For our health care system to remain sustainable, scarce resources must be managed effectively both at the system level and on the front lines. In health care, decisions by doctors have a major impact on resource management in front-line care. But our health care system does not provide doctors with all of the information they …
Kishore VisvanathanIt must be a tough time to be an American astronaut. Since the US Space Shuttle program shut down a year ago, their opportunities for spaceflight are limited to hitching a ride with the Russians. It must be incredibly frustrating. Consider the years of training, childhood dreams, and self-sacrifice – all for naught. That …
Recent events in Ontario have focused public attention on emergency response capacity. Making the case to continue to invest in services and programs available to respond in an emergency is a challenge in the current fiscal climate. Elliot Lake is a picturesque mining town of 11,000 residents on the north shores of Lake Huron, located …
Recently I had a discussion with some physician colleagues about the Ontario Medical Association (OMA) campaign and specifically the principle of communicating non-neutral, political information to our patients. The campaign to which I am referring is that seeking to solicit the support of Ontario patients for physicians who are trying to get the government back …
The economic costs associated with chronic diseases are significant, particularly in an era of reduced public funding and greater government accountability. I would argue that inter-professional education (IPE) is going to emerge as a key component in the successful management and prevention of chronic diseases. Yet true inter-professional education requires a radical rethinking of the …
The current negotiation process between the Ministry of Health (MOH) and the Ontario Medical Association (OMA) is deeply flawed. Currently, the negotiations focus primarily on physician pay and not on the best interests of the patients. The broader issue lies not in the details of which physician services received fee cuts and by how much, …
Nurse practitioners are a key plank of government efforts to improve access to primary care. However, a continuing gap in pay and benefits for nurse practitioners who choose to work in primary care compared to those who work in hospitals, limits recruitment and retention to community settings. From a zippy online campaign to an economist-authored …
There are three options when a service or product costs more or is perceived to cost more than it should – agree to pay more, find a similar product for lesser cost, or refuse to purchase. All of these options are valid in health care, including the last one – with funders deciding that some …
Taking a drive through some states south of the border, you might notice a peculiar phenomenon: not only are there billboards showcasing the latest fashion or promoting certain consumer goods, but obscenely large billboards advertising the ER wait times of various hospitals. “Come to our ER! The wait is only 3 minutes to see a …
In the internet age there is an unprecedented amount of information available to anyone with access to the web. In health care, this is slowly shifting power dynamics, with patients taking increased responsibility and ownership of their health. What needs to be done so a health care system built in the 20th century can address …
On June 12, 2012, the OMA announced its intention to launch a constitutional challenge to the Ontario Government’s decision to reduce physician fees for 37 procedures and services. No doubt the OMA’s decision to attempt to shift the locus of its dispute with the government from the bargaining table to the courts was motivated by …
Here’s a startling but true story. In 2008, the Ontario Ministry of Health and Long-Term Care paid about 10 million dollars for 13 million blood sugar test strips. They were used by 49,000 Ontarians aged 65 or older who had diabetes. What’s so startling about that? The people who used the strips were not receiving …
Telehomecare programs offer remote monitoring for people living with chronic diseases, linking patients to providers without requiring an in-person visit. Ontario is currently developing a number of large-scale telehomecare programs with the promise that they are patient centred, cost effective approaches to care. While there is great enthusiasm for telehomecare programs from patients, providers and …
The thought of the annual Pap smear causes me as much discomfort as it does any young woman. When I read the new guidelines for cervical cancer screening in Ontario, reported in last month’s issue of Journal of Obstetrics and Gynaecology of Canada, I was slightly relieved at the recommendations being put forth. Rather than …
A recent Canadian Institute for Health Information (CIHI) Report obscurely titled Health Indicators 2012 revisits the topic of the impact of prevention on reduced mortality which was first profiled in the 1974 Lalonde Report – A New Perspective on the Health of Canadians. This caused me to go back and reread the 38 year old …
Changes to the fee structure of Ontario’s Docs are stoking a fiery dispute between the Ontario government and physicians. But the current standoff takes the momentum out of physician-centred reforms with durable opportunities for cost savings in the health sector – such as having doctors commission care on behalf of their patients. Getting better value …
By all accounts, Kaiser Permanente (a non-profit healthcare insurer and provider in the United States) is one of the best performing health care systems in the world. Shouldn’t it follow then, that its health plan members fare better as a population in terms of their health status? Not quite. A few weeks ago, Kaiser Permanente …
The Northern Ontario School of Medicine (NOSM) has developed a model of medical education to address the needs of people living in northern Ontario. NOSM was founded in 2005 with mandate of social accountability to the communities of the region. As the first NOSM graduates begin to enter practice, there are hopes that this school …
The fiscal health of the province should not be cured by detrimental changes to the health of Ontarians. The rhetoric of rising health care costs and a population aging ‘crisis’ are a means by government, health service providers, and even the consumer to obscure reality. The main crisis facing Ontario is a debt crisis. The …
When I present my research, a question I often get asked is “When will Canada support the pharmaceutical industry?” What do they mean? With sales of $41.3 billion in 2009 and net revenues of $1.3 billion, the industry would in all accounts appear healthy. Furthermore, employment in the pharmaceutical industry has increased by 12% in …