Down a dark (carpal) tunnel.
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Biomedical subjects
Publications and source records attributed to M OReilly.
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Ontario is the latest province to step into the health care reform spotlight. Proponents hope its proposed series of primary care pilot projects, built around the concept of patient rostering, will improve the delivery of care. If the project goes ahead, doctors in 5 participating sites will be paid under a capitation system, with payments starting at $70.29 annually for men aged between 25 and 35.
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Last June CMAJ described how Marathon--a remote town in Northern Ontario--had gone from medical rags to riches in just over a year (CMAJ 1997;156:1593-6). Once chronically underserviced in terms of physician services, this community of 5500 people went from a single overworked doctor to a group practice of 7 physicians. The change involved far more than numbers, however. The Marathon solution was built on a philosophy of physician sustainability and long-term retention, not just recruitment. The change was designed to ensure that the town could finally get off the roller-coaster ride that saw more than 75 doctors come--and go--during the previous 10 years. A year after its initial report, CMAJ returned to see if the Marathon experiment was still working.
In their 4 short years in medical school, members of the Class of '98 have witnessed massive changes within the health care system. These are going to have a direct, and often negative, impact on the way they practise. Despite this, members of this group can't wait to become full-fledged members of the medical profession.
Canada's lack of self-sufficiency in blood products has led to the opening of a blood-plasma collection centre in Thunder Bay, Ont.--the first of its type in Canada. In convincing donors to donate plasma, the new centre had to overcome some lingering public concern about the safety of the blood-collection system.
Physicians attending a recent conference on the retention of physicians in rural areas proposed more than 40 recommendations for dealing with recruitment and retention issues. The conference was organized by Ontario's residents, who have been feeling the impact of attempts to encourage physicians to move to rural and underserviced areas.
Two years ago, the 5500 residents of marathon, ont., had 1 overworked physician to look after their medical needs. Today, they have 7 physicians to share the load. In this article Michael OReilly looks at the steps the town took to attract new doctors. It offered a financial incentive and also worked to revitalize its hospital. As Marathon worked to attract new doctors, it also found that a new generation of physicians has much different career aspirations than past generations.
Although not all physicians welcome the current move toward evidence-based medicine, Dr. Warren McIsaac, a member of the Institute for Clinical Evaluative Sciences in Ontario, says it is designed to save them time and energy. He made the comments during a meeting of family physicians in Ontario.
Ontario is in the midst of major health care reform, and one of the goals is to equalize the care available across the province. The authors of a study on the health status of people living in Southwestern Ontario question whether equalization is a wise goal, given that some areas face more serious health problems than others. Dr. Evelyn Vingilis, one of the authors, said government calls for standardization of health care delivery run "completely contrary" to the requirements of a needs-based system.
Canada's largest magnet, which is now making functional magnetic resonance imaging possible at Ontario's Robarts Research Centre, is expected to cast some light on mysteries buried within the brain. With the huge magnet, said Dr. Ravi Menon, "I can distinguish between centres that control the thumb and the index finger."