And in the case of both ER and GP situations, patients are handled with a triage mentality.
In the case of an ER I suppose it can be a "little" more understandable, but with GP's it's less about time/manpower constraints and instead seems like it has more to do with keeping on friendly terms with insurance companies (costs, etc). Since they have to justify anything they do to insurance companies.
It's honestly a fucking joke. In a big book full of horrible jokes.
Your first half definitely describes a lot of the reality.
But another huge factor as I mentioned elsewhere in the thread is that the "universal healthcare" model in Toronto where the OP talks about maxes out at about a $35 dollar cap that the government will pay out to a GP for a visit.
So the GP can't set their prices for the value of their labour or to keep pace with rising CoL, inflation, overhead, etc. The only way they can make the numbers work is to increase patient volumes and continually shorten visits and quality.
In general, they can't even hire more staff to streamline things because staffing only adds salary costs while the rate-limiting step is the doctor's face-to-face time (at $35 a pop and the government will only pay out for physician one-on-one time, not those of extenders).
This is on top of ever increasing liability, more & more diversity with non one speaking English, more forms, paperwork & more BS non-medical demands, more automated requests from the pharmacy, the lab, the patient portal (all unpaid but more liability), longer wait times to see specialists, more BS astroturfed campaigns from your betters such as screening for poverty, for DV, for guns in the home, for new cancer screening, new STI screening, pushing the new jab, screening for the latest Public Health scare disease, screening for early childhood developmental problems, etc.
The heartless, entrepreneurial shitbags thrive off the high volume by being reductionist, ruthless & pushing whatever is The Current Thing and new Big Pharma New Product.
Anyone with any introspection or qualms quickly gets crushed by the Leviathan and either finds a small niche to fill to get off the conveyor belt or burns out.
The natural cutoff for capillary refill is 2 seconds.
A sluggish capillary refill alone isn't an emergency, but it's another quick beside assessment of perfusion (specifically newly oxygenated blood coming in).
A cyanotic limb, a sluggish capillary refill at 3, 4, 5 seconds, absent peripheral pulses, cool to touch, pain out of proportion, particularly with passive extension of some muscle compartments (this is more specific to Compartment Syndrome), all build a case to try to order investigations or specialist consults that are a pain in the ass to acquire because of resources.
And in the case of both ER and GP situations, patients are handled with a triage mentality.
In the case of an ER I suppose it can be a "little" more understandable, but with GP's it's less about time/manpower constraints and instead seems like it has more to do with keeping on friendly terms with insurance companies (costs, etc). Since they have to justify anything they do to insurance companies.
It's honestly a fucking joke. In a big book full of horrible jokes.
Your first half definitely describes a lot of the reality.
But another huge factor as I mentioned elsewhere in the thread is that the "universal healthcare" model in Toronto where the OP talks about maxes out at about a $35 dollar cap that the government will pay out to a GP for a visit.
So the GP can't set their prices for the value of their labour or to keep pace with rising CoL, inflation, overhead, etc. The only way they can make the numbers work is to increase patient volumes and continually shorten visits and quality.
In general, they can't even hire more staff to streamline things because staffing only adds salary costs while the rate-limiting step is the doctor's face-to-face time (at $35 a pop and the government will only pay out for physician one-on-one time, not those of extenders).
This is on top of ever increasing liability, more & more diversity with non one speaking English, more forms, paperwork & more BS non-medical demands, more automated requests from the pharmacy, the lab, the patient portal (all unpaid but more liability), longer wait times to see specialists, more BS astroturfed campaigns from your betters such as screening for poverty, for DV, for guns in the home, for new cancer screening, new STI screening, pushing the new jab, screening for the latest Public Health scare disease, screening for early childhood developmental problems, etc.
The heartless, entrepreneurial shitbags thrive off the high volume by being reductionist, ruthless & pushing whatever is The Current Thing and new Big Pharma New Product.
Anyone with any introspection or qualms quickly gets crushed by the Leviathan and either finds a small niche to fill to get off the conveyor belt or burns out.
The natural cutoff for capillary refill is 2 seconds.
A sluggish capillary refill alone isn't an emergency, but it's another quick beside assessment of perfusion (specifically newly oxygenated blood coming in).
A cyanotic limb, a sluggish capillary refill at 3, 4, 5 seconds, absent peripheral pulses, cool to touch, pain out of proportion, particularly with passive extension of some muscle compartments (this is more specific to Compartment Syndrome), all build a case to try to order investigations or specialist consults that are a pain in the ass to acquire because of resources.