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Monthly Archives: June 2014

Beverly Medical Clinic – Family Medicine – Paediatrician – Internist

Beverly Medical Clinic

4243 118th Ave NW, T5W 1A5

Edmonton, Alberta, Canada 

EdmontonSkyline2013

This is your chance to live in a Canadian city ranked among the best places to live in North America. It is a city with education and arts as the center of its cultural life, an outstanding place to raise a family, earn excellent income and enjoy a very comfortable lifestyle.

Work-life:

1)      Physician income is Fee-For-Service, with average annual income exceeds $325,000 for Family Physicians/GPs, and more than $400,000 for Specialists.

2)      Revenue is split 70% /30%, physician/clinic to cover capital costs and operating expenses.

3)     Average patient intake per hour ranges from 4-10 depending on individual physician work style and patient acuity.

4)     Patient records are electronic Health Quest/Net Care.

5)     The patient mix is currently 30% appointment and 70% walk-in patients.

6)     The patient population is cross-section ranging from middle to low income families, and a post-secondary student population – living in detached homes, apartments, and condominiums in the local area.

7)     The clinic currently accommodates various medical students as part of their curriculum.

Edmonton Lifestyle:

a)      Edmonton is a vibrant, energetic city at once diverse and highly connected by a welcoming sense of community. Northeast Edmonton has the advantage of easy access to shopping, cultural events, youth activities and the downtown, while still providing families with space and autonomy. The public school system second to none featuring a wide variety of programs and extracurricular activities, including sports, the arts, hobbies, and academic pursuits.

b)      Post-secondary education opportunities include the renowned University of Alberta, Grant McEwan College, and Northern Alberta Institute of Technology (NAIT).

c)      Edmonton lives up to its name as the “Festival City” of Canada! Events include the Fringe Festival (showcasing local theatre), Heritage Days (celebrating the city’s multiculturalism), Folk Festival, K-Days, and the Festival of Trees (charitable winter celebration) just to name a few…

d)      Edmonton is a highly diverse city, exemplified by the numerous religious, ethnic and cultural roots of its citizens. The city has hundreds of churches and religious buildings representing a wide variety of religious sects.

e)      With over 460 community parks, 17 recreation centres and dozens of sport fields, arenas, and swimming pools, families always have something to do.  The many indoor facilities ensure that most seasonal sports (cricket, soccer, basketball, lacrosse, etc.) and community activities are available year-round.

f)       Edmonton’s four distinct seasons ensure that youth and adults have boundless and diverse family activities and social pursuits.

g)      Professional sport fan?? Do you love the thrill and excitement of cheering on your favourite world class home team? Then plan to buy your season tickets now to cheer on the Edmonton Oilers of the National Hockey League, and/or the Edmonton Eskimos of the Canadian Football League.

h)      Edmonton’s Light-Rail Transit (LRT) system, supported our city-wide public bus transit system provides easy city-wide access. In addition, the Anthony Henday Ring Road highway encircles Edmonton and acts as a quick and easy route to travel from one end of the city to the other. Whether driving or using public transit, the average commute shouldn’t take more than 30-40 minutes.

i)        There is an abundance of quality child care, preschool, and after-school programs options throughout the city.

j)        Depending on size and area, an upscale 3 bedroom, 2500 ft2 home within city limits can range from $600,000 – $1 million.

k)      Edmonton weather changes with each of its 4 distinct seasons – from balmy, hazy summers, to busy harvest autumns, to classic Canadian chilly and snowy winters, finally assuaged by the warming longer days of spring promising a return to the lazy days of summer.

l)        While most outdoor festivals take place in the spring, summer, and autumn – most seasonal sports are also available year-round at numerous, well-appointed indoor venues. However this does not take away from the fact that Canadians still have a love of their outdoor autumn and winter activities, including football, hockey, skating, tobogganing, Nordic skiing, alpine skiing, snowmobiling, to name a few….

Incentives include:

– Practice setup assistance, and advertising.

– Immigration assistance and/or referrals for you and your family, if required.

– Medical licensing and credentialing assistance.

– Housing and travel assistance.

– Pre-approved Banking services.

This is your opportunity to practice medicine your way in a new, state of the art medical clinic in one of Canada’s major economic metropolitan centres

Contact me NOW! ….

Phil Jost, HSM,MBA

VP Operations & Regional Manager

CanAm    Physician Recruiting Inc.

Office: 902-439-3400

Toll Free – Canada/USA: 866-446-4447

Email: phil@canamrecruiting.ca

www.canamrecruiting.com

U.S. Foreign Account Tax Compliance Act (FATCA) in Canada

This U.S. legislation aims to prevent offshore tax evasion by
U.S. persons. If you are a US citizen or Green Card holder working outside the USA, you need to click on the link and read this NOW!

FATCA is coming into force on July 1.  Here is a new article by RBC Wealth Management about FATCA in Canada.  http://goo.gl/Jdwvn9

Stateside: Doctors hold 9 of 10 highest paid jobs in America

Figures released by the Bureau of Labour statistics and published by Vox show the nine highest paid jobs in the U.S. in 2013 were in health care.

The results have once again drawn attention to the controversial costs of American health care

Anesthesiologists were paid the highest mean wage at $235,100 annually followed closely by surgeons at $233,200.

Behind the 10th highest paid profession—chief executives ($178, 400)—spots 11 through 14 were also comprised of health-care professionals including pediatricians ($170,500), dental specialists ($170,300), dental generalists ($164,600) and nurse anesthetists ($157,700).

The data, originally compiled into chart form by Reddit user Dan Lin, can be viewed here.

The results have once again drawn attention to the controversial costs of American health care, especially when contrasted with the cost of the same services in other countries.

According to a study published in the policy journal Health Affairs, primary care physicians in the U.S. earned an average of $186,582 while those in the U.K. earned $159,532 and those in Australia only earned $92,844.

Orthopedic surgeons  earned an average of $442,450, compared to only $154,380 in France and $324,138 in the U.K.

In Canada, fees for hip replacement paid to these orthopedic surgeons are about $625 while in the U.S. it’s about $1,634.

That said, one doctor, Kevin Pho, has argued that while these salaries seem rather high, they make up only a small portion (20%) of total national health spending and much of that percentage goes towards professional expenses such as malpractice premiums.

He also commented on the French health care comparisons, explaining that medical education and malpractice premiums are almost non-existent.

So, “if you want to pay me like a French doctor, also give me the French cost of medical school and the French medical malpractice system,” he wrote.

(Written by Tristan Bronca         on         June 25, 2014         for The Medical Post)

‘Panic Situation” Top Doctor Critical of Drug Shortage Information Sharing

Canada is facing a major drug shortage problem and authorities must do more  to notify patients when supplies of the medications they rely on are dwindling,  as well as investigate the causes of the shortages, says the president of the  Canadian Medical Association.

There are now more than 500 drugs listed on Health Canada’s drug shortages website. Recent additions to the list include  the anti-inflammatory drug Naproxen and the epilepsy drug Valproic Acid.

CMA President Dr. Louis Hugo Francescutti said the growing list is a major  concern for patients whose health depends on regularly taking medication.

Photos

Drug shortages in Canada

Dr. Louis Hugo Francescutti, president of the Canadian  Medical Association, appears on Canada AM, Wednesday, June 25, 2014.

He said the addition of Valproic Acid, which is primarily used to treat  children, is particularly concerning, given how sensitive epilepsy patients are  to any change in medication.

“There should be great concerns, simply because people who live with  epilepsy are pretty well walking on egg shells,” he told CTV’s Canada AM.

“If they find a medication that works well for them in controlling their  seizures, it gives them the freedom to go on and do their daily activities.”

He said the problem is that patients often aren’t aware that a medication  they rely on is in short supply until they reach the pharmacy to fill their  prescription. This can lead to a “panic situation,” he said, in which the  patient must contact their doctor and scramble to arrange an appointment and  find a substitution.

“And the replacement medication should not be started abruptly,”  Francescutti said. “For people living with epilepsy this is a major problem  (and) potentially could lead to death as well.”

He added that patients may also face additional costs if a generic drug is  no longer available, but the brand-name version still is.

The latest additions to the drug shortages website highlight the scope of  the drug shortage problem, he said, adding that Health Canada’s reporting  website does not adequately address the issue.

The drug shortages website, which was launched in 2012, often reports the  problem too late and reporting is on a voluntary basis, which means the list  isn’t comprehensive, Francescutti said.

But it appears that Health Canada is taking steps to assess the issue. The  agency recently launched a public consultation website, where Canadians can give  feedback on the way drug shortages are reported.

The consultation site is accepting submissions until July 5. Canadians can  also participate by downloading a PDF form and mailing it to Health Canada.

Francescutti said he hopes people will participate and share their stories  so that the government is encouraged to act.

“If we get more Canadians to share their personal experience then hopefully  the government will move to a solution, rather than right now (with) a website  that reports the problem,” he said.

“We need to figure out why we have these continual drug shortages. Having a  website that tells us we have a drug shortage may help a little bit, but in the  past two years we’ve noticed that nothing has really improved,” he said.

Francescutti said the problem is so widespread that, at least once a shift  in his emergency department, he gets a call from a pharmacist informing him that  a previously available medication is no longer in stock. He said this causes  costly delays, as he and his colleagues are forced to make additional calls and  assessments.

“It’s very inefficient, and for folks with epilepsy this could potentially  be life-threatening,” he said.

Read more: http://www.ctvnews.ca/health/panic-situation-top-doctor-critical-of-drug-shortage-information-sharing-1.1885093#ixzz35l9Ovj7v

(Reprinted from CTVNews.ca story by Marlene Leung, CTVNews.ca                                       Published Wednesday, June 25, 2014  8:54AM EDT)

Foreign doctors welcome in Alberta

It’s pretty hard to sympathize with the College of Physicians and Surgeons over their concerns about the 145 foreign doctors who have been brought in to work in walk-in clinics in Calgary and Edmonton in the past two years.

Anyone who has spent three, four and even five hours sitting in a walk-in clinic waiting room crammed to the gills with patients, but with only one doctor on duty, will welcome the news that the clinics are doing something to ease the agony of waiting. So will anyone who has asked a clinic receptionist how long the wait is, and upon hearing the discouraging answer, has left the clinic, preferring to see if the problem will go away overnight.

Some of those patients who choose to go home rather than sit for hours in the waiting room might end up in the emergency room if their condition worsens, adding to the crowding at the hospital. Having more doctors at walk-in clinics ensures patients are treated in a timely way and helps prevent them from going to the ER.

As long as these doctors meet Canadian standards and are qualified to work here, their arrival is all to the good. And while some of them are family physicians, among their number are also pediatricians, internists and surgeons. If they are starting life in Canada working in a walk-in clinic and then move on to practise in their specialties, it will help shorten wait times in those areas.

Increasing the number of students graduating from Canadian medical schools is a solution, but it’s a very long-term one, given how many years it takes to be trained.

Albertans are sick of interminable waits for care. These doctors are helping to ease the burden. Good for the clinics for seeing the need and filling it.

© Copyright (c) The Calgary Herald – Editorial re;rinted from the Calgary Herald of June 23, 2014.

Are Quebec’s doctors really fleeing the public system?

Screaming headlines suggesting record numbers of family doctors are streaming for the exits of Quebec’s public health-care system guaranteed a packed house for a College of Physicians conference on the subject here on May 9.

Quebec Health Minister Dr. Gaetan Barrette said doctors who do not improve productivity will “face consequences.”

But it was the province’s new health minister who stole the show during a morning conference session featuring both sides of the public-versus-private health-care debate.

Held just days after the Journal de Montréal reported that 200 general practitioners are now in private practice in Quebec-twice the number as in 2007-it attracted a capacity crowd of some 400 physicians and residents to the Château Frontenac.

The first speaker-Dr. Marc Lacroix, who opened the first private medical clinic in the provincial capital in 2009-argued that private clinics complement the public system and provide more timely access. “Sixty per cent of our patients have a family doctor (but) are rotting on waiting lines (and) searching for help,” said Dr. Lacroix.

He added that, as a physician, he also enjoys the “complementary aspects of private practice,” such as having more control over staff and scheduling.

Dr. Vadeboncoeur

The second speaker, Dr. Alain Vadeboncoeur, an emergency physician and the president of Quebec Doctors for the Public System, countered that private clinics undermine manpower and confidence in the public system. “Accessibility shouldn’t depend on a patient’s ability to pay.”

In an interview, the president of the Quebec Federation of General Practitioners (FMOQ) downplayed the news about the so-called exodus of Quebec GPs toward the private sector.

“Two hundred is not a huge number when you’re talking about more than 7,000 family doctors in Quebec,” Dr. Louis Godin said. “But it is cause for concern (and) a symptom of something.”

The new health minister, Dr. Gaètan Barrette, also spoke and used his appearance to berate his critics and plead with doctors to work with him-or else. Notably, Dr. Barrette also said he would impose penalties on health-care professionals who did not make efforts to reduce costs and improve productivity.

“It won’t be the apocalypse, but I am telling you that there is going to a clear change in direction,” Dr. Barrette told listeners. “You can either go in our direction or face the consequences.”

He refused to give details of what those changes and penalties could be. “They will be simple but efficient,” Dr. Barrette said afterward in media scrum. “The resources in the system now are adequate. They just need to be managed well.”

Dr. Barrette also told his medical audience they have “the opportunity to participate in the healthy management of the system (and) protect your revenues.”

He added that his role as health minister is to “ensure money is well spent.”

That jives with Liberal election promise to reduce the price of generic medication and ensure that all medical imaging, such as scans and ultrasounds, carried out in private clinics would be covered by public health care.

Dr. Barrette also confirmed that he will work to fulfil another promise: To create 50 “super clinics,” which would be open seven days a week, to alleviate the stress on hospitals.

“This is not private medicine,” he added. “(Super clinics) are conventional.” MP

(Reprinted from Medical Post and  WRITTEN BY MARK CARDWELL ON MAY 20, 2014 FOR THE MEDICAL POST)

USA Doctors Migrating North to Canada

With the prospect of greater pay, fewer bureaucratic headaches and the opportunity to provide better care for patients, the number of American doctors migrating north is rising, according to Canadian recruiters and Canadian Medical Association data.

Susan Craig, president of the Toronto-based physician recruiter, Susan Craig Associates, said that Canada is becoming “increasingly attractive,” while John Philpott, the Halifax-based chief executive director of Can-Am Recruiting, noted “interest is doubling each year for American doctors” seeking to move north.

Increased pay is the main driver of this interest. Philpott said family physicians, pediatricians and psychiatrists can make $100 000 more in Canada, on average, compared to the US.

“American family physicians can lose out on up to 30% of earnings due to insurance company loopholes and technicalities.”

According to data from the Canadian Medical Association, the number of US-trained physicians grew less than 3% from 1996 to 2005 (up from 493 to 506), but jumped 42% from 2006 to 2014 (508 to 721).

The increase would be much higher, however, if estimates distinguished between specialists and family doctors, as the majority of US physicians crossing the border are in family medicine, said Philpott.

In the US, thanks to insurance company loopholes and technicalities, American family physicians aren’t paid up to 30% of the time, whereas under a single-payer system, only about 2% of his billings aren’t covered, explained Dr. Sajad Zalzala, a US-trained family physician who moved to Windsor, Ont. in 2012.

Communicating with insurance companies and filing claims is so bewilderingly bureaucratic, in fact, that while “a family physician in Canada can manage with one or two secretaries, in the US, one doctor could need 10 secretaries,” said the recruiter Susan Craig.

Even referrals are a headache as insurance companies often only pay for specific hospitals and specialists, added Zalzala.

The introduction of Obamacare isn’t stemming the tide of US physicians heading North. Quite the opposite, in fact.

“For every problem that Obamacare solves, it creates two to three other problems,” said Zalzala. For example, the Blue Cross plan under the Affordable Care Act is different from the Blue Cross employer-paid plan, so doctors will have double the paperwork.

Canadian registration constraints

Depending on the regulations of the provincial Colleges of Physicians and Surgeons, US doctors have to undergo a period of supervision (usually several months to a year) or must complete the Medical Council of Canada exams, or both, to obtain a full license to practise in Canada.

There are numerous procedural delays and doctors often have to show they have a job before they can start the process, which can lead to a period of unemployment, said Dr. Bridget Reidy, who moved north two years ago and has worked as a locum doctor in Prince Edward Island, as a full time physician in Ontario, and is about to start a job in BC.

“I think a lot more doctors would want to work in Canada if [the licensing process] was easier,” she said, adding that the barriers are a shame as most provinces “desperately need doctors.”

Since the credentials of US-trained doctors are recognized by the College of Family Physicians of Canada (CFPC), Philpott doesn’t understand why the provincial colleges put barriers up.

“The provincial colleges are slapping the CFPC in the face,” said Philpott. “I guess they feel they have a greater understanding of certification than our own national bodies.”

But Craig thinks the supervision is a “wise thing.” There are billing practices and different drug names to be learned, and American doctors often feel the need to order more tests — a practice known as defensive medicine — to avoid lawsuits, she said. “In the US, they practice fairly intensivedefensive medicine and in Canada we don’t encourage that.”

Another attraction for family doctors is that their work is more valued in Canada, said Reidy, who explained that US patients tend to go to walk-ins or straight to specialists. “There’s just not that understanding of the need for someone to be the captain of the outpatient care. Doing proper care becomes more difficult as a result,” she said.

Dr. Jack Lucas, who works in forensic psychiatry in New York City and commutes to Owen Sound, Ont. to practice psychiatry two weeks every month, said he appreciates that his Canadian patients can access psychiatric services much more easily than in the US, and are supported through social programs rather than being “criminalized” like they are south of the border.

And Zalzala appreciates that the lack of a “defensive medicine” culture. “If I’m worried about missing something, it’s because I’ll feel terrible for the patient, not because the patient will come back and sue me,” he said.

(Reprinted from CMAJ by Wendy Glauser, Toronto, June 19, 2014 – DOI:10.1503/cmaj.109-4805)

Alberta College concerned about number of IMGs at walk-in clinics.

The College of Physicians and Surgeons of Alberta is concerned about the number of foreign-trained doctors coming to Alberta to work at walk-in clinics.

The CPSA noted that 145 IMGs have been sponsored to work at clinics in the province over the past two years, most of which are in Edmonton and Calgary—even though there may not be evidence they are needed, the Calgary Herald is reporting.

Back in February, the Medical Post reported that CPSA registrar Dr. Trevor Theman said that many foreign-trained doctors were being siphoned away by urban clinics while rural areas remained underserviced.

And no, assistant registrar Dr. Ken Gardener said the gap between the cities and the rural areas is concerning.

“The concern is, if we are seeing an ever-increasing proportion of recruitments of internationally trained physicians to urban walk-in clinics, is that aligned with the most critical needs of the health system?” said Dr. Gardener.

“We are getting pushback that this is not something the system needs, and we are getting that from individual physicians, we are getting it from academic departments, and we are getting it from AHS (Alberta Health Services).”

Walk-in clinics have been a controversial topic in Canadian medicine over the years.

While governments seek to find solutions to the doctor shortages, walk-ins are seen as a way to provide care quickly to patients in need. However, there have been vocal critics who say the walk-ins simply siphon off the easiest cases and the healthiest patients while leaving office-based family physicians with the most ill.

In January, Dr. Peggy Yakimov from British Columbia’s Interior Health Authority expressed frustration with the model.

“(Clinic physicians) don’t cover on-call at night time,” said Dr. Yakimov, the executive medical director for physician support at the health authority.

“They don’t provide services to patients when they’re admitted to hospital. And they don’t provide any additional care at the hospital such as emergency coverage or delivering babies.

“They work a specific shift in the hospital and that’s all they work and then they leave and they’re not responsible for their patients.”

(Reprinted from the Canadian Healthcare Network, WRITTEN BY JERED STUFFCO ON JUNE 23, 2014)