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Old Mar 6th 2014 | 4:18 am
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Default Re: Australia or canada for doctors

Originally Posted by Jsmth321
Ongoing prescription and some other ongoing medical issues, the walk in wont deal with those type of things on an ongoing basis.
Ah. If it's people with chronic conditions who need a GP then maybe it would be most efficient to have the walk-in deal with the newly sick and refer people to GPs only after a few visits. That way GPs wouldn't have to have much in the way of diagnostic skills and cheaper substitutes, such as nurse practitioners, could take on more of their role.
 
Old Mar 6th 2014 | 4:27 am
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Default Re: Australia or canada for doctors

Originally Posted by dbd33
It's a bit off topic but why do you feel that you need a GP? Why is a walk-in clinic not adequate?

(I've no axe to grind here but I haven't had a GP since I was a small child, my children have never had a GP, we don't feel unserved.)
The problem I've found with walk in clinics is doctor availability. On several occasions I've arrived to find a notice on the door stating they're not taking any more patients that day. After a 45 minute drive to a clinic, taking pot luck to find they're full for the day, isn't very practical. My GP can be booked 5-7 days ahead, so making an appointment for something that needs treating reasonably quickly can be frustrating.

I've been on a waiting list for 2 years to have an initial consultation with an orthopedic surgeon, which to my mind is unacceptable. Neighbouring health authorities have waiting lists of 3-6 months, but I can't access them as I don't live in their catchment. Those sort of discrepancies are common.
 
Old Mar 6th 2014 | 4:52 am
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Default Re: Australia or canada for doctors

Originally Posted by dbd33
It's a bit off topic but why do you feel that you need a GP? Why is a walk-in clinic not adequate?

(I've no axe to grind here but I haven't had a GP since I was a small child, my children have never had a GP, we don't feel unserved.)
I think the problem is you won't be getting the best care. The husband says he has pts who are registering with him who just do the rounds of walk in clinics who are on all sorts of drugs they don't need to be on, that don't work together etc etc. he says the patients records are way behind that of the uk so you only have the pts word for medical history, medication etc etc which can obviously lead to all sorts of problems. He also says benzodiazepam addiction is very high here, again from people able to pick it up from various walk in clinics. He says it's much higher than the UK. Who has duty of care to you if you only see a doctor once? For the likes of me someone healthy- physically or mentally fine, for those on the border it's not good.
 
Old Mar 6th 2014 | 4:53 am
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Default Re: Australia or canada for doctors

Originally Posted by dbd33
Ah. If it's people with chronic conditions who need a GP then maybe it would be most efficient to have the walk-in deal with the newly sick and refer people to GPs only after a few visits. That way GPs wouldn't have to have much in the way of diagnostic skills and cheaper substitutes, such as nurse practitioners, could take on more of their role.
I had a nurse practitioner in the US, she was good and knowledgeable, and they are quite popular in many parts of the US, only time I saw an actual doctor was when something was wrong that was out of the nurse practitioners scope, but there was a GP in the office at all times, he just dealt with more pressing/serious issues and the NP dealt with everyone else.

Upside for was co-payment too, NP was co-pay free where the GP was a 25 co-pay..
 
Old Mar 6th 2014 | 5:00 am
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Default Re: Australia or canada for doctors

Originally Posted by Tirytory
I think the problem is you won't be getting the best care. The husband says he has pts who are registering with him who just do the rounds of walk in clinics who are on all sorts of drugs they don't need to be on, that don't work together etc etc. he says the patients records are way behind that of the uk so you only have the pts word for medical history, medication etc etc which can obviously lead to all sorts of problems. He also says benzodiazepam addiction is very high here, again from people able to pick it up from various walk in clinics. He says it's much higher than the UK. Who has duty of care to you if you only see a doctor once? For the likes of me someone healthy- physically or mentally fine, for those on the border it's not good.
Records are a good point. My GP is all electronic record keeping, and its quite nice for the doctor and me for him to just be able to see everything, but the walk in's are mostly paper records still and then they file them away never to be seen again, each time I go they start a new sheet, but previous visits are not readily available to the doctor.


Most walk in's I have been to in BC, wont prescribe the most commonly abused drugs, as well as most mental health meds.
 
Old Mar 6th 2014 | 5:12 am
  #21  
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Default Re: Australia or canada for doctors

Originally Posted by dbd33
Ah. If it's people with chronic conditions who need a GP then maybe it would be most efficient to have the walk-in deal with the newly sick and refer people to GPs only after a few visits. That way GPs wouldn't have to have much in the way of diagnostic skills and cheaper substitutes, such as nurse practitioners, could take on more of their role.

See in the UK, it's the other way round, nurse pracs are dealing with more treatment of chronic conditions within acute and GP settings. They can work in a specialised area within defined parameters of a role.

Think about it this way, you have a sudden onset of systems which possibly point to an urgent suspected cancer, do you want to take that to your own doctor who is fully aware of your medical history, any family history, previous symptoms and treatment, or do you want to take it someone new who you don't know, and hope that they treat you appropriately?
 
Old Mar 6th 2014 | 5:15 am
  #22  
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Default Re: Australia or canada for doctors

Originally Posted by Jsmth321
Most walk in's I have been to in BC, wont prescribe the most commonly abused drugs, as well as most mental health meds.
What do those without a doctor do? Fall by the wayside? As far as this area goes, it's a very common addiction at least compared to UK addictions!!!
 
Old Mar 6th 2014 | 5:27 am
  #23  
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Default Re: Australia or canada for doctors

Originally Posted by akshabhi
Thank you sooo much for all your replies.

Thank you Tirytory for your kind detailed reply. There was lot of useful information.

Oink!! you are absolutely spot on with whats going on in my mind. Only thing I would add is small houses for the prices. I always liked to have huge ones.

Sorry but few more questions-

1.I was just wondering if you have any clues on Australian pay for GPs and Paeds?
2.i think average pay a full time GP gets in UK is 100-120k for 8-9 sessions + pension. How would be range in Ontario? I understand pension not paid as in nhs. Is it still higher considering this?
3. Is workload equivalent or higher than UK GPs considering I will do only GP surgery with no other special interest.
4.What are the preferred places in Ontario to live or work??

akshabhi
We came to Ontario so no idea about Australia, maybe best ask them!!!

I think your average for a UK GP is pretty high. Where my husband worked, he was 9 sessions plus a lot of ooh work and still wasn't as high that and getting less by the month with the various government changes. So yes, the wages are higher.
Workload is defined by yourself, however much you want to earn, although keep in mind there are still requirements to ooh. Husband does every Wednesday after clinic hrs and a weekend a month..
Ontario is about 3 times bigger than the UK, but there is also Alberta, BC, plus other provinces to think about it. You have to consider what you want out of a new life. Country? City? Lots of snow? Not much? How much cold can you out up with?

If you contact Health Force Ontario, they will be able to help you run through what you need to do to get licensing, salaries and jobs etc. Only for Ontario obviously, you might find Alberta is prepared to help you substantially to go work out there. But you need to do the basics first, figure out what you want and where you want to be- if it helps, we narrowed down to flight time, weather, the information on the different provinces and then the different licensing requirements within provinces.
 
Old Mar 6th 2014 | 5:28 am
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Default Re: Australia or canada for doctors

Originally Posted by Tirytory
I think the problem is you won't be getting the best care. The husband says he has pts who are registering with him who just do the rounds of walk in clinics who are on all sorts of drugs they don't need to be on, that don't work together etc etc. he says the patients records are way behind that of the uk so you only have the pts word for medical history, medication etc etc which can obviously lead to all sorts of problems. He also says benzodiazepam addiction is very high here, again from people able to pick it up from various walk in clinics. He says it's much higher than the UK. Who has duty of care to you if you only see a doctor once? For the likes of me someone healthy- physically or mentally fine, for those on the border it's not good.
Health care here is not really very good at total care. Hospitals rarely have doctors on the staff so you continue to be treated by your GP who has admitting rights. If you do see a specialist they have their offices and thus their own notes/charts which remain separate from the hospital ones. People use the local Emerge as their GP and i don't blame them. They often see the same doctor, their charts are available, diagnostic tests all on site.

My own GP is on vacation so often i rarely see the same doctor twice, i coukd see a nurse practitioner but i am not impressed by the ones at my health clinic.
 
Old Mar 6th 2014 | 5:30 am
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Default Re: Australia or canada for doctors

Originally Posted by Tirytory
Think about it this way, you have a sudden onset of systems which possibly point to an urgent suspected cancer, do you want to take that to your own doctor who is fully aware of your medical history, any family history, previous symptoms and treatment, or do you want to take it someone new who you don't know, and hope that they treat you appropriately
Sometimes I wonder if doctors even remember their patients... With electronic records, I wish the practice which has 8 or 9 doctors in it, would just let patients see any of them, they all have access to the records in the practice, but they still make you just see the doctor you have, just a pain when you have a semi-retired doctor with limited working hours at his practice.

Originally Posted by Tirytory
What do those without a doctor do? Fall by the wayside? As far as this area goes, it's a very common addiction at least compared to UK addictions!!!
If its not a mental health drug, or pain killer, walk in's will usually do a refill but the one's I am familiar with wont re-fill pain killers and mental health drugs because of the potential for abuse and addiction.

If one needs these and has no doctor at all, they can go to the ER and try their luck, or just do without.

ER doctors have more access to medical history and history of medication, where a walk in won't.

I was surprised how the doctor in the ER was able to pull up all my medication history having never been to that ER before.

If you have a severe mental illness, you can usually get a social worker and psychiatrist at mental health unit for your region, if your mild to moderate mental illness, then its a lot harder to get either.

Last edited by scrubbedexpat091; Mar 6th 2014 at 5:34 am.
 
Old Mar 6th 2014 | 5:39 am
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Default Re: Australia or canada for doctors

Originally Posted by Jsmth321
Sometimes I wonder if doctors even remember their patients... With electronic records, I wish the practice which has 8 or 9 doctors in it, would just let patients see any of them, they all have access to the records in the practice, but they still make you just see the doctor you have, just a pain when you have a semi-retired doctor with limited working hours at his practice.



If its not a mental health drug, or pain killer, walk in's will usually do a refill but the one's I am familiar with wont re-fill pain killers and mental health drugs because of the potential for abuse and addiction.

If one needs these and has no doctor at all, they can go to the ER and try their luck, or just do without.

ER doctors have more access to medical history and history of medication, where a walk in won't.

I was surprised how the doctor in the ER was able to pull up all my medication history having never been to that ER before.

If you have a severe mental illness, you can usually get a social worker and psychiatrist at mental health unit for your region, if your mild to moderate mental illness, then its a lot harder to get either.
Yeah but if you're smart though, and a lot of addicts are, you can find your way around symptoms to get the drugs you require. I'm talking benzodiazepams here.....
 
Old Mar 6th 2014 | 6:07 am
  #27  
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Default Re: Australia or canada for doctors

Originally Posted by Jsmth321
Sometimes I wonder if doctors even remember their patients...
My experience is they don't. Nor do they read notes prior to seeing you.

Last visit, I was offered drugs I'd already suffered adverse reaction to, a cortisone injection and X-ray diagnosis, which I'd already had.
 
Old Mar 6th 2014 | 6:11 am
  #28  
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Default Re: Australia or canada for doctors

Originally Posted by R I C H
The problem I've found with walk in clinics is doctor availability.
I can see that would be an issue in a rural area. We just drive on to the next one.
 
Old Mar 6th 2014 | 6:17 am
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Default Re: Australia or canada for doctors

Originally Posted by Tirytory
Think about it this way, you have a sudden onset of systems which possibly point to an urgent suspected cancer, do you want to take that to your own doctor who is fully aware of your medical history, any family history, previous symptoms and treatment, or do you want to take it someone new who you don't know, and hope that they treat you appropriately?
I don't think it would matter if I had the medical records, I could walk in with my history (on a USB or similar) and any doctor would be as well informed and as any other. The same could be achieved by OHIP maintaining a database shared between doctors.

That's an information sharing problem not one altered by the doctor knowing or not knowing the patient.
 
Old Mar 6th 2014 | 6:33 am
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Default Re: Australia or canada for doctors

Originally Posted by R I C H
My experience is they don't. Nor do they read notes prior to seeing you.

Last visit, I was offered drugs I'd already suffered adverse reaction to, a cortisone injection and X-ray diagnosis, which I'd already had.
I am not even sure some doctors really know what they are prescribing half the time, luckily the doc I have now isn't a pill pusher like the last doctor was.
 


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