Kelowna desperately needs Family Doctors!

I take heart with the news that graduating Okanagan young professionals are choosing to stay in the Okanagan as mentioned by Jon Manchester. I just wish it were true for family doctors. In 2013 there were 13 graduates from the local family medicine program. Only one graduate chose to stay in Kelowna. The Medical Post reports that less than 20 percent of the graduates of rural medical programs end up staying in the rural communities in which they were trained. This is true despite the BC government’s stated goal to supply doctors to the interior of BC by training them in the interior of BC. The simple fact is that most young physicians go where they are best paid because they have huge debts to service upon graduation. Governments give incentives for some rural communities but not for Kelowna. We are losing ten percent of our physician workforce annually as older doctors retire. Over the past three years Kelowna has suffered a net loss of doctors. This local physician shortage has meant the closure of medical clinics reducing primary care services to the community. Kelowna General Hospital has seen a ten percent increase in emergency room visits over the same period of time. Government and business wags in Kelowna appear oblivious to this fact preferring to pretend that lifestyle and setting make Kelowna so attractive it will never experience a physician shortage. Not so in Kamloops. Their Chamber of Commerce has teamed up with the local city council to create video and a recruitment strategy for family doctors. In a recent family medicine conference in Vancouver communities such as Cranbrook manned a booth to recruit physicians. There is much Kelowna could do to attract physicians here and keep them here when they come. First thing they could do is to make someone responsible for paying attention to the physician supply in Kelowna. It doesn’t appear that Interior Health is making it a priority as they are more concerned with finding doctors for Kaslo and Enderby and other smaller communities who are so critically short of physician manpower that they are having to close their emergency rooms over the holidays. The IHA website is out dated, postings are old and there are no listings for Kelowna vacancies which gives the impression we don’t have a problem. I hear rumour that Kelowna wants to become the best mid sized city in North America. I don’t see how it is going to do that if it can’t recruit and retain physicians. Memo to City Council. Stop the complacency! Pay attention to physician recruitment and retention in 2014!

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Election profile: James fed up with BC Liberals | Local News | Kelowna Daily Courier

Election profile: James fed up with BC Liberals Subscriber

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Liberal supporter Graeme James became so disillusioned with that provincial party that he not only joined the Conservatives but became their candidate in Kelowna-Lake Country.
“That’s the main reason I’m running,” said James. “I finally had to step away from the Liberal party because I just couldn’t agree with their policies anymore and their performance, actually.”
The businessman, land-use consultant and farmer believes that for the first time in history the standard of living for his three children will be lower than their parent “because of our massive debt.”
The Liberals and NDP have racked up $60 billion in deficits and the Liberals have added another $90 billion-plus in contractual obligations that his children will have to pay for, he said.
“I don’t see a lot of difference between the NDP and the Liberals. They are both a tax-and-spend government, and we really have to stop living beyond our means. I think that the electorate really do care that these two mainstream parties don’t really care about the deficits.”
During a recent all-candidates forum, it became clear to him that politicians aren’t trusted anymore, he said, “and it’s warranted. Trust is a big issue.”
The Liberals said they wouldn’t bring in the HST and did. They said it would be revenue-neutral and it was not, for example. “The HST actually brought in about $4 million extra dollars in taxes a day,” said James.
The Pacific Carbon Trust takes $50 million out of health care and education, and gives it to private industry like Encana. After receiving $1.6 million in carbon credits, Encana, in turn, donated $770,000 to the Liberal Party of B.C. which James found unacceptable and “I believe it’s corrupt.”
James, a former regional district director, also pointed to the West Kelowna land swap: 700 acres to Westbank First Nation in exchange for seven acres of reserve land used for the Highway 97-Westside Road interchange. “It was just not a very good deal for the people of British Columbia.”
In spite of promises by local MLAs for two years, the province won’t contribute toward millions in water upgrades by Kelowna’s water providers, he said.
James believes farmers need more direct financial assistance, such as long-term funding for replanting and packinghouse upgrades, “not programs that farmers don’t use.”
This province has probably the toughest land-use policies in North America yet supports agriculture the least in all of Canada, he said, adding B.C. needs high-paying jobs so its residents don’t leave every Sunday for employment in Alberta.
Conservatives promise to balance the budget through proper management of all spending from government ministries to Crown corporations to hospitals and educational institutions, and getting all advertising approved first by the auditor general like Ontario now requires.
“What we need in health care is leadership. People of B.C. need to have answers on how we can reform our system. Billions of dollars a year are being wasted because the present two parties are afraid to take a leadership role on health-care issues,” he said.
“We’re also going to ban union and corporate donations. It’s funny because now all of the corporate donations are moving to the NDP.”

Elect Graeme James as BC Conservative MLA for Kelowna Lake Country!

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Some physicians worried McGill will be turned into ‘family doctor factory’ | Canadian Healthcare Network – Physicians

Some physicians in Quebec are concerned that a curriculum rethink toward family medicine at McGill University will result in a loss of research prowess and turn the venerable institution into a “family doctor factory.”

The Montreal Gazette reported some physicians believe the new medical school curriculum cuts too much from science and will result in the loss of clinician scientists.

Advocates believe the new teachings will not only create better family doctors but also provide more independent learning skills—a key skill in the new scientific world

But other health advocates say the adjustment is necessary because of a shortage of family doctors. They also believe the new teachings will not only create better family doctors but also provide more independent learning skills—a key skill in the new scientific world.

The move away from a lecture-dominated freshman year will now feature afternoon group work focused on patient problem-solving.

But at a recent town hall, cancer researcher Dr. Phil Gold said opposition among many eminent physicians was united.

“We’ve been a science-based institution all of our lives and I see that being eroded to some extent, although I may be surprised at the wonderful result we get in the end.”

Comments (5)

  1. Many family doctors are clinical scientists. For those who do basic research, med school has never provided a foundation for research. I challenge these eminent scientists to provide examples of clinician scientists who do not have degrees other than an MD.

  2. The family doctor of today is trained to encompass all areas of medical activity, including scientific research, information technology, management, business administration, simulation in clinical skills, publishing, as well as all the clinical expertise from ICU, CCU, obstetrics and gynecology, pediatrics, and so on. There has been too much denigration of the family physician for too many years. When will it be realized that primary care in the community is the first line of consultation, and that although we need the excellent scientists that are forthcoming, we should never overlook the importance of providing first class health care to all in the community, wherever and whenever possible. Looking to the future, what would one like universities to produce – a plethora of excellent family physicians all serving well, or a scarcity? Of course we need scientists but let us all see the need for clinical care too, and pre-empt the active disease but work to prevent it in the first instance. Mohamud Verjee BSc(Hons), MBChB, CCFP

  3. The current FP program is a watered down version of the GP program which produced far better trained physicians at the end rather than the “FP’s” who often lose many of their clinical skills by training in an overly specialized environment for their second year of their “residency” training.

    Having worked in neuropharmacologic research before medical school, the only practical type of research that I can see GP’s doing is N=1 trials on patients. This form of research is how newly graduated physicians tune their wetware to become an exquisitely powerful mechanism for treating individual patients rather than treating a random cohort of individuals using a paradigm where the treatment result is statistically significant using Gaussian statistics.

    The statistics of N=1 trials are not taught in medical schools yet this is the way in which physicians deal with patients. Yes, there are numerous confounding effects in N=1 trials such as the placebo effect, but whatever results in an improvement in individual patients is a positive outcome. As long as an active placebo treatment instigated by me has fewer harmful than beneficial effects, I consider it to be a success.

    • Hats off to Boris Gimbarzevsky for accurately describing the science of Family Practice.

      There are three kinds of medicine:

      Credential-Based Medicine: “I am an eminent scientist; I have lots of letters after my name; therefore my treatments are good.”

      Evidence-Based Medicine: “This treatment either comes from official guidelines or from the “accepted” medical literature (regardless as to whether it has been industry-tweaked); therefore it is bound to work.”

      Outcome-Based Medicine: “This treatment may not have yet become part of official guidelines, but it promised to give you far more benefit than harm. We tried it; it worked for you; therefore for you it is good medicine.”

      Too much emphasis on evidence-based science stifles the ART of medicine, which includes an ability to think outside of the box.

  4. Perhaps it is time to revamp the medical school curriculum into more than one stream. The first two years could be the same with the subsequent years triaged into family medicine, clinical specialists and research or clinical scientists. This could of course mean restricted licences since one could not expect a clinical scientist trained in the latest scientific literature, methods and hypotheses to practice good family medicine. Similarly, someone graduating from the Family practice stream would not likely qualify for a residency program or a Phd program.

McGill University is taking the lead in training more family physicians and updating the curriculum to include the “art” of medicine as well as the science of medicine. Well done

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