I could go on and on about the healthcare system. Biggest issue is nurses not doctors although GPs are a big issue. There was a worldwide movement to get rid of mental health institutions and give care in the community. Unfortunately doesn’t necessarily work. There is a huge shortage of mental health beds but it is also very hard to keep the people suffering the most severe mental health issues in hospital. Once people are stable enough they can leave if they want. Addiction, which is a mental health condition on its own, has lead to more mental illness and exacerbates existing mental illness. It is very expensive and labour intensive to provide mental healthcare. Most med students don’t want to be psychiatrists, most nurses don’t want to work on mental health floors because it can be very scary and chances of attack are high (you have to look behind each door, there a mirrors so you can see around the corner, etc.), it can be very challenging work and there is sadly a lot of death involved which can take a toll on healthcare providers. Compliance is an issue in most severe cases so it often takes a long time to treat a mental health issue before it is stabilized and once people feel better they can often stop taking their treatment because mental illness tricks you into thinking you’re cured. The majority of mental health services and therapy is done by psychologists not physicians. Psychiatrist primary treat mental health issues, figure out treatment plans, etc. Paychologists aren’t typically covered under public healthcare. Getting licensed as a foreign trained psychologist or counsellor isn’t that difficult. The bigger issue is that people don’t have access to care unless they have the funds or have extended healthcare benefits. If they did cover care I think most people would want access to therapy which would be a big problem. The easiest place to start would be to provide more detox and rehab facilities. The government spends a significant amount of money taking addicts to the ER/hospital, policing, jailing addicts, providing disability or welfare, etc. it should be fiscally easy to justify. Unfortunately because most don’t get sober and stay sober the first attempt the metrics don’t look great on paper and spending money treating addicts illicits a lot of negative response from many people who feel like people should be able to get sober and stay sober baed on will power. Given how bad the situation has gotten and tranq In the drug supply is going to lead to a wound care and amputation nightmare hopefully something will happen soon. We need more GPs. Canada should be creating more GP only medical schools and the CARMs match system has to ensure that every residency gets matched every year if there is an IMG interested in getting licensed in the specialty. This may still be difficult for French speaking residencies and some specialties like pathology or psychiatry that arn’t the right career for many medical students or IMGs but too many spots are going unfilled. Most are GP spots and we desperately need GPs. For other training programs governments need to pay GPs if they want them to take on extra responsibilities of overseeing training and signing off on charts. The government also needs to pay GPs more or med students will continue to specialize in other fields. They also need to stop the addition of a 3rd year of residency for GPs. If anything the GP only med school should be a condensed 3 year full-time program with lower tuition than regular med school. Hospitals also need to rewarded for innovation. And not have caps on how many surgeries can be compensated per year for example. Ontario currently penalizes you once you hit a certain number of types of surgeries. There needs to be less of a difference between healthcare worker compensation between the provinces because it incentivizes healthcare workers to work in certain provinces not others. We need to boost capacity in LTC dramatically or put more money into homecare so seniors don’t take up hospitals beds waiting for a bed in LTC for often months. We need to pay PSWs more because their jobs are incredibly hard and there is is a lot of turnover. The ratio between patients and PSWs have to change as well. We need to increase hospital capacity but that is dependent on increasing the number of nurses. No point in extra beds if you have no nurses to staff them. Biggest issue in Canadian hospitals is nurses and budgets. Most physicians only get a fraction of OR time they want/need and ORs arenk’t run at full capacity because they need staff and will need money to pay the staff. In general Canada pays healthcare workers more than many other countries which is why we are seeing an influx of healthcare workers from UK, Ireland, etc. Contrary to popular belief Canadian doctors aren’t moving to US like it was the 90s. Nurses have more incentive to move. We also need to increase capacity for other healthcare techs (ultrasound, MRI, etc.) and increase the number of medical lab workers. We have significantly less training spots than we need.
The wait times for proper therapy under IFHP can feel endless, especially when the stress of the whole process piles up day after day. I went through something similar and eventually looked beyond the usual channels for ways to manage the anxiety. At one point a friend mentioned trying
nebula palm reading and it actually helped me sort through some of the heavier thoughts without the long queues. Just sharing what worked for me in case it gives anyone else a different angle while dealing with the system.
Doctors aren’t actually the biggest tissue except GPs but they are the issue that gets the most attention. There are efforts to make IMG licensing easier. There have been a few more countries added to the list of countries where medical education and training is evaluated as similar enough to Canada’s that transition to practicing in Canada is mostly paperwork. The paperwork should be processed much more quickly and paper copies and duplicates of things seem ridiculous these days but hopefully that is slowly getting better. There is an attempt to make relicensing more of a checklist versus having to repeat full years of residency but in certain countries there are large inconsistencies depending on what med school you attend and what hospital you work at. Canada also wants to ensure they are doing their due diligence before licensing a physician. You also want to ensure residents and fellows get enough experience so you can’t easily add numerous people to every year of residency. Canada also has a limited amount of teaching hospitals so using regional hospitals to do some training is being implemented or discussed depending on where you are doing your training,
