KristoffWixenschon

There is no way Dzingel clears

I agree with what you're saying. I share those concerns. Until we know the actual plan for how these services are proposed to be implemented, families will be feeling anxious. And your personal experience is a really important point. With strong, well-funded early intervention, kids on the autism spectrum can grow to be very functional adults. A reduction in service could be devastating. Who will be making the decision as to which family receives how much support? I understand that children living with other (non-spectrum) developmental delays also need access to funding but it seems reasonable to just give those families access to direct funding much like the autism funding model.

I get worried any time the government tries to take on the management of services. I live in a small community. I think our families benefit from the current model. They have complete flexibility to choose their own service provider. I worry that when the government gets involved, they will spend more money on management and overhead, limiting the number of available service providers...or mandate that each service provider must hold a specific diploma...when we have all experienced that sometimes the best service providers are not the ones with the academic background. I worry that this will mean waitlists for Behavioural Intervention services. I worry that small communities that do not have access to Behavioural Consultants will be unable to operate a hub... I think it will be messy and I hope I'm wrong.

I miss being excited about hockey! I find myself checking the scores before bed more often than I watch the games. I started to check out during the Tortorella year but it's really fallen off since we haven't been allowed to gather with people to watch the games. The atmosphere of everyone glued to the screen while working through a pint is part of the experience for me.

I always check this forum for Vintage updates. I haven't used nhl.com's trade tracker for years. Vintage does it faster and does it well-formatted. Vintage is irreplaceable.

I don't think it's motivated by greed. I think it's motivated by burn-out. They have waaaay too many people to see. Canadian physicians get paid on a "fee for service" basis. This means that your visit gets billed for the exact same amount of money as anyone else's visit. You come in, your medical issue is pretty straight forward, you have a sound enough mind to follow the doctor's advice, you are in and out in 10 minutes. Now for example, somebody else comes in after you.... and they have a long history of trauma, they inject drugs, they have chronic pain (probably caused by their trauma and anxiety), they want to get off of heroin but they want to refill their prescriptions for morphine, they are dealing with an infection from injection sites that just won't heal.... their visit takes an hour. The doctor gets paid the same amount for that visit. The doctor puts in waaaay more time and energy to deal with their problem than they did with your problem, but they get compensated the same amount. So in a way, physicians probably prefer a panel full of people that are a little more like you (if you came in more often haha). They would obviously prefer to see people with non-complex problems, who can follow their medical advice. If everyone they saw were like you, they could run through 55 patients per day and make a ton of money. The problem is, doctors are usually really good people, so they continue to take on these complex patients. They recognize that these people desperately need medical care. Then their patient panels explode up to 1500-2000 patients and they get overwhelmed. That is 1500-2000 people who might make an appointment in clinic, but also might.... get pregnant, get in a car accident, have a heart attack, move into long term care.... The doctor will still have to see them for those reasons as well. It becomes a lot. Anyway, long story short, I totally understand why they need to trim off patients from their panels. But I agree I think the way that some physicians have been going about it is pretty bad. Really we just need more doctors in Canada. Our process to import doctors is needlessly long and there are so many expensive hoops to jump through. We would attract way more physicians from overseas if we cleaned up that process. And we should probably pay them more so that they stop moving to the US... And I guess we should actually have more medical programs with residency training in Canada.... the number of residencies in Canada is shockingly low... most of our grads do residency in the US and then stay there..... lots of systems issues.

Yeah that's pretty ridiculous and frustrating. I've heard similar stories where the office did not contact patients about this rule to explain what was going to happen, but just started firing patients. I think it's obvious that doctors should have to at least attempt to make contact to explain this rule before they start removing people from their panel. But it definitely wasn't the receptionist's decision. She is taking direction directly from your doctor. Sounds like she probably had to go track down your doctor to say that some scary dude was going to come and break covid protocols to yell at her so the doctor changed his mind about dropping you to prevent the receptionist from having to deal with an angry man conflict. Squeaky wheel. There are definitely a lot of people who no longer have family doctors because they do not feel comfortable being assertive. I still feel bad for that receptionist though

Interestingly enough, when you end up with a chronic disease because of an unhealthy lifestyle (diabetes, COPD, emphysema..) you can apply for a disability tax credit. So they end up paying fewer taxes to fund the healthcare system that they use disproportionately more. But it brings up an interesting concept. We are really talking about addiction. Addiction to processed foods, tobacco, alcohol.... How much choice does someone have when it comes to their addiction? If we, as a society, feel that addiction is a disease... then we can't really punish someone for having a disease. We know that addiction is usually associated with some sort of life trauma. Addiction is usually the coping mechanism to repress that trauma. And we know that trauma is effectively a type of brain damage.... so... that's where I struggle. On the one hand, I want people who "choose" to smoke or eat garbage food to pay more into the healthcare system. But on the other hand, they probably have way less control over their "decisions" than I give them credit for. We should probably be hitting up the tobacco and processed foods companies to chip in financially.

I don't think that would change anything. Hospitals wouldn't deny space to someone who was dangerously ill with covid. Hospitals will continue to give priority to whoever has the most pressing concern at the time. Generally though I hear what you're saying. It continues to be frustrating that other peoples' choices are having such a direct impact on the lives of people we love. It won't make a difference to the way medical care is provided though.

You and me, Jimmy! Let's get to work fixing this province! I just don't think you get cool things like a rural health training initiative without the advocacy and insight of a Health Authority. We need a certain amount of administrative effort to research the needs of communities, interview professionals on what their needs are, develop plans for recruitment and retention and submit those proposals to the province. All we (the north) usually see out of centralized systems (MCFD, Ministry of Ed) are endless pilot programs that leave people hanging when the funding runs out. But who knew? All Northern Health needed to do was to send people out into the world to marry medical professionals and convince them to live here. I should charge NH a recruitment fee for my service! Honestly we can thank covid for bringing her here. The border closure really forced our hand to make a decision where to live.

Haha well said. Though we have to consider, its not just a funding issue that results in rural health care being understaffed. It is insanely challenging to hire, train, and retain people in small communities. My wife recently immigrated to Canada and is working as a physician in Northern Health. There were so many barriers in her way. If it wasnt for the fact we were married, she would never have muddled through all this needless Fed/Provincial bureaucracy. But to Northern Health's credit, the reason she may stay for longer than intended is because of the freedom she has within the health authority. She has access to northern research grant funding, paid training initiatives, the ability to get paid to train to do day surgeries and an incredible amount of independence in her practice. These initiatives would be missed in a centralized system and they really fill the gaps in care within smaller communities.

At least we agree that there are better models for care. I just cant imagine that care for small communities improves when the needs of each small community must be decided provincially instead of by a health authority. I might agree to at least centralize licensing to the federal government. It's never made sense to me why a physician who practices in BC has a bunch of bureaucracy to go through to become licensed in any other province. And for a country that imports many of our doctors from other countries, it's an unnecessary hurdle to their immigration process.

How is that really different than what we have now?

I think we just have to disagree. The autonomy of the health authorities is their greatest strength. Rural medicine does not function the same way that it does in urban centers. You cant have the same process for recruitment and care.

Not all, but some. Completely agree. I think most physicians would agree. My wife is a family doctor and is annoyed when she has to see people just to write the same prescription again. Now her patients who are on pain medication for example... that's a different story. You want to be meeting with them regularly and not just renewing meds.

You would have a second layer of decision making either way, centralized system or not. Even if you took away the label of health authorities, theres no way a provincial system could operate with a "one size fits all" plan. The local health authority has insight into what the needs of their communities are. They (at least try to) spend money on what is actually important to community health, which is different in different areas. I'm not saying that there isnt redundancy and waste in our system. I just dont think it's in the separation of health authorities. I think that leads to better outcomes

I think having different health authorities makes a lot of sense. Healthcare is very different in rural northern BC than it is in New Westminster. The challenges that northern rural medicine faces are different challenges than more populous areas face. Access to care... training, hiring and retaining professionals... outdated systems, aging population, more individualized service to local indigenous population... I think there is a good argument for separate health authorities

OPs attempt at shaming someone for insulting a group of people.... has led to themselves being shamed for insulting a group of people... fun!

Language is important. We use language to define things and people. I agree we need to use respectful language to show people that we respect them. And I also agree that this is a complex topic and we probably will not see a valuable discussion about it here. But I also think that if someone experienced puberty with a large production of testosterone, that they generally have a physical advantage over those that did not. But there are just too many variables for there to be a solution that makes everyone feel happy, secure, safe and heard. For example, when would someone have started hormone replacement therapy? What is the data on that? What about people who have an XX chromosomal profile but have outwardly male sex organs, or vice versa? There are some questions we just don't have the answers to right now.

Awesome! Kudos to your parents. People dont often teach their kids to think critically. That's great!

And here I always thought it was the other way around! Hahahaha Yknow, I tend to believe that people will always do the best they can, with the information and circumstances that they have at the time. If we see someone coming from a hateful, ignorant place, they might need our acceptance and validation most of all.

I agree. Many peoples only social outlet is social media these days. More so now with covid than ever.

Haha I hear you. But stupidity is absolutely something that is taught. Racism, sexism, hatred, ignorance... all of these things are things we learn or unlearn by the modeling we got from our upbringing

Yeah, I think we are all a product of our environments. I'm sure they were taught to think in these faulty ways from early on in their lives. You often hear their cries that their "truth" is being silenced. I absolutely think that would radicalize someone, if they think they have the truth but aren't allowed to tell anyone

Oh they definitely share their views on social media (at least my crazy uncle does), but they are often banned for it. And that's a tricky situation. I understand the inclination to want to remove misinformation. Misinformation can be actively harmful if people believe it. However, when people get banned from social media, they dont just go away. They find another medium through which they express their views. And then they are only surrounded by other knuckleheads repeating the same ignorant propaganda. It's been said before, but the only cure for bad information is to be exposed to better information. I think if society listened to and engaged with people who are misinformed, instead of forcing them to shut up, we wouldn't have such division on a lot of topics.