Congratulations to the authors on what is otherwise an excellent article.
they are needed? They do! If they weren't needed, if they had no work, if they couldn't earn a living, they would move on. Why Guido M.A. Van Rosendaal, MD don't they go where they are most Director of clinical education needed? For the same reason that Department of Medicine lawyers, bishops and business exUniversity of Calgary ecutives don't: they have preferCalgary, Alta. ences and desires. Few people [Drs. Linton and Peachey reply.] have an inner need to be a missionary, and there is nothing unWe thank Dr. Van Rosendaal for christian, immoral or unethical in his support, and we apologize if doing an honest day's work for an our paper conveyed any sense of honest day's pay in pleasant surregional bias. The issues are of roundings. course national (and even internaThe relationship between life tional) and will call for debate and expectancy and the physician-tocollaboration among all the prov- population ratio is perhaps valid inces and territories. when comparing a backward, disOur only excuse is that, as ease-ridden Third World country described in part 2 ("A possible with a developed country, but it is strategy" [ibid: 629-632]), we be- not a cause-and-effect relationlieve that the primacy of provin- ship. There are very few 90-kg cial governments in health care 90-year-old couch potatoes, no makes local initiatives more likely matter where you look. to succeed, at least at first. Should "maldistribution" be We also advocate the creation legislatively remedied? No one of a national coordinating body, profession or business should be and both the federal government singled out. The process should and the CMA have begun to ad- involve all professions as well as dress this issue. We would enthu- businesses and industries. Come siastically support attempts to de- to think of it, there are few areas velop national health policy and with a thriving commercial or inin future will try to avoid Ontario- dustrial base that lack legal or specific designations. medical services. Adam L. Linton, MB Vice-president of the Board David K. Peachey, MD Director of professional affairs Ontario Medical Association
Daniel Myhal, MD
Rheumatology Division Centre hospitalier universitaire de Sherbrooke Sherbrooke, Que.
Why won't doctors go where they are needed?
CME in PEI
P5 atrick Sullivan's report (Can Med Assoc J 1990; 143: 949-950) on the presentation by Dr. William MacDonald, Saskatchewan's deputy minister of health, at the CMAsponsored information session on medical manpower at the association's annual meeting last August raises interesting points. Why don't doctors go where
J am one of the fortunate doctors who benefits from the continuing medical education (CME) program described by Dr. Douglas Cameron in his article "Innovative CME program having impact on medical practice in western PEI" (Can Med Assoc J 1990; 143: 1235, 1237). It has been useful and refreshing to hear speakers dedicated to their fields. As Cameron notes,
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CAN MED ASSOC J 1991; 144 (2)
this results in changes in practice and prescribing habits. Since medicine is a progressive subject, keeping up to date is not easy. Cameron is modest in describing the role of the local organizer; he is that person. I am grateful that he arranges all these sessions for us. Terence R. Verma, MB, BS PO Box 700 O'Leary, PEI
The grass is always greener . . . R
~ecurring US interest in the Canadian health care system, as outlined by Ann Silversides in her article "Our health care system causes 'immune system rsponse' in US, economist says" (Can Med Assoc J 1990; 143: 936-937), reminds me of the illusion that "the grass is always greener on the other side." I agree that our health care insurance system can and should be improved in order to best serve those for whom it is intended. However, to implement socialized health care across the board seems rather naive. The Canadian system isn't cheap, and the British is not much better. The best example of socialized, state-run health care is the Soviet system. It is a dismal failure, like the rest of communist plans. You would not want to get sick in the Soviet Union. According to presentations and exchanges by delegates at the People to People Citizens Ambassador Program at the Women's Consultation Center, Moscow University, June 23, 1989, the infant mortality rate in the Soviet Union is twice as high as ours, even though there are no barriers to prenatal care. The solution to problems of both cost and quality of health care seems to lie in the committed
they are needed? They do! If they weren't needed, if they had no work, if they couldn't earn a living, they would move on. Why Guido M.A. Van Rosendaal, MD don't they go where they are most Director of clinical education needed? For the same reason that Department of Medicine lawyers, bishops and business exUniversity of Calgary ecutives don't: they have preferCalgary, Alta. ences and desires. Few people [Drs. Linton and Peachey reply.] have an inner need to be a missionary, and there is nothing unWe thank Dr. Van Rosendaal for christian, immoral or unethical in his support, and we apologize if doing an honest day's work for an our paper conveyed any sense of honest day's pay in pleasant surregional bias. The issues are of roundings. course national (and even internaThe relationship between life tional) and will call for debate and expectancy and the physician-tocollaboration among all the prov- population ratio is perhaps valid inces and territories. when comparing a backward, disOur only excuse is that, as ease-ridden Third World country described in part 2 ("A possible with a developed country, but it is strategy" [ibid: 629-632]), we be- not a cause-and-effect relationlieve that the primacy of provin- ship. There are very few 90-kg cial governments in health care 90-year-old couch potatoes, no makes local initiatives more likely matter where you look. to succeed, at least at first. Should "maldistribution" be We also advocate the creation legislatively remedied? No one of a national coordinating body, profession or business should be and both the federal government singled out. The process should and the CMA have begun to ad- involve all professions as well as dress this issue. We would enthu- businesses and industries. Come siastically support attempts to de- to think of it, there are few areas velop national health policy and with a thriving commercial or inin future will try to avoid Ontario- dustrial base that lack legal or specific designations. medical services. Adam L. Linton, MB Vice-president of the Board David K. Peachey, MD Director of professional affairs Ontario Medical Association
Daniel Myhal, MD
Rheumatology Division Centre hospitalier universitaire de Sherbrooke Sherbrooke, Que.
Why won't doctors go where they are needed?
CME in PEI
P5 atrick Sullivan's report (Can Med Assoc J 1990; 143: 949-950) on the presentation by Dr. William MacDonald, Saskatchewan's deputy minister of health, at the CMAsponsored information session on medical manpower at the association's annual meeting last August raises interesting points. Why don't doctors go where
J am one of the fortunate doctors who benefits from the continuing medical education (CME) program described by Dr. Douglas Cameron in his article "Innovative CME program having impact on medical practice in western PEI" (Can Med Assoc J 1990; 143: 1235, 1237). It has been useful and refreshing to hear speakers dedicated to their fields. As Cameron notes,
116
CAN MED ASSOC J 1991; 144 (2)
this results in changes in practice and prescribing habits. Since medicine is a progressive subject, keeping up to date is not easy. Cameron is modest in describing the role of the local organizer; he is that person. I am grateful that he arranges all these sessions for us. Terence R. Verma, MB, BS PO Box 700 O'Leary, PEI
The grass is always greener . . . R
~ecurring US interest in the Canadian health care system, as outlined by Ann Silversides in her article "Our health care system causes 'immune system rsponse' in US, economist says" (Can Med Assoc J 1990; 143: 936-937), reminds me of the illusion that "the grass is always greener on the other side." I agree that our health care insurance system can and should be improved in order to best serve those for whom it is intended. However, to implement socialized health care across the board seems rather naive. The Canadian system isn't cheap, and the British is not much better. The best example of socialized, state-run health care is the Soviet system. It is a dismal failure, like the rest of communist plans. You would not want to get sick in the Soviet Union. According to presentations and exchanges by delegates at the People to People Citizens Ambassador Program at the Women's Consultation Center, Moscow University, June 23, 1989, the infant mortality rate in the Soviet Union is twice as high as ours, even though there are no barriers to prenatal care. The solution to problems of both cost and quality of health care seems to lie in the committed
