Why is there a family doctor shortage?
There are quite a few reasons for this. But in the end they can all be boiled down to one word - politics.
Over the coming weeks I will show how chronic mismanagement of the doctor supply has resulted in the current shortage of family doctors. And for a few reasons that are going to surprise you.
For example, one big reason is the College of Physicians and Surgeons of B.C.
But first, some preamble is necessary. ( And if you make it all the way to the end, I may throw in some stories of sex and violence.)
For example, one big reason is the College of Physicians and Surgeons of B.C.
But first, some preamble is necessary. ( And if you make it all the way to the end, I may throw in some stories of sex and violence.)
Why am I speaking out now? Because I couldn't before.
A lot of this information has brewing for quite a while. But I was forbidden by the College to talk about it. ( I think they were still sensitive about the goats. )
I probably still wouldn't be able to talk about it, if I had not pointed out - a few dozen times - that the College conditions I had to follow were contrary to the Freedom of Speech items of the Canadian Charter of Rights and Freedoms, Article 2(b)
I probably still wouldn't be able to talk about it, if I had not pointed out - a few dozen times - that the College conditions I had to follow were contrary to the Freedom of Speech items of the Canadian Charter of Rights and Freedoms, Article 2(b)
And now for the main event - the College of Physicians and Surgeons of B.C. and the current doctor shortage!
Dr. Unger is a Deputy Registrar with the College of Physicians and Surgeons. And in the email here (from a Freedom of Information request ) he appears to be telling a psychiatrist NOT to rush in getting a physician in the province ( me ) back to work.
Dr. Unger suggesting the psychiatrist delay!
The psychiatrist involved ( "Brian" ) appeared quite willing to oblige with delaying his report. The report could have been ready within days, but he managed to delay release of the report it so as to prevent me from returning to work for several months. Details are here.
I have to admit that this struck me as weird and annoying. But I am sure everything must have been okay. After all, Dr. Unger knows ethics!
Heidi told him to do it
To be fair to Dr. Unger, he was just following the lead of his boss, Dr. Heidi Oetter. Who seems not to like me.
So, at a time of pandemic, and a huge doctor shortage, two Registrars at the College of Physicians and Surgeons are doing their darndest to not let an obsessive workaholic doctor back into practice.
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As far as I am aware, Heidi has no special relationship with ethics.
Why don't they want to let me work?
Mostly I think it is because they don't like me. But they need an excuse. They don't have a single good one, so they have been trying out a series of four silly ones. Which I call the PICA efforts.
What is PICA?
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If you look PICA up in a medical dictionary, it means "likes to eat dirt". Which is not my problem, but the acronym appeals to my sense of whimsy. And there is definitely "dirt" in my history with the College.
But in my case I am using PICA as an acronym for the four things the College would truly, madly, deeply love to believe about me. That I am:
P erverted
I ncompetent
C razy
A ddicted
P erverted
I ncompetent
C razy
A ddicted
How did they try and prove this?
I ncompetent would be the easiest one. They could prove this by giving me exams. Lots of exams.
No, not that kind.
But pretty much everything else!
What kind of competence exams?
Well, they sent an entire team out to my office to try and dig up some dirt. Several times.
That kind of backfired. The first team found me "competent in all areas". And even "outstanding" in several.
Complementary stuff, especially when coming from my enemies.
Complementary stuff, especially when coming from my enemies.
The Hearing on Pregnancy Tests
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They sent another team out another time. To try and dig up some dirt. Again. (You would think they would smarten up. )
After two years of study, the best that they could come up with was that they didn't like the way I was doing pregnancy tests. They actually convened a Hearing over this. Dumb idea! |
Re-writing the bar exam
I challenge them to a duel
So then they tried for the others - perverted, crazy, and addicted. The land of psych assessments.
I thought that 38 separate consecutive forensic psych assessments to determine whether or not I am an alcoholic was a bit much. So a few years ago I wrote to Guinness.
They agree that I have the world record.
Although they are not going to publish it.
They said it is not the sort of record they want to encourage anyone to break!
They agree that I have the world record.
Although they are not going to publish it.
They said it is not the sort of record they want to encourage anyone to break!
What about addiction?
So they have been trying to pretend that I am an alcoholic.
To try and prove this they have sent me to an expert, to try and prove that I am an alcoholic.
About 38 times!!!
To try and prove this they have sent me to an expert, to try and prove that I am an alcoholic.
About 38 times!!!
What did the 38 experts say?
This one I had to go all the way to Texas to get. The author is Dr. Glen Gabbard. Dr. Gabbard is the author of 360 academic articles and 29 books on psychiatry. Including one on the psychiatry of The Soprano's.
And he says I am not an alcoholic!
And if he is good enough for Tony...
And he says I am not an alcoholic!
And if he is good enough for Tony...
For another one I had to go all the way to Kansas. To see Dr. Richard Irons, who is an expert on alcoholic doctors. He was one. And he even wrote a book on them. And he said I was never an alcoholic! Twice!
Has any one of the 38 ever said I was an alcoholic?
Nope. Not a single one. I am 0 for 38.
And how many people do you know who could go see 38 psychiatrists and not come out with about 38 diagnoses?
And how many people do you know who could go see 38 psychiatrists and not come out with about 38 diagnoses?
Did I mention that 38 assessments might be unethical?
The College of Psychologists of B.C. feels that too many assessments are abusive. Their opinion is that after a couple of assessments either a person should have been adequately diagnosed, or it is never going to happen. Which makes further assessment a waste of time, and even a form of punishment. They feel so strongly about this that they have included it in their Code of Conduct.
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I wrote a letter to the College asking about this. Given that they have an ethics expert like Dr. David Unger. I have been waiting years for a reply. Maybe they are shy.
I actually could have stopped at 37
Number 37 was one of the College's "pet" addiction docs. There are at least 40-50 addiction doctors in the lower mainland. But the College only likes to accept reports from their favorite two. One got successfully sued by a health care professional for trying to force someone into a 12 Step Program that they didn't want. And then there is my guy. Who has his own quirks, as shown below.
Number 37 was given all the reports by the College from assessments 1-36. He reviewed them all, and spent hours assessing me himself. He sent me for two batches of lab tests. And then wrote the College a 30 page report summarizing his findings. I will spare you the whole report ( although I have it for those who are interested ) . But the last paragraph on the last page looks like this...
In other words, I have never been addicted to anything, ever!
And addictions develop when people are young. Now that I am a grumpy old fart I am too old to develop an addiction. If it was going to happen, it would have happened long, long ago.
And addictions develop when people are young. Now that I am a grumpy old fart I am too old to develop an addiction. If it was going to happen, it would have happened long, long ago.
They decided to treat me like an addict anyway!
Even though there was absolute agreement over the first 37 assessments that I had:
- no genetic risk factors for being an addict
- no personal risk factors for being an addict
- no history of ever being an addict
- no lab tests that ever showed I was an addict
- On the 11 point scale of the DSM 5 for addiction, I scored a zero
Why were they going to treat me like an addict anyway?
This may be why the College has those two " pet" addiction doctors. They never, ever find anyone "innocent".
Between them they have assessed hundreds of physicians over the past decade. And - according to Dr. David Unger himself - they have never once ended up not treating any doctor as if they were not an addict. Not even me!
Between them they have assessed hundreds of physicians over the past decade. And - according to Dr. David Unger himself - they have never once ended up not treating any doctor as if they were not an addict. Not even me!
I got sent for "medical addiction monitoring".
They said if I wanted to get back to practicing I would have to go for "medical addiction monitoring". Which consisted of ( among other things):
- weekly counselling ( for an addiction I did not have)
- random drug testing ( also for addictions I did not have)
No meetings required!
Curiously, I did not have to go to any meetings, like AA or NA.
Why not? Because everyone was in agreement that I had no addictions, of course.
Why not? Because everyone was in agreement that I had no addictions, of course.
The drug testing was an expensive nuisance - and made me suicidal!
It is not like I was afraid of failing a test. After all, I had no addictions. But it was hugely annoying, having to check in every day to see if it was a test day. It all seemed hugely unfair. And having to go for weekly chats about my non-addiction to a doctor who knew less than I did about addiction was a pain. And expensive!
$1000 a month !!!
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Since I had no actual addictions, I think the decided to just check me for everything they could think of. I got checked regularly for drugs that even I have never heard of. Some of the tests were so rare and exotic that only one or two labs in North America do them. And they were expensive.
Which was a complete waste. There was a drug testing kit for sale at my local dollar store (literally costing a dollar) that could have done all the tests I really needed. |
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That was addiction specialist #37. Which is why I needed #38! To say that if I am not an addict, don't treat me like one.
Just to summarize here. I had 37/37 addiction specialists verify that I have never had any addictions. So why did I need #38?
Because #37 said that - even though I have never had any addictions - I should get treated like an addict anyway. (I think that is why the College likes him so much. He ALWAYS recommends drug testing forever.
Because #37 said that - even though I have never had any addictions - I should get treated like an addict anyway. (I think that is why the College likes him so much. He ALWAYS recommends drug testing forever.
And I mean forever. Not just while I was practicing medicine. "Number 37" recommended addiction testing for the rest of my entire life! At great expense. Even though he acknowledges that I have never been an addict, and have no risk factors. ( Now you know why the College likes him so much.)
So, even though 37 experts agree that I have never been an addict, I am supposed to never have another beer or a glass of wine, ever!
What did #38 say?
There were two main conclusions.
1) I am not an addict, so there is no need to treat me like one. At all. Ever.
2) The College should let me get back to work immediately!
1) I am not an addict, so there is no need to treat me like one. At all. Ever.
2) The College should let me get back to work immediately!
The College was furious!
They tried to think up all sorts of reasons to not accept opinion #38.
The 1rst excuse was that doctor #38 was "not qualified".
To which I pointed out that he was much more qualified than #37. In fact, #38 is a psychiatrist who works at an addiction clinic. And who has even written a book about addictions. Is that qualifications enough for you, Dr. Dave???
The 1rst excuse was that doctor #38 was "not qualified".
To which I pointed out that he was much more qualified than #37. In fact, #38 is a psychiatrist who works at an addiction clinic. And who has even written a book about addictions. Is that qualifications enough for you, Dr. Dave???
They were more furious. And wanted to be able to have secret conversations about me!
More is coming - stay tuned (Hint: there is sex and violence coming )
