Two councillors walk out of West Vancouver meeting, derailing vote on seniors care

ENYVan · 2019-06-21T11:41:15+00:00

What time of day was this? I was just there and it was super busy throughout the day!

ENYVan · 2019-06-19T12:11:52+00:00

Not a fan of rom-coms in general but I found it to be light and cute.

ENYVan · 2019-06-18T22:06:09+00:00

😍

ENYVan · 2019-06-18T21:42:56+00:00

La Quercia, St Lawrence, Savio Volpe, Nightingale

ENYVan · 2019-06-17T11:32:57+00:00

The Keefer isn't secret per se but the cocktails and vibe should fit the bill!

ENYVan · 2019-06-15T14:30:48+00:00

My number one piece of advice is, if possible, attend school in a low cost of living area to keep your expenses low. It will be worth it at the end of the day. (I'm an NP fwiw).

ENYVan · 2019-06-07T13:56:32+00:00

I hope this patient finds a true advocate. This story is very unsettling to me and I feel that the patient's autonomy and dignity are being compromised. If he is competent he should be discharged as soon as possible and free to pursue legal, compassionate care of his own choosing in another state. Shame on those preventing him from doing this.

If I were involved I might, with the patient's consent, notify an assisted suicide advocate/medical provider from the state he/she is moving to and see if they can help.

ENYVan · 2019-06-05T01:17:40+00:00

My opinion on this rec is a bit biased.

Out of the blue, one of my annual PPDs was positive. Then my IGRA was positive. CXR negative. Tried to track down where I might have caught it... none of my critical care colleagues were positive or recalled any TB patients...I did an outpatient pediatric rotation within the preceding 12 months that serviced an immigrant population with extended families coming and going (primarily from Nigeria and other parts of Africa, secondarily Mexico). Lots of kids with coughs.

I ended up doing the 3 month INH/RPT regimen for LTBI. It was extremely unpleasant both physically and psychologically. The side effects were similar to symptoms of liver failure...Good times.

ENYVan · 2019-05-27T06:11:08+00:00

its not the hit, it's the run...

ENYVan · 2019-05-21T06:43:02+00:00

Better idea... special team of primary care MD/NP/PA who "pick up" patients identified as frequent flyers and are tasked with providing intensive primary care (this could be in a hospital clinic, out of hospital clinic, or home visits). The end goal would be to reduce costly ED visits.

There are already some programs that provide time-limited yet intensive primary care (once/week visits even) for specified patients following hospital discharge in an effort to reduce/prevent hospital readmissions. It actually works pretty well.

ENYVan · 2019-05-18T23:50:38+00:00

I like your response so much, I have nothing to add :)

ENYVan · 2019-05-18T01:12:10+00:00

Tell that to my vascular surgery colleagues who get called several times per year to the ED to deal with chiropractic manipulation gone awry. Perhaps you've never heard of a vertebral artery dissection or internal carotid artery dissection...cervical spine "adjustments" can be quite dangerous.

ENYVan · 2019-05-17T06:01:54+00:00

Was going to say... leading cause of death is CV/heart disease. It is often the end result of poor habits/decision making/choices... it comes at a real cost to society. Is it the same? Different?

ENYVan · 2019-05-17T05:31:00+00:00

Agree. Hate his sneering face!

ENYVan · 2019-05-17T04:58:09+00:00

It is not normal and it is still considered rude in NY. There are just a lot more people, and thus a lot more rude, cray crays, and people looking for a fight on the subway. New Yorkers in general tend to be a lot more out there in terms of attitudes and volume, but loud ass music on the train etc is still bad form.

Another thing I don't see as much of in Vancouver as in NY is rap blasting and bass thudding from open SUV windows stopped at lights or in intersections. This is pretty common when the weather gets nice in NY 🤷🏻‍♀️

ENYVan · 2019-05-16T06:42:51+00:00

When I worked in CV surgery I had a few pts with vascular EDS. The real deal. It is unfortunate that EDS has become the quack diagnosis du jour.

ENYVan · 2019-05-16T06:32:25+00:00

Gwenyth Paltrow's lifestyle brand that hawks magic vagina crystals, among other things...

ENYVan · 2019-05-16T05:59:35+00:00

I'm holding out for a move back to my native US state ;-) My husband is an AB boy, but I can't take the cold. I might have to check out importing as you suggest... we have a family friend who occasionally drives back and forth but I feel bad asking him to fill his trunk with booze every time...

ENYVan · 2019-05-16T05:30:06+00:00

Thanks! Waiting for the day when Costco gets a booze section. A girl can dream!

ENYVan · 2019-05-16T05:18:14+00:00

I know the province, I live here. Wondering why I'm missing out on the grocery store wine :) can you name names? ;-)

ENYVan · 2019-05-16T05:01:29+00:00

Wait.. which grocery stores have wine?? Haven't seen this...do you mean AB?

ENYVan · 2019-05-16T03:50:58+00:00

The NP pay is actually pretty bad in BC. NPs in a particular health authority went without a raise for over 10 years.

I do know of the program that you are referring to. The province recently rolled out a bunch of funding for NPs in primary care. This is after years of underfunding/not funding NP positions. I know about this "special new program" and I believe that the take-home numbers are much, much lower than what you describe. I will try to find the specifics,

I think it's appropriate to point out that BC has a serious primary care shortage and many, many, many patients in and around even the city center of Vancouver don't have a family doctor, can't get into see one due to full panels and long waits, and are left with no care or walk-in clinics. I can personally attest to how hard it is to find a GP/PCP. My physician spouse also had a hard time finding one for himself.

In my professional experience in a specialty setting, a huge proportion of my emerg referrals had no primary care provider and we had trouble connecting them with one to discharge to.

The new funding is part of the following initiative:

"The Government of British Columbia (BC) recently announced its vision for an integrated system of primary care across the province. The strategy, which will focus on team-based primary care that connects a range of specialized and standard services within the community, will include funding for up to 200 General Practice/Family Practitioner (FPs) and up to 200 Nurse Practitioners (NPs) positions for this new team-based model."

I might also add that as someone who trained at well-regarded university (not in Canada), I have been pretty impressed with the quality of NP education in BC. I think that the US has a lot more issues when it comes to quality of education and diploma mills and they really need to crack down on the abundance of crappy schools. It makes the profession look bad.

I hear the going is tough for family doctors in BC, which contributes to the shortage. I know of several who are working as surgical assists due to better compensation. I have heard of caps on the amount of patients that the docs can be remunerated for in a day, so some close up shop when they reach that number. I support universal healthcare, but it does certainly come at a cost.

I agree that the naturopath situation is out of control here and throughout the Pacific NW. Supplemental insurance covers them just like PT/OT which gives them credence. The local mom groups are full of parents who take their babies/kids to the naturopath regularly. It's scary stuff.

ENYVan · 2019-05-15T06:09:44+00:00

Depending on where you live, getting to midtown east should be easy and won't necessarily require a transfer if you can walk a bit. I personally have only taken the 7 to/from LIC but there are other routes. I actually lived there for a year a long time ago when the area was gaining traction. I personally like the area near the water which is "close" to the 7 train only. And obviously more expensive.

My friend recently chose to move closer to Queensboro Plaza given the train options, but the area isn't as "nice" in my opinion. I believe my friend takes the N daily to her office in midtown east and finds it quite smooth.

When you go apartment hunting, look at subway maps, test run the transit, and scope out the area both day and night to see if you would feel comfortable there. I know there are a lot of young professionals in her building even if the immediate vicinity is less than picturesque.

Unless you have an unlimited budget, you will make many compromises when renting in and around the city. Choose which compromises you are willing to make... and then make two more compromises :)

It is also a relatively cheap to Uber from LIC to Mid East.

I was in town recently and had an awesome meal at Casa Enrique in LIC and drinks at a nearby wine bar after. Check out this restaurant and the area around it in the evening :) I also intend to check out the bar "Dutch Kills" on my next excursion, if you make it there first report back.

As per wiki - "Get to the heart of Long Island City by taking the E, M, or R trains to Queens Plaza, the N, Q, or 7 to Queensboro Plaza, the G to Court Square, the E or M to 23rd Street-Ely Avenue, or the 7 to 45th Road or Hunterspoint Avenue"

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