With over 10,000 members few stand for election to the NINE posts available.
NOMINATIONS are due Wed. JAN. 16 ,2013.( ONLY THREE WEEKS NOTICE)
AGM FEB. 13 (LOCATION STILL NOT PUBLISHED)
VOTING by Wed. FEB. 27.(2 pm)
At present, chances of being elected are 50/50.
Dist 11 with approx $250,000 in the bank, employs a full-time Secretary (Mrs.K.BUGEJA)
OMA pays well for time spent in Committees. Many have been committee members for over TWENTY YEARS.
Between about $870 and $1250 a day up to approx. 46 days a year
DISTRICT CHAIR gets BONUS OF 25% ..
.
A well-paid SECOND CAREER for many Toronto Docs.(easily $46,000/year + free food)
OMA HOURLY RATE for meetings and travel increases with the number of committees:
up to 15 days/year HALF-DAY $380 TRAVEL:/HOUR $108
15.5- 25 $465 $133
25+ $547.50 $156
HALF-DAY = 2.5-4.5 hrs
FULL-DAY = 5 - 8.5 hrs.
ONLY THREE NOMINATORS NEEDED.
NEW IDEAS URGENTLY REQUIRED.
28 Dec 2012
TORONTO Sick Childrens' Hosp Influenza immunisation stats
TORONTO: SICK CHILDRENS' HOSPITAL
CLINICAL STAFF: 64.3% immunized against INFLUENZA ( 35.7% of CLINICAL STAFF FAILED TO BE IMMUNISED)
NURSING STAFF 78% immunized agaainst INFLUENZA ( 22% of NURSING STAFF FAILED TO BE IMMUNISED)
CLINICAL STAFF: 64.3% immunized against INFLUENZA ( 35.7% of CLINICAL STAFF FAILED TO BE IMMUNISED)
NURSING STAFF 78% immunized agaainst INFLUENZA ( 22% of NURSING STAFF FAILED TO BE IMMUNISED)
PRIVATE MONEY subsidizes STATE MEDICINE.
Founder & CEO of MATTAMY HOMES Ltd., PETER GILGAN donated $40,000,000 to TORONTO SICK CHILDRENS' HOSP. RESEARCH & LEARNING CENTER.
(Strictly according to OHIP rules a MD could be fined for giving Mr.GILGAN -or his family-priority medical attention).
This absurdity makes a mockery of the Ontario State monopoly of (never defined) MEDICALLY NECESSARY MEDICINE.
As with USA Prohibition the Ontario OHIP rules are broken daily through use of "WELLNESS CENTRES" that at do not bill OHIP for the DOCTOR visits, (but bill OHIP for investigations). The trick is that the office provides ext ra services e.g. a Dietitian or Physiotherapist. An example is The Toronto CLEVELAND CLINIC CANADA -30,000 sq.ft.- that charges about $3,500/yr for unlimited medical services, a five hour annual exam and direct commuinication with the USA Cleveland Clinic.
QUEBEC has allowed PRIVATE HOSPITALS ( e.g. ROCKLANDMD)
(Strictly according to OHIP rules a MD could be fined for giving Mr.GILGAN -or his family-priority medical attention).
This absurdity makes a mockery of the Ontario State monopoly of (never defined) MEDICALLY NECESSARY MEDICINE.
As with USA Prohibition the Ontario OHIP rules are broken daily through use of "WELLNESS CENTRES" that at do not bill OHIP for the DOCTOR visits, (but bill OHIP for investigations). The trick is that the office provides ext ra services e.g. a Dietitian or Physiotherapist. An example is The Toronto CLEVELAND CLINIC CANADA -30,000 sq.ft.- that charges about $3,500/yr for unlimited medical services, a five hour annual exam and direct commuinication with the USA Cleveland Clinic.
QUEBEC has allowed PRIVATE HOSPITALS ( e.g. ROCKLANDMD)
18 Dec 2012
GPs: 2013 Ontario pay lower; USA pay higher
Ontario Health Insurance reduced all MDs' pay by 0.5%
USA Medicare increased GPs pay by 7%.
Toronto emigration lawyers with USA offices expected to have increased business.
California & Florida preferred.
Escape from irritating time-wasting CPSO investigations about trivial patient complaints such as not prescribing antibiotics for minor respiratory complaints or refusing to perjure oneself signing phoney disability and sickness forms.
USA Medicare increased GPs pay by 7%.
Toronto emigration lawyers with USA offices expected to have increased business.
California & Florida preferred.
Escape from irritating time-wasting CPSO investigations about trivial patient complaints such as not prescribing antibiotics for minor respiratory complaints or refusing to perjure oneself signing phoney disability and sickness forms.
11 Dec 2012
URBAN HOUSE CALLS a waste of medical talent.
Most URBAN HOUSE CALLS are a waste of Medical talent. Can easily be done by a visiting DISTRICT NURSE: an important person in the UK NHS since 1947.
House Calls are useful in making sure that there are no safety hazards such as loose carpets. That there is food in a clean fridge. That there are Aids-to-Daily-Living in the bedroom, toilet and bath. That smoke and Carbon monoxide detectors work.
Urine dip-stick , and Diabetic blood tests can be done by a Nurse.As well as Blood pressure.and other vital signs.
Office visits are more CLINICALLY valuable as more equipment is available together with other paramedical services.
In most Ontario cities there are Wheel-Trans facilities that cost between $2-3 a journey. making a visit to the GP cheap and easy.
Stairs can be a problem Many GP offices have ramps and elevators. An OCCUPATIONAL THERAPIST
is valuable in advising Structural Alterations and various PERSONAL Aids.for dressing and cooking.
A visiting PHYSIOTHERAPIST can instruct DIY exercises and provide simple equipment.to maintain muscle strength
Relatives should learn FIRST AID. An OXYGEN CYLINDER (with a suction adaptor) is a good investment especially in Rural areas. Electronic personal emergency devices improve yearly. and are now inexpensive.
(Personal opinion)
House Calls are useful in making sure that there are no safety hazards such as loose carpets. That there is food in a clean fridge. That there are Aids-to-Daily-Living in the bedroom, toilet and bath. That smoke and Carbon monoxide detectors work.
Urine dip-stick , and Diabetic blood tests can be done by a Nurse.As well as Blood pressure.and other vital signs.
Office visits are more CLINICALLY valuable as more equipment is available together with other paramedical services.
In most Ontario cities there are Wheel-Trans facilities that cost between $2-3 a journey. making a visit to the GP cheap and easy.
Stairs can be a problem Many GP offices have ramps and elevators. An OCCUPATIONAL THERAPIST
is valuable in advising Structural Alterations and various PERSONAL Aids.for dressing and cooking.
A visiting PHYSIOTHERAPIST can instruct DIY exercises and provide simple equipment.to maintain muscle strength
Relatives should learn FIRST AID. An OXYGEN CYLINDER (with a suction adaptor) is a good investment especially in Rural areas. Electronic personal emergency devices improve yearly. and are now inexpensive.
(Personal opinion)
8 Dec 2012
$350-$500,000 yr.for GP in Northern Ontario
COCHRANE (5340) + IROQUIS FALLS (4595) + MATHESON (2410)
BONUS for Underserviced area ($98,080 - $111,400) depending on contract.time,
FREE HOUSING + subsidized office for TWO YEARS
Relocation expenses + yearly study allowance.
All-expenses paid visit.
RECRUITMENT@ MICSGROUP.COM
705-272-7200 ext 2345
BONUS for Underserviced area ($98,080 - $111,400) depending on contract.time,
FREE HOUSING + subsidized office for TWO YEARS
Relocation expenses + yearly study allowance.
All-expenses paid visit.
RECRUITMENT@ MICSGROUP.COM
705-272-7200 ext 2345
OMA MD MPPs
More Ontario MDs considering entering Provincial politics. Legislative building in TORONTO Home of
many Internationally famous PRIVATE SCHOOLS and Top SOCIAL & SPORT CLUBS.
MPPs get an indexed pension after serving two 4 year terms..
Toronto Liberal MPPs Drs. HOSKINS & QAADRI are well known practicing Toronto GPs.
Politics now an attractive mid-life career.
Ont. MDs do not receive a professional pension,unlike the UK NHS.
many Internationally famous PRIVATE SCHOOLS and Top SOCIAL & SPORT CLUBS.
MPPs get an indexed pension after serving two 4 year terms..
Toronto Liberal MPPs Drs. HOSKINS & QAADRI are well known practicing Toronto GPs.
Politics now an attractive mid-life career.
Ont. MDs do not receive a professional pension,unlike the UK NHS.
6 Dec 2012
New Delhi M-1 ENZYME
From Toronto Star
Outbreaks of new superbug in Toronto-area hospitals raise worrisome spectre
Outbreaks in two Toronto-area
hospitals of a dangerous new form of superbug have infection-control
experts contemplating a worrisome future.
Both outbreaks are now over. Details of the chains of spread and how the hospitals managed to stop them are outlined in two studies just published in medical journals.
But they represent the first reports of hospital outbreaks of bacteria containing the so-called NDM-1 enzyme in Canada. In each case, at least one of the people who carried the bacteria into the hospital seemed to have acquired it in Canada.
Previous NDM-1 cases in this country have been seen in individual cases and generally in people who had travelled outside Canada for health care — most commonly to India, but also on occasion to the United States.
“For many years the term superbug has been used and thrown around. And there have been threats that we’ll end up with a situation where there are infections that end up not being treatable because of the risk of drug resistance,” says Dr. Andrew Simor, senior author of one of the studies, which appeared in the journal Infection Control and Hospital Epidemiology.
“I think we’re actually seriously now approaching that point with these NDM-1s.”
The NDM-1 enzyme — the ND stands for New Delhi — was first found in 2008 in a Swedish person who had travelled to India for medical treatment. The discovery, reported in the journal Lancet, rang alarm bells the world over because of it represented a new mechanism of drug resistance.
NDM-1 positive bacteria were first found in Canada in 2010.
Drug-resistant bacteria have been around as long as there have been antibiotics. And with increasing use of the drugs in the second half of the 20th century, the resistant bacteria flourished, leaving the pharmaceutical industry scrambling to try to stay ahead of the bugs.
But NDM-1 isn’t a bacterium. It’s an enzyme produced by some bacteria which disables an alarming array of antibiotics.
The few drugs that do treat NDM-1 positive bacteria are antibiotics that are rarely used. One, colistin, is highly toxic; doctors do not use it if they have an option. And NDM-1 positive bacteria become resistant to colistin over time, Simor says.
Perhaps more upsetting is the fact that the gene responsible for making the enzyme is promiscuous: It is able to move from one bacteria to another, conferring on each a level of drug resistance that leaves doctors with few treatment options.
One patient described in one of these studies had both E. coli and Klebsiella pneumoniae bacteria that contained NDM-1, leaving the authors to conclude the enzyme passed from one bug to the other in the patient.
Allison McGeer, the head of infection control at Toronto’s Mount Sinai Hospital, is an author of that paper, which appeared in the journal Clinical Infectious Diseases.
The article is the first describing a hospital outbreak involving NDM-1 organisms in Canada. It occurred at William Osler Health System in Brampton, northeast of Toronto, and was first spotted in October 2011.
“Everywhere you turn there is bad news,” McGeer says of NDM-1 and a handful of similar enzymes that confer resistance to drugs in the beta-lactam class of antibiotics.
The Brampton outbreak involved five patients, all carrying Klebsiella pneumoniae. Molecular study of the bacteria from all five showed they were linked. None of the patients in the outbreak had travelled to or been hospitalized in countries where NDM-1 is endemic.
The researchers who investigated the outbreak were not able to determine where the bacteria had been acquired.
Simor’s study describes an outbreak at Toronto’s Sunnybrook Health Sciences Centre, where he is head of microbiology. The outbreak was identified in January 2011 and was over by February 2012.
During that time two patients came into the hospital with different strains of NDM-1 Klebsiella pneumoniae. One had received previously health care in India, but the second had no history of travel to the Indian subcontinent.
From these two patients, the resistant bacteria spread to seven others.
Five of the nine were just carrying the bacteria. At the time of their hospitalization the bugs were not making the patients sick — other ailments were.
But four of the patients did develop infections caused by their NDM-1 positive bacteria; two had infections in their bloodstream and two had urinary-tract infections.
Some of the patients who picked up the bugs were roommates of people carrying the bacteria, and others were on the same ward.
In one case, a patient moved into a room that had been occupied by one of the positive patients and then picked up the bacteria. An investigation pinpointed a handwashing sink in the room as the likely source of the bacteria. Health-care workers had used the sink to dispose of bath water and other fluids.
NDM-1 positive bacteria were growing in the biofilms in the sink’s pipes and repeated efforts to disinfect the sink failed. Eventually the sink and the sink traps were replaced.
McGeer, who has battled a sink-related outbreak — though not with a bacteria carrying NDM-1 — shudders at the idea.
“If we get our sinks contaminated with an NDM Kleb pneumo” — a short form for Klebsiella pneumoniae — “in our ICU, it will be unpleasant. Expensive.”
Simor’s study outlines the efforts Sunnybrook’s infection control team took to stop transmission. Tracing contacts of all the patients was not easy, and in fact the majority of the contacts had been discharged before they could be tested to see if they were carrying the bug.
Typically infection-control teams would take a rectal swab of patients to see if they are carrying organisms and if they are, whether those organisms are NDM-1 positive.
But in some of the cases in the Sunnybrook outbreak, swabs were negative until about three weeks after exposure. Hospitals that didn’t test that far out might miss such cases.
With numbers of NDM-1 cases still low in Canadian hospitals, Simor suggests facilities may have a hard time deciding how much effort they should put into finding such cases at this point.
“So the question is how extensively do you do surveillance when there’s little bang for the buck? I think we’re going to have to be able to gear up our surveillance as the numbers increase. And I have no doubt they will increase.”
When asked if hospitals and public-health officials in Canada are paying enough attention to the threat, McGeer’s answer suggests she isn’t sure.
“People are paying attention to it. I am sure that we’re not paying enough attention to it to be really good at dealing with it. I’m hoping we’re paying enough attention to it to be OK.”
Both outbreaks are now over. Details of the chains of spread and how the hospitals managed to stop them are outlined in two studies just published in medical journals.
But they represent the first reports of hospital outbreaks of bacteria containing the so-called NDM-1 enzyme in Canada. In each case, at least one of the people who carried the bacteria into the hospital seemed to have acquired it in Canada.
Previous NDM-1 cases in this country have been seen in individual cases and generally in people who had travelled outside Canada for health care — most commonly to India, but also on occasion to the United States.
“For many years the term superbug has been used and thrown around. And there have been threats that we’ll end up with a situation where there are infections that end up not being treatable because of the risk of drug resistance,” says Dr. Andrew Simor, senior author of one of the studies, which appeared in the journal Infection Control and Hospital Epidemiology.
“I think we’re actually seriously now approaching that point with these NDM-1s.”
The NDM-1 enzyme — the ND stands for New Delhi — was first found in 2008 in a Swedish person who had travelled to India for medical treatment. The discovery, reported in the journal Lancet, rang alarm bells the world over because of it represented a new mechanism of drug resistance.
NDM-1 positive bacteria were first found in Canada in 2010.
Drug-resistant bacteria have been around as long as there have been antibiotics. And with increasing use of the drugs in the second half of the 20th century, the resistant bacteria flourished, leaving the pharmaceutical industry scrambling to try to stay ahead of the bugs.
But NDM-1 isn’t a bacterium. It’s an enzyme produced by some bacteria which disables an alarming array of antibiotics.
The few drugs that do treat NDM-1 positive bacteria are antibiotics that are rarely used. One, colistin, is highly toxic; doctors do not use it if they have an option. And NDM-1 positive bacteria become resistant to colistin over time, Simor says.
Perhaps more upsetting is the fact that the gene responsible for making the enzyme is promiscuous: It is able to move from one bacteria to another, conferring on each a level of drug resistance that leaves doctors with few treatment options.
One patient described in one of these studies had both E. coli and Klebsiella pneumoniae bacteria that contained NDM-1, leaving the authors to conclude the enzyme passed from one bug to the other in the patient.
Allison McGeer, the head of infection control at Toronto’s Mount Sinai Hospital, is an author of that paper, which appeared in the journal Clinical Infectious Diseases.
The article is the first describing a hospital outbreak involving NDM-1 organisms in Canada. It occurred at William Osler Health System in Brampton, northeast of Toronto, and was first spotted in October 2011.
“Everywhere you turn there is bad news,” McGeer says of NDM-1 and a handful of similar enzymes that confer resistance to drugs in the beta-lactam class of antibiotics.
The Brampton outbreak involved five patients, all carrying Klebsiella pneumoniae. Molecular study of the bacteria from all five showed they were linked. None of the patients in the outbreak had travelled to or been hospitalized in countries where NDM-1 is endemic.
The researchers who investigated the outbreak were not able to determine where the bacteria had been acquired.
Simor’s study describes an outbreak at Toronto’s Sunnybrook Health Sciences Centre, where he is head of microbiology. The outbreak was identified in January 2011 and was over by February 2012.
During that time two patients came into the hospital with different strains of NDM-1 Klebsiella pneumoniae. One had received previously health care in India, but the second had no history of travel to the Indian subcontinent.
From these two patients, the resistant bacteria spread to seven others.
Five of the nine were just carrying the bacteria. At the time of their hospitalization the bugs were not making the patients sick — other ailments were.
But four of the patients did develop infections caused by their NDM-1 positive bacteria; two had infections in their bloodstream and two had urinary-tract infections.
Some of the patients who picked up the bugs were roommates of people carrying the bacteria, and others were on the same ward.
In one case, a patient moved into a room that had been occupied by one of the positive patients and then picked up the bacteria. An investigation pinpointed a handwashing sink in the room as the likely source of the bacteria. Health-care workers had used the sink to dispose of bath water and other fluids.
NDM-1 positive bacteria were growing in the biofilms in the sink’s pipes and repeated efforts to disinfect the sink failed. Eventually the sink and the sink traps were replaced.
McGeer, who has battled a sink-related outbreak — though not with a bacteria carrying NDM-1 — shudders at the idea.
“If we get our sinks contaminated with an NDM Kleb pneumo” — a short form for Klebsiella pneumoniae — “in our ICU, it will be unpleasant. Expensive.”
Simor’s study outlines the efforts Sunnybrook’s infection control team took to stop transmission. Tracing contacts of all the patients was not easy, and in fact the majority of the contacts had been discharged before they could be tested to see if they were carrying the bug.
Typically infection-control teams would take a rectal swab of patients to see if they are carrying organisms and if they are, whether those organisms are NDM-1 positive.
But in some of the cases in the Sunnybrook outbreak, swabs were negative until about three weeks after exposure. Hospitals that didn’t test that far out might miss such cases.
With numbers of NDM-1 cases still low in Canadian hospitals, Simor suggests facilities may have a hard time deciding how much effort they should put into finding such cases at this point.
“So the question is how extensively do you do surveillance when there’s little bang for the buck? I think we’re going to have to be able to gear up our surveillance as the numbers increase. And I have no doubt they will increase.”
When asked if hospitals and public-health officials in Canada are paying enough attention to the threat, McGeer’s answer suggests she isn’t sure.
“People are paying attention to it. I am sure that we’re not paying enough attention to it to be really good at dealing with it. I’m hoping we’re paying enough attention to it to be OK.”
3 Dec 2012
New Dir. U.Tor Institute HPME Prof A. BROWN
U.Tor Dept. Health Policy, Management & Evaluation to be an INSTITUTE
New Director Oxford U. Rhodes Scholar & Harvard grad. Prof Adalsteinn BROWN.
HPME is pleased to announce that the Governing Council of the University of Toronto has approved the Department's proposal to become an Extra Departmental Unit (EDU-A)—specifically an Institute. The proposal was approved at the Council's October 27th meeting. HPME will implement the change in mid-November.Institute Proposal: April 6, 2011 - [PDF]
2 Dec 2012
UK DAILY MAIL GPs' LOCUM FEES
Recruitment firm offers locum GPs £1,200 a day to work between now until New Year
By Eleanor Harding|
Doctors are being paid £1,200 per day to work as locums in GP surgeries and other local services, it emerged last night.
They are being recruited to work up to 12 hour sessions in service across Oxfordshire from now until New Year.
The lucrative offer was uncovered when the recruiters, Merco Recruitment Ltd, posted an advertisement online.
Lucrative: Doctors are being recruited to work
up to 12 hour sessions in service across Oxfordshire from now until New
Year for around £1,200 a day
Two years ago it was revealed that the NHS spends more than £750million a year on temporary doctors - many from overseas who would not normally get work in the NHS.
The outcry drew attention to the astronomical sums paid to locums - and health chiefs pledged to crack down on the practice.
In one example, a doctor was paid £5,700 for a 24-hour shift in an A&E unit.
As well as the huge cost to the NHS, doctors leaders criticise the hidden impact of insufficient cover, poorer training and inadequate shift systems, says the Royal College of Surgeons.
One consultant surgeon, who recently moved from a London teaching hospital, told the Daily Mail that the 48-hour limit was a 'complete disaster' and leading to an 'unsafe' system.
Figures show the NHS spends more than
£750million a year on temporary doctors - many from overseas who would
not normally get work in the NHS
Some of the spend is for doctors already working in the hospitals who take on temporary shifts, but external agencies accounted for £467million last year.
OMERS PENSION FUND
OMA could copy OMERS (Ont.Municipal Employees Retirement) which bought the MetroConvention and other prime property on FRONT St.
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