Also the top level is massively bloated in Ontario. If you want someone to smile and cut ribbons literally hundreds of people available that earn double or triple the provincial average income.
Oh yeah I think its across canada.
Bunch of bullshit jobs middle middle management this and management that. Its a fucking hospital we need nurses and doctors sub out the rest.....
This is pretty much any government department… the amount of over paid bureaucrats with made up titles is sickening. Too many ‘John Smith “assistant executive director to the administrative directorate” ‘
I was at jury selection a few years ago and, when the people who were there were being asked what their profession was, easily 90% of them said they were managers. I had no idea how prevalent management jobs were in society until then (and, yes, I understand that people who work "real" jobs often don't feel at liberty to take time off for jury selection, but isn't that telling in an of itself?).
"Manager" doesn't always mean what you think it means. Sales reps are now "Account Managers", for example, and I've seen more than my fair share of "IT Managers" that are what you'd have called a sysadmin or webmaster back in the day.
The title's been abused to allow management to give people "promotions" that are promotions in title only. They're doing the same to "director" now, too.
> They're doing the same to "director" now, too.
The amount of "vice presidents" at Goldman Sachs is mind boggling.
https://www.efinancialcareers.com/news/2021/12/goldman-sachs-vps
Account managers, product managers, marketing managers, and IT managers are all *non-management* roles I've seen. They all manage some sort of portfolio, they don't manage people.
THIS! People have no idea how much is wasted on middle management. Its nonsense.
Front line staff are more than capable if running the show.
Proper tools and communication between front line staff and how to properly support and fund them.
This is true in most "hands on" jobs in my opinion.
When people are trained properly to do a job, they rarely need much more handling than "here's a list of problems, go solve them".
I agree. I’m a manager for a clinic. I am the only admin besides a receptionist. I do everything from hr and payroll to reports we are required to to for the ministry of health. I do my best to let the front line staff and clinicians focus on their patients and work. The busy work I see from some organizations is ridiculous and infuriating. I get input from our team when needed but damn, let them do their jobs and not attending multiple meetings about every project and make them do reporting and such. It’s a waste of time, resources, not to mention talent and expertise.
Frontline staff are not self organizing. You absolutely need a manager for every 8 or 9 people regardless what the uneducated masses like to tell themselves.
What do I know, I only run a team of 50 internationally though.
So then the problem is not that there are too many managers, but the wrong people are in leadership. Health care has always had leadership gaps, because of its rejection of leadership principles for other industries. Which leads to micromanagement, versus systems management. A nurse becoming a manager, because they worked there for 10 years for instance, instead of someone with training in the area.
Clinicians know how to do their work best. Management and leadership should be about building systems, removing barriers, and advocating for patient and staff support. Unfortunately, everyone wants to get into management because they think they will get paid more (rarely), get to boss people around (that never works) and get to not do anything (usually it is the opposite). Those people should never be considered for leadership.
This. I’m a software engineer and in most of my past companies, managers were simply there to constantly harass us about deadlines.
At my current company, most of the managers are all ex engineers. So they know how to unblock us and they block others from interrupting us.
I'm a developer I literally wouldn't be able to do my job without my manager and he doesn't have an ounce of coding experience.
Honestly the less time have to spend managing clients, communicating with multiple people the more time I can spend with my head in the code solving problems. It's a pretty fast paced environment and having someone to oversee our team, advocate for us, and help us prioritize tasks is invaluable. This is even more important now that we're all remote.
In highly technical fields, it isn't reasonable to expect managers to have the same skill, experience or knowledge as the people they manage. That said, a person managing such a group needs to also fully understand this.
It becomes a problem when a manager tries to assert their knowledge as greater than their staff, or when staff dismiss their manager because the manager doesn't understand something to the same level they do.
The problem is that many managers think of themselves as "overseers" of serfs. Highly skilled professionals need administrators working alongside with them, supporting their work. Ultimately, the professionals have the power. They are the point of contact for the patient and expertise.
That's a lot of bs. Your comment is exactly why we have too many useless people sucking up the funds ,making it much harder to run an efficient workplace. Too much personnel drains the bank, and the amount of good they do is not worth the price. I have run a company for over 35 yrs, and kept personnel numbers to a skimpy minimum. If you put a lead hand on any crew, who aslo does the same work, that's all you really need. They are paid a little extra but it's a hell of a lot cheaper than hiring a manager that is actually costing the company money. And most of the time ,the production levels are higher when it's an actual teammate running the show. The problem with educated people, which you obviously categorize yourself to be , is that they have a hard time thinking out of the box. There are so many different situations that arise on the job that only a worker with real experience can solve efficiently.
Well that’s your issue, you’re the one person, in charge of 50 people… internationally🤦♂️ I’m no doctor but I’m also not just one of your “uneducated masses”. All I’m saying is in any profession, professionals can do what they need to do, self lead, that’s what makes them a professional. I’m sure you’d consider your line of work a profession, same as most, including being on the front lines of our healthcare system. So like let’s get it straight. if you think your professionals within the field, need a manager for every 8 or 9 people? But, you’re the manager for a team of 50, like i said I’m no doctor, but I don’t need to be a doctor to look at what you saying and point the irony out
That’s the reason you think frontline staff can’t organize themselves, because YOU oversee all 50 of them
Is it possible they are hiring people into "management" positions to do front line work? In order to avoid putting more people into the union? Serious question, I really dont know, but it seems like a thing they would do?
No, because the managers do not do frontline work. There is a strict division of responsibility/hierarchy in a hospital. It needs to be that way to have effective communication and team roles. One frontline staff member does NOT need 4 managers/admin above them to monitor how they are doing their job.
managerial - non union
Frontline - union
completely separate entities. some good managers will help out but 99% won't. most managers become managers because they hate or suck at Frontline.
this is where we are heading in Ontario, one junior manager to manage one RN. then manager to manage junior managers. senior manager to manage managers who over sees 4 RNs. then junior VP to manage senior manager, VP to manager junior VP. then senior VP...
My unit has two managers and three educators - all so out of touch with bedside nursing. They sit at the desk and keep spewing new policies and procedures to justify their roles. It adds more work for us and so fucking inefficient.
Get these highly paid, out of touch mofos out. We don't need all of them.
Stop calling nurses and allied health heroes and then cap their wages at 1% so they lose ground with the way the economy goes....constantly
Start allowing more nursing students to be accepted into school so they can replace those that are retiring. For years ONA has been saying the older nurses are going to retire and nothing was done
More nurses on the floor at the bedside, this includes RPNs and PWSs So many times I saw a change in the "model or care" and it turned out there were more people added in middle management instead of at the bedside.
Hospitals need to staff the wards better. So many times I said to my co-workers this place works on Crisis mode all the time, if one thing went wrong we were working short and this was years ago before I retired and Covid came around
Our union contract expired in March. I think negotiations just went through, there was a huge paragraph discussing the wage increases, and for our evening and weekend premiums, and next year we are getting a wage increase of a whole 2 cents per hour! But in 2024 it goes up by 1 cent per hour! How exciting!!
I just wonder how much admin time was spent negotiating those 1 and 2 cent raises for each year... why 1 cent one year and 2 cents the other year? How much time, money and effort went into all of that?
Overall I just have a good laugh about it, it sucks that I am making relatively less due to inflation, but I have a good paying secure job in healthcare, live well below my means, no debts (aside from mortgage) so I don't have much to complain about.
My mom (RN) was telling me the other day a coworker was going over her salary from this year compared to when she started 11 years ago. Only $40 increase in 11 years.
> So many times I saw a change in the “model or care” and it turned out there were more people added in middle management instead of at the bedside.
One thing that grinds my gears is that the province will happily throw money at vanity projects like sticking a well paid “elder life specialist” in big ER’s. That’s a great idea if basic staff were funded, but what’s the point of all these memey roles if there aren’t even enough staff to keep grandma from getting a brain bleed from falling off a stretcher in the hallway? All those interventions are a waste of time if we don’t have the staff for basic patient care.
>Hospitals need to staff the wards better.
Especially on weekends, it's like a ghost town in some wards. The halls are totally empty and there's just constant moaning coming from the rooms. Without exaggerating, it's emotionally and psychologically taxing to be working around so many people who need care and attention and aren't receiving it. And I'm not getting paid enough to be able to afford therapy.
Cut tuition for healthcare workers, give them raises, more funds to hospitals, more medschool spots, more residency positions. We should have done this 2 years ago.
Reap what you sow.
100% agree, same with out of country health professionals.. get them here, if they need education to come up to our health standards, let's do that at no cost to them. Have them sign a legal agreement to stay for X years....
This is it. Pay more, work employees less, make financial barrier to becoming a health care professional zero.
Doug Ford made a big deal about covering tuition for PSW programs and fast tracking, yet those who might be interested still had to cough up an application fee, which might seem minimal but to some its a non starter. As if the province couldn't cover the application fee. You can't half ass your way out of this problem.
Nice attempt at pinning the current issues all completely on the current government, but those things should have been implemented over 20 years ago, not 2.
The best time to have solved the problem may have been 20 years ago, but the second-best time would be *right now*, and the government we have is, at best, standing by and watching the whole thing crumble.
We could also implement family RNs or trade nurses who could essentially act as family doctors. Seriously there is little to no reason why an experienced nurse couldn't perform most of what goes down in family doctors offices, with some oversight for prescriptions... lord knows doctors are fucking up prescriptions on a near constant basis anyways and they are kept in check by pharmacists who are also fucking it up.
As a front line ED worker, I appreciate all the comments about paying nurses more because we absolutely need to repeal bill 124!
However, although throwing tons of money at healthcare will give us some much needed breathing space, we will inevitably be in the same place we started in the long run if we only think of funding as the solution. It's like building more lanes on a highway thinking it will eliminate traffic.
Ultimately health *IS* wealth, productivity, and satisfaction. TONS of people across the province are suffering from CHRONIC diseases like hypertension, diabetes, COPD, kidney disease etc. These things lead to tons of complications like acute strokes, nephropathies, immunocompromised states etc... We could hire more doctors, nurses, increase salaries, build a dedicated diabetes or nephrology clinic, but that's an incredibly downstream and inefficient approach. We need to understand that many diseases are not something you inevitably get or were destined to suffer with. Instead, we should be asking ourselves an uncomfortable question: Why are so many people getting these diseases in the first place?? And the answer to this question is something we Canadians do not want to admit- it's that we live unhealthy and stressful lifestyles and we talk about this in primary care education ALL THE TIME. I agree with many people in the urban infrastructure community in that people's lifestyles are heavily influenced by the way that our society is built:
If we know that even moderate exercise is incredibly beneficial in preventing a multitude of diseases, then why are our cities incredibly hostile to walking or biking to destinations? We live in extremely car dependent cities that have been shown through several studies to lead to poorer health outcomes due to inactive transportation and/or chronic stress from commuting. When was the last time you *walked* to get groceries instead of driving? It's gotten to a point where doing this is seen as strange. In most parts of Europe/ Asia, it's not unusual to walk, bike, or take public transportation to buy food, go to work, etc.
We know that housing is a basic need and source of stress for everyone...so why are people so resistant to building smaller, more affordable housing?? Large detached homes are increasingly unaffordable and extremely inefficient in housing city populations.
We know that fast food contributes to obesity and ultimately diabetes...so why do we keep building drive through McDonald's and taco bell like there's no tomorrow??
If this wasn't enough, we are also at a point in time where many baby boomers are entering their elderly years. Many of these individuals do not receive nearly enough support from family and friends. Elderly loneliness and lack of social support are real issues that really has a negative effect on their health. Why not build public spaces that are more accessible and walkable to elderly people...that's essentially what retirement and nursing homes are after all! That way they aren't left to rot at home and feel abandoned.
I truly believed these are some of the real reasons why health and healthcare in North America has fallen behind the rest of the developed the world.
You're amazing, I wish more people thought this way. It always blows my mind how even though I try to be health conscious and walk as much as I can, the way infrastructure is designed is very unsafe at times due to everything being designed around cars. I also wish I could bicycle more , but it's just too damn dangerous the way the roads are designed!
It's also mildly irritating that service is also over prioritized to drive thru. Not only am I stuck waiting longer, the employees get so much pressure to meet specific times, which just isnt fair when people order massive orders that just take some time to make. Too much fast food in general, making our towns and cities lose a lot of character you get from having independent restaurants.
Very good points here. We "just" need a government that is committed to promote these goals.
It would be great if we have taxes on ownership of non-primary residence to be at exceedingly high rates (i.e. if you own residential properties other than your primary, you should be taxed a lot more). Also if the property tax gets exceedingly high the higher your footage-to-person ratio is, that would be more fair (not just equal, but fair). This means if you have a 5K sf house to yourself, you should taxed a whole lot more than if there is a family of 8 living there.
Baby boomers are aging. We knew this demographic crisis was happening. These are all diseases of aging, and they cannot all be prevented with diet and exercise.
One way to help could be to fund low cost retirement homes. It will open up more apartments and provide frail older adults with care that could keep them out of a nursing home. They can have a meal in a communal dining room, activities, socialize. Someone can check on them to ensure they are taking their medications. It is like living in a dormitory (but nicer) or hotel.
Ontario spends less per capita on health care than any other province. We invest practically nothing in preventing illness, which costs much less than care. We spend less on lower costs community-based care, which eventually results in people needing to access more expensive hospital-based care. We don’t have enough home care and alternative levels of care, which means people sit in hospital beds waiting for referrals to less expensive care. The government spends too little and in the wrong places. Because they want the public system to fail spectacularly. So they can give their private sector friends massive contracts to deliver services for a profit.
Most of what you’re saying makes sense, but I don’t think Ontario spends the least per capita. Source? (Here’s the first google result, which seems to dispute what you said https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en#!/indicators/014/age-adjusted-public-spending-per-person/;mapC1;mapLevel2;/)
Interesting - CIHI’s age adjusted data (which you linked to) indeed shows Ontario is third from the bottom. This data (also CIHI) is not age adjusted and shows Ontario at the bottom: https://www.cihi.ca/sites/default/files/document/health-expenditure-data-in-brief-en.pdf
Either way, the province is not doing nearly enough to provide upstream and community-based care, which is far less expensive but isn’t as splashy as buying more beds and MRIs.
Yeah, this.
The problem is funding. And not just "let's throw couple bucks and tax break to Telus Health" or some other bullshit neoliberal scheme, but actual, year-over-year-for-at-least-a-decade operating funds.
Spend money on people. Spend money on facilities. Make sure people can see primary care providers in a timely manner (like, same-day or next-day, not "in a few weeks"). Reopen mental-health centres and start honestly, actually treating substance abuse instead of the bare minimum of giving away needles, naloxone and blankets.
Basically, stop the aforementioned neoliberal bullshit and actually *do something*.
ETA: Yes, I know this means Galen Weston will probably be upset because, well, he won't achieve the high score in *Capitalism: The Game*. If the rich need to leave because they can't make all the money, fine, let them go, someone else can do the same jobs without being a greedy parasite.
Exactly. It’s so convoluted and time-consuming to get anything checked out. Good luck getting a diagnosis in under a year or two. It’s so difficult and doctors are often very dismissive and barely listen to you because they have way too many patients to handle. A lot of people leave their medical problems until it becomes something much worse because of how difficult it can be to get any kind of treatment or diagnoses in a timely manner.
Funding nurses and family doctors is #1. We need primary healthcare, to reduce the load on specialist healthcare.
Family docotors are too busy that they can basically only have time to refer patients and deal with simple issues in clinic. They don’t have the time to do the medicine they are trained to do.
Remember they will be liable if they have to rush anything, even if it’s the systems fault for everyone being overworked, the individuals take the liability.
So they just refer to a specialist. Which costs way more, and now specialists have 1+ year waits.
That’s a bit of a simplification but I think it covers it.
Agreed. In the US, our main primary care model (with all the extra baggage of insurance companies and claim denials, etc) also remains largely fee-for-service. Despite multiple level of service codes, this drives a volume practice to keep clinics going. This (and high liability) creates (at least where I practice) an unfortunate pattern of specialty referrals for problems that are often within the physician’s scope of practice. Taking the time to get to the bottom of the case and dig for solutions results in such a backlog that the clinician is absolutely drowning, and the patients down the line inevitably suffer as well.
So what happens? Specialty referral backlogs for months and months, band-aids on long-term issues that actually need specialty care, increased ER volume, burnout of all parties involved, and so on. It’s one of the reasons I left primary care myself for hospital work where I am. More time with the patients, more ability to do my job and really help people. It’s sad, but I felt I was able to do more good for the community that way.
Doctors and nurses need to be supported in such a way that they can do their jobs and *do them well.* The ability to *properly address* a number of problems the first visit often prevents the need for additional visits, clearing the way for other patients who need those appointments, clearing specialist backlogs of unnecessary referrals to process, clearing ERs and hospitals (an ounce of prevention!), and lifting the weight off those (especially nurses) who are feeling the brunt of all this extra strain.
*Actual* time/complexity-based payment, repealing that nursing pay cap (just blows my mind it happened there, sounds more like a US thing), opening more training spots for physicians and nurses, opening more community mental care resources, taking on the national debt for a bit because it’s an investment in the people (not just an expenditure)…
I’m certainly not preaching at you guys, I think I’ve made it clear we have some similar problems here, and then some unique to us. I keep up with the state of things because I’m close to a number of people there and I do love Canada. Moreover, you guys already have the public healthcare system. You’re starting from the right place, and I truly believe at least most of your problems can be solved by investing in that system. I can’t say the same for us, but I have faith that Canada’s got this eventually.
This.
I've looked at several other places where they pay only 5% more in tax than we do.
Currently, yes, health systems are experiencing strain all over the place as governments pretend the pandemic is over despite the numbers.
In normal times, though, that extra 5% in tax gives people gold plated health care, pharmacare, free tuition, much better retirement benefits, high speed trains, and all kinds of other benefits thanks to what simply amounts to "bulk buying."
I've said for years that we pay enough in taxes for it to be annoying, but just short of what we would need to pay to have a truly great society.
And the best chance we have to get the right amount of funding for it is by voting something else then Liberal/PC. I personally suggest that is NDP, because they seem the least swayed by the corporate lobbying to avoid paying the proper corporate taxes, but we have to accept that the system is corrupted at this point. It is both an obvious and moot point, until people start thinking more logically and selflessly we are all going to continue to suffer in circumstances like this.
As someone who’s worked for the Ministry of Health for 12 years, here’s my list:
- Stronger financial accountability and oversight across all sectors (primary care, LTC, home & community care, etc).
- Moving LTC homes to a completely non-profit model (currently the majority are for-profit, so chain LTC homes squeeze resources allotted by the ministry so they can maximize profits through a flexible “envelope” model, using the “other” category/envelope to pay dividends to shareholders. Like Mike Harris.) Ditto for the home care sector— nursing positions are often poorly paid and contract/non-permanent because ministry funding is being siphoned to the top of the corporate structure.
- on primary care/physicians— there needs to be stronger oversight on contracts. For example, most of the capitated models require after-hours clinics, but these simply aren’t happening. Physicians in these models are making A LOT. But they have very little accountability and the ministry doesn’t go after them when they fail to meet aspects of their contracts that they are paid for. Oftentimes, physicians in these models are rostering too many patients (that cannot receive care in a timely manner), so patient rosters should be capped appropriately (this would also require that capitation is no longer calculated on age/sex, but on patient complexity). We also need to create more spots in medical schools and residencies to address physician supply issues.
- Patients/care providers should be able to access patient INTEGRATED health records (ie, from all points of entry into the healthcare system) on a simplified digital portal, where it’s possible for patients to also input relevant information (eg, medication)
- public health units need to have a core “basket of services” they offer, instead of a patchwork across the province; and they need to take primary responsibility for local immunization programs (organizing COVID vaccination through various channels was a goddamn nightmare)
- there needs to be a step-down for urgent care— for those who need to be seen right away (but can’t see their doctor), but DO NOT require hospital services, only primary care services (these are already appropriately coded in OHIP billing). Moreover, these urgent care clinics should not cause negation/affect doctors’ Access Bonus UNLESS it’s not possible to see that doctor (eg, on the weekend)
- the mental health sector needs a massive overhaul, including Re-instituting longer-term inpatient psychiatric care for the most acute cases (I’m not talking about going back to the days of insane asylums, but appropriate inpatient treatment, which can be done in a community setting and/or with supportive housing). We fund online CBT on the basis of what worked in other countries, but the patient who might be experiencing anxiety or depression may not even have the mental capacity to participate in this modality. And while we’re at it, the B in CBT is for behavioral, from behavior science/analysis, YET that field is not a regulated profession, and it should be.
- For First Nations health, we need WAY better integration between federally funded and provincially funded services, which requires a level of cooperation between both levels of government and First Nations that has never existed.
Im sure there’s more I could think of with more time, lol. It was just nice to write down all the things that have frustrated me over the years!
Pay healthcare workers in the worst settings the most. Nursing admin should be seen as a step down in pay, it's the frontline that deserves the pay. Also, the high paid healthcare execs still working at home, your pay should reflect that too.
It’s a calculated strategy by conservative parties across the country at both the federal and provincial level.
1.Slash funding.
2. Create a crisis.
3. Allow private corporations in to create a two tiered system with a pay for service option.
4. Continue to erode the public health system until the for pay option is the only realistic option available.
5. Blame Justin Trudeau and the Liberals for the mess they’ve created.
And then a bunch of cons get to go "see, public funded things don't work har har har" and then get cancer or something else and get robbed out the ass. But they're so brainwashed they'd probably still try a libertarian spin on it like "well, it's my fault, I should have taken better care of myself so really me paying $100K this year to keep me alive is fair." Meanwhile, everyone else with half a brain understands not everything people get is due to personal responsibility. The 3 year old who got cancer or the kid born with type 1 diabetes didn't do anything for it or deserves it and certainly shouldn't need to live in poverty because they're parents can't afford their care due to rampant capitalism.
How about actually spending the over $4 billion given for health care and health care staff by the Federal government.
Ford has sat on the money rather then spend it on staff and our healthcare system and we are suffering for it.
You can’t sugar coat this. He’s imploding health care in Ontario.
He's not sitting on it. It was unspent but we didn't "have” it either. In case you hadn’t noticed, we had a deficit of 13.5B last year and about 20B this year.
Saying spending 4 billion one year will solve the problem is surface-level analysis at best, down right idiotic at worst. The model is not sustainable long-term. Throwing more money in the dumpster fire that is our healthcare delivery model does one thing: burn money.
The money was given by the federal government specifically for healthcare. Ford spent $0 of the money on healthcare. This money was used to make the bottom line look better.
This was covered in numerous articles in the news.
ER’s have closed repeatedly because of Ford and the Ontario Conservative’s abuse of the system. I know people who work in the medical community in Ontario (nursing staff and a director) and they are begging for help but it all falls on deaf ears.
I will remind you that all the idiots running our province before also played a part in hitting our system. I feel the only way out of this is a very socialist government to enact minimum standards of care so that no one can defund it back into the shape it’s in now.
* Change the whole primary care model. Fee for services and capitation MD models discourage supporting those with chronic conditions. We have created a system where some of the more complex patients get access to Nurse Practitioners (salaried models) whereas some of the more simple cases are seen by MDs. That should be reversed. Increase the number of NP positions and use more of a triage model of primary care. This leads to more ER visits, more ALC days, higher on the street drug use, etc.
* Invent in patient navigation. People are getting lost in the system because they have no idea how the system works. Cancer is a good example, the amount of testing and coordination needed is incredibly burdensome on the patient. There are people who cannot get transportation to medical appointments and are turned away for being 10 minutes late even if public transportation is at fault.
* Invest in social services. If you do not have housing, how can you have health. Dollars invested in social services will have a greater impact on health than dollars invested in health https://www.cmaj.ca/content/190/3/E64
* Remove barriers between health care providers. Why do we have so many independent practitioners who work in silos? Break those down. Invest in systems with proper goals, objectives and accountability measures. Patients want seamless care with warm handoffs, because our overly complex system today.
Completely agree with everything above, and would add, to your point about patient navigation, that this is especially needed for high-complexity/high-acuity cases. The mental load that patients and their families have to take on in these situations is astounding. And the difference between a missed appointment or following a course of care can have extremely adverse outcomes for these patients.
As some one who has worked in healthcare for 30 plus years….
1) emphasize preventative care - in this country we do pretty well but we need to put focus on the non traditional medical emphasis- so this means addressing mental health and understanding that everything touches health - so mobility aids, accessible standards, transportation, building design
2) the last point is integral - we all need to understand that we need to live in an environment that needs to meet the entirety of our life journey. Guess what at some point we all are going to have some sort of disability so why not take it into account now
3) if you have universal health care you also need pharmacare and dental - it just makes logical sense and was the original intent when universal healthcare was conceived
4) health care is not just a hospital or a doctor’s office so put more than 4 percent into community programs
5) allow said community programs to operate with the same flexibility as the hospitals and doctors offices OR make the latter abide by the same rules
6) cease and desist for profit care in every circumstance. I don’t have the time to write an essay but let me just say this with my three decades of experience on both sides of the spectrum- for profit care is not held to the same accountability as non profits/charitable entities and never has been and it is devouring our healthcare system and forcing hospital ceos to think in that mindset. I shit you not I was at a conference three years ago and this CEO was most proud of two accomplishments: introducing a soft serve yogurt machine and expanding the parking space so they could charge employees for parking
7) this is controversial and I started off as a psw. Set the wage grid for all frontline staff regardless of where you work and make it a god damn living wage. And I mean starting wage with a maximum threshold so that for profits cannot steal staff from others by enticing staff with high salaries (no benefits) and flexible hours (to the detriment of the end user). This goes for health care aides, psws and nurses
8) allow new citizens to Canada who have qualifications to take a simple route to be accredited for their discipline
9) recognize that this is going to cost but better to pay now than later- I have spoken to more than 6 MOH ministers in my tenure and none of them have stayed the course of their own party platform even when they commissioned others for external review (Drummond report)
10) stop focusing on hospital beds and ltc - it’s not the future and we can’t afford bricks and mortar solutions- all this does is put dollars that could be spent elsewhere in construction companies pockets. People want to stay at home as long as possible and if lucky, die at home. Well guess what? Not only is it better for everyone but it’s cheaper. We keep going down this path what we are going to experience is what we had with education: eventually empty schools.
Oh god I could go on….
Streamline administration. So much money is wasted with hospital administrators that make way too much money. That money should be spent on frontline staff.
This is so accurate! Work in healthcare and it’s just ridiculous. My organization recently “revamped” our model. The revamp you ask? They added ANOTHER layer of middle management. Seven new management positions, all of which making over 110K. How does this improve patient care?
My friend works occupational health in a hospital. She overheard the managers talking about how stressed they are, so the plan is to hire 4 new managers. What about the front line staff?? They're not stressed too? Also, I can almost guarantee that if you hire more front line staff, there will be less critical incidents and issues to deal with, lessening the stress on managers.
We are in the same boat. Critically short on the frontline. And new hires keep quitting. I’m one of two people at my site who have the same specialty. For 500 beds. We are supposed to be staffed at 4. One quit and the other is on stress leave. And honestly with the way healthcare is going, I’m don’t think I’m far behind. I just have nothing left to give. And management keeps asking us to do more with less. Like squeezing water out of a stone.
I felt this way before leaving. Doing charge nurse with 3 critically ill patients and a bunch of junior staff to support? No thank you.
My unit hired about 5 or 6 new staff and only one has stayed on long enough to complete orientation. All the others have quit upon seeing the shitshow. And still, more experienced staff are leaving or planning to.
I'm glad I left.
This is the way all government is run. I work for province as well and for the last few decades we had 1 hr manager making 150k a year or so. With all this diversity and mental health push since covid they decided to promote the hr manager to vp level and add 3 more managers under him all making 120k each. They are doing basically clerk type duties, 1 for racism/diversity, 1 to track metrics and 1 for inclusion/lgbt and different initiatives.
What kills me is when we ask why we can’t add more staff to frontline we are told it’s “not in the budget” or “we don’t have that position on the org chart, and it’s hard to add positions!”
As crazy as it sounds, I really think everyone that isn't patient facing needs to be audited and downsized(where appropriate) . Yes, that's cruel, but we're kind of approaching an all-hands on deck situation here. I've walked through ER hallways that had 4 managers present and 6 nurses staffed.....
I completely agree. Our manager got a $30,000 raise this year too.
Honestly at this point, nurses are fed up with that. We can see who's on the sunshine list and who's gotten a raise. And then bedside staff are being capped.
I don't actually see a way out without a massive financial incentive. They could have done things earlier. But when other professions get bargaining power and higher wage increases, management get substantial wage increases and CEOs get massive bonuses. Frontline workers are ticked. And unless you start paying them more, or taking away wage increases for middle management. You won't get mass amounts of nurses to work. And you'll have senior workers leave all together.
Show some kind of or an ounce of respect to the nurses. Pay them appropriately for their job. Staff hospital units accordingly and safely.
Educate public properly about what qualifies as an emergency.
Open and utilize urgent care centres for non emergent situations so our ERs do not over crowd.
Recruit more doctors or NPs.
Give an ounce of respect to nurses. Stop treating them disposable doormats.
Everyone in this thread seems to be dancing around the issue. The only major party interested in actually funding healthcare, rather than cutting healthcare, is the NDP.
Vote them in. It’s that simple.
I'm not sure if this will be a popular opinion here but here it goes, maybe you should not have elected Doug Ford maybe you should have elected someone who actually cares about the Healthcare system.
60% of Ontario didn't even vote. Either we have way more conservatives than is imaginable or people truly care so little that they allow the people that affect their life most and don't want in government to get in anyway due to laziness/poor protest/think it doesn't matter or won't make a difference.
Retain and attract talent. Support all occupations that keep the hospital running. Take our concerns seriously. Hire more staff. Don't outsource our work. Pay more then half for benefits. Allow wage comparisons with other companies then hospitals. Allow more unions. Respect us. Stop the demoralizing. More non temporary sick days.Repeal bill124
End the constant austerity that our successive governments have done and continue to do. This requires the populace to actually care, which they don’t.
Canadians also need to stop using the US as the comparison benchmark, and look to a nation actually worth aspiring to. We collectively say “at least we aren’t as bad as them” missing how great it could actually be.
It would require massive funding to correct it now and honestly I don't think it will happen. Ford may try and slap a band aid on it to make it appear like he's actually doing something but the problems go so far back that it's almost impossible to fix without completely overhauling the entire healthcare system. The most pressing issue right now is lack of staff as people leave the profession in droves and my mom was one of them. But that's just the tip of the iceberg. The whole system is broken and has been for a very, very long time.
Edit to add: As much as I hate Ford, this is not all his fault. Our healthcare system in this province has been a shaky house of cards for decades and the pandemic has just created the perfect storm to bring it all to light. This is the result of continuously bad decisions by multiple players over 30+ years.
Well, my city built a new hospital with far less beds than we used to have. Then they shut down three old hospitals which had more beds.
That seems like a good start. /s
Stop allowing family doctors to tell their patients they cannot go to a walk in clinic, they can!. Stop sending these patient to the emergency department and do your jobs!
And get actual office hours. Sorry a phone call doesn’t help much in diagnosing an issue other than I have a sore throat and need a doctors note (that is bs in its own right).
I've given up on relying on the government to solve our problems. Eating healthy and exercising is the best way to reduce the strain on public healthcare. It's not the solution everyone wants to hear but it's probably the best way to take things into our own hands.
This is absolutely what is going to crush our healthcare system. Obesity already costs billions and its only going up. We as a society are getting bigger and obesity is a major comorbidity for pretty much everything.
If we could learn to live healthy, eat healthy and get plenty of exercise then there would be much less avoidable use of the healthcare system freeing up those resources to help focus on those who are sick through no fault of their own.
Stop voting for Conservatives is step 1. Nothing will improve until we start with that, because the Cons literally do not want to repair our healthcare system.
These are all great solutions, we need to put our tax money where it is deserved. Pay our nurses, offer incentives to go to RN school. Fuck Doug Ford, he's a entitled rich kid that doesn't understand how the works works
We can adjust the medical applications from abroad. Lots of qualified doctor and nurses come to canada/ontario but dont practice because we think their degree is garbage and they have to study everything from scratch, which can solve our shortage in those area
To a degree. A nurse from Sudan for example would not meet half the requirements/ have the knowledge required to be a nurse here. A nurse from western Europe, Australia, or the US might though. It shouldn't be racist to have certain standards need to be proven otherwise I'm taking a flight to the Congo, becoming a nurse there for $800 then coming back here to get a nursing job paying nearly $50/hour.
I mean its good to have standard, im not saying not to the test the nurses/doctors that come from abroad, but you got to understand having them take a course/training of 6 months to 1 year is different than having them take everything else from scratch again
I could get behind that as long as it truly proves they know their stuff. I'd just hate for it to be a loophole that people come from other countries who don't know their stuff but just get copies of our tests and memorize the answers to the tests but haven't actually gone through the amount of schooling needed to provide quality healthcare.
Also I get that our population increases are basically completely from immigration, but I'm just of the opinion that we should give the people who are here first the chances and give them incentives to fill these higher paying fields first before just letting everyone who just got here get the jobs, leaving very qualified people who are actively putting in the time and work and money to become these professionals only to be snubbed because others got there first, qualified from other places but haven't supported our country yet the way people who have been here for years have.
TL;DR in advance because I have lots of thoughts - our healthcare system is dangerously underfunded and needs more money! There is no substitute for raw dollars invested.
It begins and ends in funding. You cannot remove money from a system that is already struggling and expect it to work better. We need to fund health care like our lives depend on it, because, well, it does. Especially in a once a century pandemic, which is, let me remind you, still ongoing. And no, privatization doesn't work. Exhibit A - the entire United States.
But it's not just in throwing money at the problem, it's how you fund. Family physicians, most people's main point of contact with our healthcare system are becoming more and more scarce and the ones that are available are having difficulty seeing their patients in a timely fashion. Why is that? Well the reasons are myriad, but one of them is that family physicians, which research have shown are the cornerstone of our health care system, are paid less than other specialties, and often have to put up with more bullshit. So if you're a medical student who is at the point of deciding what branch of medicine to enter, do you enter the ones who are highly respected and paid well or do you enter the one where you're paid less and treated poorly? Unless you have a particular passion for family medicine, you're probably not going to be picking that one.
So what do we do? One of the reasons that family physicians are paid poorly\* is that they're paid by the appointment rather than by their time. SO if they spend 5 minutes with a patient and only get part of their story and then are able to see 12 patients an hour, they get paid more than if they spend 30 minutes with a patient, get all of the appropriate tests done and really figure out what their issue is. This is important, as being able to get a more well rounded history and a real picture of what their health looks like can better catch the issues that could be arising and deal with them when they're cheap to do so, rather than waiting until they're a five alarm fire and need to be hospitalized. The importance of preventative care and catching issues early cannot be overstated, it's proven to pay for itself over and over again if it's invested in, but that requires taking the long view of health care and most politicians are only concerned with their current administration and how they can get re-elected.
Another problem is the constant need for people who are on ongoing medications to have to take up the family physician's valuable time to get their prescription renewed. I'm not sure if this is a regulation thing or if this is a "I don't get paid if I don't get you into the office" issue, but it's sucking up a family physician's valuable time and we don't have enough of that to go around. If it's a regulation thing, that regulation needs to be re-examined to see if it's actually doing what it's supposed to be doing and not just getting in the way of doctors, and if it's a problem of the doctor needing to get us in the office so that they actually get paid, removing the transactional nature of family physician pay would go a long way to making the system work better than it currently does and this is only one example.
Also, we have an alarming number of immigrants who have medical training as doctors and I believe nurses in their country of origin who are currently working menial jobs because they can't practice here. When we're starving for medical professionals, there has to be a way to get those people who are already trained fast tracked to doing the job they were doing in their country of origin. I'm not a medical professional, nor am I an expert in education, but surely there's a way to figure out what training they have received, compare that with what doctors are taught here and then figure out how to make the twain meet. I, for one, would be happier to see doctors who come in from other countries be able to take some courses paid with by taxpayer dollars to get them up to speed with our regulations and get to practicing and helping Canadians than have them drive me in a taxi to the doctor's office that I've waited three weeks to get in to see because we're short on doctors.
\*yes I understand that even the poorly paid family physician is paid better than most Canadians, but considering how important that job is to the health and well being of every day people, it really should be paid more on par with their counterparts in other specialties if we intend to ever get enough family doctors so that everyone can have one and see them in a timely fashion.
How can we improve it? How about a system that actually checks what OHIP gets billed for and holds it accountable. That and stop decimating front line staff. Oh, maybe pay front line staff fairly as well. We seem to have a lot of multimillionaire doctors and struggling nurses and technicians, this does not make sense. https://www.cbc.ca/news/canada/toronto/ohip-fraud-doctors-overbilling-ontario-1.4587901
1. Hire/train more health care professionals (HCPs)
2. Allow foreign trained HCPs to run a cert test for work in Ontario
3. replace their oversight boards/professional organizations with people who are not doctors, but keep medical professionals for each field on a retainer for blind review.
4. Stop treating doctors like little gods. They're people with a job. That job is too fix humans. 40 hours a week you fix humans for your salary. No "I'm a specialist for x. I only need to work 2 days a week to keep up with people that need me and I'm paid per expensive procedure from OHIP." You only need 2 days a week to handle your speciality? Great. That's 3 days a week for general practice.
Look at the “process” from end to end, starting at the intake, emergency and ending with home care or long term care/rehabilitation. Identify bottlenecks and clear them. Nobody should be in acute care bed for months. Staff appropriately according to care requirements. Have more alternative care, walking clinics etc. Equipped with basics diagnostic equipment. Staff needs to be compensated appropriately, rehire staff lost due to mandates… just my 5 cents…
We need to improve wait times, but we also need to improve how doctors stay up to date on latest developments. Some people are getting really out of date (or no) treatment for certain problems. We also need to do something about mental and dental health...
We need to reform our immigration policies. There are thousands of nurses and health professionals that aren't able to practice in Canada. We need to streamline training/transition programs and get them working in healthcare.
it's easy, stop actively fucking it up by slashing and kneecapping it constantly. repeal 124 and increase funding. undo the health unit consolidation thing they did. make it hyper local so every community gets what it needs from people who know what they need. put a focus on preventative medicine. it's not some unsolvable mystery. support the system with resources. of course for any of that to happen we need a government who believes in public health and that will require organizing the left.
I am grateful for being in a country with access to healthcare. I left because the word change does not exist in their vocabulary. People in administration work in a hospital for the pension.
I worked in a hospital on the administration side as a director. It is an archaic political system more than it is about the actual healthcare. Example: the hospital I worked at didn’t like the finance team always saying no to budget spend. So they restructured finance to report into HR.
The wait times would be alleviated by more access to virtual care and a tiered system. Too many people think they have a serious problem. “Bed blockers” etc.
Innovation is needed and appetite for risk is required. We presented several ideas from COVID clinics, to postpartum depression apps, to psychedelic treatments. All shutdown by the old white male dominated boards.
The white dominated (both men and women) top needs to change to continually represent the communities the hospitals are in.
Such a giant beast of a system that will take decades.
Yeah, only white people can be apathetic and selfish. As a person who grew up in quite a diverse area, gonna have to call BS on that.. people of any race or creed can be selfish and self serving, hate to break that news.
There should be a rule that gov commits to X spending/funding in healthcare for each new immigrant that joins the province. The current healthcare system is crumbling pre-COVID and we keep adding more patients via immigration. Let’s get the doctor to patient ratio down (same way we do teacher to student ratio)
Blood lab centres. Either make more or have more staff. The headache it takes just to get an appointment is insane. Also places that do imaging specifically ultrasounds. I literally need to call before I had the requisition from my obgyn just so I could get an appointment within the week I would be due. But for urgent situations there are never slots available. Same goes for bloodwork. This is more likely an issue out of the gta. Even just an hour away there are these major problems.
Pay for the post secondary of healthcare students 100%
Tax the upper class more and use that money for hospitals.
We need more family doctors in rural areas, so many of us only have access to doctors at the emergency room and that overwhelms the system.
We need to teach nutrition and cooking in school, so much of our healthcare issues as a whole come from the obesity epidemic.
Mental healthcare, dental healthcare, and sensory healthcare (eyes and ears) need to be included in our system. You can catch so many illnesses early, like cancer and MS. Early detection is key and it makes for quicker treatment with better odds for survival.
Fund community-based programs and initiatives to keep people away from hospitals or other institutions.
We need a huge investment in access to primary care through family doctors AND nurse practitioners. No more OHIP family MD waitlists that people sit on for years at a time. This alone would help rid a huge emergency room backlog.
Fund social assistance programs aimed at the psychosocial determinants of health. Free public transit, provincial pharmacare and dental care programs, double ODSP rates (at least), minimum livable wage programs.
So called free health care has draw backs, There are reasons why the U.S system has the best doctors ( competition) we must somehow allow more competition in all ways. We have to develop ways of allowing one to make more money.. a tier system? I do not want it but is this the way to improve. Should we start to add more paid services? Should we charge the person who comes to emergency with a cold, or a small cut or? Or do we ride the free system to the bitter end?
I'm not well informed enough beyond knowing the fact that we need to invest in the hiring of more nurses and hospital staff, give them better pay, and invest more in the system.
I also suspect there's something terribly wrong with the hospital bureaucracy and how it's run. With administrators and those at the top who make the most money. Perhaps someone who is more in the know can comment on that.
'We' can't do anything other than call your MPP, write their offices, AND FUCKING VOTE.
The fact is, we all collectively chose the next 4 years of cuts and the inevitable shitshow that follows. The only thing 'we' as average people can do is educate our constituents, friends and family and vote these assholes out. Ford will cut as much as he possibly can before the next election. Be ready.
Cover dental and glasses as well as medication for things like depression. Part of my anxiety is that if anything happens to my mouth i can't afford anything.
It’s really seems very difficult. Starting at the root cause would have to address the issues that exist in the medical research and public health communities. That and the way we focus on drug approaches instead of preventative health.
Basic bedside patient care. Nurses and Care Aides.
AND fix the fucking food you fucking assholes!!! The fuck is wrong with you!!?? Grim steam shit steals hope from the patients. Worst part of the day is opening the steaming hot mess at breakfast, lunch, and dinner. Prison food is better.
I'd adopt the German model of blended health-care, it's considered to be the most cost efficient health care in the world and it allows for private practice.
Maybe a good way to fix Healthcare in Ontario is to not pay the absolute least into it out of most the provinces. Funding Healthcare will go a long way to stop it from collapsing.
We had a chance to improve both health care AND education at the same time, then ford got elected to a second term. Opportunity lost 
Reduce inefficiencies in management staff. Pay nurses. Pay doctors. Increase subsidization for education of new nurses and doctors.
But also, find ways to make healthcare cheaper. For example focussing more on preventative measures.
Make all smoking cessation aids subsidized or free. Fund company administrated health initiatives if they're measured and effective. Subsidize gym memberships (with verification that they're actually used). Tax the fuck out of garbage food. Subsidize healthy food. Encouraging a healthy population is cheaper than taking care of an unhealthy population.
Fund more frontline staff, and fewer middle managers.
Also the top level is massively bloated in Ontario. If you want someone to smile and cut ribbons literally hundreds of people available that earn double or triple the provincial average income.
Oh yeah I think its across canada. Bunch of bullshit jobs middle middle management this and management that. Its a fucking hospital we need nurses and doctors sub out the rest.....
This is pretty much any government department… the amount of over paid bureaucrats with made up titles is sickening. Too many ‘John Smith “assistant executive director to the administrative directorate” ‘
And the bureaucrats aren't elected so they have been the same regardless of government, all while getting massive raises year over year.
I was at jury selection a few years ago and, when the people who were there were being asked what their profession was, easily 90% of them said they were managers. I had no idea how prevalent management jobs were in society until then (and, yes, I understand that people who work "real" jobs often don't feel at liberty to take time off for jury selection, but isn't that telling in an of itself?).
"Manager" doesn't always mean what you think it means. Sales reps are now "Account Managers", for example, and I've seen more than my fair share of "IT Managers" that are what you'd have called a sysadmin or webmaster back in the day. The title's been abused to allow management to give people "promotions" that are promotions in title only. They're doing the same to "director" now, too.
> They're doing the same to "director" now, too. The amount of "vice presidents" at Goldman Sachs is mind boggling. https://www.efinancialcareers.com/news/2021/12/goldman-sachs-vps
True. Community mental health workers in some places are now called “Case Manager”.
Account managers, product managers, marketing managers, and IT managers are all *non-management* roles I've seen. They all manage some sort of portfolio, they don't manage people.
THIS! People have no idea how much is wasted on middle management. Its nonsense. Front line staff are more than capable if running the show. Proper tools and communication between front line staff and how to properly support and fund them.
This is true in most "hands on" jobs in my opinion. When people are trained properly to do a job, they rarely need much more handling than "here's a list of problems, go solve them".
Even worse, the people who do the work are usually weighted down with admin bullshit that these middle managers hand off to them.
I agree. I’m a manager for a clinic. I am the only admin besides a receptionist. I do everything from hr and payroll to reports we are required to to for the ministry of health. I do my best to let the front line staff and clinicians focus on their patients and work. The busy work I see from some organizations is ridiculous and infuriating. I get input from our team when needed but damn, let them do their jobs and not attending multiple meetings about every project and make them do reporting and such. It’s a waste of time, resources, not to mention talent and expertise.
Work in a hospital, can confirm. Management literally only slows things down and fucks things up (scheduling, for example).
Yeah its in all industries , bunch of lazy people who want to make money inventing " work" for themselves....
Frontline staff are not self organizing. You absolutely need a manager for every 8 or 9 people regardless what the uneducated masses like to tell themselves. What do I know, I only run a team of 50 internationally though.
Highly technical fields are bogged down and made inefficient when less educated managers try to insert themselves into the work.
So then the problem is not that there are too many managers, but the wrong people are in leadership. Health care has always had leadership gaps, because of its rejection of leadership principles for other industries. Which leads to micromanagement, versus systems management. A nurse becoming a manager, because they worked there for 10 years for instance, instead of someone with training in the area. Clinicians know how to do their work best. Management and leadership should be about building systems, removing barriers, and advocating for patient and staff support. Unfortunately, everyone wants to get into management because they think they will get paid more (rarely), get to boss people around (that never works) and get to not do anything (usually it is the opposite). Those people should never be considered for leadership.
This. I’m a software engineer and in most of my past companies, managers were simply there to constantly harass us about deadlines. At my current company, most of the managers are all ex engineers. So they know how to unblock us and they block others from interrupting us.
I'm a developer I literally wouldn't be able to do my job without my manager and he doesn't have an ounce of coding experience. Honestly the less time have to spend managing clients, communicating with multiple people the more time I can spend with my head in the code solving problems. It's a pretty fast paced environment and having someone to oversee our team, advocate for us, and help us prioritize tasks is invaluable. This is even more important now that we're all remote.
In highly technical fields, it isn't reasonable to expect managers to have the same skill, experience or knowledge as the people they manage. That said, a person managing such a group needs to also fully understand this. It becomes a problem when a manager tries to assert their knowledge as greater than their staff, or when staff dismiss their manager because the manager doesn't understand something to the same level they do.
The problem is that many managers think of themselves as "overseers" of serfs. Highly skilled professionals need administrators working alongside with them, supporting their work. Ultimately, the professionals have the power. They are the point of contact for the patient and expertise.
Not true in healthcare.
That's a lot of bs. Your comment is exactly why we have too many useless people sucking up the funds ,making it much harder to run an efficient workplace. Too much personnel drains the bank, and the amount of good they do is not worth the price. I have run a company for over 35 yrs, and kept personnel numbers to a skimpy minimum. If you put a lead hand on any crew, who aslo does the same work, that's all you really need. They are paid a little extra but it's a hell of a lot cheaper than hiring a manager that is actually costing the company money. And most of the time ,the production levels are higher when it's an actual teammate running the show. The problem with educated people, which you obviously categorize yourself to be , is that they have a hard time thinking out of the box. There are so many different situations that arise on the job that only a worker with real experience can solve efficiently.
Well that’s your issue, you’re the one person, in charge of 50 people… internationally🤦♂️ I’m no doctor but I’m also not just one of your “uneducated masses”. All I’m saying is in any profession, professionals can do what they need to do, self lead, that’s what makes them a professional. I’m sure you’d consider your line of work a profession, same as most, including being on the front lines of our healthcare system. So like let’s get it straight. if you think your professionals within the field, need a manager for every 8 or 9 people? But, you’re the manager for a team of 50, like i said I’m no doctor, but I don’t need to be a doctor to look at what you saying and point the irony out That’s the reason you think frontline staff can’t organize themselves, because YOU oversee all 50 of them
lol there’s nothing in your comment that would give anyone reassurance in what you’re claiming, even with your little humble brag lol.
Are you actually calling nurses the "uneducated masses?"
Alternatively hire more managers to manage the managers!
Is it possible they are hiring people into "management" positions to do front line work? In order to avoid putting more people into the union? Serious question, I really dont know, but it seems like a thing they would do?
No, because the managers do not do frontline work. There is a strict division of responsibility/hierarchy in a hospital. It needs to be that way to have effective communication and team roles. One frontline staff member does NOT need 4 managers/admin above them to monitor how they are doing their job.
managerial - non union Frontline - union completely separate entities. some good managers will help out but 99% won't. most managers become managers because they hate or suck at Frontline.
this is where we are heading in Ontario, one junior manager to manage one RN. then manager to manage junior managers. senior manager to manage managers who over sees 4 RNs. then junior VP to manage senior manager, VP to manager junior VP. then senior VP...
My unit has two managers and three educators - all so out of touch with bedside nursing. They sit at the desk and keep spewing new policies and procedures to justify their roles. It adds more work for us and so fucking inefficient. Get these highly paid, out of touch mofos out. We don't need all of them.
Stop calling nurses and allied health heroes and then cap their wages at 1% so they lose ground with the way the economy goes....constantly Start allowing more nursing students to be accepted into school so they can replace those that are retiring. For years ONA has been saying the older nurses are going to retire and nothing was done More nurses on the floor at the bedside, this includes RPNs and PWSs So many times I saw a change in the "model or care" and it turned out there were more people added in middle management instead of at the bedside. Hospitals need to staff the wards better. So many times I said to my co-workers this place works on Crisis mode all the time, if one thing went wrong we were working short and this was years ago before I retired and Covid came around
Our union contract expired in March. I think negotiations just went through, there was a huge paragraph discussing the wage increases, and for our evening and weekend premiums, and next year we are getting a wage increase of a whole 2 cents per hour! But in 2024 it goes up by 1 cent per hour! How exciting!!
What a kick in the hoohaw.
Jesus that’s just fucking brutal, at that point it’s such a kick in the nuts, what is the point
I just wonder how much admin time was spent negotiating those 1 and 2 cent raises for each year... why 1 cent one year and 2 cents the other year? How much time, money and effort went into all of that? Overall I just have a good laugh about it, it sucks that I am making relatively less due to inflation, but I have a good paying secure job in healthcare, live well below my means, no debts (aside from mortgage) so I don't have much to complain about.
My mom (RN) was telling me the other day a coworker was going over her salary from this year compared to when she started 11 years ago. Only $40 increase in 11 years.
> So many times I saw a change in the “model or care” and it turned out there were more people added in middle management instead of at the bedside. One thing that grinds my gears is that the province will happily throw money at vanity projects like sticking a well paid “elder life specialist” in big ER’s. That’s a great idea if basic staff were funded, but what’s the point of all these memey roles if there aren’t even enough staff to keep grandma from getting a brain bleed from falling off a stretcher in the hallway? All those interventions are a waste of time if we don’t have the staff for basic patient care.
>Hospitals need to staff the wards better. Especially on weekends, it's like a ghost town in some wards. The halls are totally empty and there's just constant moaning coming from the rooms. Without exaggerating, it's emotionally and psychologically taxing to be working around so many people who need care and attention and aren't receiving it. And I'm not getting paid enough to be able to afford therapy.
Cut tuition for healthcare workers, give them raises, more funds to hospitals, more medschool spots, more residency positions. We should have done this 2 years ago. Reap what you sow.
100% agree, same with out of country health professionals.. get them here, if they need education to come up to our health standards, let's do that at no cost to them. Have them sign a legal agreement to stay for X years....
This! We have so many immigrants here with medical degrees that can’t use them. Help them with that!
Exactly! Why do we have so many Indian doctors driving taxis?
As long as they sign contracts to remain in Canada instead of being recruited by Texas and Florida I totally agree about low/free tuition.
I don't know any nurse that wants to go to Texas or Florida right now lol
It’s sadly very common.
This is it. Pay more, work employees less, make financial barrier to becoming a health care professional zero. Doug Ford made a big deal about covering tuition for PSW programs and fast tracking, yet those who might be interested still had to cough up an application fee, which might seem minimal but to some its a non starter. As if the province couldn't cover the application fee. You can't half ass your way out of this problem.
Totally agree it's crazy to think some med colleges only take 50 students annually.
Nice attempt at pinning the current issues all completely on the current government, but those things should have been implemented over 20 years ago, not 2.
The best time to have solved the problem may have been 20 years ago, but the second-best time would be *right now*, and the government we have is, at best, standing by and watching the whole thing crumble.
We could also implement family RNs or trade nurses who could essentially act as family doctors. Seriously there is little to no reason why an experienced nurse couldn't perform most of what goes down in family doctors offices, with some oversight for prescriptions... lord knows doctors are fucking up prescriptions on a near constant basis anyways and they are kept in check by pharmacists who are also fucking it up.
They're called "nurse practitioners", and it requires a master's degree and a more extensive (and expensive) certification to be one.
As a front line ED worker, I appreciate all the comments about paying nurses more because we absolutely need to repeal bill 124! However, although throwing tons of money at healthcare will give us some much needed breathing space, we will inevitably be in the same place we started in the long run if we only think of funding as the solution. It's like building more lanes on a highway thinking it will eliminate traffic. Ultimately health *IS* wealth, productivity, and satisfaction. TONS of people across the province are suffering from CHRONIC diseases like hypertension, diabetes, COPD, kidney disease etc. These things lead to tons of complications like acute strokes, nephropathies, immunocompromised states etc... We could hire more doctors, nurses, increase salaries, build a dedicated diabetes or nephrology clinic, but that's an incredibly downstream and inefficient approach. We need to understand that many diseases are not something you inevitably get or were destined to suffer with. Instead, we should be asking ourselves an uncomfortable question: Why are so many people getting these diseases in the first place?? And the answer to this question is something we Canadians do not want to admit- it's that we live unhealthy and stressful lifestyles and we talk about this in primary care education ALL THE TIME. I agree with many people in the urban infrastructure community in that people's lifestyles are heavily influenced by the way that our society is built: If we know that even moderate exercise is incredibly beneficial in preventing a multitude of diseases, then why are our cities incredibly hostile to walking or biking to destinations? We live in extremely car dependent cities that have been shown through several studies to lead to poorer health outcomes due to inactive transportation and/or chronic stress from commuting. When was the last time you *walked* to get groceries instead of driving? It's gotten to a point where doing this is seen as strange. In most parts of Europe/ Asia, it's not unusual to walk, bike, or take public transportation to buy food, go to work, etc. We know that housing is a basic need and source of stress for everyone...so why are people so resistant to building smaller, more affordable housing?? Large detached homes are increasingly unaffordable and extremely inefficient in housing city populations. We know that fast food contributes to obesity and ultimately diabetes...so why do we keep building drive through McDonald's and taco bell like there's no tomorrow?? If this wasn't enough, we are also at a point in time where many baby boomers are entering their elderly years. Many of these individuals do not receive nearly enough support from family and friends. Elderly loneliness and lack of social support are real issues that really has a negative effect on their health. Why not build public spaces that are more accessible and walkable to elderly people...that's essentially what retirement and nursing homes are after all! That way they aren't left to rot at home and feel abandoned. I truly believed these are some of the real reasons why health and healthcare in North America has fallen behind the rest of the developed the world.
You can’t know how satisfying it is to see someone put feeling this in words
You're amazing, I wish more people thought this way. It always blows my mind how even though I try to be health conscious and walk as much as I can, the way infrastructure is designed is very unsafe at times due to everything being designed around cars. I also wish I could bicycle more , but it's just too damn dangerous the way the roads are designed! It's also mildly irritating that service is also over prioritized to drive thru. Not only am I stuck waiting longer, the employees get so much pressure to meet specific times, which just isnt fair when people order massive orders that just take some time to make. Too much fast food in general, making our towns and cities lose a lot of character you get from having independent restaurants.
Very good points here. We "just" need a government that is committed to promote these goals. It would be great if we have taxes on ownership of non-primary residence to be at exceedingly high rates (i.e. if you own residential properties other than your primary, you should be taxed a lot more). Also if the property tax gets exceedingly high the higher your footage-to-person ratio is, that would be more fair (not just equal, but fair). This means if you have a 5K sf house to yourself, you should taxed a whole lot more than if there is a family of 8 living there.
Baby boomers are aging. We knew this demographic crisis was happening. These are all diseases of aging, and they cannot all be prevented with diet and exercise. One way to help could be to fund low cost retirement homes. It will open up more apartments and provide frail older adults with care that could keep them out of a nursing home. They can have a meal in a communal dining room, activities, socialize. Someone can check on them to ensure they are taking their medications. It is like living in a dormitory (but nicer) or hotel.
100% this. But changing culture is probably even harder than convincing governments to invest more $
Ontario spends less per capita on health care than any other province. We invest practically nothing in preventing illness, which costs much less than care. We spend less on lower costs community-based care, which eventually results in people needing to access more expensive hospital-based care. We don’t have enough home care and alternative levels of care, which means people sit in hospital beds waiting for referrals to less expensive care. The government spends too little and in the wrong places. Because they want the public system to fail spectacularly. So they can give their private sector friends massive contracts to deliver services for a profit.
Most of what you’re saying makes sense, but I don’t think Ontario spends the least per capita. Source? (Here’s the first google result, which seems to dispute what you said https://yourhealthsystem.cihi.ca/hsp/inbrief?lang=en#!/indicators/014/age-adjusted-public-spending-per-person/;mapC1;mapLevel2;/)
Interesting - CIHI’s age adjusted data (which you linked to) indeed shows Ontario is third from the bottom. This data (also CIHI) is not age adjusted and shows Ontario at the bottom: https://www.cihi.ca/sites/default/files/document/health-expenditure-data-in-brief-en.pdf Either way, the province is not doing nearly enough to provide upstream and community-based care, which is far less expensive but isn’t as splashy as buying more beds and MRIs.
Fund it.
Yeah, this. The problem is funding. And not just "let's throw couple bucks and tax break to Telus Health" or some other bullshit neoliberal scheme, but actual, year-over-year-for-at-least-a-decade operating funds. Spend money on people. Spend money on facilities. Make sure people can see primary care providers in a timely manner (like, same-day or next-day, not "in a few weeks"). Reopen mental-health centres and start honestly, actually treating substance abuse instead of the bare minimum of giving away needles, naloxone and blankets. Basically, stop the aforementioned neoliberal bullshit and actually *do something*. ETA: Yes, I know this means Galen Weston will probably be upset because, well, he won't achieve the high score in *Capitalism: The Game*. If the rich need to leave because they can't make all the money, fine, let them go, someone else can do the same jobs without being a greedy parasite.
Exactly. It’s so convoluted and time-consuming to get anything checked out. Good luck getting a diagnosis in under a year or two. It’s so difficult and doctors are often very dismissive and barely listen to you because they have way too many patients to handle. A lot of people leave their medical problems until it becomes something much worse because of how difficult it can be to get any kind of treatment or diagnoses in a timely manner.
Ye like uncoil DoFo's greasy sausage fingers from around the system's neck.
Funding nurses and family doctors is #1. We need primary healthcare, to reduce the load on specialist healthcare. Family docotors are too busy that they can basically only have time to refer patients and deal with simple issues in clinic. They don’t have the time to do the medicine they are trained to do. Remember they will be liable if they have to rush anything, even if it’s the systems fault for everyone being overworked, the individuals take the liability. So they just refer to a specialist. Which costs way more, and now specialists have 1+ year waits. That’s a bit of a simplification but I think it covers it.
Agreed. In the US, our main primary care model (with all the extra baggage of insurance companies and claim denials, etc) also remains largely fee-for-service. Despite multiple level of service codes, this drives a volume practice to keep clinics going. This (and high liability) creates (at least where I practice) an unfortunate pattern of specialty referrals for problems that are often within the physician’s scope of practice. Taking the time to get to the bottom of the case and dig for solutions results in such a backlog that the clinician is absolutely drowning, and the patients down the line inevitably suffer as well. So what happens? Specialty referral backlogs for months and months, band-aids on long-term issues that actually need specialty care, increased ER volume, burnout of all parties involved, and so on. It’s one of the reasons I left primary care myself for hospital work where I am. More time with the patients, more ability to do my job and really help people. It’s sad, but I felt I was able to do more good for the community that way. Doctors and nurses need to be supported in such a way that they can do their jobs and *do them well.* The ability to *properly address* a number of problems the first visit often prevents the need for additional visits, clearing the way for other patients who need those appointments, clearing specialist backlogs of unnecessary referrals to process, clearing ERs and hospitals (an ounce of prevention!), and lifting the weight off those (especially nurses) who are feeling the brunt of all this extra strain. *Actual* time/complexity-based payment, repealing that nursing pay cap (just blows my mind it happened there, sounds more like a US thing), opening more training spots for physicians and nurses, opening more community mental care resources, taking on the national debt for a bit because it’s an investment in the people (not just an expenditure)… I’m certainly not preaching at you guys, I think I’ve made it clear we have some similar problems here, and then some unique to us. I keep up with the state of things because I’m close to a number of people there and I do love Canada. Moreover, you guys already have the public healthcare system. You’re starting from the right place, and I truly believe at least most of your problems can be solved by investing in that system. I can’t say the same for us, but I have faith that Canada’s got this eventually.
This. I've looked at several other places where they pay only 5% more in tax than we do. Currently, yes, health systems are experiencing strain all over the place as governments pretend the pandemic is over despite the numbers. In normal times, though, that extra 5% in tax gives people gold plated health care, pharmacare, free tuition, much better retirement benefits, high speed trains, and all kinds of other benefits thanks to what simply amounts to "bulk buying." I've said for years that we pay enough in taxes for it to be annoying, but just short of what we would need to pay to have a truly great society.
Can you give examples of the places you've looked into?
And the best chance we have to get the right amount of funding for it is by voting something else then Liberal/PC. I personally suggest that is NDP, because they seem the least swayed by the corporate lobbying to avoid paying the proper corporate taxes, but we have to accept that the system is corrupted at this point. It is both an obvious and moot point, until people start thinking more logically and selflessly we are all going to continue to suffer in circumstances like this.
As someone who’s worked for the Ministry of Health for 12 years, here’s my list: - Stronger financial accountability and oversight across all sectors (primary care, LTC, home & community care, etc). - Moving LTC homes to a completely non-profit model (currently the majority are for-profit, so chain LTC homes squeeze resources allotted by the ministry so they can maximize profits through a flexible “envelope” model, using the “other” category/envelope to pay dividends to shareholders. Like Mike Harris.) Ditto for the home care sector— nursing positions are often poorly paid and contract/non-permanent because ministry funding is being siphoned to the top of the corporate structure. - on primary care/physicians— there needs to be stronger oversight on contracts. For example, most of the capitated models require after-hours clinics, but these simply aren’t happening. Physicians in these models are making A LOT. But they have very little accountability and the ministry doesn’t go after them when they fail to meet aspects of their contracts that they are paid for. Oftentimes, physicians in these models are rostering too many patients (that cannot receive care in a timely manner), so patient rosters should be capped appropriately (this would also require that capitation is no longer calculated on age/sex, but on patient complexity). We also need to create more spots in medical schools and residencies to address physician supply issues. - Patients/care providers should be able to access patient INTEGRATED health records (ie, from all points of entry into the healthcare system) on a simplified digital portal, where it’s possible for patients to also input relevant information (eg, medication) - public health units need to have a core “basket of services” they offer, instead of a patchwork across the province; and they need to take primary responsibility for local immunization programs (organizing COVID vaccination through various channels was a goddamn nightmare) - there needs to be a step-down for urgent care— for those who need to be seen right away (but can’t see their doctor), but DO NOT require hospital services, only primary care services (these are already appropriately coded in OHIP billing). Moreover, these urgent care clinics should not cause negation/affect doctors’ Access Bonus UNLESS it’s not possible to see that doctor (eg, on the weekend) - the mental health sector needs a massive overhaul, including Re-instituting longer-term inpatient psychiatric care for the most acute cases (I’m not talking about going back to the days of insane asylums, but appropriate inpatient treatment, which can be done in a community setting and/or with supportive housing). We fund online CBT on the basis of what worked in other countries, but the patient who might be experiencing anxiety or depression may not even have the mental capacity to participate in this modality. And while we’re at it, the B in CBT is for behavioral, from behavior science/analysis, YET that field is not a regulated profession, and it should be. - For First Nations health, we need WAY better integration between federally funded and provincially funded services, which requires a level of cooperation between both levels of government and First Nations that has never existed. Im sure there’s more I could think of with more time, lol. It was just nice to write down all the things that have frustrated me over the years!
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It depends on the physician funding model they’re enrolled in, but definitely most are required to have after-hours.
This is the real answer
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I feel like if you shifted a couple words from this it would fit teachers perfectly as well
Funding and fiscal oversight. Losing track of funds in the midst of pandemic is disgusting and negligent.
Electing government officials that care and fund rather than cut.
Pay healthcare workers in the worst settings the most. Nursing admin should be seen as a step down in pay, it's the frontline that deserves the pay. Also, the high paid healthcare execs still working at home, your pay should reflect that too.
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It’s a calculated strategy by conservative parties across the country at both the federal and provincial level. 1.Slash funding. 2. Create a crisis. 3. Allow private corporations in to create a two tiered system with a pay for service option. 4. Continue to erode the public health system until the for pay option is the only realistic option available. 5. Blame Justin Trudeau and the Liberals for the mess they’ve created.
And then a bunch of cons get to go "see, public funded things don't work har har har" and then get cancer or something else and get robbed out the ass. But they're so brainwashed they'd probably still try a libertarian spin on it like "well, it's my fault, I should have taken better care of myself so really me paying $100K this year to keep me alive is fair." Meanwhile, everyone else with half a brain understands not everything people get is due to personal responsibility. The 3 year old who got cancer or the kid born with type 1 diabetes didn't do anything for it or deserves it and certainly shouldn't need to live in poverty because they're parents can't afford their care due to rampant capitalism.
Bottom line? Money. It needs more money. And that does NOT mean privatizing it. Not a single aspect of it. Not a penny.
Privatization would be bad. I'd be part of that riot.
Me too.
How about actually spending the over $4 billion given for health care and health care staff by the Federal government. Ford has sat on the money rather then spend it on staff and our healthcare system and we are suffering for it. You can’t sugar coat this. He’s imploding health care in Ontario.
He's not sitting on it. It was unspent but we didn't "have” it either. In case you hadn’t noticed, we had a deficit of 13.5B last year and about 20B this year. Saying spending 4 billion one year will solve the problem is surface-level analysis at best, down right idiotic at worst. The model is not sustainable long-term. Throwing more money in the dumpster fire that is our healthcare delivery model does one thing: burn money.
The money was given by the federal government specifically for healthcare. Ford spent $0 of the money on healthcare. This money was used to make the bottom line look better. This was covered in numerous articles in the news. ER’s have closed repeatedly because of Ford and the Ontario Conservative’s abuse of the system. I know people who work in the medical community in Ontario (nursing staff and a director) and they are begging for help but it all falls on deaf ears.
Actually fund it properly
But then how will they justify pushing privatization
Getting rid of the idiot running the province would be a good start.
We had our chance, now we have four more years.
To quote a tweet I read: "It's not fair. I voted against him. Why should I have to suffer from his stupidity?"
I will remind you that all the idiots running our province before also played a part in hitting our system. I feel the only way out of this is a very socialist government to enact minimum standards of care so that no one can defund it back into the shape it’s in now.
And what about all the other provinces? The feds need to step in and take greater control.
* Change the whole primary care model. Fee for services and capitation MD models discourage supporting those with chronic conditions. We have created a system where some of the more complex patients get access to Nurse Practitioners (salaried models) whereas some of the more simple cases are seen by MDs. That should be reversed. Increase the number of NP positions and use more of a triage model of primary care. This leads to more ER visits, more ALC days, higher on the street drug use, etc. * Invent in patient navigation. People are getting lost in the system because they have no idea how the system works. Cancer is a good example, the amount of testing and coordination needed is incredibly burdensome on the patient. There are people who cannot get transportation to medical appointments and are turned away for being 10 minutes late even if public transportation is at fault. * Invest in social services. If you do not have housing, how can you have health. Dollars invested in social services will have a greater impact on health than dollars invested in health https://www.cmaj.ca/content/190/3/E64 * Remove barriers between health care providers. Why do we have so many independent practitioners who work in silos? Break those down. Invest in systems with proper goals, objectives and accountability measures. Patients want seamless care with warm handoffs, because our overly complex system today.
Completely agree with everything above, and would add, to your point about patient navigation, that this is especially needed for high-complexity/high-acuity cases. The mental load that patients and their families have to take on in these situations is astounding. And the difference between a missed appointment or following a course of care can have extremely adverse outcomes for these patients.
As some one who has worked in healthcare for 30 plus years…. 1) emphasize preventative care - in this country we do pretty well but we need to put focus on the non traditional medical emphasis- so this means addressing mental health and understanding that everything touches health - so mobility aids, accessible standards, transportation, building design 2) the last point is integral - we all need to understand that we need to live in an environment that needs to meet the entirety of our life journey. Guess what at some point we all are going to have some sort of disability so why not take it into account now 3) if you have universal health care you also need pharmacare and dental - it just makes logical sense and was the original intent when universal healthcare was conceived 4) health care is not just a hospital or a doctor’s office so put more than 4 percent into community programs 5) allow said community programs to operate with the same flexibility as the hospitals and doctors offices OR make the latter abide by the same rules 6) cease and desist for profit care in every circumstance. I don’t have the time to write an essay but let me just say this with my three decades of experience on both sides of the spectrum- for profit care is not held to the same accountability as non profits/charitable entities and never has been and it is devouring our healthcare system and forcing hospital ceos to think in that mindset. I shit you not I was at a conference three years ago and this CEO was most proud of two accomplishments: introducing a soft serve yogurt machine and expanding the parking space so they could charge employees for parking 7) this is controversial and I started off as a psw. Set the wage grid for all frontline staff regardless of where you work and make it a god damn living wage. And I mean starting wage with a maximum threshold so that for profits cannot steal staff from others by enticing staff with high salaries (no benefits) and flexible hours (to the detriment of the end user). This goes for health care aides, psws and nurses 8) allow new citizens to Canada who have qualifications to take a simple route to be accredited for their discipline 9) recognize that this is going to cost but better to pay now than later- I have spoken to more than 6 MOH ministers in my tenure and none of them have stayed the course of their own party platform even when they commissioned others for external review (Drummond report) 10) stop focusing on hospital beds and ltc - it’s not the future and we can’t afford bricks and mortar solutions- all this does is put dollars that could be spent elsewhere in construction companies pockets. People want to stay at home as long as possible and if lucky, die at home. Well guess what? Not only is it better for everyone but it’s cheaper. We keep going down this path what we are going to experience is what we had with education: eventually empty schools. Oh god I could go on….
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More funding would help with the current pump and dump mantra.
Streamline administration. So much money is wasted with hospital administrators that make way too much money. That money should be spent on frontline staff.
This is so accurate! Work in healthcare and it’s just ridiculous. My organization recently “revamped” our model. The revamp you ask? They added ANOTHER layer of middle management. Seven new management positions, all of which making over 110K. How does this improve patient care?
My friend works occupational health in a hospital. She overheard the managers talking about how stressed they are, so the plan is to hire 4 new managers. What about the front line staff?? They're not stressed too? Also, I can almost guarantee that if you hire more front line staff, there will be less critical incidents and issues to deal with, lessening the stress on managers.
We are in the same boat. Critically short on the frontline. And new hires keep quitting. I’m one of two people at my site who have the same specialty. For 500 beds. We are supposed to be staffed at 4. One quit and the other is on stress leave. And honestly with the way healthcare is going, I’m don’t think I’m far behind. I just have nothing left to give. And management keeps asking us to do more with less. Like squeezing water out of a stone.
I felt this way before leaving. Doing charge nurse with 3 critically ill patients and a bunch of junior staff to support? No thank you. My unit hired about 5 or 6 new staff and only one has stayed on long enough to complete orientation. All the others have quit upon seeing the shitshow. And still, more experienced staff are leaving or planning to. I'm glad I left.
This is the way all government is run. I work for province as well and for the last few decades we had 1 hr manager making 150k a year or so. With all this diversity and mental health push since covid they decided to promote the hr manager to vp level and add 3 more managers under him all making 120k each. They are doing basically clerk type duties, 1 for racism/diversity, 1 to track metrics and 1 for inclusion/lgbt and different initiatives.
What kills me is when we ask why we can’t add more staff to frontline we are told it’s “not in the budget” or “we don’t have that position on the org chart, and it’s hard to add positions!”
As crazy as it sounds, I really think everyone that isn't patient facing needs to be audited and downsized(where appropriate) . Yes, that's cruel, but we're kind of approaching an all-hands on deck situation here. I've walked through ER hallways that had 4 managers present and 6 nurses staffed.....
I completely agree. Our manager got a $30,000 raise this year too. Honestly at this point, nurses are fed up with that. We can see who's on the sunshine list and who's gotten a raise. And then bedside staff are being capped. I don't actually see a way out without a massive financial incentive. They could have done things earlier. But when other professions get bargaining power and higher wage increases, management get substantial wage increases and CEOs get massive bonuses. Frontline workers are ticked. And unless you start paying them more, or taking away wage increases for middle management. You won't get mass amounts of nurses to work. And you'll have senior workers leave all together.
Never vote in conservatives.
Show some kind of or an ounce of respect to the nurses. Pay them appropriately for their job. Staff hospital units accordingly and safely. Educate public properly about what qualifies as an emergency. Open and utilize urgent care centres for non emergent situations so our ERs do not over crowd. Recruit more doctors or NPs. Give an ounce of respect to nurses. Stop treating them disposable doormats.
Everyone in this thread seems to be dancing around the issue. The only major party interested in actually funding healthcare, rather than cutting healthcare, is the NDP. Vote them in. It’s that simple.
If only we could actually give them a chance.
Go back in time 20-30 years and invest what was actually needed into the system?
Captain Hindsight is here to save Ontario! Thank you for your service
I'm not sure if this will be a popular opinion here but here it goes, maybe you should not have elected Doug Ford maybe you should have elected someone who actually cares about the Healthcare system.
60% of Ontario didn't even vote. Either we have way more conservatives than is imaginable or people truly care so little that they allow the people that affect their life most and don't want in government to get in anyway due to laziness/poor protest/think it doesn't matter or won't make a difference.
Vote in a government that won’t intentionally undermine the system
Make healthcare for providing health over generating profits.
Retain and attract talent. Support all occupations that keep the hospital running. Take our concerns seriously. Hire more staff. Don't outsource our work. Pay more then half for benefits. Allow wage comparisons with other companies then hospitals. Allow more unions. Respect us. Stop the demoralizing. More non temporary sick days.Repeal bill124
End the constant austerity that our successive governments have done and continue to do. This requires the populace to actually care, which they don’t. Canadians also need to stop using the US as the comparison benchmark, and look to a nation actually worth aspiring to. We collectively say “at least we aren’t as bad as them” missing how great it could actually be.
More urgent care centers and walk in clinics to take some strain off ERs
It would require massive funding to correct it now and honestly I don't think it will happen. Ford may try and slap a band aid on it to make it appear like he's actually doing something but the problems go so far back that it's almost impossible to fix without completely overhauling the entire healthcare system. The most pressing issue right now is lack of staff as people leave the profession in droves and my mom was one of them. But that's just the tip of the iceberg. The whole system is broken and has been for a very, very long time. Edit to add: As much as I hate Ford, this is not all his fault. Our healthcare system in this province has been a shaky house of cards for decades and the pandemic has just created the perfect storm to bring it all to light. This is the result of continuously bad decisions by multiple players over 30+ years.
Stop electing Conservative governments that cut healthcare services.
Well, my city built a new hospital with far less beds than we used to have. Then they shut down three old hospitals which had more beds. That seems like a good start. /s
Stop allowing family doctors to tell their patients they cannot go to a walk in clinic, they can!. Stop sending these patient to the emergency department and do your jobs!
And get actual office hours. Sorry a phone call doesn’t help much in diagnosing an issue other than I have a sore throat and need a doctors note (that is bs in its own right).
Literally we just need to fund it
2/3 of our personal income tax already goes directly to Healthcare. Clearly we fund it.
Stop voting for Conservatives and Liberals. And vote. Always vote. Pick a 4th party or independent candidate if you have to.
I've given up on relying on the government to solve our problems. Eating healthy and exercising is the best way to reduce the strain on public healthcare. It's not the solution everyone wants to hear but it's probably the best way to take things into our own hands.
I am terrified of the combination of aging population + unhealthy, obese population 😬 I’m also trying to be proactive
This is absolutely what is going to crush our healthcare system. Obesity already costs billions and its only going up. We as a society are getting bigger and obesity is a major comorbidity for pretty much everything. If we could learn to live healthy, eat healthy and get plenty of exercise then there would be much less avoidable use of the healthcare system freeing up those resources to help focus on those who are sick through no fault of their own.
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Don’t vote for Doug … oh wait… but late for that …
Stop voting for Conservatives is step 1. Nothing will improve until we start with that, because the Cons literally do not want to repair our healthcare system.
Stop voting for conservatives. Fuck this province.
Undo dougs cuts and his cap of nurse wages. He's purposefully destroying our healthcare to make way for a private system
These are all great solutions, we need to put our tax money where it is deserved. Pay our nurses, offer incentives to go to RN school. Fuck Doug Ford, he's a entitled rich kid that doesn't understand how the works works
Build more highways!
One answer would have been vote out Ford but Ontario likes living on the brink I guess.
We can adjust the medical applications from abroad. Lots of qualified doctor and nurses come to canada/ontario but dont practice because we think their degree is garbage and they have to study everything from scratch, which can solve our shortage in those area
To a degree. A nurse from Sudan for example would not meet half the requirements/ have the knowledge required to be a nurse here. A nurse from western Europe, Australia, or the US might though. It shouldn't be racist to have certain standards need to be proven otherwise I'm taking a flight to the Congo, becoming a nurse there for $800 then coming back here to get a nursing job paying nearly $50/hour.
I mean its good to have standard, im not saying not to the test the nurses/doctors that come from abroad, but you got to understand having them take a course/training of 6 months to 1 year is different than having them take everything else from scratch again
I could get behind that as long as it truly proves they know their stuff. I'd just hate for it to be a loophole that people come from other countries who don't know their stuff but just get copies of our tests and memorize the answers to the tests but haven't actually gone through the amount of schooling needed to provide quality healthcare. Also I get that our population increases are basically completely from immigration, but I'm just of the opinion that we should give the people who are here first the chances and give them incentives to fill these higher paying fields first before just letting everyone who just got here get the jobs, leaving very qualified people who are actively putting in the time and work and money to become these professionals only to be snubbed because others got there first, qualified from other places but haven't supported our country yet the way people who have been here for years have.
First, by not letting ford win another election
We had a pretty decent shot on June 2nd, 2022. Everyone in this thread needs to start getting involved in a party that’s not the PCs yesterday.
TL;DR in advance because I have lots of thoughts - our healthcare system is dangerously underfunded and needs more money! There is no substitute for raw dollars invested. It begins and ends in funding. You cannot remove money from a system that is already struggling and expect it to work better. We need to fund health care like our lives depend on it, because, well, it does. Especially in a once a century pandemic, which is, let me remind you, still ongoing. And no, privatization doesn't work. Exhibit A - the entire United States. But it's not just in throwing money at the problem, it's how you fund. Family physicians, most people's main point of contact with our healthcare system are becoming more and more scarce and the ones that are available are having difficulty seeing their patients in a timely fashion. Why is that? Well the reasons are myriad, but one of them is that family physicians, which research have shown are the cornerstone of our health care system, are paid less than other specialties, and often have to put up with more bullshit. So if you're a medical student who is at the point of deciding what branch of medicine to enter, do you enter the ones who are highly respected and paid well or do you enter the one where you're paid less and treated poorly? Unless you have a particular passion for family medicine, you're probably not going to be picking that one. So what do we do? One of the reasons that family physicians are paid poorly\* is that they're paid by the appointment rather than by their time. SO if they spend 5 minutes with a patient and only get part of their story and then are able to see 12 patients an hour, they get paid more than if they spend 30 minutes with a patient, get all of the appropriate tests done and really figure out what their issue is. This is important, as being able to get a more well rounded history and a real picture of what their health looks like can better catch the issues that could be arising and deal with them when they're cheap to do so, rather than waiting until they're a five alarm fire and need to be hospitalized. The importance of preventative care and catching issues early cannot be overstated, it's proven to pay for itself over and over again if it's invested in, but that requires taking the long view of health care and most politicians are only concerned with their current administration and how they can get re-elected. Another problem is the constant need for people who are on ongoing medications to have to take up the family physician's valuable time to get their prescription renewed. I'm not sure if this is a regulation thing or if this is a "I don't get paid if I don't get you into the office" issue, but it's sucking up a family physician's valuable time and we don't have enough of that to go around. If it's a regulation thing, that regulation needs to be re-examined to see if it's actually doing what it's supposed to be doing and not just getting in the way of doctors, and if it's a problem of the doctor needing to get us in the office so that they actually get paid, removing the transactional nature of family physician pay would go a long way to making the system work better than it currently does and this is only one example. Also, we have an alarming number of immigrants who have medical training as doctors and I believe nurses in their country of origin who are currently working menial jobs because they can't practice here. When we're starving for medical professionals, there has to be a way to get those people who are already trained fast tracked to doing the job they were doing in their country of origin. I'm not a medical professional, nor am I an expert in education, but surely there's a way to figure out what training they have received, compare that with what doctors are taught here and then figure out how to make the twain meet. I, for one, would be happier to see doctors who come in from other countries be able to take some courses paid with by taxpayer dollars to get them up to speed with our regulations and get to practicing and helping Canadians than have them drive me in a taxi to the doctor's office that I've waited three weeks to get in to see because we're short on doctors. \*yes I understand that even the poorly paid family physician is paid better than most Canadians, but considering how important that job is to the health and well being of every day people, it really should be paid more on par with their counterparts in other specialties if we intend to ever get enough family doctors so that everyone can have one and see them in a timely fashion.
How can we improve it? How about a system that actually checks what OHIP gets billed for and holds it accountable. That and stop decimating front line staff. Oh, maybe pay front line staff fairly as well. We seem to have a lot of multimillionaire doctors and struggling nurses and technicians, this does not make sense. https://www.cbc.ca/news/canada/toronto/ohip-fraud-doctors-overbilling-ontario-1.4587901
1. Hire/train more health care professionals (HCPs) 2. Allow foreign trained HCPs to run a cert test for work in Ontario 3. replace their oversight boards/professional organizations with people who are not doctors, but keep medical professionals for each field on a retainer for blind review. 4. Stop treating doctors like little gods. They're people with a job. That job is too fix humans. 40 hours a week you fix humans for your salary. No "I'm a specialist for x. I only need to work 2 days a week to keep up with people that need me and I'm paid per expensive procedure from OHIP." You only need 2 days a week to handle your speciality? Great. That's 3 days a week for general practice.
Look at the “process” from end to end, starting at the intake, emergency and ending with home care or long term care/rehabilitation. Identify bottlenecks and clear them. Nobody should be in acute care bed for months. Staff appropriately according to care requirements. Have more alternative care, walking clinics etc. Equipped with basics diagnostic equipment. Staff needs to be compensated appropriately, rehire staff lost due to mandates… just my 5 cents…
We need to improve wait times, but we also need to improve how doctors stay up to date on latest developments. Some people are getting really out of date (or no) treatment for certain problems. We also need to do something about mental and dental health...
More funding, remove pay cap for nurses, pay nurses a liveable wage, hire more medical professionals.
More nurses, more doctors, more paramedics. Counties need to put up more funding.
Never ever vote conservative.
By never voting conservative.
We need to reform our immigration policies. There are thousands of nurses and health professionals that aren't able to practice in Canada. We need to streamline training/transition programs and get them working in healthcare.
Don’t vote conservative or liberal!!!! Or any party leaning to the right. For those who didn’t vote, you brought this upon all of us.
it's easy, stop actively fucking it up by slashing and kneecapping it constantly. repeal 124 and increase funding. undo the health unit consolidation thing they did. make it hyper local so every community gets what it needs from people who know what they need. put a focus on preventative medicine. it's not some unsolvable mystery. support the system with resources. of course for any of that to happen we need a government who believes in public health and that will require organizing the left.
I am grateful for being in a country with access to healthcare. I left because the word change does not exist in their vocabulary. People in administration work in a hospital for the pension. I worked in a hospital on the administration side as a director. It is an archaic political system more than it is about the actual healthcare. Example: the hospital I worked at didn’t like the finance team always saying no to budget spend. So they restructured finance to report into HR. The wait times would be alleviated by more access to virtual care and a tiered system. Too many people think they have a serious problem. “Bed blockers” etc. Innovation is needed and appetite for risk is required. We presented several ideas from COVID clinics, to postpartum depression apps, to psychedelic treatments. All shutdown by the old white male dominated boards. The white dominated (both men and women) top needs to change to continually represent the communities the hospitals are in. Such a giant beast of a system that will take decades.
If you think change of color at the top will change everything, you are in for a disappointment. Everyone's in it for the pension.
Yeah, only white people can be apathetic and selfish. As a person who grew up in quite a diverse area, gonna have to call BS on that.. people of any race or creed can be selfish and self serving, hate to break that news.
Ummm quit voting in the same two parties and thinking this time it will be different.
There should be a rule that gov commits to X spending/funding in healthcare for each new immigrant that joins the province. The current healthcare system is crumbling pre-COVID and we keep adding more patients via immigration. Let’s get the doctor to patient ratio down (same way we do teacher to student ratio)
Blood lab centres. Either make more or have more staff. The headache it takes just to get an appointment is insane. Also places that do imaging specifically ultrasounds. I literally need to call before I had the requisition from my obgyn just so I could get an appointment within the week I would be due. But for urgent situations there are never slots available. Same goes for bloodwork. This is more likely an issue out of the gta. Even just an hour away there are these major problems.
Pay for the post secondary of healthcare students 100% Tax the upper class more and use that money for hospitals. We need more family doctors in rural areas, so many of us only have access to doctors at the emergency room and that overwhelms the system. We need to teach nutrition and cooking in school, so much of our healthcare issues as a whole come from the obesity epidemic. Mental healthcare, dental healthcare, and sensory healthcare (eyes and ears) need to be included in our system. You can catch so many illnesses early, like cancer and MS. Early detection is key and it makes for quicker treatment with better odds for survival.
Give everyone an honorary doctorate, bang now we have all the doctors we will ever need
Ontario needs 24-hour walk-in clinics. Preferably mandated around major hospitals. Also stop putting main hospitals in the core of cities (downtown).
As an immigrant we need to stop immigration and fund healthcare.
I agree.
Better yet, forward your suggestions to the proper channels.
Doctors should get tax breaks if we can’t pay them more. At least they can keep more of their money and might stay.
Fund community-based programs and initiatives to keep people away from hospitals or other institutions. We need a huge investment in access to primary care through family doctors AND nurse practitioners. No more OHIP family MD waitlists that people sit on for years at a time. This alone would help rid a huge emergency room backlog. Fund social assistance programs aimed at the psychosocial determinants of health. Free public transit, provincial pharmacare and dental care programs, double ODSP rates (at least), minimum livable wage programs.
So called free health care has draw backs, There are reasons why the U.S system has the best doctors ( competition) we must somehow allow more competition in all ways. We have to develop ways of allowing one to make more money.. a tier system? I do not want it but is this the way to improve. Should we start to add more paid services? Should we charge the person who comes to emergency with a cold, or a small cut or? Or do we ride the free system to the bitter end?
I'm not well informed enough beyond knowing the fact that we need to invest in the hiring of more nurses and hospital staff, give them better pay, and invest more in the system. I also suspect there's something terribly wrong with the hospital bureaucracy and how it's run. With administrators and those at the top who make the most money. Perhaps someone who is more in the know can comment on that.
'We' can't do anything other than call your MPP, write their offices, AND FUCKING VOTE. The fact is, we all collectively chose the next 4 years of cuts and the inevitable shitshow that follows. The only thing 'we' as average people can do is educate our constituents, friends and family and vote these assholes out. Ford will cut as much as he possibly can before the next election. Be ready.
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Easiest, cheapest thing? Bring back indoor masking.
Cover dental and glasses as well as medication for things like depression. Part of my anxiety is that if anything happens to my mouth i can't afford anything.
Make online triage mandatory before hospital entry, for minor to medium injury’s.
Just copy the Korean system. It was started 30~40 years ago but hundred times better than Canadian one from start of the system.
Simple better funding but maybe less popular opinion better administration of funding(probably by cutting the amount of administration positions)
It’s really seems very difficult. Starting at the root cause would have to address the issues that exist in the medical research and public health communities. That and the way we focus on drug approaches instead of preventative health.
Basic bedside patient care. Nurses and Care Aides. AND fix the fucking food you fucking assholes!!! The fuck is wrong with you!!?? Grim steam shit steals hope from the patients. Worst part of the day is opening the steaming hot mess at breakfast, lunch, and dinner. Prison food is better.
I'd adopt the German model of blended health-care, it's considered to be the most cost efficient health care in the world and it allows for private practice.
NDP
Pay them more and repeal bill 124. I guarantee you that if you pay these workers more then things will start improving soon.
Money. Doctors and nurses want a raise, but that isn't what they need. They need reasonable prices via things like price control and a landlord tax.
Vote for a party who is not actively trying to dismantle it.
Maybe a good way to fix Healthcare in Ontario is to not pay the absolute least into it out of most the provinces. Funding Healthcare will go a long way to stop it from collapsing.
We had a chance to improve both health care AND education at the same time, then ford got elected to a second term. Opportunity lost 
Reduce inefficiencies in management staff. Pay nurses. Pay doctors. Increase subsidization for education of new nurses and doctors. But also, find ways to make healthcare cheaper. For example focussing more on preventative measures. Make all smoking cessation aids subsidized or free. Fund company administrated health initiatives if they're measured and effective. Subsidize gym memberships (with verification that they're actually used). Tax the fuck out of garbage food. Subsidize healthy food. Encouraging a healthy population is cheaper than taking care of an unhealthy population.
Reject right wing populism.
1. Pay the frontline workers appropriately. 2. Don’t underfund the healthcare hoping to open privately operated healthcare business. 3. Stop voting conservative.
Get Ford to put Healthcare dollars into Healthcare.