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So this is my experience with the partial privatization of surgical healthcare in Quebec (french translation at the end)Due to the collapse of our hospital systems and exploding surgical wait lists, the government of Quebec created a program to utilize private surgical centres to provide publicly insured surgeries (CMS: Centre médical spécialisé).https://ift.tt/NJMisCk existing private surgical clinics (generally plastic surgery) were given contracts to provide access to perform public surgeries. The clinics would provide the physical space, the personnel (excluding surgeon/anaesthetist), the equipment and the medications. The health authorities organize the patients, surgeons, anesthesiologists and then schedule them in the clinics.The surgeries being performed are generally shorter, minor surgeries and the patient population are generally healthy to avoid risk of complications. We are talking breast reductions, hernia repairs, minor hand surgery, ect. These are cases that we would classify as priority D, or E on an A through E scale. Right now the waitlist for an E surgery may be 2-3 years!So this sounds good right? People who would be waiting 2-3 years get their surgery faster, for free!But wait!1) Why are there wait lists. The system has been underfunded for years. In the Gatineau area the region has been funded at 75% the Quebec average for healthcare for decades! Then add on the Liberal/Gaetan Barette years where we were attached left and right and tons of nurses and other professionals left the profession. At the same time the number of students entering the profession dropped like crazy (local school has less than 50% capacity nursing students and less than 30% respiratory therapy students. So we got into the Pandemic with both a shortage of people in the system AND a shortage of students in training.Then with the pandemic we were Fck’d. There were no plans (government told us in JANUARY 2020 when we were asking for planning help that pandemic preparations were “not a priority”). We had no isolation hospital plans, infected elderly were sent back to retirement homes if they were not ICU candidates. These homes had no training, no PPE, no plans and we know what the results were. Nurses and personnel were re-affected to short staffed areas (ICU, Covid units, emergency) for months to years and many of them quite because THEY DID NOT WANT TO WORK THERE.So now we get to the CMS. These private surgical clinics now have contracts to perform public surgeries. That means they need to increase activities. That means they need MORE nurses, respiratory therapists, orderlies, sterilization teams, ect. Where will they get them? FROM THE PUBLIC SYSTEM! Sure there are contracts where they are not allowed to hire someone from the public system for 3-6 months but they get around this.10-20% of our hospital staff were retired people working a couple extra days per week as extra spending money. They got no benefits, no pension top-ups and always got the crappy rooms. So what did they do? Stopped offering availability to the hospital and moved to the CMS where they are paid more.What about all those nurses who were reaffected to crappy areas like ICU, ER, Covid units? They quite and 3 months later joined the CMS for more money, no nights, no weekends.What about our operating rooms that are short staffed (some are at 30% staffing!!!!). They are working TONS of nights and 1 weekend in 2! Well they quit and go work in the CMS or the private sector.So now we have CMS doing low priority hernia repairs and the wait lists have dropped to sometimes 1 month from time of initial visit with surgeon to being scheduled. In some cases we LACK cases for the CMS and the day ends at 1 pm instead of 3:30 because we lack cases. What effiency!At the same time category B and C cases including breast cancer and brain cancer cases are waiting MONTHS due to lack of hospital operating room time or ICU capacity.So we starved the public system which stimulated passing work the private system which has WORSENED the access of critical surgeries in the public system!We are loosing medical teams to the private system. I know of anesthesiologists who have left to do only private.This is the reality.Instead SUPPORT the public system. INCREASE nursing, radiology technician, respiratory therapy, ect training spots. INCREASE surgical and anaesthesia residency spots. Offer $10k/year interest free loans to these student/residents during training that are paid back 10k/year for each year they return of service in the public system in the province they were trained. If they DO NOT return of service convert the interest free loans to regular student loans at a higher interest rate.SUPPORT PUBLIC AND AVOID PRIVATE.This has been my TED talk.Voici mon expérience avec la privatisation partielle des soins chirurgicaux au Québec.En raison de l’effondrement de nos systèmes hospitaliers et de l’explosion des listes d’attente en chirurgie, le gouvernement du Québec a créé un programme d’utilisation des centres chirurgicaux privés pour fournir des chirurgies assurées publiquement (CMS : Centre médical spécialisé).https://ift.tt/WTOk96S, les cliniques chirurgicales privées existantes (généralement la chirurgie plastique) ont reçu des contrats pour permettre l’accès à la pratique de chirurgies publiques. Les cliniques fourniraient l’espace physique, le personnel (excluant le chirurgien/anesthésiste), l’équipement et les médicaments. Les autorités public (CISSS) organisent les patients, chirurgiens, anesthésistes puis les programment dans ces cliniques.Les chirurgies pratiquées sont généralement plus courtes, des chirurgies mineures et la population de patients est généralement en bonne santé pour éviter les risques de complications. Nous parlons de réductions mammaires, de réparations de hernies, de chirurgies mineures de la main, etc. Ce sont des cas que nous classerions en priorité D ou E sur une échelle de A à E. À l’heure actuelle, la liste d’attente pour une chirurgie E peut être de 2 à 3 ans!Alors ça sonne bien non? Les personnes qui attendraient 2-3 ans obtiendraient leur chirurgie plus rapidement, gratuitement!Mais attendez!1) Pourquoi y a-t-il des listes d’attente. Le système est sous-financé depuis des années. Dans la région de Gatineau, la région est financée à 75 % de la moyenne québécoise pour les soins de santé depuis des décennies ! Ajoutez ensuite les années Libéral/Gaétan Barette où nous étions attachés à gauche et à droite et où des tonnes d’infirmières et d’autres professionnels ont quitté la profession. Dans le même temps, le nombre d’étudiants entrant dans la profession a chuté comme un fou (l’école locale compte capacité moins de 50 % d’étudiants en soins infirmiers et moins de 30 % d’étudiants en inhalothérapie. Nous sommes donc entrés dans la pandémie avec à la fois une pénurie de personnes dans le système ET une pénurie d’étudiants en formation.Puis avec la pandémie, nous étions Fck’d. Il n’y avait aucun plan (le gouvernement nous a dit en JANVIER 2020, lorsque nous demandions une aide à la planification, que les préparatifs en cas de pandémie n’étaient “pas une priorité”!!!!!!). Nous n’avions pas de plans d’hôpital d’isolement, les personnes âgées infectées étaient renvoyées dans des maisons de retraite si elles n’étaient pas candidates aux soins intensifs. Ces maisons n’avaient aucune formation, aucun EPI, aucun plan et nous connaissons les résultats. Les infirmières et le personnel ont été réaffectés dans des zones à personnel réduit (unités de soins intensifs, unités Covid, urgence) pendant des mois, voire des années, et beaucoup d’entre eux tout simplement demissioné parce qu’ILS NE VOULAIENT PAS Y TRAVAILLER LA.Alors maintenant, nous arrivons au CMS. Ces cliniques chirurgicales privées ont maintenant des contrats pour effectuer des chirurgies publiques. Cela signifie qu’ils doivent augmenter leurs activités. Cela signifie qu’ils ont besoin de PLUS d’infirmières, d’inhalothérapeutes, de préposés aux bénéficiaires, d’équipes de stérilisation, etc. Où les obtiendront-ils ? DU SYSTÈME PUBLIC ! Bien sûr, il y a des contrats où ils ne sont pas autorisés à embaucher quelqu’un du système public pendant 3 à 6 mois, mais ils contournent cela.10 à 20 % de notre personnel hospitalier étaient des retraités qui travaillaient quelques jours supplémentaires par semaine pour avoir de l’argent supplémentaire. Ils n’ont reçu aucun avantage social, aucune pension complémentaire et ont toujours eu des chambres de merde. Alors qu’ont ils fait? Cesser d’offrir la disponibilité à l’hôpital et passer au CMS où ils sont mieux payés.Qu’en est-il de toutes ces infirmières qui ont été réaffectées dans des zones merdiques comme les soins intensifs, les urgences, les unités Covid ? Ils se sont demissioné et 3 mois plus tard ont rejoint le CMS pour plus d’argent, pas de nuits, pas de week-ends.Qu’en est-il de nos blocs opératoires qui manquent de personnel (certains sont à 30% de personnel su program (eg 60% absent maladie, maternité or posts vide!!!!). Ils travaillent des TONNES de nuits et 1 week-end sur 2 ! Eh bien, ils démissionnent et vont travailler dans le CMS ou le secteur privé.Alors maintenant, nous avons les CMS qui effectue des réparations de hernie de faible priorité et les listes d’attente sont tombées à parfois 1 mois entre le moment de la première visite avec le chirurgien et la date de chirugie en CMS. Dans certains cas on MANQUE de cas pour le CMS et la journée se termine à 13h au lieu de 15h30! Trés efface bien sur!Dans le même temps, les cas de catégories B et C, y compris les cas de cancer du sein et de cancer du cerveau, attendent des MOIS et des MOIS ou PLUS LONG en raison du manque de temps dans la salle d’opération de l’hôpital ou de la capacité des soins intensifs.Nous avons donc affamé le système public qui a stimulé le passage du travail au système privé qui a EMPIRE l’accès aux chirurgies critiques dans le système public!Nous perdons des équipes médicales au profit du système privé. Je connais des anesthésistes qui sont sortis pour faire uniquement du privé.C’est la réalité.SOUTENEZ plutôt le système public. AUGMENTER les places de formation en soins infirmiers, en radiologie, en inhalothérapie, etc. AUGMENTER les places de résidence en chirurgie et en anesthésie. Offrir des prêts sans intérêt de 10 000 $/an à ces étudiants/résidents pendant la formation qui sont remboursés 10 000/an pour chaque année de retour de service dans le système public de la province où ils ont été formés. S’ils NE RENDENT PAS le service, convertissez les prêts sans intérêt en prêts étudiants réguliers à un taux d’intérêt plus élevé.SOUTENIR LE PUBLIC ET ÉVITER LE PRIVÉ.Cela a été ma conférence TED. via /r/ontario https://ift.tt/Jzno3Dx

My Quebec experience with Privatization of Healthcare (why it is a bad idea)

So this is my experience with the partial privatization of surgical healthcare in Quebec (french translation at the end)Due to the collapse of our hospital systems and exploding surgical wait lists, the government of Quebec created a program to utilize private surgical centres to provide publicly insured surgeries (CMS: Centre médical spécialisé).https://ift.tt/NJMisCk existing private surgical

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I’m currently on my second read through and I’ve reaffirmed the fact that this is my favorite book of all time. The “thousand layered complications” of this book are impossible to completely describe in a Reddit post. But it’s a beautiful story that is bursting with humanity and charm. The Count is such a an excellent protagonist, I kind of take him everywhere I go if that makes sense? It’s a book that has stayed with me since I first read it.Edit: Author is Amor Towles. His other novels are Rules of Civility and Lincoln Highway; both are great. via /r/books https://ift.tt/tTofMuc

A Gentleman in Moscow is a life changing read.

I’m currently on my second read through and I’ve reaffirmed the fact that this is my favorite book of all time. The “thousand layered complications” of this book are impossible to completely describe in a Reddit post. But it’s a beautiful story that is bursting with humanity and charm. The Count is such a an

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I’ve been looking for songs or music that will encourage me to remain on track since I know how good working out is for both the mind and the body, especially now when we need to boost our immune systems because we’re in the grip of a pandemic. I’m doing this not just to keep physically healthy, but also to stay emotionally well. And music became one of my greatest companions to keep me calm.I just wanted to share this with anyone else who is in the same situation or is going through the same thing since I found solace in listening to music rather than chatting or going out with friends. I enjoy EDM, Pop, and anything upbeat since it motivates me more.Here are some of the top songs I listen to:Abel Point – Northern IntrovertElectric Elephants – Jay HardwayForbidden Voices – Martin GarrixFeel free to share the songs that you like or any songs that you enjoy. I would love to listen to them too. via /r/Music https://ift.tt/c5RLQgA

What songs do you usually listen to when you work out?

I’ve been looking for songs or music that will encourage me to remain on track since I know how good working out is for both the mind and the body, especially now when we need to boost our immune systems because we’re in the grip of a pandemic. I’m doing this not just to keep

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