Last week, the governing council of the College of Physicians and Surgeons of Ontario (CPSO) voted unanimously in favor of changing its bylaws to allow for public reporting of the results of inspections of Out-of-Hospital Premises, such as private colonoscopy and plastic surgery clinics. This change was made following reporting by the Toronto Star, which …
I recently saw a patient with cancer who came to the emergency room complaining of shortness of breath, who was coughing up small amounts of blood, had a racing heart and sharp chest pain that was worse when he took a deep breath. In deciding the likelihood that this patient had suffered a clot in …
Medical school taught me a lot about treating disease, but guns were never on the curriculum. I am a family doctor who cares for patients with addictions, and I am faced daily with the challenge of balancing patient confidentiality and public safety. My patients are largely law-abiding citizens with an illness that requires treatment. Doctors …
As Director of Specialty Education at the Royal College of Physicians and Surgeons of Canada, I was interested to read Kieran Quinn’s recent blog post entitled “Should we Embrace a Return of the Rotating Internship?” Mr. Quinn’s thoughtful post echoes many of the sentiments that the Royal College has recently embodied in its initiatives and …
A typical doctor working in a community hospital is not an employee of the hospital, but has been appointed to the hospital medical staff as an ‘independently contracted professional’, and is paid by the government on a fee-for-service basis. Structuring the relationship between a hospital and its doctors in this way is the historical norm …
The rotating internship was abolished in the early 1990s, mainly at the prompting of the College of Family Physicians of Canada to address shortages in Family Medicine. Prior to this, newly graduated medical students completed a one-year internship to obtain a general license to practice medicine and were then free to pursue further specialty training …
An Ottawa area pilot project that facilitates electronic consultations between family physicians and specialists has proved so popular among doctors and administrators that its architects are finding ways to make it permanent. These consultations occur before an actual referral to a specialist is considered by the family doctor. “Doing referrals as a family doctor is one …
A growing number of Canadian doctors are underemployed after finishing their training. There are a number of likely causes, including a lack of infrastructure funding, delayed retirements, and a lack of health human resource planning at the national level. After about two decades of strongly worded public headlines and numerous government reports about doctor shortages, …
An interesting story came across my desk recently. Apparently, some states in the U.S. have moved towards a punitive model in trying deal with medical errors and adverse outcomes – this particular story describes how Utah will no longer fund healthcare providers and hospitals for dealing with illnesses that resulted from avoidable errors and infections. On …
I’ve had a couple of sour experiences with teamwork since entering medical school. These experiences are bad teamwork of the usual sort: a miscommunication, a slighted ego, and pretty soon we’re starting arguments with no other reason than to prevent the other person from having his way. And though I know experiences of bad teamwork …
As medical students, we fall under the scope of ‘future physicians’ and the public expects us to behave as such. A patient needs to be able to trust their physician to exercise good judgment and to act in the best interest of their health. This trust is rooted in the confidence that physicians will put …
So far this year, I’ve visited my dentist and optometrist once each for routine checkups. As most people know, the Ontario government does not pay for routine dentistry and optometry for most people. Or at least this is what we think. Indirectly, the government shoulders a significant portion of the cost. In other words, most …
About one in four Ontarians visit a walk-in clinic each year. While the government has made access to family doctors a key priority, there is no policy framework for walk-in clinics. Although walk-in clinics have been part of Ontario’s health care landscape for decades, they remain controversial. Walk-in clinics have generally been excluded from government …
As a 3rd year medical student, I am a junior member (also known as a clinical clerk) of a large health care team. Throughout my rotations, situations arise where – if I was in charge – I would do things differently. Most of the time, these differences in style or approach are minor in nature …
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 …
The Ontario Medical Association (OMA) and Ministry of Health and Long Term Care negotiate fee schedules on a four year basis. This year, the process has garnered a great deal of attention as negotiations broke down, and the Ministry of Health unilaterally imposed fee reductions in some areas. Understanding the history of bargaining between doctors …
In Ontario, specialists are concentrated in larger cities, and Ontarians living in smaller cities and rural regions have challenges accessing specialist services. In Ontario, Local Health Integration Networks (LHINs) use non-financial incentives to try to attract specialists to practice in hospitals that serve rural areas, and provide telemedicine and outreach clinics for patients. In contrast, …
In Ontario, new ways of paying doctors have been introduced in an attempt to improve the quality of their services. One approach is pay-for-performance, which pays doctors for meeting certain treatment goals. However, there is little high quality evidence that pay-for-performance improves the quality of care, and it appears to have had limited impact in …
In the last decade, efforts to improve access to primary care in Ontario have led to major changes to how family doctors practice and are paid. A recent report suggests that these newer models of primary care are not meeting the needs of vulnerable populations, and that Community Health Centres (an older model of care) do …
The Drummond Report recommended no increase in total compensation for Ontario’s doctors. A number of factors affect how much Ontario pays doctors including the number of doctors in practice, how many patients they see, and how much they are paid for each service. Achieving zero growth would require difficult decisions and trade-offs. The February 2012 …