<p>I have read that Canadian physicians tend to be happier as they can set up their own offices easily as the billing practices are quite simple and the patients all have insurance, so you don't have the hassles of trying to do something for the unisured. </p>
<p>They apparently make less than US doctors around $100k. Not as many multimillionaire doctors? Is this true?</p>
<p>What would you practicing doctors say to your own kids if one of them wanted to be a doctor? Would you try to steer the child away from the profession?</p>
<p>The main reason it seems rather overwhelming to me re my D wanting to be a doctor is getting into medical school (and paying for it) more than anything. We only have one medical school in our state, so that makes it more difficult. (If she doesn't get in, would probably have to go to private med school...if she gets in...)</p>
<p>One of my sons has an interest and I have leaned to the positive side with him...try not to be too discouraged by our gripes....it is still a rewarding career if you can get past all the stuff. It so happens that these days there is a lot of stuff.</p>
<p>I get the impression that Canadian docs are also frustrated by the confines of their system though I'm not up on the details.</p>
<p>Well, Bookiemom, there is no way around the fact that it is hard to get in - and like Oldman, I think you have to take the griping with a grain of salt, it is another one of those personality traits. Many of the gripers would not be happy in another profession.</p>
<p>I have encouraged my daughter to keep her eyesopen about medicine, not discouraged her to try. I've had her talk to docs in more time demanding specialties than mine, I'm also encouraging her to try on pre-med early, and get into a medical setting early - so that if she doesn't like it, she has plenty of time to look at other fields.</p>
<p>It would be hard if there was only one med school - is your state low in population, or is it one where there is only one state school and many private schools? Some states have reciprocal agreements with neighboring state to allow OOS students to pay in-state rate, but this may only be in situations where the one state has no med school.</p>
<p>It is fairly common around here for a student to go out of state for college, apply for residency in that state, then work one year after graduation and apply for med school in the new state. This happens a fair amount at certain LACs that are in town with the med school, kids do projects as undergrads with profs at the med school (even though they do not actually attend the med school's undergrad), then hang on for another year before applying.</p>
<p>Thanks, Cangel and Oldman, for your comments. We live in Washington State, so there is just the University of Washington med school here, which would be fine if she gets in. No private med schools in the state or even in surrounding states. (UW does have that reciprocal agreement with other Northwest states, holding a certain number of places for students from those states.)</p>
<p>The griping from doctors in the field doesn't bother me much, and my D not at all. Her uncle is a doctor and she has heard a lot of negatives from him. It doesn't bother her. She is interested in ob-gyn, wants to help women who have poor medical care, wants to do Doctors without Borders type of service misisons. She is very focused, very determined, loves to learn, loves a challenge. Just tell her she can't do something and then look out, because she will do it.</p>
<p>She volunteered last year at the hospital in her college town, although that was a mixed experience. (They loved her; she thought it was kind of busywork.) This fall she will have regular chemistry, genetics, and calculus, so we will see what happens after that. So far she has a 4.0 in all science and math classes, but has had only one chem class so far.</p>
<p>Texdad, my sister's husband is a doctor in Canada and I can tell you they are not a happy lot. In fact those who can often leave and come here.</p>
<p>Canadian doctors make comparatively much less. After going through med school, internships, residencies and training, many can barely live a middle class lifestyle while paying off loans. It is also quite frustrating for them as Canada has much less availability of things like MRI machines and they have sick patients waiting months for access to testing and specialists. Wealthy Canadians who are sick come here for treatment.</p>
<p>Poor and elderly Americans from my state go there for medicine. In my little town 3 1/2 hours each way to the border), we send two whole busloads a week. In Seattle, they've launched a pleasure/medicine cruise that takes you to Victoria, where you put in your prescriptions in the morning, shop and take tea, pick up your drugs, and return in the evening. Our Governor has set up a website to help folks see docs when necessary and get their meds in Canada, including retired state employees. Our uninsured folks get their primary care in the emergency room, if they get it at all. At HMOs (like the one I pay for), my d. waits 5 weeks for an appointment to see an asthma specialist; it took me over a monthly to see an occupational therapist for an injury (and I now have a permanently swollen thumb as evidence.) It is true that doctor salaries in Canada, generally speaking, are lower than in the U.S., though for rural docs (remember, most of Canada is rural), relative to cost of living, it is actually slightly higher (and malpractice is lower, and health care costs are lower). RN salaries are higher in British Columbia than they are in Washington State.</p>
<p>Wealthy people can get their care wherever they want - there frankly aren't enough of them to count.</p>
<p>You don't have to be wealthy to shop for a better HMO. BC/BS Personal Choice in PA paid for my son's OT and gave us an appointment within a week. I share Zagat's opinion of the Canadian system, having had an emergency room experience of my own (involving my daughter) while on vacation in Nova Scotia a few years ago. It was ridiculous, and our ability to pay had nothing to do with it.</p>
<p>I actually belong to the highest rated HMO on the west coast. Anyway, where I live, we have so many more people going north for medical care/medicine than coming south, it isn't even close.</p>
<p>Buying cheaper medicine is a different issue. If the majority of Washatonians are going to Canada to see the doctor, I'll eat my hat.</p>
<p>Not a majority, but start eating. Many of the medicines being prescribed require a physician-intake/examination before the pharmarcy will fill the prescription, and the Canadian doctors are doing a booming business. Laser surgery centers, too.</p>
<p>OK, so someone has to see a Canadian MD to get the less expensive Viagra. I have no doubt that Canadian docs are very adept at writing prescriptions, and that they have turned it into an industry, given the bleakness of the rest of the medical practice up there.</p>
<p>The bleakness up there, and the moral bankruptcy down here. We make quite a pair. ;)</p>
<p>I didn't appreciate the "joke". I'm glad you don't have to make the choice between your hypertensive drugs and your food. Too many folks in our state do, and it isn't pretty.</p>
<p>The interesting thing is that there exists good polling data on this, between neighboring state and province. We all know what the problems are, living side by side, and having the media scream at us. 88% of BC residents, when asked, prefer their health care system to ours. 78% of Washington State residents prefer their health care system to ours. Both of them cross liberal/conservative, Republican/Democratic lines. The majority of Republicans in Washington State prefer their system to ours. </p>
<p>The rich don't show up much in either survey. There just aren't that many of them.</p>
<p>How it relates to the original question? In my town, docs are just picking themselves up and moving, or simply closing up shop. They aren't being replaced by Canadians.</p>
<p>I wasn't joking, and I think we should let this thread return to its natural bent. The price of prescription medications is a very narrow criterion to use in evaluating something as complex as overall medical care.</p>
<p>From the Journal of the Canadian Medical Association:
<a href="http://www.cmaj.ca/cgi/content/full/168/6/751%5B/url%5D">http://www.cmaj.ca/cgi/content/full/168/6/751</a>
Back on topic: I haven't participated in the original thrust of this thread before, but, yes, medical family here, as well. Husband is a specialist,and as Oldman (I hate calling you that) has said, the lifestyle can still be quite good, even in an area (southeastern PA) known for malpractice abuses, where the finest physicians in the world can expect to be sued for any unsatisfactory outcome. The specialties also allow the entrepreneurial MDs to satisfy that aspect of their professional aspirations in the form of multiple offices, treatment/diagnostic centers, etc. It's very hard work, and you must be a compulsive person to be good at it. In that regard, it's not that different from law.</p>
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<blockquote> <p>She is very focused, very determined, loves to learn, loves a challenge. Just tell her she can't do something and then look out, because she will do it.<<</p> </blockquote>
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<p><strong>Winces</strong> Well, that sounds familiar!! She sounds like she is very much the type of person who flourishes in pre-med and med school. As for getting in and paying for med school, it is like that old adage about eating an elephant - one bite at the time! No doubt, the young physicians I've known, particularly in the past 10 years (I was in med school just before the big round of tuition inflation hit, and when the federal government still had some very generous loan packages for med school) have some true money worries, if you have a 100K debt, I don't care what your salary is, it is worrisome, but they seem to work the finances out. I hope she is able to get through undergrad with few or no loans, that plus public med school really seems to help keep the loans bearable.</p>
<p>Also I know quite a few who went thru on a military or public health scholarship ( pay back in years/sweat).</p>
<p>I know some of them, too. Husband's good friend from Penn medical school spent a number of years in <em>extreme</em> rurality doing the public health pay-back. He said he saw things that were considered extinct by modern medical standards. Kind of like those who end up in urban ERs, and become such experts in bullet trauma that the military consults with them.</p>
<p>Both my hubby and I went to med school courtesy of the military: I went to a civilian school, he went to USUHS (the military med school).</p>
<p>The type of medicine these days matters (and why the Washington/BC drift wasn't off-topic.) I have doc friends in town who are close to packing up shop. Most are primary care docs or internists. They do see patients without insurance, or on Medicare, or whatever. They can prescribe the necessary pharmaceuticals, but they know that in many cases, the patients won't be able to afford them, and will be back in their offices soon - if they are lucky. The thing is - the insurance company or the state or the feds will pay for the quadruple bypass, or the liver transplant, or (usually) for dialysis, but won't pay (or pay enough) for the drugs that might have helped prevent the quadruple bypass, or the liver transplant, or the need for dialysis. So it is demoralizing. </p>
<p>And makes their offices crowded at the same time. I have one friend who works for a federally funded community health center in our town. She used to love her work, and still loves her patients, but with funding cutbacks, and greater and greater needs (as a result of lack of access to pharmaceuticals to control chronic conditions, and an aging population), her waiting lists get longer and longer, even as she has to see the same clients again and again. It used to be that the community would do lots of fundraising to help them out. But now a neighborhood "free" clinic has opened up, to deal with clients who are not being seen in the community health center. And both are appealing for help. We had a little row in our Friends Meeting two weeks ago when someone came in asking for support for the free clinic (we have a doc in our Meeting who donates time there) and a local nurse practitioner got all upset because she saw it as a diversion from the need to support the community health center. (We took no action - typical Quakers - so we could "season" the concerns.) No happy campers. </p>
<p>But specialists of every type are sprouting up all over town. It's not a happy time to be a doc, if you are of the wrong type.</p>