severe (and costly to treat) before visiting the doctor?

 

It seems to me that the number of people who are frivolously visiting their doctors for fun is not all that large and unlikely to be a major public health problem! I get that there are some weird people out there such as the anecdotes in this thread, but most people just don't consider visiting the doctor to be all that enjoyable, no? And a ten-minute doctor's appointment just isn't that expensive in the context of the healthcare system, is it?

 

 

If you don't have a fee, then you have another barrier and that is the severe wait time. Im from Ontario and I can tell you at the hospital I volunteer that for certain times in the day there was 1 doctor for 27 patients. I talked to patients who had to wait for hours until they saw a nurse who would tell them the doctor would arrive shortly. THere are a lot of people who are like F it, im going home and just don't wait at all just because they don't feel that the condition is that severe.

dropping a socioeconomic barrier such as fee may begin to be more friendly to families with below average incomes but all that its going to do is introduce another barrier imo

[Rock*]

I would tend to disagree about the duties of PA's performing minor surgeries. The only state that I could find minor surgery specifically listed as scope of practice for a PA was Arizona.

 

But then think about it, a PA is a senior medical student who gets paid. H&P's, write orders, do little procedures. All without much knowledge or responsibility.

You're mistaken. Physician's Assistants are actual careers. People enter them by doing a master's in PA

[Rock*]

wikipedia reference.

 

Check out the first sentence "Physician Assistants (PAs) are non-physician clinicians licensed to practice medicine with a physician's supervision"

[Rock*]

If you don't have a fee, then you have another barrier and that is the severe wait time. Im from Ontario and I can tell you at the hospital I volunteer that for certain times in the day there was 1 doctor for 27 patients. I talked to patients who had to wait for hours until they saw a nurse who would tell them the doctor would arrive shortly. THere are a lot of people who are like F it, im going home and just don't wait at all just because they don't feel that the condition is that severe.

dropping a socioeconomic barrier such as fee may begin to be more friendly to families with below average incomes but all that its going to do is introduce another barrier imo

That's exactly what I'm experiencing with my work in walk-in clinics. True, most people do not abuse the healthcare system, but the few who do usually waste incredible resources that could be used to serve dozens of people. It's often hard to understand why some people would keep going back if we make our assumptions based on our own feelings as opposed to actual observations. From what I've seen, the abusers come in because waiting and seeing a doctor repeatedly is a lesser evil than what they would have to face if they didn't continuously abuse the system. Some people come in to get their narcotic prescription refills, others are in denial about their diagnosis and would rather get 2nd, 3rd, 4th, 5th, etc opinions than accept the truth, and still more people come to get physicals and try to fake problems to get government social assistance. These people are a small minority. Instead of physical healthcare, I think many of them need mental health assistance but too bad OHIP doesn't cover psychological therapy.

[Smurfette]

Actually, wait times could actually be a SOCIOECONOMIC barrier too. I remember having a discussion in a sociology course about why poorer people tend to go to the doctor less and often only when their situation is more severe EVEN THOUGH health care in Canada is "free". One of those reasons is education. But another major reason is because they don't have time. For example, a single mother working a full-time job plus a part-time job trying to make ends meet and take care of her two kids doesn't have time to go to the doctor for the flu or the pain in her stomach. She might also be afraid to take time off because she's afraid of losing her job. Moreover, the doctor's clinic is usually open 9-5 and she's at work then. So she doesn't go. If it takes her 4 hours to get to see the doctor, she definitely won't go.

 

Compare this to a (middle-class) high school teacher. She's got a pretty secure job, has some "sick days", and is unionized so she's not worried that taking the day off will make much of a difference. So she goes.

 

I think this can be a real problem. I remember meeting a patient in the hospital who wanted to get out quickly after surgery even though the doctors didn't recommend it. The reason was that he was desperately afraid he would lose his job if he took any more time off...and then how would his family survive? He was a poor immigrant with few language skills and he would probably have a difficult time getting another job.

[cindersley]

Hmm..but as the GP / or the GP's secretary...really what can you do if a patient INSISTS he must see the doctor about his paper cut.

 

Also, don't surgeons in canada also have to pay for malpractice insurance?? Isn't the likelihood of being sued in Canada just as high as in the US?

[Dal07]

I believe the settlements in Canada are MUCH less than those awarded in the U.S.