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Monthly Archives: January 2015

$400K Guaranteed for Family Physician to Work in Specialty/Cosmetic Clinic in Eastern Ontario

Overview This well-established specialty clinic has recently completed an expansion and is looking for a Physician to join their busy practice. The clinic specializes in hair restoration procedures, and combines medicine, art, and science into aesthetic results for their patients. The clinic’s exemplary results have given it an excellent reputation, attracting an international private-fee client base. There’s also an opportunity to perform minor cosmetic procedures, such as Botox and fillers. Physicians with previous experience, or interest in these procedures will be an asset.

Candidate Features The right candidate will have a strong passion for using their medical skills for artistic results, working with patients’ features.  The candidate will have the confidence and desire to do this minor cosmetic surgery in an outpatient setting. Ideal candidates should be socially comfortable interacting with patients from different cultural backgrounds as the clinic caters to an international patient base.

The Position This full-time opportunity entails consulting with patients, pre-operative evaluations, performing surgery, and post-operative follow-ups. The clinic will provide any necessary training in hair restoration techniques. Training will take place in stages, including phases of observation, assisting, performing under supervision and then independently.  There will be 1-2 surgeries performed daily.  No weekend call required.

The clinic will provide full staffing, including nursing, technical and administrative. The patients are prequalified and booked by the clinic. The physician will only be responsible for the medical aspect of the patient care.

For physicians with the desire to do extra family medicine, this opportunity can be combined with optional practice at a nearby family clinic.

Remuneration There is a generous guarantee of $400K in the first year, including training. Once performing procedures independently, there is a bonus structure commencing in year two and beyond. A relocation allowance for the right candidate will be considered.

Qualifications An independent license to practice medicine in Ontario. American Board-certified Family Physicians with Ontario license may also be considered. Previous experience with Botox and fillers an asset. Full training in hair restoration procedures will be provided.

In accordance with immigration requirements, preference will be given to Canadian citizens or permanent residents of Canada.

Interested candidates, please contact: Hedi Cameron, Regional Manager, CanAm Physician Recruiting Inc. Office: 647-883-7185 E-mail: hcameron@canamrecruiting.com, www.canamrecruiting.com

Researchers Test Whether Stem Cell can Alleviate MS Symptoms

TORONTO — Two Canadian research centres are gearing up for a clinical trial to determine if a type of stem cell can help alleviate the symptoms of multiple sclerosis.

Researchers at the Ottawa Hospital and Winnipeg’s Health Sciences Centre will each recruit 20 MS patients for the trial that will test whether mesenchymal stem cells can reduce inflammation and even help repair damage already caused by the disease.

Read more: http://www.ctvnews.ca/health/researchers-test-whether-stem-cell-can-alleviate-ms-symptoms-1.2213186#ixzz3QQ8I82gb

Solution to Physician Shortage may be more than Money…

Physician shortages are common in many parts of the Newfoundland and Labrador, and the association that represents doctors says not enough is being done to find out why.

According to John Philpott, CEO of CanAm Physician Recruiting Inc., its time for government  to engage in change management from a reactive to a proactive approach to medical human resource planning. Using  a Canadian based international physician human resource consulting firm to screen physicians will increase retention. Newfoundland like many other provinces in Canada, is just now realizing what we have been saying for decades.

Follow the link to learn more and enter the discussion – http://www.cbc.ca/news/canada/newfoundland-labrador/why-doc-solution-to-doctor-shortage-may-be-more-than-money-1.2929966.

Royal College of Physicians and Surgeons of Canada Calls for Bioethics Cases

The Royal College Ethics Committee (EthC)  invites cases to enhance the breadth of its existing bioethics curriculum. Cases should reflect new and emerging ethical issues and challenges facing residents and Fellows practising in Canada.

Some suggested topic areas include, but are not limited to:

  • the growth of transplantation/medical tourism, more particularly a physician’s obligations to provide care when patients return from abroad after receiving elective procedures in another country;
  • issues surrounding the aging physician/surgeon population, including delayed retirement and concerns over employment opportunities for new Fellows;
  • recruitment of patients from third world countries to participate in research studies which are not applicable within a third world context;
  • protecting the aging population from unnecessary tests, investigations, procedures;
  • end of life issues/euthanasia,
  • ethical issues related to reproduction, including abortion/feticide;
  • trauma experienced by physicians training in remote communities
  • placebo controlled trials

Get noticed, get published, follow the link to learn more – http://www.royalcollege.ca/portal/page/portal/rc/resources/bioethics/proposals.

New Canadian Guidelines put Family Physicians on the Front Line Against Adult Obesity

National guidelines say family physicians have to do more in the battle against obesity.

According to a recent article in Canada’s national business newspaper, the Globe and Mail, the guidelines, issued by the Canadian Task Force on Preventive Health Care and published on Monday in the Canadian Medical Association Journal, urge physicians to track the body mass index (BMI) of all adult patients and prescribe physical activity, dietary changes or counselling to those who are overweight or obese. The number of Canadians who are considered obese has increased dramatically in recent years – from 14 per cent of the adult population in 1978-1979 to 26 per cent in 2009-2011. Being overweight or obese puts individuals at risk for serious health problems, including high blood pressure, heart disease, stroke, Type 2 diabetes, cancer and arthritis.

Follow the link to learn more on the expanded role for MDs – http://www.theglobeandmail.com/life/health-and-fitness/health/new-guidelines-put-family-doctors-on-the-front-line-in-the-battle-against-adult-obesity/article22640516/

 

Appealing to Public Emotions and Greed, Personal Injury Law Firms on Rise in Canada

Personal injury: the changing landscape, by Dr. H. Jaye Goldstein on January 20, 2015

In the course of my morning commute across the roads of Vaughan and north Toronto, I see them everywhere—on billboards and the broadside of buses and in transit shelters. I hear their ads on my all-news radio choice of the day, sponsoring traffic and weather reports. At day’s end, while catching up on local and national news, their TV commercials intrude upon my attempt to unwind from the stresses of my general practice toils. I am not referring to real estate brokers, car dealerships, alarm companies or travel agencies. I am speaking of personal-injury law firms.

Appealing to the emotions of the public, and possibly their greed, must be working because there appears to be no end to these commercials and an ever-increasing competition in this expanding legal playing field—this, in spite of changes to auto insurance legislation, which has significantly limited funding for patient accident benefits.

These ‘minor injuries’ can drag on forever and challenge the patience and expertise of even the most experienced physician.
For those of us who have practised long enough to remember the days before no-fault car insurance was introduced, you will recall the painstaking and unpleasant task of writing voluminous medical legal reports, which very often resulted in years of delay in payment while we awaited “every effort to recover funds pending settlement.” There wasn’t anything else in those days that raised the hairs on the back of my neck more than when I received a letter with a law firm logo (except perhaps an envelope with the CPSO logo).

The times have changed! Today the accident patient arrives with the OCF-3 secured in a manila envelope, having already seen their legal counsel, who has referred them to an “independent” accident rehab facility. Some patients have been “counselled” by tow-truck operators, emergency department personnel, paralegals or insurance claims advisers and have similarly started rehab well before their arrival in the doctor’s office with the requisite envelope. Not uncommonly, followup is minimized by the variety of other services the patient is concurrently receiving.

Whereas the medical legal report in years past necessitated a comprehensive review, updating status and prognosticating recovery, the legal system now requests copies of clinical notes and all related reports, as well as notes and records for five years prior to the accident. While the time required to meet these requests, for the doctor, is considerably reduced, there is a significant burden that is placed upon our office staff in terms of time.

We are guided by the OMA schedule for uninsured benefits in determining fees for such services, somewhat generously I might add; however, there implies an obligation to ensure that the clinical records for these specific visits be detailed, descriptive and adequately reflect the comprehensive care received from all allied professionals should the case ultimately proceed to litigation. These “minor injuries” can drag on forever and challenge the patience and expertise of even the most experienced physician.

My first-hand experience

In early January 2003, I had the misfortune of slipping on black ice, obscured by packed snow, in a strip-mall parking lot. This occurred the day following a major snowstorm in Toronto. The parking lot had not been maintained to the standards of the day, and my resulting hip fracture was directly the result of negligence on the part of the management company and maintenance services of the shopping mall, or so my lawyer set out to prove. My undisplaced femoral neck fracture was treated conservatively with eight weeks of non-weightbearing, in an attempt to avoid the curse of adverse surgical/anesthetic events often seen in physician patients.

Although I missed but one week of work, I was limited to half-day offices, with the capable assistance of my RN wife, and feeling quite spoiled as I had never had the luxury of an office nurse in all my years in practice. The half-day was necessitated by unexpected and profound fatigue by mid-day, as well as painful armpits secondary to walking with crutches. I quickly learned the complexities of applying for insurance benefits, a process I had previously taken for granted as my patients navigated their own way through what I was to learn is anything but a seamless journey.

I had my first personal interface with the medical-legal process when I hired a lawyer to represent my claim. I was subjected to an insurer (previously known as “independent”) exam, as well as an expert opinion exam to establish my status and prognosis. Interesting process to be the physician as patient. Neither of my examiners was stellar, especially the orthopedic surgeon my lawyer referred me to. He never appreciated the fact that I was a medical colleague nor the impact the fracture had had on my ability to perform the duties of a busy GP working 50 hours a week.

The fracture healed uneventfully and by week 10, I was walking unassisted on a treadmill and back at full-time work. My wife moved on to a new and more challenging job as an endoscopy nurse, while I returned to flying solo. I continued to look over my shoulder, however, anticipating AVN or progressive O/A and the total hip arthroplasty sure to follow.

The wheels of justice moved slowly. I would soon experience the examination for discovery and mediation processes and their associated futility. Having failed to arrive at a reasonable settlement, I was advised that the next step was court and that if I lost, I would be responsible for costs incurred by the other side. Then, of course, there were my lawyer’s fees.

Almost four years from the time of my fateful fall, I received a call from my lawyer informing me that he had a “number” to propose. It was an offer I couldn’t refuse. I just wanted to end the procedural nonsense. After paying his fees, I received a cheque that didn’t come close to covering my lost income (my disability insurance elimination period was 90 days), nor did it take into account the very real possibility that at some time in the foreseeable future I would be custom-fitted with a prosthetic hip joint.

Today, I walk 10 miles a week and maintain an active lifestyle and general practice. I continue to see MVA and personal-injury cases regularly in the practice and, given my personal experience, take a more empathetic approach to the implications of personal injuries. With the recent advertising deluge on the part of our legal colleagues, I pause to contemplate how our profession would conduct itself if regulations were eased and the ethical advertising principles and practices we are bound by, blurred.

Will we one day see colleagues “pop up” on a popular websites, hear radio commercials advertising personal injury physicians during traffic reports or see the familiar face of a colleague on the side of a bus or highway billboard? Not likely, I think.

Dr. Howard Jaye Goldstein is an Ontario physician.

Are the Canadian public and physicians getting fair ‘bang-for-their-buck’ from the provincial medical colleges?

According to Wendy Glauser in her recent article for the Medical Post, the average yearly fees paid by US physicians is $240 (Cdn), while their Canadian colleagues, on average, pay in excess of $1500 (Cdn) per year.

In addition a review of cross-border medical licensing authorities reveals that their respective organizational missions are essentially the same, – physician licensing, competency, discipline and the development and approval of policies to ensure public safety.

Research by Glauser also revealed that some US physicians involved in cross-border medical practices, who would normally maintain multiple US licenses, would not be able to do the same in Canada simply because the cost to maintain their Canadian credentials, at up to 400% more than their US fees, was too financially onerous.

A review of possible differences, include the provision of ‘glossy’ publications, an apparent enhanced emphasis on Continued Medical Education, and an emphasis on quality assurance programs by some Canadian colleges. In particular, the Ontario college focused on their QA programs and peer review assessment program. Unfortunately, when approached, other Canadian colleges refused to discuss potential program enhancements that could explain the significant cross-border fee differences.

However, from the perspective of American physicians working in Canada, who would not normally be involved in these ‘enhanced’ benefits, they really don’t see any substantial difference in the services being provided by the Canadian medical licensing authorities.

Economies of scale seem to play a role, particularly from the American perspective. Over the past several years some Canadian colleges have made some inroads in this area, however, there is still a long way to go to obtain cross-Canada consensus on the standardization of licensing and service delivery.

Phil Jost, vice-president of operations at CanAm Physician Recruiting, said the high initial and renewal licensing fees in Canada are a source of frustration for the U.S.-trained physicians that his company recruits to work here. He thinks a national or zone-based licensing authority would make sense. “It would be helpful if whatever categories you have—full licence, provisional licence, etcetera—were all called the same thing and recognized as being equivalent by all colleges, so it would be possible to transfer them from one province to the other”.

In the meantime, there are strategies that could be taken that could reduce the bureaucracy for physicians and colleges, said John Philpott, executive director of CanAm. He pointed out that when his physician wife was applying to work in Prince Edward Island, she had to obtain letters of good standing from two previous jurisdictions, Newfoundland and Ohio, even though the Ohio letter had previously been reviewed by the college in Newfoundland. He thinks letters of good standing from a previous jurisdiction should suffice. “Why do you have to go back your whole life?” he asked.

Funding of the American medical boards is provided directly by the respective state legislatures, and thus can be a bureaucratic and political nightmare to even try to obtain an increase in annual funding. Some states, are so financially strained, some feel that patient safety could be jeopardized. As a consequence, the US the state medical boards are highly motivated to seek internal operating efficiencies, before asking the politicians for more funding.

In Canada, the main funding is from physicians’ annual fees, augmented by subsidies from the respective provincial legislatures.

In summary, the research shows that although the respective medical authorities are somewhat different, essentially they are mandated to provide the same services, – the provision of safe medical services to the public.

Ms. Glauser provides a comparison of the Medical Board of North Carolina and the College of Physicians and Surgeons of BC. The mandates of the respective agencies are very similar, except that the BC college manages peer assessments, inspects physicians’ offices, inspects non-hospital medical facilities and oversees Rx review programs. Notable is the fact that:

  1. The NC Board, serving a population of 9.7 million – closed 2,730 medical complaints, with a staff of 69 people, a budget of $9.2 million, while charging physicians an annual fee of $191.
  2. The BC College, serving a population of 4.8 million – closed only 1,024 medical complaints, with a staff of 136 people, a budget of $23 million, while charging physicians an annual fee of $1,542.

CanAm believes that in view of the above information, that the time has come for Canada’s provincial governments to review their legislation governing the provincial medical colleges to determine if physicians and the public could be better served through economies of scale, such as:

–          Integrating provincial colleges to create regional organizations

–          Standardizing the types of medical licenses to improve inter-provincial physician mobility.

–          Creating a national licensing system.

–          Creating a single national medical licensing body.

We encourage your feedback to provide us with your views regarding your satisfaction and value of the services provided by Canada’s provincial colleges.

To learn more about this important issue, readers are encouraged to read Ms. Glauser’s article in the October 7, 2014 issue of the Medical Post magazine.

Family Physician Opportunities in Downtown Montreal

Our client is seeking a number of family physicians to join a modern, fully-equiped public medical clinic in Downtown Montreal.

Candidates must be eligible for a license to practice in the Province of Quebec.

Candidates that have their CCFP are preferred, but international medical graduates who are eligible, or may become eligible, for the CCFP designation are encouraged to apply.

Contact: David Nurse, 902-719-7309, david@canamrecruiting.ca