Unlike Ontario's Premier, I don't blame patients for coming to the ER. The problem in Canada is that profiteers are just salivating to capture the need for urgent care. The fundamental problem of ERs is not kids with fevers, it's the admitted with no hospital beds. www.cbc.ca/news/health/...

Despite the author's vested interest, micromobility makes sense. It's illegal in Toronto. With bylaws, mandatory helmets and maximum speeds, they reduce congestion, reduce pollution, less costly and help people. But in ER, we see many serious injuries. www.thestar.com/opinion/cont...

Medicine is political in this "post-truth" era where some cannot agree on basic facts. If you believe in any modern healthcare at all - by far the most proven and safest intervention is vaccination. Solid op-ed by @manishakrishnan.bsky.social www.thestar.com/opinion/cont...

Nasal injury with misalignment. When I first started these were an ENT outpatient referral of unclear date. With time, I started doing them under procedural sedation. Now I am doing cases with effective pre-procedural analgesia. The patient breaths better, looks better and can still have follow-up.

Ontario’s Premier Doug Ford nails it that Trump is just still upset after we burned down the American White House 212 years ago.

There are humanitarian emergencies that dominate the news and others with far more humans affected which get paltry attention and support - like Sudan. "People from all walks of life must push our governments and global bodies." www.thestar.com/opinion/cont...

Among the many disgusting parts of American life that repulse Canadians is their morally bankrupt healthcare system which impoverishes millions. And all the wars we fought with them - we won by the way. www.thestar.com/news/canada/...

I did my residency in Quebec, work in the publicly funded system in Ontario, overseas with MSF and remain in the public system. I didn't feel part of Quebec society, an outsider, while speaking French and from eastern Canada. I support barring MDs from profiteer work. @picardonhealth.bsky.social

We need to be honest Ontario. You have a drinking problem. And Ontario Conservative policy is part of the problem and not part of the solution.

There are not enough ER stretchers in Ontario for those presenting on a daily basis intoxicated. Thankfully our publicly funded system has offsite stabilization centres that are warm and where patients can sober up safely. This frees EMS crews, frees ER beds and hopefully is a bridge to supports.

"Swapping a dirty needle for a clean one is not a pathway out and does not give people hope" said Ontario Deputy Premier Jones. Swapping a live person for a dead person is not a pathway out either and does not give people hope.

"There’s a phrase in provincial auditor general Shelley Spence’s report that could, by now, serve as a slogan for Doug Ford’s government: “Without proper planning".... an all-purpose description of The Doug Ford Way." - by @thekeenanwire.bsky.social www.thestar.com/opinion/star...

In this instance I agree with the Action démocratique du Québec. Québec taxpayers pay between $435,000 and $790,000 to train an MD. They should be barred for not 5 years - but many more - for leaving the publicly funded healthcare system for the profiteer system. www.cbc.ca/news/canada/...

Americans: Canadians have 4 words for you: Vietnam, Somalia, Afghanistan, Iraq.

This is pretty funny.

If President-Elect Trump wants Canada to be the 51st US state he will have to contend with NATO Article 5. I hope all NATO nations would join Canada in its armed resistance to an American invasion. You may laugh, but this is not funny for Canadians.

"Without proper planning" and "without a needs assessment" - that is the determination of the Ontario Auditor General on the creation of Ontario HART Hubs. Our tax dollars and human lives in play.

Ontario rushed Bill 223 into legislation without basic planning. www.thetrillium.ca/news/health/...

"Health Minister Sylvia Jones once promised that ‘people are not going to die,’ but the province hasn’t tried to figure out if they will or not, the auditor general reports". In 2022-2023 1600 overdoses were prevented. Where these will go now? www.thetrillium.ca/news/health/...

In a consistent policy pattern of introducing harms to Ontarians without effective mitigating strategies (like liberalization of alcohol) the Auditor General rips Ontario's Health Ministry for lack of basic planning.

Ontario's Auditor General rips to shreds the dangerous and deadly policies of the Ford Conservative Government.

The Ontario Auditor General slams the Ford government for its lack of "Anything done to mitigate an “increased risk of overdoses” likely to end up in hospital emergency rooms that are already overcrowded." - ER doctors like I totally agree with Auditor General Shelley Spence

"In a scathing annual report to the legislature Tuesday, auditor Shelley Spence also found Ford’s decision to close 10 supervised drug consumption sites near schools and daycares was made “without proper planning.” - An unprofessional, uncaring and disorganized government.

André Picard nails it - "As Robert Redfield, former director of the U.S. Centers for Disease Control and Prevention has said: “It’s not a question of if, it’s more a question of when we will have a bird flu pandemic.” - an important read. @picardonhealth.bsky.social

Let's not forget the policy lunacy of Ford Conservatives, slashing wastewater testing in July 2024 and the 1918 Influenza epidemic killing 50 million and 50,000 in Canada. Two timestamps that should evoke fear but moreso a shrug by Conservatives focused on bike lanes. @picardonhealth.bsky.social

Ontario doesn't take epidemic disease seriously. We do commissions like by Justice Campbell on SARS in 2006, and then ignore it. We are condemned to stumble into repeated infectious emergencies because public health surveillance is not something our governments value. @picardonhealth.bsky.social

Clinically we are seeing this. As microbiologic cause is not on the child's forehead, amoxicillin is still first line for pneumonia. If needed, a macrolide can be added if no improvement. The PCR NP swab should be of the throat, not NP.

The American healthcare system is morally bankrupt. I cannot imagine how awful it would be to be a doctor there. In 2016 Vox reported on a 1-year old who needed a bandaid and the family was charged $629. @picardonhealth.bsky.social

This is no joke. Anyone else wonder if a war between the US and Canada would be like the Russian war with Ukraine? In the post-truth world where only force and stupidly reigns, we have to seriously think about this. Canada should expect the world would just watch with an American invasion.

There is absolutely no #1 hospital. Medicine is vast with the critical elements of geography, local knowledge, an incredible array of clinical services and local expertise, as well as research and teaching components. To claim to be #1 is patently false. Just to clear things up.

What is regrettable is the Ford government is ramming through legislation in omnibus bills, limiting debate and consultation. But they delayed the session by 5 weeks. Bike lanes, Highway 413 environmental assessment, safe consumption sites, auto-theft, sex offenders registry - it's all mixed up.

If normally you walk but you now cannot, we have to question ER discharge. The overdosed patient just would not wake enough to walk. Labs >> CT head >> CXR. Then more bloodwork. Still too sleepy. Finally, blood cultures with 2/2 bacteremia, and admission. Polysubstance users are high risk.

Promise made. Promise broken. Ontarians don't forget easily the Premier Ford of 2018. The Premier of small things like bike lanes, liquor paper bags and $200 bribes before the Spring election. This is what matters to regular Ontarians.

MPP Dr. Adil Shamji said Liberals' plan is "dramatically different" - they promise people their own family MD close to home within 4 years, while the government is promising to connect everyone to "more convenient primary health care within the next five years." By @jessiecatherine.bsky.social

Time and again for patients with advanced illness like metastatic cancer, with recent admission, I wake their family at night to break the bad news the situation is critical, now is the time to come. No one has even begun to broach goals of care. MDs - one day we all die. It's OK to talk about it.

Leader Crombie - don't poach MDs from other nations - they need them. Repeal Bill 60 privatizing our healthcare system and Bill 7 on ALC patients. Enact Ontario 173 on IPV and Dr. Shamji's excellent Bill 203 bringing NPs into OHIP. @bonnieforontario.bsky.social www.thestar.com/politics/pro...

The story of Canada despite all our advances is that we have failed to provide the basic medical care to our citizens for the diagnosis and treatment of unforeseen and time dependent illness and injury. Profiteers lurk to capitalize, but if we band together, we can make this work.

"A lot of times we don't even hear about the ones that couldn't get care, because they die at home or they have really bad outcomes. My hope is that we're not waiting till people die, till we make these really structural and foundational changes." - Dr. Andrew Park, ER MD and OMA Past-President

Agency nursing is a big problem in Ontario. They don't know their MDs. They don't know the resources. I've been an ER MD for years and they think I'm surgery just because I'm working on a broken bone. Privateers hoard the money, overcharge taxpayers and the Ford government is fine with that.

I don't blame RNs for leaving ER. It is too violent. A patient who assaulted me goes to court this week. I expect zero justice. The same week I got assaulted, another patient said he would kill me and a family member dropped his shoulder to ram through me. ER is violence. People have had enough.

CBC's documentation of Ontario being a leader in closed ERs doesn't take into account Minden which lost its ER completely under Premier Ford. I get called "STAT" to bedside routinely and you have to wonder what happens to patients in that community.

While Ontario's Conservative government is ripping up bike lanes, liberalizing alcohol and sending out $200 election bribes, ERs see their worst year of closures ever. ER closures did not happen prior to Premier Ford. Second, minutes and hours matter to my ER patients. www.cbc.ca/news/canada/...

Pericardial effusion. You will hunt down the US machine and look and look and look with POCUS (along with the lungs) - and so many will be negative - until you finally find a patient with a significant one which makes all the negative looks worth it.

Talking to loved ones - or your patient with metastatic cancer - is better beforehand, rather than with me as and ER MD at 3AM in the midst of a health crisis while my phone is ringing for tylenol orders or when the nurses request another urgent patient be seen ASAP. @picardonhealth.bsky.social

This unauthorized ad campaign in Toronto makes an important point. Ontario Conservatives are forcing safe use sites which have zero mortalities across Canada since inception, into the streets, coffee shops, school yards and alleyways.

Why I cancelled my X subscription.

The 1918 Don Valley bridge was dubbed "a bridge to nowhere". In short-time traffic was jammed. The same for bike lanes - if we build them - people will feel safer biking to work or their kids there. Premier Ford lives in the past. @thekeenanwire.bsky.social www.thestar.com/opinion/star...

It is possible to say that both the October 7th attacks and hostage-taking, and the destruction of Palestinian health care facilities and killing of scores of healthcare workers are wrong. www.thestar.com/opinion/cont...

You would think that 'hunt the illegals down by any means necessary' kind of people like Jaime Watt would be on the Board of Directors of prisons, but in fact, people like him on are the Board of Directors of prominent hospitals. - 1/2 www.thestar.com/opinion/cont...

Clover briefly leaves Earth for heaven.