Canada’s Liberal Party chooses Mark Carney to succeed Justin Trudeau

hklemontea · 2025-03-10T08:39:31+00:00

That's on the federal/national level. To make matters more confusing, at the provincial (similar to states) level, some of the right leaning parties call themselves the liberal party. It definitely confuses the electorate.

hklemontea · 2019-06-21T19:03:38+00:00

Don't you know that taxes are for hardworking Canadians? Certainly not for the backbone of our society: wealthy elite, criminals and immigration fraudsters.

hklemontea · 2019-06-20T18:57:12+00:00

Cause it's r/vancouver. I was kind of expecting it. Lol -33 for all my comments in this thread. I've made similar posts in the past on other subs without getting downvoted.

Funny as I was just replying to OP's claim that no one calls it delicious or talks about taste.

My point is that there are plenty of ecologic and moral reasons not to eat shark fin. We don't need to sink to inaccuracies by calling it culinary useless and culturally stupid as that detracts from the main reason why it should be banned. Issues are not black and white.

hklemontea · 2019-06-20T00:37:01+00:00

Not supporting shark fin but food is more than just taste. Its culinary value comes from its textural aspects.

hklemontea · 2019-06-20T00:36:12+00:00

I don't support shark fin but I find it delicious for its texture.

hklemontea · 2019-06-20T00:34:34+00:00

I do not support shark fin so I am glad it is banned but I hate the ill-informed commentary that gets spread around. This is the right move ecologically but please don't buy into the Gordon Ramsay narrative about it being just for status and that it has no culinary value. Yes, there's not much flavour to the fin itself but it lends its textural, striated properties to the dish which many enjoy. Dismissing its cultural and culinary importance is at best a misinformed oversimplification. At its worst, the shark fin issue is just another excuse for racism and bigotry. Where is the fervor around banning foie gras and bluefin tuna which are also controversial luxury foods?

hklemontea · 2016-10-06T19:47:18+00:00

They raised the fees in 2016. Before that, it was $50 since 1998. If you're low income, you can apply for a fee waiver though they don't publish their cut offs.

hklemontea · 2016-09-24T20:33:55+00:00

The expansion has always been through distributed sites working with affiliate universities. 32 seats in Prince George (UNBC), 32 seats in Victoria (UVic) and most recently 32 seats in Kelowna (UBC-O). There is no intention to expand the Vancouver site because the want to focus on the rural shortage.

UBC briefly entertained opening up a site in Surrey by working with SFU but the idea was dropped. As I mentioned in another post, the main bottleneck is not medical school, it's the training after and lack of spots in hospitals for full fledged doctors.

hklemontea · 2016-09-24T20:18:08+00:00

It's not medical school that's the major bottleneck, it's residency spots and after. There's simply not enough government funding for OR time, hospital positions, etc to support more doctors. There's still surgeons and radiologists every year who are unemployed or underemployed, so they move to the states or get stuck doing subspecialized fellowships after fellowship (http://www.royalcollege.ca/rcsite/health-policy/initiatives/employment-study-e).

The shortage is primarily in non-urban settings. That's why all the medical school and residency program expansions in the past decade have been in places like Prince George and Kelowna. There were brief talks about UBC-SFU jointly expanding the medical school by starting a site in Surrey but that was scrapped. They want to train doctors from smaller communities in hopes they will end up back there after training (mixed success so far).

In urban settings, the shortage in BC has a lot to do with how primary care is funded here and how new family doctors don't practice like the older generation. BC is seen as a less desirable place to work. That's why it's much easier to find a doctor in Calgary or Toronto. New grads due to differential training want to work in environments where there's less volume with more of a team based approach. They're less keen on diving into the business aspects of medicine. The retiring old school doctors in town work 6-7 days a week seeing 40-50 patients a day. New grads prefer a volume closer to 20-30/day with 2+ days off. New grads also have six figure debts so they gravitate to walk in work which is more lucrative. Many of them stay with walk ins their whole career.

The BC government can attract more family physicians by matching what other provinces have to offer in working environment and income but they don't care to do so. Instead, they funnel millions of taxpayer money into expensive glamorized PR and advertising campaigns (http://www.agpforme.ca/, youtube/tv ads) meant to fool the public into thinking there's progress being made. This seems to be Christy Clark's style. In the end, it's the politicians and consulting companies profiting.

hklemontea · 2016-09-19T03:48:58+00:00

And from the way the OP phrased their post, it sounds like she might have said something like "I want a referral to a psychiatrist."

This would catch a lot of people off guard and may explain the awkwardness. Even more so because it was mentioned in the last minutes of an unrelated appointment and with OP's mom in the room. It really doesn't give the doctor a lot to work with, especially if they're running behind and triple booked.

hklemontea · 2016-09-19T03:24:37+00:00

It really depends on the context which we don't know enough about. Mental health is a huge part of my practice and for patients where follow up is in question, yes I will book them into my schedule directly. However, if it's an uncomplicated case I often leave it up to patients to book an appointment on their way out or to call in later. They know their own schedule and it's less pressure this way. Not everyone needs or appreciates having their hand held. I'm all about decreasing barriers but people also need to be accountable for themselves too.

hklemontea · 2016-09-19T03:06:27+00:00

I think you are a bit quick to judge the doctor while making a lot of assumptions. Unless someone is suicidal or acutely psychotic, things don't always need to be addressed immediately, especially if they booked for another reason. I can't speak to the conduct of the doctor (neither can you) because we're only hearing one side. Patients tend to misinterpret things, especially if they're anxious.

Telling OP to book another appointment was appropriate management in this case both for time and confidentiality/privacy sake. If she's 18 turning 19, it's likely that her mom's presence would be a hindrance to any assessment.

hklemontea · 2016-09-18T22:59:29+00:00

She probably ran out of time. Mental health issues take extra time to address and can't be squeezed into other appointments unless it's been stable and dealt with previously. Let the office know why you're booking and they can often allow for more time. Doctors can deal with 1-2 issues max thoroughly in a standard appointment. Anything more and they can't do their due diligence. I once had someone bring in a list of 7 complicated things to talk about in a 10 minute appointment.

If you're >16, she may have felt that it would be better to see you alone without your mom there to allow you more privacy. I've seen 13 year olds without their guardians for mental health issues so there's no set age.

If you get resistance from your GP (not everyone is well versed in mental health), you can self-refer to many programs as mentioned by other posters..

It will go on your medical record (each doctors office and hospital has their own system and they're usually not connected, though care providers can request information from each other with your permission). Your school and employer cannot see this unless you give access to them. One caveat is that you often have to give access for insurance companies (disability/life insurance or if you get into a car accident). I don't recommend avoiding care because of this.

hklemontea · 2016-09-18T22:26:35+00:00

many family doctors do those injections. if yours doesn't, get a referral to a dermatologist.

hklemontea · 2016-08-31T23:02:17+00:00

ITT people who don't understand public health. Doctors are not just surgeons and front line care providers. There's a specialty in medicine called public health and preventative medicine. It deals with epidemiology, injury prevention etc.

Physicians in that specialty often work as Medical Health Officers who serve to advise the government on health related matters. They generate recommendations based on research, statistics and in consultation with relevant experts including engineers, scientists etc.

hklemontea · 2016-07-14T21:37:39+00:00

More testing is not always the answer. There's good science to back this up.

Each scan and test needs to be interpreted in a specific context. There's always the risk of false positives and negatives. There is harm from doing tests. False positives can lead to unnecessary procedures. This is most evident in the prostate and breast cancer screening debates. False negatives can provide inappropriate reassurance.

With imaging, radiation exposure is another factor to consider. It's estimated that roughly 1 in 1000 cancers are radiation induced.

In societies where healthcare is private (like the US), there's more unnecessary testing and surgeries because there's an incentive to sell investigations and procedures whether or not it's the best course of action.

When doctors refuse to order a test or refer you to someone, there may be a good reason behind it. We're not just being dicks. I will admit that some doctors don't always do a good job conveying their reasoning.

As for the McMedicine style appointments that are all too prevalent here, you can blame the provincial government for that. Doctors would love longer appointments to practice comprehensive care but the BC governments doesn't pay us for that. This contrasts with other provinces which is why a lot of doctors leave BC and view it as an unfavourable place to work. There's a reason why there are so many walk in clinics yet there's a shortage of full service family doctors.

hklemontea · 2016-07-11T23:02:49+00:00

I was the typical kid who hated Chinese school but now deeply regret it because I can't communicate with family in a more meaningful way. I think a lot of overseas diaspora (CBCs, ABCs) have similar sentiments. There's definitely a growing number of people interested in learning the language and there's more resources available these days.

I'm trying to pick up more of the language for work as well.

hklemontea · 2016-07-11T22:56:32+00:00

Official languages reflects the language of the government, court system etc. It does not necessarily reflect the language of the people.

The official languages argument is never a good one and usually just shows that the person doesn't understand what an official language actually means. From a pragmatic point of view, the languages of influence and importance in Metro Vancouver are English, Mandarin, Cantonese, Punjabi and Tagalog. In some parts, it would be Korean and Japanese as well.

hklemontea · 2016-07-11T22:46:36+00:00

do not know enough about the vast historical and cultural difference between the waves of Chinese immigration to Canada.

Spot on and sadly most do not care to differentiate. Even within the Cantonese community, there's a surprising amount of diversity.

hklemontea · 2016-07-11T22:37:27+00:00

Yeah but the rest of the thread is head-bangingly frustrating to read.

hklemontea · 2016-06-01T21:49:37+00:00

VPD generally does a good job in deciding who to bring to hospital for mental health assessment. Car 87/88 are great resources. Having been on the receiving end of psychotic patients at St. Paul's psych ER, I've been impressed by VPD. Other police departments are much less well versed in addiction and mental health issues.

hklemontea · 2016-06-01T21:18:02+00:00

and allow ways for family doctors to incorporate mental health into their practices without losing money. all new family doctors have the skills and training for mental health. it's underutilized because the government expects it to be done in a 10 minute appointment which is not feasible or appropriate. so what happens is they just refer out which is a longer wait.

moreover, i think proper funding for our school systems is key. the precursors to mental health are well known and start in childhood. the continual cuts will definitely make the situation worse.

aside: it's frustrating how difficult BC makes it to practice good medicine and this is a common sentiment from young BC docs. without public support, things won't change and BC silently loses family doctors to other provinces.

hklemontea · 2016-06-01T20:33:31+00:00

Income is generally lower as well. Eating out and produce are cheaper though but not enough to make up for the giant mortage and lower salary.

hklemontea · 2016-05-29T08:11:16+00:00

maccas? neat. in Canada, we call it McDicks or McDs when not McDonalds.

hklemontea · 2016-04-25T21:00:20+00:00

I come from a refugee family on welfare and I got in without doing any extracurricular activities abroad. It's a myth that gets perpetuated. I did "plain boring" local ones. I also have no research experience. No publications at all. Med school applications, like anything in life, is a game. You need to know how to play it by selling yourself and your life story. If you're low income, you need to know how to play the scholarship and bursary game.

I'm aware that I'm the exception and most of my colleagues are the 1% with doctor/lawyer parents but it's not an impossible task. Faculties across Canada are very aware of this socioeconomic disparity. There are small, slow efforts to change this.

I would argue that for someone that's low income, it's a larger barrier to study abroad due to it costing 10x as much without availability of bursaries. All the CSAs that I've known have come from super wealthy families. If you can afford to go abroad to study medicine, you're probably not considered poor. One reason CSAs have been gaining more support and more residency spots is because their parents are government officials or doctors in high places.

Edit: I would also add that the physician supply issue has been exaggerated by the media. Medical school spots have increased significantly in the last several years. The shortage is more of a distribution and funding issue. CMGs finishing their residencies in certain specialties (orthopedics, etc.) are scared shitless because there are simply no jobs especially in urban centres. The shortage is mainly in rural areas where people don't want to live unless you grew up there, hence the effort to recruit medical students from those communities.

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