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.
Doomed. When they can't say 'equal' you know it's fucked. Equitable means no white men.
in a free market system, people who can pay for it get 10/10 medical care. extremely high quality. but some people get literally none. some people don't need any (e.g. i'm healthy, much cheaper to pay out of pocket, and only insurance for huge accidents). but some people can't afford much if at all, and still get 0-3 out of 10 even though they need healthcare.
what "equity" is doing is saying that it's not fair that some people can afford 6-10 out of 10, so what they're going to do is regulate it out of existence. rich and wealthy people will still be able to go to another country and get it... they already do this. as much as the US has expensive medical care, and as much as the US has a lot of outbound medical tourism, there's also a ton of medical tourism TO the US by rich people seeking out the best.
but then the programs realize that they can't afford 5/10 for everyone, so it's usually a 2/10 in quality of care. this is the shit you're seeing right here. and it will only get worse.
but wait, there's more! tons of NGOs and "studies" gaslight people into thinking the quality of care in these socialist countries is so high. it's not. when you look at healthcare metrics, they always massively overweight pervasiveness of care levels. so everyone who doesn't have insurance, or who intentionally has cheap insurance (healthy people like me), is automatically counted as being basically 0/10. even worse, some even add in disparity in care levels, like a genii coefficient, complaining that some people getting amazing care somehow prevents others from getting care. these people look at healthcare as one total spend pile that is to be divvy'd up under socialist principles, not as individuals being able to make our own choices.
Yep equitable means everyone and everything is going to shit and will be alot worse than before. But there won't be anybody getting good treatment. Everyone's will be equally bad or non-existent.
The point of healthcare systems at this point is to extract money from people. They are working as intended and that’s the problem. The point of a system is what it does.