London College of Clinical Hypnosis
University validated clinical hypnosis and hypnotherapy training
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A FORUM on ONTARIO MEDICINE: business and professional Information from various contributors edited by Dr.Alex Franklin MBBS(Lond.)Dip.Phys.Med(UK) DPH & DIH(Tor.)LMC(C)FLex(USA).Fellow Med.Soc.London, Liveryman of London Society of Apothecaries. Freeman of City of London. Member Toronto Faculty club & Toronto Medico-Legal society.
30 Jan 2015
28 Jan 2015
OMA BOARD MEETINGS NOT OPEN TO OMA MEMBERS
The OMA Board meetings are closed to OMA members. In Ontario the public can see the Legislative assembly and Courts at work. Also College pf Phys & Surgeons Tribunals and Council meetings are open to the ;public. HSARB Tribunals are also open to the public. The OMA Board meet in secret. No reason given. Attendance figures are also secret.
23 Jan 2015
J.CLIN.ONCOL.:MRI & MULTIPLE MYELOMA
Role of Magnetic Resonance Imaging in the Management of Patients With Multiple Myeloma: A Consensus Statement.
Authors
Dimopoulos MA1, Hillengass J2, Usmani S2, Zamagni E2, Lentzsch S2, Davies FE2, Raje N2, Sezer O2, Zweegman S2, Shah J2, Badros A2, Shimizu K2, Moreau P2, Chim CS2, Lahuerta JJ2, Hou J2, Jurczyszyn A2, Goldschmidt H2, Sonneveld P2, Palumbo A2, Ludwig H2, Cavo M2, Barlogie B2, Anderson K2, Roodman GD2, Rajkumar SV2, Durie BG2, Terpos E2.
Journal
J Clin Oncol. 2015 Jan 20. pii: JCO.2014.57.9961. [Epub ahead of print]
Affiliation
Abstract
PURPOSE: The
aim of International Myeloma Working Group was to develop practical
recommendations for the use of magnetic resonance imaging (MRI) in
multiple myeloma (MM).
METHODS: An
interdisciplinary panel of clinical experts on MM and myeloma bone
disease developed recommendations for the value of MRI based on data
published through March 2014.
RECOMMENDATIONS: MRI
has high sensitivity for the early detection of marrow infiltration by
myeloma cells compared with other radiographic methods. Thus, MRI
detects bone involvement in patients with myeloma much earlier than the
myeloma-related bone destruction, with no radiation exposure. It is the
gold standard for the imaging of axial skeleton, for the evaluation of
painful lesions, and for distinguishing benign versus malignant
osteoporotic vertebral fractures. MRI has the ability to detect spinal
cord or nerve compression and presence of soft tissue masses, and it is
recommended for the workup of solitary bone plasmacytoma. Regarding
smoldering or asymptomatic myeloma, all patients should undergo
whole-body MRI (WB-MRI; or spine and pelvic MRI if WB-MRI is not
available), and if they have > one focal lesion of a diameter > 5
mm, they should be considered to have symptomatic disease that requires
therapy. In cases of equivocal small lesions, a second MRI should be
performed after 3 to 6 months, and if there is progression on MRI, the
patient should be treated as having symptomatic myeloma. MRI at
diagnosis of symptomatic patients and after treatment (mainly after
autologous stem-cell transplantation) provides prognostic information;
however, to date, this does not change treatment selection.
© 2015 by American Society of Clinical Oncology.PMID
25605835 [PubMed - as supplied by publisher]22 Jan 2015
CAPIO UK Swedbank House 4th Floor 42 New Broad Street London EC2M 1SB Contact: Sarah Gillson, CommunicationCapio is a leading healthcare provider in Europe and supplies services within several medical specialities. Capio´s ambition is to be the healthcare provider that in the best way possible fulfils the demands of our patients, the public healthcare as well as from companies and organisations. That is why we focus on high quality and effective care services with the individual patient's needs and expectations in the centre. Instead of traditional competition, Capio has chosen to collaborate with public healthcare. In close co-operation with healthcare purchasers, principles, methods, models and concepts are developed that create innovative working practices. The Capio Group comprises more than 100 operating units with some 16,000 employees. Capio currently operates in Sweden, Norway, Denmark, Finland, France, the UK, Spain and Switzerland with an annual turnover rate of more than SEK 11, 000 M. Customers are public sector purchases, businesses as well as public and private insurance companies that buy healthcare services. - See more at: http://www.healthcare-today.co.uk/organisation.php?id=3#sthash.0PjBJIit.dpuf
Organisations
0
0
Capio Healthcare UK
Swedbank House4th Floor
42 New Broad Street
London
EC2M 1SB
Contact: Sarah Gillson, Communications Manager
Sub-category: Company - Other
Capio is a leading healthcare provider in Europe and supplies services within several medical specialities. Capio´s ambition is to be the healthcare provider that in the best way possible fulfils the demands of our patients, the public healthcare as well as from companies and organisations. That is why we focus on high quality and effective care services with the individual patient's needs and expectations in the centre.
Instead of traditional competition, Capio has chosen to collaborate with public healthcare. In close co-operation with healthcare purchasers, principles, methods, models and concepts are developed that create innovative working practices.
The Capio Group comprises more than 100 operating units with some 16,000 employees.
Capio currently operates in Sweden, Norway, Denmark, Finland, France, the UK, Spain and Switzerland with an annual turnover rate of more than SEK 11, 000 M.
Customers are public sector purchases, businesses as well as public and private insurance companies that buy healthcare services.
Organisations
0
0
Capio Healthcare UK
Swedbank House4th Floor
42 New Broad Street
London
EC2M 1SB
Contact: Sarah Gillson, Communications Manager
Sub-category: Company - Other
Capio is a leading healthcare provider in Europe and supplies services within several medical specialities. Capio´s ambition is to be the healthcare provider that in the best way possible fulfils the demands of our patients, the public healthcare as well as from companies and organisations. That is why we focus on high quality and effective care services with the individual patient's needs and expectations in the centre.
Instead of traditional competition, Capio has chosen to collaborate with public healthcare. In close co-operation with healthcare purchasers, principles, methods, models and concepts are developed that create innovative working practices.
The Capio Group comprises more than 100 operating units with some 16,000 employees.
Capio currently operates in Sweden, Norway, Denmark, Finland, France, the UK, Spain and Switzerland with an annual turnover rate of more than SEK 11, 000 M.
Customers are public sector purchases, businesses as well as public and private insurance companies that buy healthcare services.
CAPIO AB: : PRIVATE MEDICINE FRANCE,GERMANY, NORWAY, SWEDEN
This is Capio
- Last updated
- 22 Jan, 2015 15:39
The Capio Group is one of Europe’s leading healthcare companies.
Via our hospitals, specialist clinics and primary care units we
offer a broad range of medical, surgical and psychiatric healthcare of
high quality. Our operations and 11,875 employees1 are located in four countries*. In 2013 we received more than 4.3 million patient visits2.
Sweden
One emergency hospital, two local hospitals, 24 centres for specialist care, 21 centres for psychiatric care and 78 centres for primary care.
Norway
Six medical centres and three specialist clinics, for example within eating disorders.
France
Seven emergency hospitals, 12 local hospitals and three specialist clinics primarily
for such areas as dialysis, rehabilitation and psychiatry.
Germany
Four local emergency hospitals, five specialist clinics, two hospitals with rehabilitation
and care facilities, and six outpatient clinics.
1 Number of employees as full-time equivalents on average during 2013.
2 Number of inpatient and outpatient visits in 2013.
* In July 2014 Capio UK (Capio Nightingale
hospital) was divested. In 2013 Capio UK received approximately 20,000
patient visits and contributed to Group net sales with 121 MSEK.
Investments in Capio UK during 2013 were 31 MSEK and the number of
employees (FTE) was 167.
2 Number of inpatient and outpatient visits in 2013.
20 Jan 2015
UK INDEPENDENT DOCTORS FEDERATION (not in NHS)
History of the IDF
The IDF was started in 1989 under the name Independent Doctors Forum and it incorporated as a company limited by guarantee in 1992. It was set up by a group of conscientious, like-minded and enthusiastic doctors working fulltime in the independent sector, who felt a platform was needed for open discussion, voicing ideas and exchanging views.Since that time the IDF has grown in stature and significance and has taken on roles which far exceed the boundaries initially envisaged. This has been particularly true with the introduction of appraisal and revalidation and its implications for member doctors. It is also lobbying hard to make sure that the voice of the independent sector is heard within government, DOH, GMC, CQC.
Although aptly describing the initial aims of the group it was felt that the word Forum no longer fitted with the IDF's changing role and at a General Meeting held on 11th June 2009 members voted to change the company name from Independent Doctors Forum to Independent Doctors Federation.
Membership of the IDF currently stands at just under 1200 - these are all GMC registered doctors in Independent Practice. Members are currently split 2/3 Consultants; 1/3 GPs. We also have 46 corporate sponsors.
To download a copy of the IDF's most recent accounts please click here.
18 Jan 2015
TORONTO FREE CONFERENCE (inc.lunch) HEALTH & HIGH POLITICS @ MUNK SCHOOL of GLOBAL AFFAIRS
Health & High Politics: The modern state’s interest in health equity & security
Saturday, January 31, 10:00 AM - 5:30 PM
Sponsored by: International Relations Society, Munk School of Global Affairs, Arts and Science Student Union, University of Toronto Student Union, Trinity College
Register online at:
http://munkschool.utoronto.ca/
The Vivian and David Campbell Conference Facility, 1 Devonshire Place
(Comment: Hopefully some of the elected OMA BOARD will attend together with some of the 250 OMA staff).
15 Jan 2015
OMA President’s Update: OMA Board Unanimously Rejects Government Final Offer, Ministry to Impose Further Cuts to Medical Services
PRESIDENT’S UPDATE
Vol. 20, No. 1
January 15, 2015
OMA Board Unanimously Rejects Government Final Offer, Ministry to Impose Further Cuts to Medical Services
Today,
the OMA Board of Directors unanimously rejected a final offer from the
Ontario government that would cut an additional 4% in medical services,
and place an arbitrary ceiling on the physician services budget, which
would cap the number of services physicians are able to provide to our
patients.
The government’s final offer, submitted late Wednesday evening, included:
· $580 million in cuts over two years, including
- $259 million through 9 specific cuts in physician payments, the majority of which impact family practice;
- $50 million in system savings;
- Increasing the current 0.5% payment discount to 1% on all physician payments;
- Further additional increases to the payment discount by specialty of practice.
· A 1.4% one-time payment in year 3.
The
Ministry warned the OMA that if we did not accept this punitive offer,
it would pursue unilateral action against physicians immediately. We
have received details of this arbitrary action and are assessing its
potential impacts.
The
OMA and the physicians of Ontario have worked hard to build and
maintain a positive relationship with government. We have negotiated in
good faith to improve the health care system for our patients. In 2012,
Ontario’s doctors did our part and contributed more than $850 million in
fee concessions and health system savings. To impose a further $580
million in cuts to medical services and payments is unwarranted and
destabilizing.
The
government’s position will lock in system underfunding for future years
and subject physicians to open-ended liability for growth in the
utilization of medical services that is beyond our control. It will
limit training opportunities in primary care, mental health, and many
other specialties. Also, the government’s pattern of heavy-handedness
toward doctors, and unwillingness to negotiate reasonable agreements
with the profession, will make Ontario an undesirable place to practice.
The
OMA will be active in the media and other venues to ensure that the
public and our patients understand the truth and the real impacts of the
government’s final offer and its arbitrary measures.
We
anticipate the government will claim to have offered the profession a
modest raise based on the language in its proposal — this is
disingenuous and misleading. In fact, government plans to set an
arbitrary baseline for the physician services budget that is more than
$80 million below current levels, and fund growth of no more than 1.25%
per year, despite the current growth of 2.7%. This difference will be
funded through cuts to physician payments. Also, the government intends
to claw back from physicians through reconciliation any expenditure that
exceeds its arbitrary budget.
While
we have rejected the government’s final offer, and it has been
withdrawn by the Ministry, the OMA Board considers it vital that we
share the government’s proposal with all members. We know that members
will have many questions, and we will work to ensure that you get the
information and answers that you need in a timely and effective manner.
The
OMA will undertake an extensive member education campaign to provide
all details of the rejected government offer, as well as the Ministry’s
unilateral cuts. We are organizing a series of face-to-face meetings and
teleconferences across the province.
OMA
Council will meet in the near future to review these developments and
plan how we intend to move forward championing our patients and
supporting our members in the face of the government’s cutbacks.
The
OMA has been negotiating with government for more than a year. These
talks have been difficult. Since the outset, the government focused
exclusively on cutbacks and balancing its budget. We concluded the first
round of negotiations in August and were unable to reach an Agreement.
We then moved to facilitation, and subsequently conciliation with former
Chief Justice of Ontario Warren Winkler. Here too, we were unable to
reach a deal. Justice Winkler submitted his report to the parties on
December 11. In his report, he suggested the OMA should reconsider the
government’s offer, and we did.
The
OMA called a meeting of physician leaders, which was held December 20.
More than 150 physicians from across the province attended. The Board
outlined the negotiations timeline, the government position, and the
results of our facilitation and conciliation process. We detailed the
challenges at the negotiations table and the significant gap between
both sides. We circulated the offer on the table from government at that
time and we shared Justice Winkler’s then-confidential report, which
will be available on the OMA website. We set out the positives and
negatives of the government position, and reviewed the Winkler
recommendations and the critical elements not referenced in the final
conciliator’s report. Physician leaders provided valuable perspective to
inform the final stage of the negotiations process.
The
OMA and Ministry reconvened for a brief final round of negotiating that
concluded January 9, with the government tabling its final offer on
January 14. Today, the OMA Board met to review that offer. After careful
consideration of the potential impacts of the proposal, threatened
unilateral action, and the valuable input from more than 150 physician
leaders who attended the December 20 meeting, the Board voted
unanimously to reject it.
This
offer will not improve quality of care, nor will it improve public
access to medical services. In fact, we know the opposite will result.
In the face of this arbitrary action, the OMA and Ontario’s doctors, on
behalf of our patients and our partners in the health care system,
intend to candidly and aggressively inform the public and all
stakeholders about the truth of the government’s offer and the real
implications for health care.
I
urge all members to stay focused on our patients and avoid divisive
actions or any actions that will compromise patient care. We need to
monitor the impacts of the government’s measures on the system and our
ability to practice. We need to work together as a profession and with
our partners in the system to assess our relationship with government,
and establish our collective strategy going forward.
I
want to thank all members for your tremendous patience during the past
year. The Board recognizes that these developments will be frustrating
for physicians and have significant implications for your practice and
your patients. We have made every effort to convince government that
heavy-handedness is not the solution, however, it is clear the government is entirely focused on fiscal targets and not patient care.
The
OMA will be communicating regularly with you in the coming days.
Documents will be posted on the OMA website and the site will be updated
on a continuing basis (www.oma.org).
Once
again, I encourage all members to maintain focus on patient care and
professional unity as we assess the current circumstance, and let’s work
together to address this challenge collectively on behalf of our
patients and our colleagues.
Dr. Ved Tandan MD(Tor.1989) FRCS(C)
OMA President
(Hamilton General Surgeon)
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Past Ont.Chief Justice Hon.Warren K. WINKLER BA(Manitoba) LLM(York) QC CONCILIATOR'S REPORT
Physician Services: Ten-Point Plan For Saving And Improving Service
Backgrounder
Physician Services: Ten-Point Plan For Saving And Improving Service
"During the Conciliation, much progress was made towards achieving a three-year PSA. A three-year PSA would be a significant win for the public, health system and the Parties... In the circumstances, I would urge the OMA to reconsider its rejection of the Ministry's Proposal."
-- Conciliator's Report, The Hon. Warren K. Winkler, Q.C., December 11, 2014
The Ministry of Health and Long-Term Care will implement 10 changes to physician services payments. These include changes to fees and payments wherever possible so that Ontarians are paying the right amount for the right services. Other specific initiatives included will enhance the quality of care offered, improving how the health care system works, and making sure every dollar spent on health care gets the best results.
Specific Changes Planned to Physician Services Payments
Getting the best results:
When a patient goes to a walk-in clinic instead of his/her own doctor, there isn't as much continuity of care. Currently a visit to a walk-in clinic on a weekend or holiday costs more than a visit to your own doctor. The fee for a walk-in visit on these occasions will become comparable to the fee for a visit to your doctor.
Updating payments to specialists:
Internal Medicine, Nephrology, Gastroenterology and Cardiology are specialists that currently benefit from a 50 per cent premium payment on fees for assessing patients for certain diagnoses. These higher payments are no longer relevant, as these particular specialities are closer to the higher end on the physician income scale.
Removing obsolete programs:
All professionals, including doctors, have an obligation to remain current in the knowledge of their area of practice. No profession gets government funding to meet their obligation. That is why we will eliminate funding for doctors to attend courses and events that are considered part of their continuing medical education. This was funding the government established in the 1990s when Ontario had a doctor shortage. Doctors are still obligated to remain current in their medical knowledge.
Doctors who treat a roster of patients are paid a premium for accepting patients with complex health care needs. Doctors have also been paid a premium for accepting healthy patients on their roster - patients who they would have likely accepted anyway. This premium for accepting healthy patients is being eliminated.
Prioritising underserviced areas:
Doctors who work in underserviced areas will benefit from income stabilization payments and doctors who work in over-serviced areas will no longer benefit from these payments.
Only areas with a high need for physician services will get new Family Health Organisations and Family Health Teams.
Improving payment models to better reflect current needs:
The Hospital On Call Coverage program provides funding to ensure timely access to physician services for hospital patients 24/7. A new funding model will be developed that better recognizes local patient and hospital needs. Until then,
- Hospital On-Call Coverage funding will be frozen at the current level; and
- Planned funding increases, which were not directly linked to improving patient care, will be eliminated.
Payment reduction:
The ministry will apply a 2.65 per cent discount to all fee for service physician payments, effective February 1, 2015 and apply the reduction to non-fee-for-service payment contracts after the respective requirements for providing notice are met.
Under this element of the plan, the ministry will work with the OMA on a savings methodology that results in a higher proportion of savings from higher paid specialties.
The ministry will also be prepared to adjust the across-the-board rate reduction based on any agreed to savings initiatives with the OMA that result in comparable savings, as necessary.
Doctors will still be able to provide any and all services for their patients that they feel are required.
Payment to doctors - by the numbers:
The physician services budget is 25 per cent of the total health budget and 10 per cent of government spending.
The average payments have been reduced since 2011/12 to an estimated $354,000 in 2013/14.
Spending on physician compensation will continue to increase;
Fiscal Year | 2013/14 | 2014/15 | 2015/16 | 2016/17 |
Spending Target | $11.379B (actual) | $11.437B | $11.578B | $11.720B |
On average, gross payments to doctors are now 61 per cent more than in 2003.
2003/04 (ICES) | 2013/14 (MOH) | $ Increase (03/04 to 13/14) | % Increase (03/04 to 13/14) | |
Family Medicine | $189,000 | $317,800 | $128,800 | 68% |
Specialists | $246,000 | $381,500 | $135,500 | 55% |
Diagnostic Radiology | $398,527 | $613,900 | $215,373 | 54% |
Ophthalmology | $413,232 | $641,200 | $227,968 | 55% |
Nephrology | $446,981 | $563,650 | $116,669 | 26% |
Cardiology | $371,874 | $509,300 | $137,426 | 37% |
All Physicians | $220,000 | $354,000 | $134,000 | 61% |
ONTARIO:Value of a worker's life. $150,000.
9 of 79,977
Future Mobility Healthcare Fined $150,000 After Worker Killed
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16:40 (33 minutes ago)
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Court Bulletin
Future Mobility Healthcare Fined $150,000 After Worker Killed
January 15, 2015
MISSISSAUGA,
ON - Future Mobility Healthcare Inc., a Mississauga company that specializes in
the assembly of wheelchairs, has pleaded guilty and has been fined $150,000
after a worker was killed while removing a 3,500-pound machine from a tractor
trailer.On May 26, 2013, a crew of workers at the company's premises at 3209 Orlando Drive was assigned the task of emptying the contents of trailers. The machine was being moved with a forklift and two workers were standing in the trailer attempting to guide and stabilize the machine. The distance between the two forks of the forklift was too wide and the machine was lifted on just one fork. As the forklift operator began to lift the machine, the load began to tip toward the one side of the trailer. One worker was able to jump out of the way and the other stayed beside the machine and tried to stop it from tipping. The machine continued to tip off the fork and pinned the worker against side of the trailer. Emergency services were called to the scene but the worker succumbed to injuries sustained in the incident. A Ministry of Labour investigation found that the company failed to ensure that materials were lifted or moved in such a way that they did not endanger the safety of any worker, as required by law. Future Mobility Healthcare Inc. pleaded guilty to failing, as an employer, to ensure that materials or equipment were lifted or moved safely and to failing to ensure that the material was transported so that it did not tip or fall, as required by Ontario Regulation 851/90 (the Industrial Establishments Regulation) and the Occupational Health and Safety Act. The company was fined $150,000 by Justice of the Peace Jeannie Anand in Provincial Offences Court in Mississauga on January 13, 2015. In addition to the fine, the court imposed a 25-per-cent victim fine surcharge as required by the Provincial Offences Act. The surcharge is credited to a special provincial government fund to assist victims of crime. Court Information at a Glance Location: Provincial Offences Court/Ontario Court of Justice 950 Burnhamthorpe Road West Mississauga, Ontario Judge: Justice of the Peace Jeannie Anand Date of Sentencing: January 13, 2015 Defendant: Future Mobility Healthcare Inc. 3223 Orlando Drive Mississauga, Ontario Matter: Occupational health and safety Conviction: Occupational Health and Safety Act Section 25(1)(c) Ontario Regulation 851/90 (Industrial Establishments Regulation) Section 45 Crown Counsel: Line Forestier |
14 Jan 2015
TORONTO: ROGERS COMMUNICATION has donated $130-million for a new "TED ROGERS CENTRE FOR HEART RESEARCH"
The Provincial Medical service still relies on Private donations.
10 Jan 2015
NaCl content of POPPADOMS
In many Toronto hospitals patients are allowed to have food delivered. NaCl content in a 10G Punjabi lentil poppadom is about 150 mg..
6 Jan 2015
SANTIS HEALTH consulting: 120 FRONT STREET EAST Suite 208,Toronto
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