$ 6 million a year revisited

AM and SAM Z

I am reposting this blog.  Originally posted almost two years ago, it was unintentionally prophetic.  As we approach a provincial election, it begs to be reviewed again.  The cut to physician's income is now at 15 %.  We are in the middle of a flu epidemic.  Your GP is working way beyond any healthy capacity.  The after-hours clinic manned by the doctors I work with is churning through over 30 patients in an evening with people lined up in the parking lot.   We are not reimbursed for this vitally important work.  Doctors agreed to this arrangement as part of the contract we struck with this government 10 years ago in good faith.

 I will write a future blog that outlines how they have illegally over-ruled that contract leaving all of us in a very unhealthy position.  A government that 'loses' billions of your dollars through mismanagement and recklessness and then cuts your health care ( hospitals, nurses, doctors) and your education system ( God love the teachers who have survived )in order to make up for what they have 'lost', should not be allowed to continue governing.  A government that uses deceitful tactics to make you think these beautiful front line folks deserve to be sacrificed does not deserve to continue governing.

I am not of any particular political persuasion.  I am an advocate and an activist for people who cannot speak for themselves.  I am now advocating for you and your health.  On June 7th, you will have a voice.  Let's use our voices very, very wisely.

April 2016- updated

How disappointing.  Ontario's Minister of Health stood up on a podium with a poster beside him today.  The poster announced that one doctor in the province made over $6 million last year.

Really?   Does the bloated salary of one doctor represent the average salary of your hard working GP?  Come on.  Your government wants you to believe that all doctors can afford more cuts to their income.  Apparently, the 7 % cut we have already taken is not enough.  They must have one heavy-handed agenda if they are resorting to misleading you in this way.

Let's put a dose of the truth out there;  no pun intended.

I BILL OHIP $470,000 /year

I CARE FOR APPROXIMATELY 2000 PATIENTS

I am an average GP

I WORK OVER 40 HOURS A WEEK

(well over 40 hours a week)

I EMPLOY 5 STAFF PEOPLE:
(at a cost of $250,000 annually)
A nurse, an office manager, two receptionists and a nurse practitioner.

We all provide care to these 2000 patients

RENT, UTILITIES, INSURANCE, MAINTENANCE, MEDICAL SUPPLIES....

I PAY A TOTAL OF $360,000 annually in expenses,

 and together, Ontario's Doctors employ a huge network of healthcare and administrative workers supporting a substantive economy 

THAT MEANS THAT AFTER EXPENSES, AN AVERAGE GP LIKE ME MAKES

$110,000 annually

Now pay Licensing Fees, medical education fees

and I am left with a grand total of....

wait for it.....

$100,000 annually

Subtract the taxes and RRSP's, remember docs do not have pensions or extended health care plans, and
I don't even want to know what the final tally is but it is less than your lawyer, your accountant, your dentist and most likely, less than the police officer who cruises your streets.

WHY IS THE AVERAGE FAMILY PHYSICIAN'S SALARY AFTER EXPENSES NOT ON THE MINISTER'S POSTER?

THE GOVERNMENT WOULD LIKE YOU TO THINK YOUR DOCTORS ARE FAT CATS.

More cuts to healthcare will be dangerous, very, very dangerous.

The minute we have to re-consider whether or not we can afford to stay in practice, your healthcare is in jeopardy.

Your healthcare is my responsibility.

I take that, very seriously

 WE ARE ON THE BRINK OF A SERIOUS DISINTEGRATION IN HEALTH CARE IN ONTARIO

And that doctor who bills the government over $6 million a year?  He should be thrown out of the province and his government should curb his income instead of making him their poster boy.

Unfortunately, that disintegration is well underway, as predicted.

Dr.Anne-Marie Zajdlik MD CCFP, MSM, Order of Ontario

Founder ARCH Clinic

Founder Hope Health Centre

Founder Bracelet of Hope

Thanks,
AM

Just an MD on the front lines of healthcare

I have tried really hard not to blog about this.  I hear a voice in my head telling me to suck it up.  I have a good job.  I love my work.  But, at this rate, no one on the front lines of healthcare will survive the onslaught of the ever increasing demands of an ageing population in the setting of shrinking health care resources and a government that doesn't give a damn about me or you or our health.

I now spend 10 hours a day at my job.  I work through lunch with no breaks.  I spend 3 hours of the day smothered in paperwork.  I could use those hours to see real patients but our professional lives have become overwhelmed by regulations and legislation.  Everywhere I turn, a new guideline pops up, smothering any creativity or intuition I once used to care for my patients.  Patients that once required 10 minutes of my time now need 30 minutes.  Don't get me wrong, I love my ageing patients.  Their complex health issues require all my intellect and problem-solving abilities.  That is exactly what I signed up for.  But, it is becoming increasingly difficult to keep up.

Today, I saw four people whose specialists have found ways to abandon the system.  I don't blame them at all.  It now takes 12 months to see a dermatologist, 6 months to see a psychiatrist (if you can find one), 8 hours or more, to see an emergency room doctor, 18 months to have a joint replaced and 8 months to be seen at a pain clinic.  Three out of 10 referrals I make come back with a notice that the specialist is overwhelmed and can't accept the referral.  My staff spends hours looking for alternatives.  They are as dedicated to their work as I am.  I have stretched and extended my scope of practice to make up for these deficits, ineptly trying to pull together the unravelling strings of an imploding system.  Your government is more than happy to leave me in this spot.  They have to pay that specialist five to 10 times more than they pay me.  Cheaper healthcare is their goal, not better health care.


Your average family doctor belongs to a really good bunch of people who set out to tackle a career that involves the constant care of others.  We love that work.  We love our patients.  We are deeply concerned about their needs and search for ways to meet them.  We care for our patients over the course of their lives.  We have the privilege of delivering their babies and watching them grow into adulthood.  I know the intimate details of the lives of 2,000 people and every detail is kept in strict confidence.  I celebrate with these folks and I grieve with them.  They bring me their greatest joys and their lowest moments.  Every day, thirty people need my full attention, 15 minutes at a time.  By the end of the day, I have made thousands of decisions that directly affect the health of my patients.   We become that unseen part of every family that is critical to their health and wellbeing.  I fully understand the weight of this responsibility and I carry it on my shoulders with great humility and respect.

But, you have a government that disrespects the health and well being of every person who works in this system.  If we can no longer manage, people will die.  It's as simple as that.

I don't know how to change this mess we are in.  I am too busy trying to survive.  There is no time for activism.  God help us when 8 million baby boomers become increasingly ill and frail.  That will finally sink the ship.  Reckless mismanagement will finally sink the system and people will die needlessly.  My guess is, they already are.

World AIDS Day

                              90-90-90

               An ambitious treatment target

              to help end the AIDS epidemic

We will end AIDS in my lifetime.  By joining the global movement and using our unprecedented intelligence, knowledge and wealth, we will not only save millions but we will lay the foundation for a healthier, more just and equitable world for future generations.  We will demonstrate what can be achieved when humanity takes action for the good of all.  

We can do this.  We will do this.  The goal:  by 2030, 90 % of all people living with HIV will know their HIV status.  By 2030, 90% of all people with HIV will receive effective treatment and by 2030, 90 % of all people receiving treatment will have an undetectable viral load.  

With an undetectable viral load, the disease cannot be transmitted....the pandemic ends and millions of lives are saved.

Accomplish this goal, and we can use that same intelligence, knowledge and wealth to solve the massive global problems we face.  

Let's do this, for our grandchildren and our great-grandchildren and our great-great-grandchildren. Let's pass on a blessing to people we will never know. 

Join Bracelet of Hope as we celebrate World AIDS Day and all the miraculous progress that has been made.

Join us as we reach out to provide testing and treatment to 100,000 people in Lesotho, Africa.

Dr. Anne-Marie Zajdlik MD CCFP O. Ont. MSM

Founder of Bracelet of Hope.

Braceletofhope.ca

World War II Hero and my Hero

Mamokhele is 16.  By the age of 12 she had lost both parents and her older sister.  She took charge of her four younger siblings until they all became part of one of Bracelet of Hope’s Foster Families.  Her's is a life worth saving.

This weekend, I finished a book by Alison Pick called, ‘ Far to Go’.  It’s a tough read but beautifully written.  It tells the story of a Jewish family trapped in their homeland of Czechoslovakia after the German occupation in 1939.  The focus of the story is their six-year-old son, Pepik, and their efforts to protect him from the ravages of war.  His parents find him a spot on a Kindertransport which carries him to England.  He never sees his parents again.  

I have never been able to read books or watch movies about the 6 million Jews who were killed in Nazi concentration camps.  I can’t stomach it.  My father was 9 years old and living in Amsterdam when the Germans occupied the Netherlands.  He was transported out of the city and onto a farm in the countryside where he lived until Holland was liberated.  He never talked about this time in his life.  What was it like for parents to load their children, unattended, onto trains that took them to far away places to live with strangers?  What was it like for the children?

Kindertransport was the term used to describe a series of rescue efforts which brought thousands of refugee children to Great Britain from 1938 to 1940.  Most of these children were never reconnected with their families.  They were the only members of their families that survived the Holocaust.  

 Geertruida Wijsmuller-Meijer was a Dutch woman who was responsible for saving the lives of 10,000 Jewish refugee children.  Her efforts made her one of the greatest heroes of World War II.  A number of children saved by the Kindertransports went on to become prominent public figures.  Four of these children became Nobel Laureates.  Orphaned by war and rescued by strangers, they went on to change that world in dramatic ways.

I was sitting down to dinner with my adult children tonight.  It is birthday week in our family.  When my father was alive, we celebrated three birthdays in 7 days:  His, My oldest son’s and my husband’s.  Three generations under one roof at one point; in our world, that’s a blessing.  I mentioned this book to my kids and told them the story of Geertruida and her Kindertransport.  “ You never know who your efforts will save”, I said. 

 Every soul is worth saving.  Every child deserves to be raised in a family.  Every child deserves to be rescued from the ravages of war, famine, death, and disease.  I am often asked why I work so hard and dedicate so much of my time to the lives of children that live 10,000 km away.  There are many answers to that question.  I am sure that Geertruida never imagined that four of the children she saved would win the Nobel Prize, the world’s highest achievement.  Good begets good.  Good can conquer evil.  Good can change the world.  Nothing else will.

We all understand this, don’t we?  Or maybe we have lost the knowledge that there even is good and evil and that we have a choice between one or the other in every interaction, every action, every decision.   Or maybe the choice is even simpler than that; maybe we just need to be a little less self-focused and more focused on all the good that can be done in the world, one good deed, one kind word, one saved orphan at a time.

Thanks again for your support.

Anne-Marie

The link to one more good deed: 

https://www.canadahelps.org/en/charities/bracelet-of-hope/battleofboard/dedicated-to-khotso-and-my-twin-brother-dan/

The cherished work of non-for-profits

She is three and we love her
Photo by Philip Maher

I would imagine that many of you have lives that are very busy and that you are inundated with requests for support and donations from this cause and that.  I am too.  We are so overwhelmed that we tend to ignore or delete these requests or respond by asking to have our names removed from bulk email lists.  This bulk list has been very kind to me and you have accomplished amazing things as a result.

This is the non-for-profit world.  We set ridiculous goals that would see our greatest humanitarian issues erased from the planet.  We seek to change the world to make it a much better place.  We attempt to stand up against dark and often political forces, demanding that things be different.  We do this in the background of the for-profit world that has the lions share of the public wealth and has permission to use daring marketing tools with massive overhead budgets to sell things like Coca Cola and iphones  ( no offence to Coca Cola or Apple ).  We live under the constant strain of reducing our administrative costs to please our donors which often makes us handicapped in our efforts to make the world a just place for the most vulnerable.  

We are David, the issues we tackle are Goliath. 

 If we lose in our collective non-for-profit battles, cancers will not be cured, the victims of war will not be rescued, poverty will not be erased and health pandemics will not be defeated.  We won’t find a cure for AIDS or an answer to the terrifying forces of global warming.  Here is what I predict; we won’t lose.  Despite the impossible odds, we won't lose.  Because organizations like Bracelet of Hope will keep finding innovative ways to fundraise and even more innovative ways to provide service and care to the people we support including this little one who depends on us for her future.  We will help end AIDS in Lesotho, plain and simple but impossible without our collective generosity.

I am thankful for you and your support.  I am thankful for the country I live in and the many blessings that smother my life, day after day.   How lucky are we to have been born in a country like Canada.? To whom much is given, much is expected.

Let's get the cherished work of non-for-profits done.

The fundraising goal is $15,000.  That keeps three foster homes open for another year.  It gives our foster children school uniforms, school fees, warm blankets, and a foster family to grow with.  Stay tuned.  Our next bold move will be to assist in the role out of AIDS treatment to the most remote areas of the country.

Happy Thanksgiving.  You are a beautiful bunch.  

Blessings to you and yours.

Anne-Marie Zajdlik

MD CCFP
Founder of Bracelet of Hope

Donate here:

 http://bit.ly/2fj1pzO

Mafusa: Grace Community Church saves two precious lives

Foster Children at Larobane Foster Home
Lesotho 2017
Photo by Philip Maher

This is a great story.  I think it should be told to everyone out there who is feeling more and more hopeless about the state of the world.

Bracelet of Hope supports 6 foster homes in Lesotho and a total of 39 orphans, most of them orphaned by AIDS.   Mafusa  (name changed for her privacy), was 17 years old when she attended a party with other teenagers.  One interaction, one time, and she became pregnant.

Teenage pregnancy is still very stigmatizing in Lesotho.  For the health and safety of the other children in the foster home, she was moved to the home of an aunt, her only remaining relative.   The aunt has children of her own and is barely able to care for them.  While we were in Lesotho two weeks ago, Mafusa gave birth to a tiny, healthy baby boy.  She delivered at home.

Tracey and Candice, two of our team members visited with Mafusa last weekend.  She was suffering from the complaints that most new mom's experience.  She was tender and sore and overwhelmed by the constant demands of this new babe.  She sleeps on a mattress on the floor in an old, dingy room.  Bracelet of Hope has provided her with all of the necessities.  She has diapers, blankets, clothing, formula, pads and so on; but, she is entirely alone.  She was not able to complete her high school studies and without this her chances of meaningful employment are next to none.  Mafusa is very bright.  Given the opportunigy to complete her education, she will have a very good chance of finding a job that will support her and her child.

Life is very fragile in resource poor countries.  One difficult circumstance, one unexpected problem can change the fortune of an individual overnight and forever.  Death of a caregiver loss of a job, an unexpected illness, an unplanned pregnancy; a person's security is so tenuously held together that one event can send them spiralling into extreme poverty.

Mafusa has lost both her parents.  She is unwanted by the one family member she has left.  She is hopeless and despondent.  She misses the only family she has known;  her foster mother and the foster siblings she lived with.

I can't even imagine that kind of aloneness or the fear Mafusa must feel.

Mafusa no longer meets the criterion for support received by Bracelet of Hope.  She is not a child in one of our foster homes.  But her situation breaks us.  Broken people can do one of two things : we can stay broken and give up or we can stand up and do all we can to change the circumstances that broke us.

Candice had a meeting with Bryan Bitton before our trip to Lesotho.  He is one of the pastors at Grace Community Church in Guelph.  Bryan was looking for other ways to help Bracelet of Hope.  The church is already a monthly donor.  Bryan and the leaders of Grace Community Church have offered to support Mafusa with monthly income that will provide her with a child caregiver who will care for her son so that she can go back to school.  The funding will provide her with formula, diapers and baby's personal items  With this kind of support, Mafusa may be able to return her foster home.  That is what we are working towards.

A good friend recently reminded me of a quote that I used to use in my speeches years ago.

The only thing necessary for the triumph of evil is for good men and women to do nothing.
Sir Edmund Burke


I don't know what kind of emotions her rescue stirs in you but I know personally, that rescuing Mafusa makes all the difference in the world to her and to us.  The work we do will not bring about world peace.  It will not change the actions of super-powered narcissists who threaten global security with their careless and ridiculous antics.  It will not solve world poverty or the ever increasing threat of global warming.  Our efforts are just a tiny light in a very dark world.

But here's the beauty about light.  It is recognizable in the darkness.  It gives direction and hope.  One tiny spark of light can burst into even the darkest places on earth.  The small light that Bracelet of Hope and Grace Community Church has held out to Mafusa is not just for her, it is for us and for everyone who is watching.  It is for every person young and old who has started to believe that there is no hope for a world as messed up as ours.  And if every person young and old responds with other acts of courage, compassion and selflessness, well, then our world becomes a beacon of light and nothing is impossible.


What a joy it will be to watch this beautiful young lady as she grabs onto a brighter future.  Well done team!  If you would like to help support Mafusa or one of our other beloved foster children, please consider becoming a monthly donor.  Follow the links on our web-site at braceletofhope.ca.  If you'd like to watch me gasping for breath after a 100 km cycle, sponsor me here:  http://bit.ly/2fj1pzO

Cheers and thanks

Anne-Marie

Traveler’s Diarrhea and Justin Bieber

photo by Philip Maher

A day off at the Lipofung caves, Lesotho:

Minus their fearless leader

I almost made it.  It took seven days and despite extreme precautions, I developed symptoms of the travel bug……no detailed description necessary.  On other trips I am often out for three or four days.  I hope today is the only day for this trip.

The team took the day off of foster home repair and clean up and headed up to the only ski resort in the highlands; a treacherous drive.  Apparently, the van needed a ‘rest’ several times as it climbed.  Phil is our driver and we are going to knight him for his efforts.

The view up there is incredible.  The highlands of Lesotho are the most magical, eerily beautiful place on earth.  I am sorry I missed the trip this year.  I had an entirely different day.    Getting up, except when absolutely necessary, was too difficult so I laid in my bed looking out the heavily sheared window recognizing only blue sky and sunlight above the decaying walls of the cottages that surround our courtyard.  Not much to see which left ample room for the sounds of Lesotho.   Off in the distance, all day long, I heard cheering and chanting teenagers.  At least I think they were teenagers.  It must have been some sort of sports tournament.  Their exuberance was extraordinary.  All day long, chanting and cheering in harmony, of course.  It was the sound of pure joy.  I could here honking taxis on the road in front of the convent, the drivers accosting each other and their customers.  When the cheers died down, I heard birds chirping in the heavily blossomed bushes.  At one point this morning, a group of men and women made their way up the street singing in that un-mistakable African harmony.  I could make out the hymns.  They seemed to slowly make their way up the street and then back down.  Funerals are on Saturdays here.  The sadness in their voices made me wonder whether that was what this procession was for.

On and off all day, in between deep, dreamless naps, I heard these sounds.  A housekeeper was in and out sweeping and cleaning.  No vacuum cleaner but the worn out carpets were swept clean.  She made her way into my room several times, just to see how I was.  She told me the story of her efforts to finish her high school diploma.  At 23, she had managed to complete grade ten but then was forced to work in order to eat.  She has been caring for the nuns here since April.  Several of the nuns are quite elderly.  Her responsibilities include caring for them.  The nuns are holding on to her pay so that she can save it for her education.  She wants to be a nurse.  Completing grade 11 and 12 will cost her 4,000 M or $400.  That’s a fortune for someone like her.  The longer it takes, the less likely she’ll succeed.  If a woman in the developing world gets 1 or 2 years more education, she reduces the under 5 child mortality rate in her community, by 15 %.  I contributed a wee bit to her education fund.  The amount I donated covers my groceries for a week in Guelph.  It covers all of grade 11 for her. 

Just as I was dosing off for nap number six, I heard a song that I recognized playing somewhere off in the distance, the bass way too loud.   There was nothing African about this music.  It was Justin Beeber.  I was disappointed.  His music doesn’t even come close to the traditional hymns and songs of Lesotho but apparently he is very popular here. 

Everything moves forward, even here. 

It’s dark and I am dosing off again.  I can hear the excited chatter of the team, just returned, down the hall in the dining room.  They are talking about how difficult it is to raise funds for international development and how exhausting the work is.  It requires the patience and perseverance of Job.  If that is the only thing they pick up on this trip, I will have done my job.

Almost asleep, I hear this lovely, almost Gregorian chant coming from the church across the compound; all male voices, slow profound harmonies.  No Justin B. here.  Faith in humanity restored.

The church bells chime on the hour just as the raucous noises of the day settle into a chorus of crickets.  I love Africa, travel bug and all.

Donate if you can.  Lot's of work done, so much more to do!

Anne-Marie

Click Here.

www.canadahelps.org/en/charities/bracelet-of-hope/battleofboard/dedicated-to-khotso-and-my-twin-brother-dan/