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A lot of the problems in medical care have nothing to do with the system (Canada vs US) and everything to do with doctor supply. It’s simply not a great career

A lot of the problems in medical care have nothing to do with the system (Canada vs US) and everything to do with doctor supply. It’s simply not a great career choice anymore. You start work very late in life, and make only OK money. Some specialists make a lot but they start even later. Some GPs make a lot but they run patient mills. For most GPs, it’s an extreme slog without extreme reward. The same career issue goes triple for nurses. Young nurses are quitting in droves.

preommr 2y ago
It's a broken system. Years of training, very selective, highly expensive... only for a lot of it to be telling people common sense things like eat less and excercise more.
- mrguyorama 2y ago
  Never mind that half your patients will swear to your face that your entire decade of training was part of a global conspiracy by Bill Gates to put microchips in your arm or other bullshit. And half of your nurses will agree with them!
Pxtl 2y ago
I know it would be political suicide, but I do believe that we could still have a very good medical system if the level of education we demand of doctors was reserved for surgeons and leadership and the front-line work of GP-style treatment was 100% left to people who were qualified by a normal nurse-style process of undergrad + apprenticeship + test.
- triceratops 2y ago
  That's kind of how it works outside of North America. Students go into medical school right out of high school, and medical school is about 6 years - maybe including residency. They graduate with a degree that allows them to practice general and family medicine. If they want to become specialists, they keep studying and more residency. North America seems to be alone in requiring a 4 year degree before letting a student anywhere near a medical school.
  - fma 2y ago
    Also "rest of the world" the medical professionals do not get into massive debt and hence do not need massive compensation upon graduation to offset. One issue of getting more supply of doctor would, I believe, be the resistance from the current system since more supply means lower prices... Additionally since a lot of our healthcare is managed by Private Equity or other forms of investors that are looking for a profit, I suspect with cheaper staff they will just keep prices the same and increase their profits.
andrewla 2y ago
> and make only OK money Sounds like it has a lot to do with the system. In the US, because of employer insurance, the cost of insurance is mostly hidden from patients. The cost of medical care is similarly opaque -- consumers expect routine checkups to be essentially free, and sick visits to cost next to nothing. Insurance companies are always trying to drive down their costs, and control access for a huge set of patients.

preommr 2y ago

It's a broken system. Years of training, very selective, highly expensive... only for a lot of it to be telling people common sense things like eat less and excercise more.

mrguyorama 2y ago
Never mind that half your patients will swear to your face that your entire decade of training was part of a global conspiracy by Bill Gates to put microchips in your arm or other bullshit. And half of your nurses will agree with them!

Pxtl 2y ago

I know it would be political suicide, but I do believe that we could still have a very good medical system if the level of education we demand of doctors was reserved for surgeons and leadership and the front-line work of GP-style treatment was 100% left to people who were qualified by a normal nurse-style process of undergrad + apprenticeship + test.

triceratops 2y ago
That's kind of how it works outside of North America. Students go into medical school right out of high school, and medical school is about 6 years - maybe including residency. They graduate with a degree that allows them to practice general and family medicine. If they want to become specialists, they keep studying and more residency. North America seems to be alone in requiring a 4 year degree before letting a student anywhere near a medical school.
- fma 2y ago
  Also "rest of the world" the medical professionals do not get into massive debt and hence do not need massive compensation upon graduation to offset. One issue of getting more supply of doctor would, I believe, be the resistance from the current system since more supply means lower prices... Additionally since a lot of our healthcare is managed by Private Equity or other forms of investors that are looking for a profit, I suspect with cheaper staff they will just keep prices the same and increase their profits.

andrewla 2y ago

> and make only OK money Sounds like it has a lot to do with the system. In the US, because of employer insurance, the cost of insurance is mostly hidden from patients. The cost of medical care is similarly opaque -- consumers expect routine checkups to be essentially free, and sick visits to cost next to nothing. Insurance companies are always trying to drive down their costs, and control access for a huge set of patients.