Saturday, February 12, 2005

How to deal with the Doctors shortage-practical tips

Useful article an tips -but why do we not get the Medical schools to open the gates, or allow Doctors trained from other accredited medical schools(international) to practise in Canada. Why can we not make it easier to practise medicine in Canada by getting rid off the obstacles put in place by the multiple "Ministry Health" aministrations?


How to deal with the doctor shortage Stephen Kaladeen, MD

o, I'm sorry. Dr. K. is not taking any new patients at this time."
I have heard my secretary say these words hundreds of times over the past four years. And every time, I feel regret. The callers are simply asking for something that we have taken for granted for decades – access to a family physician. Ten years ago, when I started working in the small town where I currently reside, there was no doctor shortage. But today, I'm one of only nine practising in the area instead of the 20 that used to work here.

This past decade has brought changes in the delivery of health care across Canada. These changes are the result of growing concerns by government about the cost of medical care and how medical practitioners now choose to work – as fee-for-service providers or salaried doctors. As a result, the number of family doctors available to the public has been reduced. Part of this problem is because of cutbacks in medical school enrolment and the restrictions on how a doctor can practise. Another significant fact is the emigration of doctors to the United States.

Concerns regarding the ever-increasing health care budget are certainly valid. The various levels of government, however, never really anticipated the increased demand for medical services as our demographics changed and a large group of citizens moving into their 50s required additional medical resources. The other unexpected problem was that doctors, having been trained in larger urban centres, would prefer to stay in those larger centres, leaving smaller, rural communities desperately struggling to attract family doctors. To compound the problem even further, family medicine as a medical specialty has become less attractive to medical students; specialty training seems to offer a more secure job and a better lifestyle.
The result has left large parts of Canada urgently looking for family doctors and communities competing with each other for this finite human resource. Various incentives and inducements have been offered to doctors, and the competitive game continues to up the ante into thousands of dollars in recruitment packages. Despite these packages, the number of doctors remains limited.

So what do you do if you've just lost your family doctor or you've moved to a new community outside of the city and need to find a physician who is taking new patients? Here are a few things you can do to get the care you need.

If you are moving to a retirement community from a larger city, retain your current doctor. It may be easier to drive to the city than to find a new physician, especially if you have a good relationship with that doctor.
If you have friends or relatives in the area, ask them to approach their doctor about taking you on as a patient.
If the community has a walk-in clinic, use it. However, try to establish a relationship with one of the doctors who works there. If possible, get that doctor's schedule and try to build a relationship with him or her.
Get to know your local pharmacist. This professional may be aware of doctors in neighbouring towns who may be taking on new patients.
If you haven't found a doctor and you've run out of your medication, go to the emergency department of the nearest hospital. The best time to go is just before eight o'clock in the morning when the staff changes shifts. You will wait less and the department is usually less busy at that time.

If you or a member of your family has a chronic disease such as arthritis or Alzheimer's disease, contact community support organizations, such as the Alzheimer Society. They usually offer connections to local area experts and home-care nursing assistance.
Make use of the numerous health services offered within the community, such as free blood pressure and diabetes clinics at the health unit or pharmacy. Also, mammogram and flu vaccine clinics available through the public health unit or at the hospital usually don't require a doctor's referral.

If the community is trying to recruit a doctor, get involved. This may give you some first-hand contact that will help to eventually get the service you need.
Remember that you are the most important determinant of your health. Exercise, watch your weight and don't smoke. Much of what family doctors do is preventative, and maintaining a healthy lifestyle can enhance this aspect of your health.
© April 2004 50Plus Magazine

Friday, February 11, 2005

We all look forward to the commissioners report

And they say the justice system is blind - not anywhere as blind as the old Minister of Finance. Check it out -is this not a great way to spend our Money -chuckle . Be outraged -these people have no excuse for the public defrauding .

News canada.com network: "Martin, the first sitting prime minister to testify publicly in over 130 years, also testified Thursday that he:
Had no involvement with the ad agencies that got money through the program.
Didn't know until 1996 about a secretive unity reserve fund Chretien controlled that was used as startup funding for the sponsorship program, even though it was included in federal spending plans the previous year.
Wasn't involved in doling out grants in Quebec even though he was the Liberal lieutenant for the province.
Martin said he was absorbed with slashing the deficit and dealing with an international economic crisis in the mid-1990s - not focusing on sponsorship. "

The South-East Asia Earthquake and Tsunami Blog

This is a good reference for those that want to offer direct help .
The South-East Asia Earthquake and Tsunami Blog

A " one day study session" in bad public service

Again the customer , the general public is held up for ransom and abuse . The "service providors are having a dispute "or tiff at the public's expense . Who cares which one is right - Smitherman or the doctors. What about the patients?

Why is it that those that need the service are always disdainfully held up for ransom - in this low delivery health system of ours? We need choice and options .

Do you think it is time for some alternatives? Maybe -some competition and care alternatives would make the "government" service providors less arrogant or indifferent to their customers needs. Who gets the tax money in our overpriced " Care" monopoly anyway- the customer you jest.

Sympatico / MSN : News : CTV.ca Ont. anesthetists' job action delays surgeries

He said he would resign if he was involved-the election promise

Paul Martin has testified . What will happen next? Good that the press is keeping the promise made in public view

News | canada.com network

Good Things Come to Those Who Ask

This is a common sense refresher in how to communicate to get better service.

Good Things Come to Those Who Ask

Ask Questions -improve your effectiveness

Asking questions smartly is effective. Action oriented questions yield results in the accountability quest. " Public organizations have nothing to hid or do they? "
Questions shine the light of transparency on them.

Source : Leeds Special from Bottom Line/PersonalPublished: September 15, 2001

Many people believe asking questions makes them look vulnerable... or stupid... or as if they are challenging authority. When they do ask questions, they elicit little information.

Here's how to use smart questioning to communicate more effectively, make better decisions and solve problems faster -- in your business and personal life.
QUESTIONS AT WORK
Get employees and clients to persuade themselves. No one wants to be talked into anything. Rather than use a canned sales pitch or formal directive, pose questions that let the other person make your argument for you.
Example: A client converted his company's database to a complicated new software program. As often happens when new technology is introduced, everyone hated it. Rather than try to convince them to stick with it, however, he asked his staff, Would you like to go back to the old system? When they responded no, he asked Why not? Their answers highlighted all the advantages of the new system that they had overlooked because of the difficulties of the changeover.
Begin conversations with open-ended questions. Closed-ended questions yield short answers and reveal limited information. Open-ended questions encourage people to explain themselves thoughtfully. Examples...
Closed-ended: Do you want a domestic or imported car? Two- or four-door?
Open-ended: What kind of car are you looking for?
Begin questions with phrases such as describe, illustrate and walk me through. Such language stimulates clients or colleagues to think in interesting ways.
Example: Tell me what you like and don't like about the car you're driving now and how that will affect what you are going to buy.

Close deals with closed-ended questions. Many people become tentative when it is time to secure a sale or an agreement. Asking a closed-ended question can help you gauge if the prospect accepts the ideas you discussed.
Examples: Does what we've discussed make sense to you?... Have I addressed all of your concerns?

Follow up with questions that seek a definitive answer.
Examples: Is it a deal?... Can we agree on a contract now?

Let subordinates solve their own problems. Avoid simply giving them advice. Instead, use questions that probe the problem and its causes. That lets subordinates find their own answers. Examples...
Tell me what you have done to deal with the problem so far. How has that worked?
Tell me how your view would change if you were on the opposite side of this problem. Does that suggest any steps you might consider?
Have you ever dealt with a similar problem? What happened in that case?
Build meetings around answering questions. Meetings are the bane of contemporary business. That's because they are bogged down with mundane information. One person usually winds up doing most of the talking. To improve meetings...
Before the meeting, circulate a memo listing topics to be discussed. Ask participants to prepare questions that need to be answered.

Start the meeting with these prepared questions. Encourage participation from everyone.
During the meeting, ask more than you tell. Constantly spur discussions.
To test ideas: Suppose we did it this way -- what would happen?
To advance a discussion logically: What is the next step to ensure this proposal will be carried out?
To broaden a discussion: What other factors are important besides the ones already mentioned?
To bring out opinions and attitudes: How would you feel if you were confronted by this sudden change?
End the meeting with summary questions.
Examples: Did we answer the questions we set out to address? Have any new questions arisen as a result of this meeting? What are we going to do about them?

Use self-questioning to monitor your own work. The former CEO of pharmaceutical giant Warner-Lambert, Lodewijk J.R. de Vink, asks himself four questions as part of his daily mental regimen...
In the morning: Where do I want to be?... Am I on track to get there?
In the evening: What did I accomplish today?... What could I have done better?

QUESTIONS AT HOME
Seek information from family members without being intrusive.
Discuss sensitive topics at a neutral time. That helps separate the problem from the emotions surrounding it. Asking questions when one or both of you are agitated almost always fails.
Watch your body language. If you take an aggressive posture -- standing over someone, hands on hips -- the other person is likely to clam up. Some of the most effective questioning takes place when people are not facing each other directly, such as in a car or while preparing dinner.
Disagree -- but with respect. Avoid being judgmental.
Example: If your teenager is doing poorly in school, you can question him/her about his study habits. But do not say, How can you be scared of tests? That's just stupid.
Leave wiggle room. People hate being told what to do -- even if they know you are right. Allow others the option of not accepting your advice. Do this by making "soft" suggestions.

Examples: Would you think about trying this way?... How would you feel if you did it my way this time?
Involve children in solving family problems. Criticizing kids or rendering judgment when there is a problem makes kids feel defensive.
Example: A client ran late every morning because her 10-year-old son was slow to get ready. Rather than yelling, she said, We need to talk about morning time and cooperation. I need your help here because what I'm doing is not working.
Then she asked...
What ideas do you have about reorganizing our morning routine? How about laying out your clothes the night before? What would you think about a five-minute warning before it's time to leave?
How do you think it makes my boss or your teacher feel when we're late?
Asking these questions helps your child empathize with what you are going through instead of just listening to you lecturing.

Avoid asking negative, unanswerable questions. It may help you vent frustration to ask, Why do you always do this to me? or How could you be so thoughtless? But it's almost impossible for a friend or family member to answer such questions.

Stick to action-oriented questions in which the other person can do something tangible to improve the situation.

Thursday, February 10, 2005

Picture the Performance Challenges


The government service challenge as perceive by the customer
  • Cloudy and hidden "non visible, non accountable" decision making
  • Predatory retaliation fears
  • Not allowed to que jump but must stay in line,be a number to get any service at all
  • You are an inconvenience to the office culture of coffee breaks and socialization perks
  • Posted by Hello

Is there a cloud over our services Posted by Hello

Monday, February 07, 2005

Investigative reporter responds to the David versus Goliath Rant

We have received a careful and colorful reply(s) from investigative reporter,Bill Dunphy of the Spectator that should be shared on this blog as we have nothing to hide and no conspiracies but the truth to protect. We will knock ourselves out to ensure proper public accountability and that everyone gets equal and fair treatment-chuckle.

Whistle blowing for rights can be fun but career dangerous , that is why we have anomynity here for your protection. Truth seekers and players should expect barbs back from those with a vested interest or other personal points of view . Great -bring it on -Dialogue, visibility and exposure of the issues is what this blog is all about. Enjoy the scrum ! We are interested in your opinion.

Subject: RE: ProActive Rants: Will Justice be served -the David against Goliath Saga

Siegfried,

So you have a first name. And multiple last names. And a blog that is unsigned with an empty personal profile.

Although I have a great deal of experience doing investigative reporting, what I wrote about Adam was a column, an opinon piece, covering that day's events in court.
The information was accurate, the opinions based on facts, and overall was fair in its treatment of Adam. In your rant reproduced below you've misunderstood or misrepresented what I wrote and that, coupled with the aforementioned reluctnace to honestly identify yourself led me to dismiss your note.

I'm glad you feel he's a cause worth championing. Knock yourself out.
And if you ever uncover anything that truly justifies your apparent belief that this is a man wronged by authorities, instead of someone who systematically engaged in financial practices that I would characterize as unethical at best - well then let me know.
I've read through the rather lengthy materials he sent me and so far I see nothing but a man failing to take responsibilities for his own failings - or frauds.

Bill Dunphy

Sent: Monday, February 7, 2005 1:22 PM To: Dunphy, Bill Subject:
RE: ProActive Rants: Will Justice be served -the David against Goliath Saga

I sent you this RED note on 1/29/05 . You did not respond although you had my e-mail address . Investigative indeed! I appreciate your professional caution but not your arrogance . You can reach me at email My name is Siegfried . "Slaying dragons is part of my namesake -chuckle " I will post your comments to the blog .

Have a nice day S.H ( Any accountability investigations at Revenue Canada-yet ?)

I read the even and fair minded or neutral comment by the Expositor reporter . I would like to comment on your article in the Hamilton Spectator. As an investigative reporter with some knowledge of the situation , I expected more from the investigative side of you. You correctly pointed out some of the facts of the Hamilton Loft project and had obviously read some of the information. Your article indicated that the project failed because there was no demand for the loft units- this is not true and you should verify your information before you publish it. Why do you think there is a 25 million dollars lawsuit on the project before the civil not criminal court? Check it out and then comment please.

You indicated to me " the David Goliath Supporter" (see blog attached) that the press was a potential objective friend of truth , justice and the underdog. Public Information was given to you based on your press inference of being a champion for the underdog and a group which believed in making public interest issues both clear and visible. I fail to see how you can comment on failed development projects , with no development experience or better investigative homework.

Let's see you go get information from your publisher ,follow his instructions, have a formal review of your work and be approved to proceed with an expanded budget. You meticulously fill out the required reports as suggested by your publishers control system. After 3 years, the publisher, has a new editor- the new investigative editor denies all your work, accuses you of taking the money , fires you from your position and then drags you into court on criminal charges before you can be heard by the internal review group. Destitute but not humble, faced with 3 years of jail- I am sure that you would put up a good defense ,convinced of the truth of the facts, vexatious or otherwise , and seek to clear both your name and reputation. Visibility of the situation and the facts would truly be your ally.

While following orders or instructions or "officially induced error", went out as a pure and unassailable defense at the Nuremberg trials -it still has merit. The question to ask is who at Revenue Canada is, or has been made accountable for this.


Best regards and good better investigative reporting
S.

-----Original Message----- From: Dunphy, Bill [mailto:BDunphy@thespec.com] Sent: Monday, February 07, 2005 11:45 AM To: 'S' Subject: RE: ProActive Rants: Will Justice be served -the David against Goliath Saga
Dear S.
I've learned not to trust people who post things on anonymous blogs and send e-mails that seek to sheild their identity.
And given that it comes from a supposed supporter of someone awaiting sentencing for fraud, I'm even less inclined to waste much time on it.If you have something to say, identify yourself, and simply say it.

Bill Dunphy The Hamilton Spectator
---------- From: S Sent: Saturday, February 5, 2005 8:55 AM To: BDunphy@thespec.com Subject: ProActive Rants: Will Justice be served -the David against Goliath Saga
S has sent you a link to a wobbles:
Thought you might find this perspective interesting. The press is the shield to protect the common people from being bullied by those special " government" interests that have the power and the agenda but not the color of right on there side
Blog: ProActive Rants Post: Will Justice be served -the David against Goliath Saga Link: http://makeaccountable.blogspot.com/2005/01/will-justice-be-served-David-against.html


Good Things Come to Those Who Ask

Good Things Come to Those Who Ask

Power of the Pen: Secrets of Effective Complaint Letters

Power of the Pen: Secrets of Effective Complaint Letters

Making people aware of the problem is 90% of the problem. A well written letter can put service organizations on notice and gives them the opportunity to deliver a acceptable solution. A letter calls for accountability! A simple letter can take down a shoddy service organization particularly if your friends write one too.

Give it a try. Lots of action for the price of a stamp. Chuckle - S


People make a good living writing letters .

Rarely does a day go by when most of us do not have to deal with surly salespeople, cheaply made products, or vast and indifferent bureaucracies. Most of us endure this with a stoicism worthy of Seneca himself. After all, what's the use of complaining? It all seems to fall on deaf ears, anyway.

But the world needn't be like this, according to Ellen Phillips, consumer consultant and founder of Ellen's Poison Pen, Inc. Since 1988, Phillips has been helping frustrated consumers to get refunds and apologies from everyone from the corner druggist to massive insurance agencies. In her book, Shocked, Appalled, and Dismayed!, Phillips shares the secrets of writing letters of complaint that get results. The first few chapters cover the general dos and don'ts of writing effective letters of complaint (remain calm, use polite language), along with useful advice from legal experts (don't embellish, stick to the facts).
The chapters that follow target specific problems we all face at some time in our lives, ranging from getting bumped from a flight to the secrets of successfully dealing with your HMO. Each chapter contains bullet points, illustrative anecdotes, and a number of example letters, most of which were based on actual letters sent on behalf of Phillips's clients. On top of all this, Phillips also provides an appendix listing the names and addresses of over 600 major companies, government agencies, and consumer organizations. Phillips believes that we should get what we pay for, and after reading her book, you'll be able to stand up for your rights with confidence.Product Description:How to get the best of shoddy shops, crooked car-dealerships, and heartless HMOs--without having to hire an attorney.
The Miss Manners of the consumer kvetch shows readers how to go postal, with complaint letters designed to melt the heart and sting the conscience of the most obdurate, negligent, or customer-hostile corporations.
Drawing on her experience as a pen-for-hire for irate consumers--and on the advice of clients, attorneys, and CEOs--Ellen Phillips shows readers:
- Who to write to, what to say, what to ask for - The names and addresses of over 600 major companies- How to draft personal petitions covering everything from tenant-landlord disputes to workman's compensation- Suggestions on what steps to take to avoid litigation- Consumer Smarts for automobile buyers- How to protect yourself from fraudulent business solicitations- Navigating the courts to ensure the well-being of your family and children- Help in getting proper coverage from your HMO- And--because sometimes the world is on your side--how to write the perfect thank- you note.Delightfully readable, easy to use, and filled with the addresses of hundreds of corporate customer relations offices and state and federal agencies, Shocked, Appalled, and Dismayed! is an essential resource for anyone who wants to reach out and scold somebody.

How to Get Paid to Save Energy

How to Get Paid to Save Energy

If it works in the U.S why can we not follow and establish the same programs in Canada? Food for thought- more action and less hand wringing talfk would be helpful. S

Saturday, February 05, 2005

CANOE -- CNEWS - Canada: Chretien aide admits to hiding deal

CANOE -- CNEWS - Canada: Chretien aide admits to hiding deal: "Chretien aide admits to hiding deal

By JIM BROWN

And they say it is all about integrity . Hmmm -hiding information that is okay along as you are a protected member of the government . Same old -same old -different rules for different folks! When will the unfairness end



Former public works minister Alfonso Gagliano testifies at the sponsorship inquiry in Ottawa. (CP PHOTO/Tobin Grimshaw)
OTTAWA (CP) - The Gomery inquiry was rocked Friday by a startling admission from a onetime top Jean Chretien aide that after leaving the prime minister's office he created a phoney paper trail to hide details of a $125,000 sponsorship deal.
The blunt revelation from Jean Carle - who is described as having a father-son relationship with the former prime minister and once lived in his basement - places the scandal in the heart of Chretien's circle of intimates.
Carle drew a tart observation from Justice John Gomery when he described the transactions, which happened he was a senior executive at the federal Business Development Bank of Canada.
'If this were a drug deal, it would be called money-laundering,' said Gomery.
'You're not wrong,' Carle meekly replied.
His lawyer, Pierre Latraverse, had a different assessment as he later left the hearing room. He called it an 'inappropriate use of words by the judge.'
Carle, who had been director of operations for Chretien from 1993 to 1998, moved to the BDC as a senior vice-president when he left the Prime Minister's Office.

It was at the bank that he got involved in the contentious deal that revolved around funding for a TV series, called Le Canada Millennaire, by producer Robert Scully.
The bank had already given $250,000 of its own to support the series. But the bank then agreed to act as a conduit in transferring an extra $125,000 to Scully's production company, Information Essentielle.
The additional money originated with the Public Works Department"

Winnipeg Sun: NEWS - Not hip to problem

Winnipeg Sun: NEWS - Not hip to problem: "Sat, February 5, 2005

Quality of health is an issue everywhere in Canada - lets do another study but lets not fix the problem. Same old -same old


Not hip to problem

Demand for orthopedic surgery, wait times rise

By FRANK LANDRY, LEGISLATURE REPORTER




The Doer government has failed to make good on a promise to slash the wait list for hip and knee replacement surgeries, charge the Opposition Tories. Six months ago, Manitobans were waiting up to two years for surgery, said Tory Leader Stuart Murray. Today, there are people waiting up to three years to go under the knife, he said.
'This wait, this suffering, is not acceptable,' Murray told a news conference.
The number of people waiting in line for surgery has increased to 2,300 from 1,488 last spring, according to figures provided by the Winnipeg Regional Health Authority.
The median wait time is 40 weeks.
DOUBLE KNEE REPLACEMENT
Winnipegger Bob Harris, 67, said he's been told he'll have to wait two years for orthopedic surgery.
He needs double knee replacement surgery.
'Why we have to wait two to three years is beyond me,' said Harris, who has difficulty walking up and down stairs and even driving his car because of his shot knees. 'If something isn't broken, don't fix it -- but this one is broken.'
Health Minister Tim Sale was not available for comment.
AGING POPULATION
Brian Postl, CEO of the WRHA, acknowledged demand for orthopedic surgery has been going up -- primarily because of the province's aging population.
'That's not unique to Manitoba,' Postl said. 'We still have favourable rates compared to other jurisdictions in the country.'
Postl said it's unusual for someone to wait as long as Harris. He said the WRHA wants to expand the number of hip and knee replacement surgeries done in W"

washingtonpost.com: Protecting the System

washingtonpost.com: Protecting the System

Wednesday, February 02, 2005

The Frontier Centre for Public Policy

The Frontier Centre for Public Policy: "Hydro and Healthcare: Freeing Economic Motors
Speaker: Peter Holle, President, FCPP
Date: 2005-04-08
Time: 7:30 am.
Place: St. James Rotary Club, Viscount Gort Hotel, Winnipeg."

Food for thought- lets learn to make things better through knowledge

Tuesday, February 01, 2005

Two Cows Explain The World :: Free Funny eCards

What do you think the two Canadian Cash cows would say? Humor is good for the soul ! Where are you on the list? -Todays chuckle.

Two Cows Explain The World

Force Accountability -Make things visible


Accountability Posted by Hello Would you like to make a difference by getting involved in the process? Blow your whistle!

Make as many people aware of what is happening to you and the people around you. Complain about bad,poor or indifferent service . Turning the other check only leads to more of the same. Speak out -make work for those that are a source of indifferent service . The noisy wheel gets the attention or the grease.

One small win by many will make a big difference.


Is Canadian Justice Blind or just slow and stupid ?


Help the Innocent Posted by Hello Blow your whistle
How do you think the justice system could be improved? What happened to natural Justice in a timely manner? How do we make fairness and natural common sense , natural justice prevail?

Is the investigative process of the press - a positive check and balance to the justice system ?

It seems that this depends on who is doing the investigating or how motivated he is to dig for facts. We wrote the reporter in Hamilton with our comments . He told us to knock ourself out in our quest of ensuring that Adam -the David in our previous post -got fair treatment. WE will knock ourself out. -PR

Overzealous Prosecution issues . When does common sense prevail?

Court resources are expensive both on a time and dollars basis. What do you think of a case where a teenager does his laundry at his estranged mother's house- gets charged and convicted of breaking and entry of his estranged mother's house with a 6 month probationary sentence. Morality judgements aside -apart from branding the teenager with a criminal record and the long term negative effect on the teenager's life and that of the custodial parent, - is this really a good use of court time and limited court resources? The benign abusive functional maliciousness of the prosecutors "judgement"should be judged somehow- does the court meat grinder really need more fresh meat to grind?- PR