Doctors Eying the U.S.: Canada Is Sick About It

NY Times ^ | 10/17/03 | CLIFFORD KRAUSS

[friendly]

Drs. Siva Sriharan and Srinivas Chakravarthi may never get rich staying in this small auto-producing city little more than a stone's throw from downtown Detroit, but they can eat all the hamburgers, ribs and potato skins they want for the rest of their lives at Casey's Bar and Grill.

For the next year, they can also get their hair cut free at the Touch of Class beauty salon, and lease a Pontiac Grand Am without charge from a dealer in nearby Essex. Patients have pledged free house repairs and landscaping for their properties, and nurses have teased them with offers of free massages.

All the two doctors have to do is continue practicing medicine in Windsor.

Residents started proffering gifts when rumors leaked out of Hôtel-Dieu Grace Hospital a few weeks ago that the two neurosurgeons — of the four serving the city — were toying with moving their practice to the United States.

"It's not about the money," said Dr. Sriharan, a 38-year-old immigrant from Sri Lanka. "We can't do our job properly with operating room time so extremely limited here."

Forced to compete for operating room time with other surgeons, he said that he and his colleague could complete only one or two operations on some days, meaning that patients whose cases were not emergencies could go months or even years before completing necessary treatment.

"Scarce resources are simply not being spent properly," Dr. Sriharan concluded, citing a shortage of nurses and anesthesiologists in the hospital where the single microscope available is old and breaking down.

The two surgeons are sharply critical of Canada's health care system, which is driven by government-financed insurance for all but increasingly rations service because of various technological and personnel shortages. Both doctors said they were fed up with a two-tier medical system in which those with connections go to the head of the line for surgery.

"It's the system that is pushing us out," said Dr. Chakravarthi, a 53-year-old Indian immigrant.

Many other Canadian doctors feel the lure of the United States these days, particularly if they live close to the border.

The supply of family doctors has increased at a rate lower than population growth in recent years, a problem that is complicated by an aging population and doctors seeking shorter hours. Waiting time for elective surgery is growing across the country, and becoming a hot political issue.

Meanwhile, there are signs that a brain drain of medical talent, particularly specialists to the United States, is becoming a serious problem.

There was a net migration of 49 neurosurgeons from Canada from 1996 to 2002, according to the Canadian Institute for Health Information, a large loss given that there are only 241 neurosurgeons in the country.

"Physicians across Canada are in an advanced stage of burnout due to work conditions," said Dr. Sunil V. Patel, president of the Canadian Medical Association, who attributed much of the problem to technological shortages and the powerlessness doctors feel when patients complain about long waits for treatment. "That burnout causes them to retire early or pull away from certain kinds of work or simply leave."

John O'Kane, 46, the owner of Casey's Bar and Grill, is leading the local crusade to keep the two neurosurgeons in Windsor. His offer of free food is rooted in personal experience; he is convinced that superior surgery performed on him last year by Dr. Sriharan to remove a broken piece of a spinal disk rubbing against a sciatic nerve is the reason he can again play ice hockey and tennis.

So far the doctors have not come by for any free food, nor have they responded to any of the other offers that have followed.

"For all I know they are vegetarians," Mr. O'Kane said with a laugh. (In fact, Dr. Chakravarthi is.)

The grass-roots surge of offers and almost daily letters to the editor published in the local newspaper urging the surgeons to stay put has not gone unnoticed by local politicians. Windsor's mayor, Mike D. Hurst, has speeded up a physician recruitment and retention initiative to combat local shortages of medical manpower.

"The popular response is an indication," he said, "that there is pure fear in our community of not having qualified, professional medical expertise available when it's needed."

As for the two surgeons, they say that while they are touched and embarrassed, they do not see how they can continue to work at the hospital under the present conditions.

[DoctorMichael]

My Uber-Furher is helping an Anti-American, Bush-hating (....private comments he has made to me....) mainland Chinese MD get his 'equivalency' so that he can practice here in the US. We are being inundated with a lot of foreign doctors that want to come here.

[verity]

Why would anyone want to be a Doctor in this day and age?"

It must be the attraction of those free massages referenced in the lead article. lol

[DoctorMichael]

.......AND, they pay half (or more) of that $300K in malpractice insurance because of the trial lawyers.

[Desparado]

The big dark secret is that it is all just a wealth shifting scheme. The govt forces us to pay taxes, and then it doles the money (Billions of dollars) out to the Healthcare industry. The poor stupid people in the middle are just being used as pawns. They are the conveyer belt that is used to move the money from the tax revenues to the Healthcare and Pharmaceutical industries. They don't care because they are not paying for it. It's easy to go to the Doctor and have thousands of dollars of useless testing done when you are not going to have to pay for it.

[friendly]

Can someone explain why all the doctors are from India and the Middle East? Doesn't Canada have medical schools ... or don't Canadians atttend them?

Medicine is not attractive to the Best and the Brightest young North Americans. If you look at the horrors of modern practice, you generally choose another field, any other field. We are reduced to stealing Best and the Brightest from other countries!

[DoctorMichael]

I agree with your statement, however..........To say that its solely the fault of 'Big Drugs' and 'Big Healthcare' is not seeing the whole picture. Its a "Perfect Storm" scenario where various forces are converging that exacerbate and accelerate a bad situation to the detriment of the American people, much the same as the illegal Mexican immigrant situation is the fault of both businesses needing cheap labor (Republicans) and certain political Party's (Democrats) needing voters that are beholden to them.

'Wealth shifting' is a by-product (an 'Effect') not the 'Cause', IMHO.

[MarkL]

Yes, and if you think health care is expensive, wait until it becomes free!

And if you like renewing your driver's license at the DMV, you'll LOVE government run health care... For a preview, go to any VA hostpital (with certain exceptions, like Walter Reed, or any other hospital near politicians!). The KC VA hospital was nearly closed down for health code violations, including rat and fly infestations!

Mark

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Of course, anyone with wealth, including the Canadian limosene liberals, just hops on an Airplane and heads south for any needed medical care

The elite in Canada (and Washington) have their own free luxury, high quality health system that in a million years they would never allow the peons.

All I want is the same health care opportunities as Hillary, Ted Kennedy, and the rest of the elite (of both parties!).

[friendly]

Post #23: amazing and interesting!

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Medicare is a nemesis to an increasing number of MDs, who try to avoid it if at all possible. Many others are trapped in Medicare based practices and burning out rapidly as a result.

[Jim Noble]

I don't think you can be put in jail by Medicare-yet.

However, you cannot treat a Medicare patient outside of the system without being banned from Medicare-which, for most primary care types means being put out of business.

[Desparado]

I understand what you are saying, but at the same time there are a lot of people letting this happen and jumping on the train for a free ride; both citizens who are getting free healthcare and meds, and industry people who are getting rich at the expense of the American taxpayers. And that doesn't even begin to address the gigantic Govt. machine of union (i.e govt) workers that it is taking to perpetrate all this on the American People.

[friendly]

There are many tens of thousands of pages of incomprehensible Medicare regulations that crminalize every aspect of physician practice. 100% of physicians are in criminal non-compliance with the code.

The fact that MDs are not being tossed in jail in this Stalinist system on a regular basis is irrelevant.

[Jim Noble]

100% of physicians are in criminal non-compliance with the code.

Yes, I know. I'm one of them.

I have assumed that, one day, we can be collectively or selectively rounded up and that we will be given an offer we can't refuse.

[DoctorMichael]

".....a lot of people letting this happen and jumping on the train for a free ride....."

Agreed. Citizens, Industry people, Politicians, Govt. Unions: The Perfect Storm.

[seowulf]

Socialism has a fundamental flaw: It removes the power to allocate scarce resources from the point of economic impact where the decision must be made to a centralized point where it is impossible to have the correct information concerning all parties within an appropriate period of time in order to make the proper decision.

---

Correct observation. Socialism in all its forms is the cause of the problem. Every socialist "solution" from progressive income taxes to free government education allocates resources inefficiently.

If there were no taxes on income (work), then there would be no incentive for peoples medical insurance to be connected to employment. Since there is a tax on income, workers want that income sheltered by having part of their income provided in "free" benefits, like health insurance. Of course government gets to make the rules on how businesses must provide the insurance. People began to believe years ago that they are not responsible for their own health because it was taken out of their hands. Now they think government or their employer are responsible for their health (witness the grocery store strikes). Now, not only do they not take proper precautions for their own benefit (healthy eating, exercise) but they expect someone else to fix everything with those "free" drugs and healthcare.

[friendly]

100% of physicians are in criminal non-compliance with the code. Yes, I know. I'm one of them. I have assumed that, one day, we can be collectively or selectively rounded up and that we will be given an offer we can't refuse.

You have just described the exact history of the medical profession in East Germany, Cuba, and (to a more velvet gloved degree) Canada.

[friendly]

bttt