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Old Nov 5th 2017, 8:45 pm   #16
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Originally Posted by Stinkypup View Post
Wanderingdoc, occasionally cattle come lumbering into this thread, it is never clear why... they are harmless but do emit a fair bit of methane so stand well back and avoid naked flames
That's just pathetic, mate. You claim (on a later post) that this is an exclusive thread for GP/FPs in and interested in Canada. Sorry, but you don't set the rules here.

This is an open forum and you should remain aware that you and your colleagues have patients who might read it.

These patients might just be disgusted that FP's in Canada are more interested in maximising income streams than acting in the best interests of their clients.

I fully realise that the NHS is under huge pressure from Jeremy *unt and the rest of those fools, and is at real risk of being broken, but the way it will be after being broken is to mimic the much more broken system in the US and perhaps Canada, I base the last remark on what I've read on this thread.

Bigly bad.
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Old Nov 5th 2017, 9:31 pm   #17
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Originally Posted by Novocastrian View Post
That's just pathetic, mate. You claim (on a later post) that this is an exclusive thread for GP/FPs in and interested in Canada. Sorry, but you don't set the rules here.

This is an open forum and you should remain aware that you and your colleagues have patients who might read it.

These patients might just be disgusted that FP's in Canada are more interested in maximising income streams than acting in the best interests of their clients.

I fully realise that the NHS is under huge pressure from Jeremy *unt and the rest of those fools, and is at real risk of being broken, but the way it will be after being broken is to mimic the much more broken system in the US and perhaps Canada, I base the last remark on what I've read on this thread.

Bigly bad.
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Old Nov 5th 2017, 9:52 pm   #18
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Sadly that seems to be the way of so many things in the UK...targets rather than results. It wouldn't be so bad if the targets were meaningful or controllable.

I wonder if that's more a religious thing over here. God's will and all that...needing another angel
You are right there Bristol, evidence doesn't confirm that meeting targets improves clinical outcomes. A much more significant barrier that we encounter here is that a lot of people cannot afford medications whereas they would likely get free prescriptions in the UK.

I think in part the culture is different, a lot people there are looking to how they can get money, be it false insurance claims or sueing doctors for alleged negligence. The problem is that the GMC has an attitude that the doctor is guilty until proven innocent. Don't get me wrong, I have no issue of answering to negligence, although many times complaints go in which get unnecessarily escalated and which put immense pressure on frequently very diligent and caring GPs who are after hearings typically cleared of allegations of negligence. Some sadly cannot take this pressure and sometimes take their own lives. I would be interested to hear comments from docs still in the UK how they feel about this.

Re the angels, you could be right in part
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Old Nov 5th 2017, 9:56 pm   #19
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

Novocastrian, may I ask who even once said they prioritised patient care over monitory gains? I feel you're missing a subtle point, with all due respect; as GP's we've worked hard to get to this stage in our careers.

I've personally completed a prior degree (a BSc Hons) in an unrelated field, which took 4 years. 1 year pre-med, 5 years med school, 2 years house jobs, 3 years specialist training. The others are comparable from what they've disclosed, perhaps even more so in terms of vested time.

Now, as GP's it's fair to say we do not prioritise money over our job satisfaction,else we likely wouldn't be where we are today. Equally, which person in their right mind would run a business, which this clearly is, in a financially poor manner and not maximise their profits? Who once said they don't care about those we are entrusted to care for?
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Old Nov 5th 2017, 10:05 pm   #20
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Originally Posted by Stinkypup View Post
You are right there Bristol, evidence doesn't confirm that meeting targets improves clinical outcomes. A much more significant barrier that we encounter here is that a lot of people cannot afford medications whereas they would likely get free prescriptions in the UK.

I think in part the culture is different, a lot people there are looking to how they can get money, be it false insurance claims or sueing doctors for alleged negligence. The problem is that the GMC has an attitude that the doctor is guilty until proven innocent. Don't get me wrong, I have no issue of answering to negligence, although many times complaints go in which get unnecessarily escalated and which put immense pressure on frequently very diligent and caring GPs who are after hearings typically cleared of allegations of negligence. Some sadly cannot take this pressure and sometimes take their own lives. I would be interested to hear comments from docs still in the UK how they feel about this.

Re the angels, you could be right in part
Very true. I find myself practicing medico-legally defensible medicine at every turn. Especially so in OOH where the risk is highest. This in turn drives my consultation documentation to be lengthy but contemporaneous and as such, I don't deal with more than one issue per 10 minute consultation. It's simply not conceivable to do otherwise.

There is inevitably an air of entitlement within the NHS. Med 3's seem a right to some, the GP is perceived as the barrier to their benefits at times, whereas patients rarely see the value to their mental well-being in regular work. I can't see the system lasting; it's being slowly dismantled and privatised for some time. Mr *unt will and is trying to vilify us to justify his plans to the general public and the number of docs emigrating or seeking alternative careers is ever-growing.

PS - I detest HV's and actually don't do these as a locum. I relish the thought that this concept doesn't exist to the most part there in day to day practice!
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Old Nov 6th 2017, 12:17 am   #21
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Originally Posted by Wanderingdoc View Post
Novocastrian, may I ask who even once said they prioritised patient care over monitory gains? I feel you're missing a subtle point, with all due respect; as GP's we've worked hard to get to this stage in our careers.

I've personally completed a prior degree (a BSc Hons) in an unrelated field, which took 4 years. 1 year pre-med, 5 years med school, 2 years house jobs, 3 years specialist training. The others are comparable from what they've disclosed, perhaps even more so in terms of vested time.

Now, as GP's it's fair to say we do not prioritise money over our job satisfaction,else we likely wouldn't be where we are today. Equally, which person in their right mind would run a business, which this clearly is, in a financially poor manner and not maximise their profits? Who once said they don't care about those we are entrusted to care for?

Extremely well put!
I think they miss the point that we are self employed, employing others and running a small business with all the associated costs.
Having all one demographic would be extremely difficult and not satisfying.
I couldn't see complex elderly all day- even though I enjoy the elderly- my brain needs the quick easy contraceptive pill refill in between. The heavy days with complex patients leaves me mentally exhausted in a way that I don't think others understand. Its because we don't just forget about people as they leave the room, we carry on thinking about them, worrying about them, wondering what we could do better, if a referral may help etc.

The system in BC actively encourages us to take on complex people by paying well for them, it also means that we can spend time with them, with is better for the patient and us. The UK doesn't do this to the detriment of those people.
I find it odd that some people don't understand that we have bills to pay, employees wages, benefits, hydro, water, rents etc etc.
Sitting twiddling thumbs with an empty waiting room won't pay those bills! Young, healthy people sometimes don't come in for 2-3 years! I think those that have only known employment rather than running a business won't understand. That goes for UK GPs also- I think its a shock to have to think in a different way. What about time off for a holiday, sickness, what about a pension? Thats why I talk about running a business and needing income!

Plus as an FYI- Stinky says I'm efficient- maybe- I put my head down and work hard all day- through lunch etc. But he works incredibly hard. He will sometimes still be going late in the evening, he tends to see a few more than me in a day but he has some very complex people who take up a lot of his time and he gives them that time! He puts himself out for his patients in a way I rarely see, so the unpleasant comments of some of the non-medics on here are difficult to take.

Suffice to say that it was attitudes like this that helped to encourage a move. I find Canadians in general to be extremely supportive, they encourage us to have vacations, get angry about no shows and genuinely ask about us and how we are.
They show concern if we aren't well ourselves, ask about family etc. Our appointments are longer than the UK as we don't have to see crazy numbers ( we could- it would pay more but we don't) so we have time for a quick chat most visits. Its leads to a good, productive relationship that works both ways. There are exceptions of course!
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Old Nov 6th 2017, 1:00 am   #22
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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I find it odd that some people don't understand that we have bills to pay, employees wages, benefits, hydro, water, rents etc etc.
Sitting twiddling thumbs with an empty waiting room won't pay those bills! Young, healthy people sometimes don't come in for 2-3 years! I think those that have only known employment rather than running a business won't understand.
That may be the case but, as someone who was last paid on a T4 in 1986, I think I have a fair grasp of the issues involved with running businesses. If doctoring is a business then fair enough, I rather admire those people who are open about their business model, for example, those people who do only penile implants and have the giant billboards by the airport. I like the Tom Vu model of crass consumption, he inspired my career.

If it's a business though, like plumbing or computering, then no government funds should be involved. It's not quite reputable to seek to maximize income from one client when that client is the taxpayer. It's also a bit naff to seek to make as much as possible from people who are sick, but I suppose you're reconciled to that.

The reference to the US doctor was only in reference to your suggestion that I was jealous, I assumed you thought I was jealous of your affluence. If you think you have something else worthy of envy then I'm sorry, I missed whatever that might be.
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Old Nov 6th 2017, 1:25 am   #23
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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That may be the case but, as someone who was last paid on a T4 in 1986, I think I have a fair grasp of the issues involved with running businesses. If doctoring is a business then fair enough, I rather admire those people who are open about their business model, for example, those people who do only penile implants and have the giant billboards by the airport. I like the Tom Vu model of crass consumption, he inspired my career.

If it's a business though, like plumbing or computering, then no government funds should be involved. It's not quite reputable to seek to maximize income from one client when that client is the taxpayer. It's also a bit naff to seek to make as much as possible from people who are sick, but I suppose you're reconciled to that.

The reference to the US doctor was only in reference to your suggestion that I was jealous, I assumed you thought I was jealous of your affluence. If you think you have something else worthy of envy then I'm sorry, I missed whatever that might be.
I've never come across a "you are a slave of the state" attitude from a Canadian. If we were merely maximizing income, why don't we take on twice as many patients?
Why do we have long days with few patients? We could see up to 50 patients a day and some do. I looked at Stinky's numbers last week- between 23-34 per day. Mine-26-31. This is for a full day in the office. We spend time with people and try to do our best for them.
Hardly behaving in an unprofessional way. We bill legally and ethically but we will bill, we would be idiots not to. I'm actually having a hard time wondering what you are complaining about. I assume you have had an issue in the past.
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Old Nov 6th 2017, 7:42 am   #24
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Originally Posted by Wanderingdoc View Post
Novocastrian, may I ask who even once said they prioritised patient care over monitory gains? I feel you're missing a subtle point, with all due respect; as GP's we've worked hard to get to this stage in our careers.
Err. I thought doctors did.

Quote:
I've personally completed a prior degree (a BSc Hons) in an unrelated field, which took 4 years. 1 year pre-med, 5 years med school, 2 years house jobs, 3 years specialist training. The others are comparable from what they've disclosed, perhaps even more so in terms of vested time.
Oh FFS. You lot aren't the only ones who are academically well qualified.

Quote:
Now, as GP's it's fair to say we do not prioritise money over our job satisfaction,else we likely wouldn't be where we are today. Equally, which person in their right mind would run a business, which this clearly is, in a financially poor manner and not maximise their profits? Who once said they don't care about those we are entrusted to care for?
Stinky referred to me as an old fashioned grump. If by old fashioned he means a pre-Thatcher-era thinking person who doesn't believe that the concepts of profit and health care belong in the same sentence, then I plead guilty.
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Old Nov 6th 2017, 8:29 am   #25
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Err. I thought doctors did.

You knew damn well what he meant

Oh FFS. You lot aren't the only ones who are academically well qualified.

No doubt but you and dbd are showing a total lack of any indication that you have an inkling about Canadian health economics and how the medical system actually functions in Canada - you yourself spent your working life over here in your ivory tower of academia protected from the real world throughout your time here and no doubt beforehand , happily collecting your paycheck and your pension .

Us, we run a business, amazingly, for profit...go figure!! If we run at a loss then we dont get the paycheck that you did month on month and we certainly dont get a pension. If we didnt run at a profit then we would go out of business as would all the other doctors, who are also running their businesses and then who will look after sick people? When the pair of you actually start knowing anything about the system then I will be more that happy about to discuss this with you but neither of you have got a damn clue.

Stinky referred to me as an old fashioned grump. If by old fashioned he means a pre-Thatcher-era thinking person who doesn't believe that the concepts of profit and health care belong in the same sentence, then I plead guilty.
You might disagree with the concept of practising medicine as being a business but that is exactly what it is in this day and age- it has been for decades here. The patients get seen, in our case, the patients get a bloody good service. We work hard, we get a profit which then can enable us to continue to employ people and look after our families, what exactly do you see that is wrong in that? Please, one of you two explain how we should conduct our business????

Snoop didnt get what your actual beef was an neither do I. I really do think that the pair of you are directly and indeed incorrectly comparing the UK and Canadian systems having seen how each work..but, we work under current Canadian system which is nothing like the UK whether you like it or not.
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Old Nov 6th 2017, 9:15 am   #26
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

I always find it funny when someone thinks that they can win an argument on the internet? What year is this - 1999? I get that being outraged all the time on the internet is the norm but it has no place in this thread. If you think doctors are the main culprit for the ills of our current society then you're sorely misguided Novocastrian. Also, you seem to lack insight into the current realities of working as a doctor in Canada as well as the UK and are just looking for a fight. I actually think you're derailing this thread from its purpose, which you have zero right to do.

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Old Nov 6th 2017, 9:35 am   #27
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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I actually think you're derailing this thread from its purpose, which you have zero right to do.
Sorry, but that's not the case. BE is a public forum and anybody can comment on any thread, as long as it's within site rules. If you don't wish to see Novo's POV, then just add him to your ignore list.

HTH.
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Old Nov 6th 2017, 10:08 am   #28
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

Good to know about the ignore feature - cheers!
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Old Nov 6th 2017, 8:44 pm   #29
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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you yourself spent your working life over here in your ivory tower of academia protected from the real world throughout your time here and no doubt beforehand , happily collecting your paycheck and your pension .
I've been reflecting about whether or not to respond to this rather personal abuse. But I think I won't. You have no knowledge of my background or career other than what I've indicated on this forum. This is equally true of my knowledge of yours.

If you get a bit sick of folk not being to prepared to think of FP/GPs as a modern version of middle-age priests, endowed with special privileges while defending this status with claims of unselfishly tending to their flock, then I get equally pissed off with ivory towers rhetoric spat out by people like you who believe that they're "special".

Quote:
Us, we run a business, amazingly, for profit...go figure!! If we run at a loss then we dont get the paycheck that you did month on month and we certainly dont get a pension. If we didnt run at a profit then we would go out of business as would all the other doctors, who are also running their businesses and then who will look after sick people? When the pair of you actually start knowing anything about the system then I will be more that happy about to discuss this with you but neither of you have got a damn clue.
Interesting that you run a business for profit. Surely the idea is to provide care to your patients while earning what you think you deserve after all those years of training?
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Old Nov 7th 2017, 2:18 am   #30
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Default Re: Calling on Canadian Family Practitioners/ex UK General Practitioners

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Sorry, but that's not the case. BE is a public forum and anybody can comment on any thread, as long as it's within site rules. If you don't wish to see Novo's POV, then just add him to your ignore list.

HTH.
This is absolutely a public forum BUT this is a thread which is if you like equivalent to an immigration thread. It has extremely useful and important information for GPs in particular but other doctors as well and dates back 5 years.
Moderators are quick to say stay on topic in immigration threads and this should be similar. We shouldn't have to be defending ourselves against 2 people who have contributed absolutely nothing positive and who are obviously trying to derail the whole thread.
Over the years , many non medics have contributed, yourself included. More often than not, the contributions were positive and helpful and a welcome addition to the thread. You have helped with immigration advice which is much appreciated, others have helped with advice about areas, housing , schools.
But giving individuals a continued platform to air their personal grievances is not helpful and may well put off potential future GPs if they mistakenly think this is how Canadians think!
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