[BeaverFever]

Baloney. The rax rate didn't change. Doctors who partner in a business just have to split the business deduction between them, they each individually claim the same business deduction.

That's not a tax hike any more than a locked door is a pay cut to burglars.

[2Cdo]

BeaverFever BeaverFever:

But no, here are the Deplorables,

Look everyone Beaver has a new buzzword.

[housewife]

Instead of fighting about it maybe you should worry about doctors leaving. It's hard to get into a specialist now. The wait times are crazy. GPs will not discuss anything that maybe related to something you have a specialist for. You can only ask one question and it's a short appointment. Not to mention the new trend of collectives where you never see the same doctor twice and none of them have the same opinion on anything wrong with you.

Took me a while to get anyone to listen to my question and concerns about my specialist. He refused to do blood tests and has said things like "don't exercise" and "your ferritin is very low but your hemoglobin is normal so it's ok". I have begun to wonder why you never hear of people going postal in doctors offices. I have done it all on my own and hopefully haven't over done it with the vitamins and minerals. Even figured out the nerve pain and started Physio to fix it. Ontario's health care is declining and if doctors leave it will be the good ones leaving not the problem ones. Longer wait times and a poor quality of care is coming to Ontario

[RUEZ]

housewife housewife:

Instead of fighting about it maybe you should worry about doctors leaving. It's hard to get into a specialist now.

This is my concern. You can spin it any way you want. Call it a tax hike or closing a loophole or whatever. If the government is actively doing something that will make it even harder to see a doctor, they are doing it wrong.

[BeaverFever]

RUEZ RUEZ:

This is my concern. You can spin it any way you want. Call it a tax hike or closing a loophole or whatever. If the government is actively doing something that will make it even harder to see a doctor, they are doing it wrong.

I think there is real reason for concern. Uprooting your family by immigrating to a new country, especially one under the Trump regime, is a huge undertaking that would be disruptiive to the whole family and I doubt would be done on a whim just because of some tax loophole that only a few are taking advantage of anyway.

Doctors are an interest group like any other, their interests need to balanced against everyone else's. We don't need to write them blank cheques and cave to every demand especially over imaginary fears.

[andyt]

Maybe it will reverse a trend:

$1:

In 2003, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out. So there’s no part of this meme that’s true. Not only are physicians not more dissatisfied practicing in Canada than in the Unites States, but more doctors are also moving into Canada to practice than leaving.

https://www.washingtonpost.com/blogs/wo ... 6d20385815

[shockedcanadian]

andyt andyt:

Maybe it will reverse a trend:

$1:

In 2003, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out. So there’s no part of this meme that’s true. Not only are physicians not more dissatisfied practicing in Canada than in the Unites States, but more doctors are also moving into Canada to practice than leaving.

https://www.washingtonpost.com/blogs/wo ... 6d20385815

Probably has to do with oversaturation and ease of movement. If lawyers could do the same we would probably see some coming North also.

[martin14]

shockedcanadian shockedcanadian:

Probably has to do with oversaturation and ease of movement. If lawyers could do the same we would probably see some coming North also.

Those 'doctors' weren't moving North; rather ... East.

[BeaverFever]

$1:

Why This U.S. Doctor Is Moving to Canada

May 05, 2015 | Updated May 05, 2016

Emily S. Queenan M.D. and advisor with EvidenceNetwork.ca.

I’m a U.S. family physician who has decided to relocate to Canada. The hassles of working in the dysfunctional health-care “system” in the U.S. have simply become too intense.

I’m not alone. According to a physician recruiter in Windsor, Ont., over the past decade more than 100 U.S. doctors have relocated to her city alone. More generally, the Canadian Institute for Health Information reports that Canada has been gaining more physicians from international migration than it’s been losing.

Like many of my U.S. counterparts, I’m moving to Canada because I’m tired of doing daily battle with the same adversary that my patients face — the private health insurance industry, with its frequent errors in processing claims (the American Medical Association reports that one of every 14 claims submitted to commercial insurers are paid incorrectly); outright denials of payment (about one to five per cent); and costly paperwork that consumes about 16 per cent of physicians’ working time, according to a recent journal study.

I’ve also witnessed the painful and continual shifting of medical costs onto my patients’ shoulders through rising co-payments, deductibles and other out-of-pocket expenses. According to a survey conducted by the Commonwealth Fund, 66 million — 36 per cent of Americans — reported delaying or forgoing needed medical care in 2014 due to cost.

My story is relatively brief. Six years ago, shortly after completing my residency in Rochester, New York, I opened a solo family medicine practice in what had become my adopted hometown.

I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology.

I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.

My spirit was being crushed. It broke my heart to have to pressure my patients to pay the bills their insurance companies said they owed. Private insurance never covers the whole bill and doesn’t kick in until patients have first paid down the deductible. For some this means paying thousands of dollars out-of-pocket before insurance ever pays a penny. But because I had my own business to keep solvent, I was forced to pursue the balance owed.

Doctors deal with this conundrum in different ways. A recent New York Times article described how an increasing number of physicians are turning away from independent practice to join large employer groups (often owned by hospital systems) in order to be shielded from this side of our system. About 60 per cent of family physicians are now salaried employees rather than independent practitioners.

That was a temptation for me, too. But too often I’ve seen in these large, corporate physician practices that the personal relationship between doctor and patient gets lost. Both are reduced to mere cogs in the machine of what the late Dr. Arnold Relman, former editor of The New England Journal of Medicine, called the medical-industrial complex in the U.S.

So I looked for alternatives. I spoke with other physicians, both inside and outside my specialty. We invariably ended up talking about the tumultuous time that the U.S. health care system is in — and the challenges physicians face in trying to achieve the twin goals of improved medical outcomes and reduced cost.

The rub, of course, is that we’re working in a fragmented, broken system where powerful, moneyed corporate interests thrive on this fragmentation, finding it easy to drive up costs and outmaneuver patients and doctors alike. And having multiple payers, each with their own rules, also drives up unnecessary administrative costs — about $375 billion in waste annually, according to another recent journal study.

I knew that Canada had largely resolved the problem of delivering affordable, universal care by establishing a publicly financed single-payer system. I also knew that Canada’s system operates much more efficiently than the U.S. system, as outlined in a landmark paperin The New England Journal of Medicine. So I decided to look at Canadian health care more closely.

I liked what I saw. I realized that I did not have to sacrifice my family medicine career because of the dysfunctional system on our side of the border.

In conversations with my husband, we decided we’d be willing to relocate our family so I could pursue the career in medicine that I love. I’ll be starting and growing my own practice in Penetanguishene on the tip of Georgian Bay this autumn.

I’m excited about resuming my practice, this time in a context that is not subject to the vagaries of backroom deals between moneyed, vested interests. I’m looking forward to being part of a larger system that values caring for the health of individuals, families and communities as a common good — where health care is valued as a human right.

I hope the U.S. will get there some day. I believe it will. Perhaps our neighbour to the north will help us find our way.

http://huffpost.com/ca/entry/7207292

[BeaverFever]

$1:

Doctor flow reversed, as U.S. physicians move to Windsor
BY BRIAN CROSS, WINDSOR STAR
ORIGINALLY PUBLISHED: MAR 28, 2014

The once-alarming outflow of doctors to the U.S. is now a beneficial inflow, with 105 physicians locating here from the States in the last decade.

“The job here is better,” is how Florida native Dr. Christopher Blue summarizes why he moved here in 2010 with his wife, Dr. Kristen Kupeyan (a Windsor native), after attending medical school in the Caribbean, and training in the United Kingdom and Michigan. Here, he works as a hospitalist, an emergency doctor and assists in surgeries at local hospitals, and has two practices with his wife. Having such a varied career is something he couldn’t do in the U.S.


“Health care in the States is changing dramatically,” said Blue, who has spent hundreds of thousands of dollars on his education but would have had a tough time recouping that in the U.S. where reimbursement isn’t what it used to be.

“As a practitioner here, you can literally rent out a place, hang up a sign and be full in a month.”

When it comes to how enjoyable it is to practise medicine, the two systems are going in opposite directions,” said Dr. Amr Morsi, a Canadian cardiologist who moved to Florida in 2001 because there weren’t many angioplasty facilities in Ontario at the time, and came to Windsor in 2008 to set up the city’s new angioplasty centre. The system in the U.S. is getting more difficult and frustrating, he said, citing the battles with hundreds of different insurance companies. “And the system here is getting better, to the point where a lot of physicians are looking across the border.”

Another American who’s set up a family practice here, Dr. Sajad Zalzala, said his initial impression of Canada was connected to billing caps and doctors leaving for the U.S. But a Canadian who was in residency with him in Michigan told him the situation was changed and when he got in touch with this region’s physician recruiter, Joan Mavrinac, she showed him that things were pretty good for doctors in Canada. One of the big draws for him was Canada’s system of universal health care. In the States, the health care system is like a class system, he said.


“If you have Blue Cross/Blue Shield (health insurance), you’re in great shape, you can go to what hospital you want, specialists, but that leaves everyone else not as fortunate,” he said.

Within a year of starting his Windsor practice in 2012, he had to stop taking new patients. Practising isn’t perfect here, he added. It’s sometimes tough getting patients in to see specialists quickly and some tests, like genetic testing, can take a long time.

But he has low overhead and fewer hassles. In the States, you need two or three staff just to fight with the insurance companies all day long, he said.

“It’s good. With the OHIP system you pretty much know how much you’re going to get paid as the patient leaves the room, as opposed to the States,” he said, explaining the insurance company may adjust your bill or reject it entirely.

Mavrinac said physicians in the States are lucky to recover 65 to 70 per cent of what they bill, compared to about 95 per cent here. Doctors also like the fact Canada is much less lawsuit-crazy. She said she talks to doctors in Windsor who’ve worked decades without being sued once. She talks to U.S. doctors “who have lost count.”

She said the flow reversed starting 10 years ago and since then 105 of the 375 doctors recruited here have come from the U.S. She’s recruited Canadians who trained in the U.S., medical school graduates of medical schools outside North America who did post-graduate residency training in the U.S., and born-and-bred Americans. Windsor gets so many Americans because it’s so close to Detroit (there are currently 16 physicians living in Michigan and working in Windsor, with two more on the way), and Mavrinac is a tremendous help at jumping through the many certification and immigration hoops.

Whether a doctor makes more here depends upon what the doctor does. Specialists who require hospital resources such as operating room time might not make as much as they would in the U.S. because local hospitals only have so much time to portion out, but other specialists and family doctors do quite well here, Mavrinac said.

“But beyond that, they like the patients, they like being able to treat their patients and not have that constant issue of, is this beyond their means,” she said, recounting stories told by U.S. doctors who want to order two or three diagnostic tests for a patient, but the patient can only afford one.

Being a doctor in the States can be “extremely frustrating,” said Dr. Charlotte Logan, a Detroiter who has worked in the emergency department at Windsor Regional Hospital’s Ouellette campus since 2012. When you’re an ER physician in the U.S., patients come in sicker because of lack of medical care, and you wonder what happens to patients with little or no insurance once they leave.

“In Canada, you don’t worry about that, they may not be able to get some medication you’d like them to have, but they can get the basics covered,” said Logan, who said she’s treated two gunshot wounds in two years in Windsor. In Detroit, she could treat two a day.

Since 2008, 36 per cent of the 213 doctors who’ve moved here have come from the U.S. But while the American recruits help with the local physician shortage, they haven’t solved it, Mavrinac said. The Windsor-Sarnia-Chatham health region called the Erie St. Clair LHIN has the lowest number of physicians for its population in the province. And the situation could worsen, since 20 per cent of practising family doctors are over 65 and 35 per cent are over 60. The Windsor-Essex region has about 650 doctors.

The lack of physicians was a big reason Dr. Syed Anees, a respirologist, and his wife Dr. Sabeen Anwar, a rheumatologist, came to Windsor from Connecticut last July, Anees said. They wanted to move to Ontario to be closer to family who had moved here, he said.

“We both thought we’d be able to contribute more than being in Mississauga or Toronto, where our family is.”

https://www.google.ca/amp/windsorstar.c ... ent=safari