I received an email today from my family doctor's clinic telling patients to be less particular about whether they get to see their doctor or not when they schedule an appointment with... their doctor. The parts I take issue with are in bold. Here's the email body:
Good Morning <clinic> Patients,
A Reminder to Our Patients: <clinic> is Proud to Be a Teaching and Team-Based Facility.
Medical learners (students and residents, most of whom are training to be family physicians) are an important part of our team. Physician assistants, nurse practitioners, and locum/covering physicians are also crucial to our clinic functioning.
With the help of our team:
- We are able to offer non-urgent appointments usually within 1-2 weeks.
- We are able to offer same-day appointments for urgent issues.
- We are able to continue to provide care to our current <clinic> patients at a time when there are a record number of family physicians leaving practice.
- We play an important role in training the next generation of family physicians.
There have been an increasing number of patients requesting appointments with their provider only (and declining to see other members of the <clinic> team). This causes significant disruptions to the clinic and affects our ability to provide equitable care to all <clinic> patients.
Moving forward, when you book an appointment, you should expect that you may see a medical learner, physician assistant, nurse practitioner, or a physician covering for your primary family physician. For many appointments, your family physician will be available to see you after you have been seen by another practitioner, if requested or needed. Please be aware that learners and physician assistants are supervised directly by your physician.
This team-based model of care may not be the right one for you, and if you wish to transfer your care to another clinic, we will be happy to waive the usual fee for transfer of records.
We appreciate the important role you play in medical education and making practicing family medicine sustainable.
Sincerely,
The physicians and staff at <clinic>.
So basically, patients want to see their doctors instead of medical students and the clinic is telling the patients to fuck off with their standards and expectations. Instead of building rapport, confidence, and sharing personal vulnerabilities with your family doctor, you can now expect to do it with random, unqualified, inexperienced people who you'll never see again and who don't know your history. If you don't like it, despite paying these fuckers' wages, you can pound sand.
FYI, when this email says the students and assistants are directly supervised, it's figurative. It means the students and assistants report to the doctors, not that the doctors are in the room while the assessments and appointments are conducted. You're expected to meet with these unqualifieds one-on-one. There used to be supervised appointments where medical students would simply shadow the doctor with permission from the patient, but that hasn't been the case for years.
Also, moving to another family doctor is extremely difficult. Most doctors have a maxed-out roster and are not accepting new patients. There are 2.3 million Ontarians without consistent access to a family doctor in a province of 14.5 million.
Canadian tax dollars at work.
In a utopia, it's the best way. The problem is utopia doesn't exist. I'd probably even be inclined to argue for single-payer in small homogeneous cultures. Because it could work there. As soon as you start adding diversity, it breaks.
For what we have somewhere like the US, if I had my way I would break up and make independent most of the doctors practices and not allow them to ally with insurance companies, let's just call that price fixing. You show up, you pay the rate to the doctor. Whatever insurances is between the patient and the insurance provider. I might be inclined to regulate hospitals a bit from a more governmental level (no larger than State government). Mainly just cost transparency and oversight type things. Insurances become as big or as small as the consumer wants to make it. Pay for it yourself, ok. Want to have a Church healthcare cost sharing plan, go for it. Faggots want to fund Buttsex United Health Corp to pool the money they don't have to pay for other faggots to deal with their doctoring needs, that's fine too. I'd likely also propose some sort of taxpayer funding for kids somehow. Adults can take their own responsibility.
That’s true. I know, for instance, Canada has straight up “sin taxes” where a pack of cigarettes or bottle of beer will cost 4x what it costs on this side of the border. So many people would cross the border just to shop for shit where I used to live, even taking the hit in currency exchange rates that usually would entail. I understand that the idea behind these extra taxes is that these people will supposedly go on to cost their healthcare system disproportionately. The funny thing is that I’ve actually seen data suggesting the opposite, that smokers and drinkers drop long before their healthcare costs hit the stratosphere, while “healthy” people in their desire to cling on later and later into old age actually end up “costing” these government healthcare systems more. So yeah, that big ramble was basically just to echo your point about how this is all basically based on utopian thinking.
Tangentially, the only thing actually that I see people buying from Canada and bringing/shipping here is, oddly enough, medicine and certain health products.
Boomers are terrified of death in a way that no previous generation of old people has ever been. Used to be that back in the day you just accepted dying as a fact of life, the moment you fell ill with common old people diseases like cancer or heart disease or kidney failure you just laid down and died. I wonder how many boomers, despite professing religiosity, either don't really believe in an afterlife, or fear that their degeneracy has landed them a spot in hell.
Not to mention that at a certain point, you just don't have quality of life anymore. Euthanasia is a slippery slope, however once you're past, say, 70, I don't think it's unreasonable to say, sorry, all we can offer from this point on is palliative care.
Aging is entropy's effect on the human body, and when you fight entropy, the law of diminishing returns will make costs go up exponentially. Why invest a given sum of cash to give a diapered fossil one extra year of life, when the same investment can give someone younger an extra decade of a much higher quality of life?
Realistically, this (an aging population, in a socialized healthcare system, clinging longer and longer as tech advances) is behind the push for MAID, and realistically most people wouldn’t have a problem if they didn’t hear about depressed teenagers or young people cripple by the vax being offered euthanasia
That I believe, because I've seen way too much of it first hand. I really don't understand it myself, maybe when I get to that point I will. They make Joe Biden look like a picture of youth and perfect health in comparison, yet will do anything to add an additional breath to their lives. I also hear of all these tricks to basically ensure the taxpayer pays for it all. Let's just say I don't get a warm response for suggesting that I've had a decent life and afforded enough opportunity that I consider it my own responsibility to make sure I'm provided for in my old age.