Canadians, fight my ignorance please. Physician related.

Factual Questions
1

My google-fu is failing me regarding the best way to phrase the questions, such that reliable Canadian sources are the sites I can report.

My brother and I are having a bit of an argument. He claims three things, each of which I think are pure bunk, but I don’t know how to disprove him using a reliable Canadian citation.

He claims:

  1. Many/most physicians in British Columbia are considered employees of the state/government, and therefore, can’t be sued. Yeah, I know. But a cite from the USA (from loc.gov of all places) doesn’t convince him he is wrong. He claims that is just our own government “spin”.
  2. He claims that Canadians surgeons can only perform X number of operations in a given year, then they are mandated by the government to stop. He had some number of hip replacements in mind when he said this.
  3. Canadian physicians have a mandated 8 weeks vacation/holiday off each year.

As I said, I don’t really think any of those statements are necessarily true. However, my bother is an avid watcher of a particular station that is often derided here (and elsewhere), so his information comes from a certain bubble of sources. He doesn’t believe cites from our own government (since they have a particular “spin” you know). So, any Canadian links or cites I can send his way? Or, if I am wrong and there is any validity to this, can you enlighten me and have me apologize? Help me with my search for the Canadian answers.

Thank you.

2

Here’s alinkto the BC Branch of the Canadian Bar Association all about medical malpractice, which would definitely seem to indicate that you can sue them.

3

Canadian physician here:

1 no
2 don’t think so
3 news to me

4

Er, these are laughable…

For starters, find him a cite of any of the numerous doctors being sued in BC. Doctors get sued a lot.

5

He, and you, can search for all kinds of Canadian medical malpractice cases at Canlii. I recommend the advanced search, which allows you to narrow down your search to British Columbia. A quick search of my own informs me that BC physicians can be, and have often been, sued for medical malpractice.

As for question 3, I’ll point out that most physicians in Canada are self-employed–they simply bill the provincial insurer for the patients they see and the services they provide. As self-employed individuals, some can take eight weeks of vacation per year if they wish–heck, as a self-employed professional myself (lawyer), I can take as many weeks of vacation as I wish. But I’ll add that as a lawyer, I am unaware of any statute or precedent in any province that mandates eight weeks of vacation per year for a physician.

6

Regarding the first point, I think that’s a lot closer to the situation of doctors who work at the VA here in the US. However, as I understand it, there is a lot less medical malpractice litigation in Canada, and the amounts awarded are much smaller for several reasons, mainly because the cases are usually decided by a judge, not a jury.

7

There are also caps on “pain and suffering” awards at $315,000.

8

Most doctors in Canada (and so BC) operate like the USA - they bill for each procedure or consulation. However, there is generally only 1 billing agency - the provincial health service, and therefore only 1 billing fee schedule. (Exceptions may be Worker’s COmpensation Board, which does separate billing; and I think, status Indians are paid through the federal government - not sure on that).

To avoid overbilling and superficial procedures, sometimes the healthcare sets limits - a consultation should take X minutes and no less, etc. This could limit what you can do each day, and the amount of money you could make as a doctor. The health care system did not appreciate paying for a full medical checkup when the patient spent 3 minutes total with the doctor.

You can sue anyone, but really - what are you getting? The main excuse to sue in the USA is for medical bills - but there are none in Canada; no matter what you need done, the cost is pretty much zero for the patient. Plus, generally in Canada the loser usually has to pay the winner’s legal bills. Awards for pain and suffering or other intangibles are not as common or as large as in the USA. SO generally, you better have a good case to sue an you won’t get filthy rich off it… less lawsuits.

The limits on critical operations are an interesting debate. The official line is there are not any quotas. In fact, according to one disgruntled hip surgeon, there is a budget for each hospital for the metal hips, staff time, operating room and other facilities - and they plan to do X operations a year and stop when they hit their budget. You can wait allegedly 6 months - in fact, my boss took 16 months - because you don’t go onto the official waiting list until all the evaluation procedures - Xrays etc. - have been done. (It’s like the USA in that regard - a patient has to be referred to a specialist by a GP, then a specialist procedure has to be approved by the health system, a physician cannot just decide to to it on their own and expect to be paid.) It’s not that there’s an official government limit, just that the facilities are not there or budgeted or scheduled for more. Potayto-potahto.

On the other hand, an elderly relative fell and broke his hip; at 86, he got a brand new hip that night. If it’s an emergency, you get it. Just that some surgery can wait - and if it can, it will.

This is the case with much of health care. I wouldn’t trade it for the US system, but the government tries in times of cutbacks to be cheap with their fee schedule - only to find that funny thing is, if you pay too low, you lose a lot of doctors, especially the specialists. Then they make a lot of publicity out of how they are dumping more money into health care, just to get them to stay.
http://www.ipolitics.ca/2010/12/16/source-say-tentative-deal-reached-in-n-l-doctors-contract-dispute/

9

This is effectively the case (IMHO).

Surgeons’ operating room time is given to them by the hospital where they work. Due to significant financial constraints imposed by the provincial governments, the operating room time itself AND the required support (e.g. nurses, post-op ICU, . . . ) are both tightly limited. So, for example, at my hospital, the surgeons may be allowed to operate two or three half days per week, but seldom if ever more. The bottom line is that, because of those constraints, it is indeed the case that most surgeons can NOT do more than ‘X’ operations per year (this does not apply, of course, to the minority of surgeons who can operate outside of hospitals and/or in “private” clinics).

Another reason (which may no longer be in effect, but was until recently) is that some docs’ fees are capped for a 12 month period. So, if by, say, October, a surgeon reached his annual limit, then any more operations he/she performed would have to be gratis, i.e. isn’t gonna happen. Effectively, then, this means that he/she stops operating after ‘X’ months if not ‘X’ operations. (Again, this may no longer be in effect, although it definitely was until recently).