Members LanEvo Posted January 26, 2008 Members Share Posted January 26, 2008 I'll have to ask my cousin (brain surgeon) why she decided to move back here. ... She moved to the states so she could do her job and get into research etc. (way more people there, so more brain surgeon work required) ... So I'm interested to see why she came back to Canada. I'm sure she made more money there and worked more in her field.I'm guessing she did her training in Canada? My understanding is that Canadian neurosurgery residency programs are not recognized by the American Board of Neurological Surgery, therefore the graduates are not Board eligible. If she trained in Canada and then went to the US to practice, that means she was probably working under tight constraints (it's pretty limiting trying to work in medicine without Board certification). On top of that, she might have had visa issues. It's seems to have been getting harder and harder for foreign nationals to secure long-term work visas. Link to comment Share on other sites More sharing options...
Members LanEvo Posted January 26, 2008 Members Share Posted January 26, 2008 Having worked as a physician in the US and Canada, I must say I find many of these comments pretty funny. Lots of misconceptions all around. I suppose this is unsurprising since private vs. public healthcare has become such a hot political issue.Is this really true? I'm asking an honest question, not criticizing. If you showed up to a hospital with a severe arm injury and no insurance, would they really make a call like that? Let's say you cut your arm up with a homemade table saw, and got rushed to the ER. They can either amputate your arm for a cost of $10,000 or put you through more intensive surgery to save it for $50,000 (with an estimated 75% chance of success). Would a hospital really say "screw it, he can't pay so we're just amputating the darn thing?"Your responsibility as a physician is to offer your patient the best care possible. That does not mean every patient should have free, easy, and quick access to elective surgery. However, saving a person's arm can hardly be considered elective surgery. As a surgeon, you would do what you can to preserve the patient's function...regardless of cost or who is paying the bills.The bare minimum duty is to stabilize the patient and transfer their care to another physician or medical center if you can't provide the service they need. No one would amputate a limb if they could save it. It just doesn't happen that way. Link to comment Share on other sites More sharing options...
Members LanEvo Posted January 26, 2008 Members Share Posted January 26, 2008 Serious Question. Are Canadian Physicians more protected from lawsuits? If not, is it just a systemic lawsuit culture here that causes this?Everyone in Canada is better protected from frivolous lawsuits. For one thing, you're not allowed to hire a lawyer on contingency. That means you need to pay a few grand up front to bring your case to court...which means people are less motivated to sue if their case doesn't have a leg to stand on. Further, there are limits to the amount of punitive damages you can seek. You can ask for direct damages and a bit more...but not millions more. Again, that makes people less motivated to go after people and/or organizations they perceive as wealthy. People tend to sue when they have legitimate complaints. And those complaints get settled for reasonable amounts of money. In my 5 years in Montreal, I was never sued. Among my 5 colleagues, only one was sued during that 5-year period (and that was a legitimate complaint). This is unheard of in Obstetrics and Gynecology in the US. The American system seems to be set up to punish physicians for every bad outcome they might have...even if they didn't really do anything wrong. You can do everything "correctly" and still have a bad outcome. That's life. These matters are better settled in M&M (Morbidity and Mortality) rounds rather than in civil court. Link to comment Share on other sites More sharing options...
Moderators Kindness Posted January 26, 2008 Moderators Share Posted January 26, 2008 I was going to make a joke about "how's that free haircut working for you?" but then saw that a bunch of people want me dead. There are lots of opportunities to do very good things for humanity as a lawyer. If more of you good people would join me in my profession maybe it'd be worth sparing a few of us from being burned at the stake. Doctors on the other hand, nothing but trouble! I've literally had my life saved several times by doctors. I also have friends that are doctors that have become so jaded with their own profession that they encourage bright young students to NOT become doctors. To me that is the biggest indication that something is drastically wrong with our current system. I am not a doctor and do not work in any fields that give me any insight into the problems and solutions so I have nothing great to contribute, but I would like to see things change in this country to the point that great minds are encouraged into professions that have extremely positive impacts on society. Link to comment Share on other sites More sharing options...
Members countrybass Posted January 26, 2008 Members Share Posted January 26, 2008 Kill all the lawyers. Link to comment Share on other sites More sharing options...
Members countrybass Posted January 26, 2008 Members Share Posted January 26, 2008 The bare minimum duty is to stabilize the patient and transfer their care to another physician or medical center if you can't provide the service they need. No one would amputate a limb if they could save it. It just doesn't happen that way. What, and transfer the patient where? To another facility that won't get paid either. Link to comment Share on other sites More sharing options...
Members Jugghaid Posted January 26, 2008 Members Share Posted January 26, 2008 The American system seems to be set up to punish physicians for every bad outcome they might have...even if they didn't really do anything wrong. You can do everything "correctly" and still have a bad outcome. That's life. These matters are better settled in M&M (Morbidity and Mortality) rounds rather than in civil court. And IMO, this is one of the central problems. Not only with the medical profession, but you culd apply this to our society in general. Link to comment Share on other sites More sharing options...
Moderators Kindness Posted January 26, 2008 Moderators Share Posted January 26, 2008 And IMO, this is one of the central problems. Not only with the medical profession, but you culd apply this to our society in general. +1 Link to comment Share on other sites More sharing options...
Members Psilocybin Posted January 26, 2008 Members Share Posted January 26, 2008 In short, if we just sent all the lawyers on a nice Auschwitz vacation, things might improve. Link to comment Share on other sites More sharing options...
Members bikehorn Posted January 26, 2008 Members Share Posted January 26, 2008 Serious Question. Are Canadian Physicians more protected from lawsuits? If not, is it just a systemic lawsuit culture here that causes this? I believe the maximum punitive damages you can be awarded for personal torts in the Canadian legal system is $250,000 plus potential for up to $250,000 special damages. So if your case is epic beyond epic, the absolute maximum payout will be $500,000. Also, for my dad's practice, his malpractice insurance is handled the Ontario Medical Association which covers you when you become a member. It isn't the norm for doctors to be sued for malpractice here so the rates are low enough to be included within membership fees(whatever they are, probably steep). That said, we aren't immune to frivolous lawsuits, and my dad is in the middle of dealing with a BS lawsuit by some dumb bitch from 10 years ago. The plaintiff is 5'2" and 350 lbs, or was when my dad anaesthetised her and had a plethora of health problems to begin with. She went for some kind of elective abdominal procedure and later tried to claim that problems in her kneecap resulted from that abdominal procedure. Her case has been dropped by three successive law firms and she is now on her fourth. Link to comment Share on other sites More sharing options...
Moderators Kindness Posted January 26, 2008 Moderators Share Posted January 26, 2008 In short, if we just sent all the lawyers on a nice Auschwitz vacation, things might improve. Is it getting uncomfortable in here or is it just me? Link to comment Share on other sites More sharing options...
Members J. Posted January 26, 2008 Members Share Posted January 26, 2008 That said, we aren't immune to frivolous lawsuits, and my dad is in the middle of dealing with a BS lawsuit by some dumb bitch from 10 years ago. The plaintiff is 5'2" and 350 lbs, or was when my dad anaesthetised her and had a plethora of health problems to begin with. She went for some kind of elective abdominal procedure and later tried to claim that problems in her kneecap resulted from that abdominal procedure. Her case has been dropped by three successive law firms and she is now on her fourth. Why can't the hammer be brought down on cunts like her? Tell her that her lawsuit has no merit and that she has to pay all court costs she's induced over the past decade. Link to comment Share on other sites More sharing options...
Members lug Posted January 26, 2008 Members Share Posted January 26, 2008 That said, we aren't immune to frivolous lawsuits, and my dad is in the middle of dealing with a BS lawsuit by some dumb bitch from 10 years ago. The plaintiff is 5'2" and 350 lbs, or was when my dad anaesthetised her and had a plethora of health problems to begin with. She went for some kind of elective abdominal procedure and later tried to claim that problems in her kneecap resulted from that abdominal procedure. Her case has been dropped by three successive law firms and she is now on her fourth. Unfortunately, you can't get away from the "free ride" citizens in this day and age unless you're poor....THEN YOU'RE EXEMPT! Link to comment Share on other sites More sharing options...
Members georgestrings Posted January 26, 2008 Members Share Posted January 26, 2008 I'm not going to slam the Canadian health care system. I figure if I lived there, I could judge for myself. We have enough problems in the US to cast stones... What he said... - georgestrings Link to comment Share on other sites More sharing options...
Members LanEvo Posted January 26, 2008 Members Share Posted January 26, 2008 What, and transfer the patient where? To another facility that won't get paid either.I think you're letting your prejudices get in the way here. By "transfer care to another physician" I do NOT mean "pass the patient off to someone else so you don't have to foot the bill." Let's say I'm a general surgeon in a small rural hospital and a guy comes in who needs a surgical procedure that can only be done by a specialist in a tertiary care center. Then it's my duty to give the patient the best care I can in this critical situation (that care might not be optimal...but it's the best I can do under the circumstances). Then, once the patient is stable, I transfer them to the other medical center to get the specialist care they need. No one is going to put a patient out on the street just because they can't pay. You treat them as per the standard of care. You worry about the bill later. Link to comment Share on other sites More sharing options...
Members J. Posted January 26, 2008 Members Share Posted January 26, 2008 Not true at all, unfortunately.Over two million people filed bankruptcy in this country in 2005. I have read studies (as I'm in the industry) where anywhere from 27% to 54% of these filings are PRIMARILY due to medical bills. Not just as a contributing factor.Granted, that's a large spread, but if you take it right down the middle and call it ~40%, then you are talking about 800,000 people in a single year forced into bankruptcy by medical bills.My brother in law, who I helped keep out of bankruptcy, got a bill for over $130,000 when he had a heart attack about 5 years ago. I settled all the bills for about $30,000 and the family helped him pay that off. But it's a pretty serious problem. Do medical bills/debts get canceled in chapter 7 personal bankruptcy, or do you still have to pay under some sort of restructuring? I know things like criminal fines and student loans can't be wiped clean (at least according to some web source I read) but I thought medical bills were in that group too. How were you able to settle $130k for only $30k? That's one heck of a big discount! I tried to deal on a medical bill I had recently and the hospital wouldn't budge. Link to comment Share on other sites More sharing options...
Members Jugghaid Posted January 28, 2008 Members Share Posted January 28, 2008 Do medical bills/debts get canceled in chapter 7 personal bankruptcy, or do you still have to pay under some sort of restructuring? I know things like criminal fines and student loans can't be wiped clean (at least according to some web source I read) but I thought medical bills were in that group too. In a chapter 7, yes. It's basically a do-over. All of your unsecured debt gets wiped out. And only government guaranteed student loans are excepted. As well as court ordered restitution and such. But even judgements can not be executed under a chapter 7. Medical bills are absolutely dischrageable through a chapter 7. How were you able to settle $130k for only $30k? That's one heck of a big discount! I tried to deal on a medical bill I had recently and the hospital wouldn't budge. Because I'm good. I actually helped one of my friends (ex-coworker) start a debt settlement company. I owned the marketing arm of it until I sold it. It's not that hard to do, you just have to be the one with leverage. Link to comment Share on other sites More sharing options...
Members wades_keys Posted January 28, 2008 Members Share Posted January 28, 2008 Is it getting uncomfortable in here...Only for attorneys... Link to comment Share on other sites More sharing options...
Members wades_keys Posted January 28, 2008 Members Share Posted January 28, 2008 No one is going to put a patient out on the street just because they can't pay. You treat them as per the standard of care. You worry about the bill later. No, of course not. They just make sure and take all of the paying patients first, while you wait in the corner dying. Link to comment Share on other sites More sharing options...
Members LanEvo Posted January 28, 2008 Members Share Posted January 28, 2008 No, of course not.They just make sure and take all of the paying patients first, while you wait in the corner dying.Again, that's just not how it works. The real world works a little differently from what you see in movies by Michael Moore or whatever. If a patient needs care (especially urgent care) they get it...regardless of cost and/or who is paying. It really is just that simple. The reason you hear about uninsured people languishing in emergency rooms is because they have no regular physician so they show up to the ER with minor complaints. If you show up at the ER with a non-emergent (let alone non-urgent) complaint, you will be put in the back of the line. That's how triage works. You bring patients into the ER in the order of seriousness and urgency of their condition. Economics has nothing to do with it. Again, I can't really blame you guys for having these misconceptions since medical care has turned into such a hot-button political issue. Sure, medicine in the US can be improved. But it's hardly anywhere NEAR as bad as what certain left-wing extremists would have you believe. Take it from someone who has worked both in Canada and the US...the system in Canada is not exactly the medical utopia Michael Moore portrays it to be. Do your own research rather than relying on being spoon-fed by propagandists. Link to comment Share on other sites More sharing options...
Members King Kashue Posted January 29, 2008 Members Share Posted January 29, 2008 All of your unsecured debt gets wiped out. And only government guaranteed student loans are excepted. Not that I was planning to declare bankruptcy or anything, but crap! Link to comment Share on other sites More sharing options...
Members Jazz Ad Posted January 29, 2008 Members Share Posted January 29, 2008 Personal bankrupty doesn't exist in France.You remain responsible for what you owe, which is fine as far as I'm concerned. Link to comment Share on other sites More sharing options...
Members J. Posted January 29, 2008 Members Share Posted January 29, 2008 Personal bankruptcy doesn't exist in France.You remain responsible for what you owe, which is fine as far as I'm concerned. Well, France has a larger safety net than the United States. The fact that nobody gets huge medical bills they can't pay probably cuts down on a ton of debt. I think it's good that personal bankruptcy exists here, although it's a shame that people abuse it. I think it should only be a last resort - something you do when you have no other options. I know people who have been there. Heck, my own parents were there when I was an infant. My dad's construction business went belly up and a ton of stuff went unpaid. My parents filed personal bankruptcy after the business tanked. There was a lien put on their house, but it expired since they continued living there for a number of years afterwards. I remember my parents getting their first credit card post-bankruptcy. Back then it must've been harder to get a credit card after filing chapter 7 than it is today. Link to comment Share on other sites More sharing options...
Members mrblockofcheese Posted January 29, 2008 Members Share Posted January 29, 2008 you guys aren't looking at the real issue. government involvement in healthcare is the whole problem. your all arguing over whether the private system or the socialist system is better when we don't even have a private (unregulated) system in the first place. doctors in this country (that's america for me) are forced to fill out reams and reams of paperwork to the extent that they have to hire people to go through it all. how much do you think they are getting paid for that? i'm willing to bet at least 30,000 a year and then think of all the hospitals that have to pay for these people. just right there you have millions if not hundreds of millions in costs that are inevitably going to be passed on to you. the real problem is government and we need to get them out of the healthcare market and have a truly free and unregulated market. Link to comment Share on other sites More sharing options...
Members Jazz Ad Posted January 29, 2008 Members Share Posted January 29, 2008 If you think private operations generate less administrative staff and paperfilling, you are sadly mistaken. Link to comment Share on other sites More sharing options...
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