How's this for irony? A story about the need for #pharmacare

I have a patient who struggled with opioid addiction over 10 years ago. They were started on Suboxone, went to a recovery program & did extremely well. They are now a group home worker, paying taxes, etc.

🧵

1/x But the reason they struggled with opioids is because of horrific arthritis. I've never seen arthritis like this & Ortho surgeons have commented the same. Their pain is marginally controlled enough to work but they frequently need to take time off work when they have flares

2/x

Today a patient told me he refused to write letters to his MLA supporting Family Docs despite phone calls by advocates. His reason: "You're all the best paid in the entire country. You don't need any help. They're lying, you're all fine"

My soul broke.

#abpoli
#ableg

1/x This patient is one of the very first people I've taken on. I've been vocal about my advocacy to him. He knows me well.

I am so angry that the @Alberta_UCP has managed to disseminate so much misinformation that my patient felt it was reasonable to say this to me

2/x

Let's clear up the most blatantly wrong thing @ABDanielleSmith has claimed so far:

That puberty blockers are irreversible and therefore can permanently alter a youth's body for life

They don't.

Read on 🧵

#abpoli
#ableg
#abhealthcare

1/x Disclaimer: I'm not a Pediatrician and I'm not a Pediatric Endocrinologist. But I am Family Doctor, which means I need to know the essentials of most things but not the complications of specialized things

So ya, I can talk about this.

Let's continue

2/x

Do you think that safety nets under the Golden Gate Bridge is a good idea? Do you think covering the railings with fencing on the High Level Bridge was reasonable?

Congrats. You believe in harm reduction

Let's talk about how @ABDanielleSmith is dismantling safety nets

👇🧵 But first off, this is a post on suicide, overdose deaths and mental illness. This is your TW.

Canada Suicide Help Line: 1-833-456-4566

Access 24/7 Mental Health Line in #yeg: 780-424-2424

Please reach out for help if you see yourself in the thread below.

2/x

I was the first doctor to manage the #COVID19 pandemic arrival at my tiny site in #yeg where we admitted patients. We were not a big tertiary hospital.

We had 5 gowns.

2 boxes of masks and 1 case of face shields

A small closet of gloves, caviwipes and hand sanitizer

1/x

https://twitter.com/PfParks/status/1737365508595515901

Our patients ranged from the young to the old in various states of health. Upper respiratory and GI illnesses were regular presentations prior to COVID.

We had no preparation except a list of symptoms to screen for

We had no guidance on how to manage our triage

2/x

Dear @ABDanielleSmith

I know you're having a great vacay right now, but I was hoping I could send you my Christmas wish list. I was going to ask Santa but since you announced we have a $5.5 billion surplus this year, I figure I would address it to the @Alberta_UCP

👇

1/x 1. Can we have a couple more hospitals please? We are running at > 100% capacity daily. #Yeg desperately needs a new hospital in the south. Also, if you moved the @StolleryKids into its own building, we could free up half the UAH for more adult ward space

2/x

Again, so many things @ABDanielleSmith got wrong

1. How insulting is it to say that NPs can't even agree amongst themselves how their training compares to a Family Doctor? She certainly doesn't give us any confidence in the NP program to do primary care

1/x

https://twitter.com/TheBreakdownAB/status/1728563443480052149

FM docs who do hospitalist care don't confuse themselves Internal Medicine docs. There is no debate on what lane they are in.

And I actually suspect there are many NPs who do not support the idea that they are "80-100%" trained the same as doctors

2/x

Dear MDs & NPs of #Alberta,

Let's talk about all the things @Alberta_UCP, @AdrianaLaGrange, @ABDanielleSmith & @SLPrendergast left out in their announcement yesterday

I've received this info from NPs and other colleagues but won't be saying their names to protect them

1/x The $300K salary for NPs that the @edmontonjournal reported yesterday is misleading and Susan has been trying to clarify that privatly but won't go to the media. This # is what the @AlbertaNPs presented but isn't what they were actually promised from the UCP

2/x

I've had several replies to my last post about my partner's impossible #Alberta classroom size of 35 & 37 students saying "So what? It was like that when I was growing up"

Yes. Teachers know that. We know that. The Millenials and Gen X of this province remember this

1/x And you know what happened? The kids who struggled in the 70s-90s in underfunded, large classrooms went on to become adults. With minimal education. Working minimum wage jobs, paycheque to paycheque. Some may have escaped this, but most don't.

And now they have kids too.

2/x

@GoAHealth You MUST fix your Alberta Health Claims billing reconciliation system. This is bordering on fraud. Ever since the pandemic, we know you decreased # of staff to process physician billing claims. And it's created such a backlog

1/x I have several bills on hold due to a minor error made by my billing clerk. We have been waiting MONTHS for the bills to be released or rejected so we can fix the error. You have closed your phone lines so all we can do is email your office and we haven't received any reply

2/x

We are down to the last few days of the election and I will end my series on Family Medicine with these graphics from @Albertadoctors

How bad is the state of Family Medicine in #Alberta compared to the early days of the UCP?

Well, read on:

1/x The number of Family Doctors accepting new patients overall in AB has dropped from 887 to 209, with the South Zone taking a near obliteration.

(I actually think this is an overestimation for all zones because many of these are walk in or niche docs only)

2/x

So on Tuesday's tweet, someone asked why AB doctors were so lazy that we needed to rely on US data.

Well troll, you just needed to be patient! Because I can deliver AB data too. In fact here it is!

And sorry #Alberta, the future of Family Medicine isn't looking good

1/x The section of Family Med with @Albertadoctors released a survey to all FM docs in April 2023 about their future plans.

927 active Family Doctors responded

Here's what they said:

2/x

I was going to announce some other important news about the disintegration of #Alberta healthcare but we are pausing this week's program today for something much more important:

No child should ever be compared to feces. In any context. In any situation. Ever. If @ABDanielleSmith doesn't immediately ask Jennifer Johnson, the @Alberta_UCP MLA candidate for Lacombe-Ponoka, to resign immediately, that is an endorsement by the UCP.

And endorsement by any political party that children should be literally compared to sh*t is abhorrent

I posted yesterday about how @ABDanielleSmith's suggestion that to solve the current hospital wait time crisis is that Family Doctors should just work evenings & weekends is absolutely ridiculous.

Many of you agreed.

But some of you didn't

Let's talk about the research:

1/x My colleague recently posted on IG this excellent summary of 3 studies done in the US about how much time Family Docs would need to spend to meet the criteria of the US preventative task force health recommendations.

He has kindly agreed to allow me to repost them here

2/x

What in the fresh hell is this new bullsh*t from @ABDanielleSmith ?!

Let's break this CTV news quote down

"NPs are trained almost to the level of Family Doctors"

Stop.

No they are not.

Any NP would confirm this as well. NPs are NOT the same as Family Doctors

1/x Any NP who respects their own profession would also say they have absolutely zero interest in trying to replace us either.

Family Doctors are SPECIALISTS in preventative medicine. We must complete an undergrad degree, spend 3-4 yrs in med school and then 2 yrs residency

2/x

@ABDanielleSmith

Let's do some education on contraception here. A thread (that I doubt you will ever read but here I go)

#abhealth #abpoli #ableg 1. Universal coverage of contraception is not a subsidy to insurance companies. Insurance companies only cover a percentage of meds, rarely 100%. There is still pay out of pocket costs, and for young women, even this small cost isn't always affordable

Constitutional law experts, correct me if I'm wrong, but am I reading that @ABDanielleSmith's Sovereignty Act allows the @Alberta_UCP to theoretically force Alberta Health/AHS to do any of the following, without it going through the legislature:

#abpoli #ableg 1. Delist and defund abortions, and quite possibly make it illegal for providers to perform them, as they could theoretically disagree with the Supreme Court's R v. Morgentaler?

In the latest edition of "What the ***** did @ABDanielleSmith just say?!", we have this hot off the press. When @Albertadoctors asked her how #Alberta will ensure all citizens have access to quality care, we have this quote from her:

1/10 "l understand we have 11,000 doctors in the province. I have been told each GP should be able to have a patient panel of 1500 patients. This is clearly not occurring....

2/10

Reasons why my 6 month old baby was vaccinated for #COVID19 today, a thread by a mom and a doctor.

Read on...🧵

1/9 1. Safety: The Moderna vaccine was tested on over 11 000 kids and they found no 'red flag' side effects. The usual was seen like a sore limb or fussing/crying. But even more serious side effects in older age groups, like Myocarditis, was not found in under 5 yrs old

2/9

I accepted transfer of 2 patients from #YEG ER depts to the facility I work at so they can get appropriate care for their medical issues & offload ER volumes.

Its been 36hrs.

They aren't here & there's no ETA

Because there is no EMS to transport them.

This. Is. A. Crisis. So tell me again why you think we should allow one of the most incompetent & destructive governments in #Alberta's history to lead us again for another 4 yrs? Because all the @Alberta_UCP has done for this province is burn #abhealth to the ground.

#abpoli #ableg

Dear @Alberta_UCP voters registering in the thousands for the leadership vote, heed my warning: Kicking out @jkenney will not save this province. Replacing him w/@BrianJeanAB will not undo the damage of the last 3yrs.

If you vote UCP again, there will be dire consequences. 1/7 I watched excellent doctors leave in 2020 due to the UCP fight w/doctors. But these were only the docs who were given opportunities to leave & weren't easily tied to this province. The rest of us stayed behind and fought b/c leaving wasn't so simple & we hoped for change 2/7