@TheresaReason Short answer: yes.

Longer answer: First thing to be aware of is that he is an ER doc. So he will, necessarily, have his compartmentalized experience.

But some specific parts.

“In the U.S., clinical judgment is routinely second-guessed”

Did a whole clinic day today without this. Yes there were clinical decisions and actions constrained by resource limitations but I wasn’t second guessed.

“the relative absence of this pay-for-performance bureaucracy”

I got paid the whole day for just seeing patients. Well I will upon submitting the much more simplified Longitudinal Family Practice billing codes.

I voluntarily do QI.

“Most Canadian doctors still believe they’re working in a system that’s fundamentally trying to do the right thing”

I actually feel this. Despite the well documented shortages, barriers and constraints and my frequent rants against [insert something that doesn’t make sense here]. As someone who has worked at all levels from primary care, hospital staff, provincial organization and university admin we are all (well except for a few of my self-important colleagues…rabbit hole) trying to do the right thing: what is best for the patient.

“In Canada, where social supports are (relatively) stronger, most patients come in with medical problems — not unsolvable social ones”

The “most” makes this true. Yes there are those who suffer from the negative effects of poor social determinants of health, but there are also folks trying to solve them.

“The bottlenecks are real, and they reflect broader staffing shortages. Canada, like the U.S., needs more doctors, nurses, and advanced care practitioners.”

Obviously true.

“Doctors aren’t acting out of fear. And the decisions we make feel more genuinely collaborative. As a result, interactions with patients are less adversarial.” (1/2)