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Dr. Pat Nesbitt M.D. ............Family Medicine and more ............drpat@ live . ca NOW BOOKING PATIENTS AT CAULFEILD 604 922 1544

Why is there a family doctor shortage?   

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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.) 

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) 
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And now for the main event - the College of Physicians and Surgeons of B.C. and the current doctor shortage!

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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.  
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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.
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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.  
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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. 

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. 
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!!!
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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!

What did the 38 experts say?

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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...


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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?

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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?

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.
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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...

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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.

They decided to treat me like an addict anyway! 

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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  
They decided to treat me like an addict anyway!

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!

I got sent for "medical addiction monitoring".

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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.

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!
​Dr. Pat  Nesbitt, Vancouver, Canada ..... drpat@live.ca