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Post new topic Reply to topic  [ 322 posts ]  Go to page Previous  1, 2, 3, 4, 5 ... 17  Next
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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 20th, 2011, 7:58 pm 
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Joined: April 9th, 2004, 7:10 pm
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Location: charlottetown
So maybe we should give all of the Dr.s on pei $500,000 so they can bring their care up to the same standards as his.....


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 20th, 2011, 8:16 pm 
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Location: Queens County
The system on PEI is absolute rubbish and needs an overhaul. We are even decades behind the mainland.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 20th, 2011, 9:19 pm 
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Location: Summerside
Any idea how long the waiting list is? I'm assuming from the CBC article that we just go back on the waiting list for a doctor.

When Dr. Coull was taking new registrations, we agreed to be taken off the list and register with him even though we're in Summerside. We wanted a doctor, and we liked his office, blog etc.

I'm hoping we'll be in line (however long that line may be) for a doctor in Summerside (where we live) and not Charlottetown (where our last doctor was). Do you think that's a reasonable assumption?

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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 20th, 2011, 9:25 pm 
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Quote:
Health PEI


The Department of Health and Wellness and Health PEI are acting to help Islanders who will be left without a family physician after the eventual closure of the Phoenix Medical Practice in Charlottetown.

“We met extensively with Dr. Robbie Coull to develop an alternative to his request for additional funding for his practice,” said Keith Dewar, CEO of Health PEI. “After thoroughly considering all the potential impacts of his proposal, it was determined that it was not financially viable and would not be in the best interests of the province or of Islanders in the long run.”

“Our primary concern now is supporting Islanders whose access to primary health care will be most directly affected by this announcement,” said Minister Bertram. “Recruitment for physician vacancies is ongoing through our Recruitment and Retention Secretariat and we will begin the process of filling this vacancy immediately.”

All former Phoenix Medical Practice patients will automatically be added to the Health PEI patient registry to be matched up with family physicians. For non-urgent care, walk-in clinics remain the best option for Islanders while they are temporarily without a family physician. For emergency situations, Islanders should continue to visit their nearest emergency department.

A listing of walk-in clinics throughout the province is available at www.healthpei.ca/walkinclinics.

Health PEI will work quickly in the coming weeks and months to place as many patients from the patient registry with family physicians as our province’s current physician complement will allow. Medical directors are now in place throughout the province to help allocate physician resources in each community, and more collaborative processes being put in place at medical facilities will help to better manage physicians’ time.

Contrary to what was stated publically by Dr. Coull, the province did not provide him with $500,000 for a pilot project for his practice. Dr. Coull is paid based on negotiations between the Medical Society of Prince Edward Island and government as are all physicians practicing on the Island.

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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 20th, 2011, 10:22 pm 
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I'm familiar with the name but haven't had any dealings with his practice.

Could someone explain what made it different from a typical family physician's office visit.

I'm hearing a lot of people here talk about it being cutting edge but to someone like who hasn't seen a doctor in 10 years and even then only to get an antibiotic, I'm curious as to what makes it so different.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 8:50 am 
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alandla wrote:
Could someone explain what made it different from a typical family physician's office visit.


It was primarily his use of technology and associate medical professionals.

On a typical visit, you would first meet with a member of the medical team (at least two of whom were medical doctors themselves, immigrants to Canada awaiting recertification to practice in Canada and/or PEI) who would spend whatever time was necessary to do a preliminary assessment, which consisted of listening to your description of what was bothering you, asking you pertinent questions based upon what you were describing and update your file on the computer (they could also pull up the results of any tests you had recently had if you were on a follow-up visit and go over the results with you and answer any questions you had). After all the prelims had been completed (5, 10 or 15 minutes which Dr. Coull could use to see other patients), Dr. Coull would ome into the examining room, iPad in hand and quickly reviewing whatever information and/or assessment that the medical associate had entered into OSCAR. Dr. Coull would then spend whatever additional time was required (which by now, usually wasn't much) before delivering a diagnosis and prescribing any medications, follow-up treatments, referrals, etc.

This process allowed him to see 3 or 4 more times the number of patients as a regular doctor. And since you medical records were all easily at his fingertips, there was little chance that a piece of paper in a file folder would be overlooked or stuck to another sheet of paper (as sometimes has happened to me with more traditional doctors meaning that a misdiagnosis was made ... which I would then end up suffering because of).

That was a typical visit.

Let's look at a non-typical visit. A while back, I had reason to believe that I was experiencing symptoms associated with prostrate cancer (I'm at that age). The medical assistant wasted no time in getting Dr. Coull into the examining room and after he questioned me on several things, over the next 30-45 minutes I got to meet half a dozen of his staff as I was whisked from one professional to another for a series of tests and assessments that they are able to perform in-house. At the end of that whirlwind tour through Dr. Coull's facility, I had a 10 minute wait before Dr. Coull came in with his iPad, having just reviewed all the test and assessment results that his staff had entered into the system and was able to deliver the diagnosis (not cancer, a condition known as BPH and easily treatable with medication).

I know that with any of my previous family doctors, that diagnosis would have taken days, if not weeks, to arrive at.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 8:58 am 
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BTW, all that "fancy furniture"?

When it came time to equip his new offices at the Sherwood Medical Centre, Dr. Coull discovered that it would be cheaper to rent a U-Haul truck and drive to the nearest IKEA than to furnish his offices from any local office furniture supplier. So he and his wife and a friend did just that. How many other doctors would make that kind of effort to save money on furniture?


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 9:13 am 
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Joined: July 9th, 2007, 8:57 pm
Posts: 1984
Location: Summerside
At the risk of stirring up a hornet’s nest, ie Kreskin, it appears to me that $$$$ was Dr. Coull’s primary motivator. I read his quotes in the media and he moans about losing $10 grand last month and moans about not getting more of our tax payer dollars for his practise (WTF!) and etc etc. Frankly, I would rather he had invested those furniture dollars locally rather than going off Island and spending my tax dollars at Ikea. His whole persona just doesn’t mesh with the Hippocratic Oath. Know what I’m saying?

Have you checked out ratemds.com? His ratings are not great. And don’t be too impressed by electronic tools....what matters more than anything is bedside manner and taking time to listen to your patients.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 9:29 am 
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Joined: January 12th, 2008, 5:09 pm
Posts: 5475
Armetis wrote:
Quote:
Health PEI


The Department of Health and Wellness and Health PEI are acting to help Islanders who will be left without a family physician after the eventual closure of the Phoenix Medical Practice in Charlottetown.

“We met extensively with Dr. Robbie Coull to develop an alternative to his request for additional funding for his practice,” said Keith Dewar, CEO of Health PEI. “After thoroughly considering all the potential impacts of his proposal, it was determined that it was not financially viable and would not be in the best interests of the province or of Islanders in the long run.”

“Our primary concern now is supporting Islanders whose access to primary health care will be most directly affected by this announcement,” said Minister Bertram. “Recruitment for physician vacancies is ongoing through our Recruitment and Retention Secretariat and we will begin the process of filling this vacancy immediately.”

All former Phoenix Medical Practice patients will automatically be added to the Health PEI patient registry to be matched up with family physicians. For non-urgent care, walk-in clinics remain the best option for Islanders while they are temporarily without a family physician. For emergency situations, Islanders should continue to visit their nearest emergency department.

A listing of walk-in clinics throughout the province is available at http://www.healthpei.ca/walkinclinics.

Health PEI will work quickly in the coming weeks and months to place as many patients from the patient registry with family physicians as our province’s current physician complement will allow. Medical directors are now in place throughout the province to help allocate physician resources in each community, and more collaborative processes being put in place at medical facilities will help to better manage physicians’ time.

Contrary to what was stated publically by Dr. Coull, the province did not provide him with $500,000 for a pilot project for his practice. Dr. Coull is paid based on negotiations between the Medical Society of Prince Edward Island and government as are all physicians practicing on the Island.



Irrespective of how good a Doctor he was or how effective his system was, he or the Medical Society are not being completely honest here. I don't mean to make this a political affair, but it does remind me of the OC fiasco. No one knows the actual facts, but people are out of a job and 4500 people are without a Doctor.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 10:18 am 
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Seems to me many of kreskin's opinions are based from Dr. Coull's opinions.

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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 10:57 am 
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Posts: 2240
The number of patients being managed by this Doctor seems high to me.

The American Academy of Family Physicians (AAFP) did a study in 2007 on the number of patients each health care provider can be accountable for (they call it 'panel size').

Read it here - http://www.aafp.org/fpm/2007/0400/p44.html

Excerpt:-

VARIABLES THAT AFFECT PANEL SIZE

Panel size can be influenced by the number of patients seen per day, the number of days the provider is available per year and the average number of visits per patient per year. For example, a provider who sees 20 patients per day, 210 days per year, with an average of three visits per patient per year, could manage a panel of 1,400 patients. By increasing capacity to 25 patients per day, the provider could manage a panel of 1,750 patients.

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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 11:13 am 
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Joined: April 10th, 2006, 12:57 pm
Posts: 14266
Location: Charlottetown
Maggie wrote:
At the risk of stirring up a hornet’s nest, ie Kreskin, it appears to me that $$$$ was Dr. Coull’s primary motivator. I read his quotes in the media and he moans about losing $10 grand last month and moans about not getting more of our tax payer dollars for his practise (WTF!) and etc etc. His whole persona just doesn’t mesh with the Hippocratic Oath. Know what I’m saying?

.

agreed.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 11:53 am 
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I'm so glad that all you non-patients with no experience in dealing with Dr. Coull know the "real story" and know his motivations. Thank you for bringing all your medical knowledge and personal experience to the table.


Funny how all his patients here have nothing bad to say about him, eh?


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 12:00 pm 
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Joined: April 10th, 2006, 12:57 pm
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Location: Charlottetown
hey, i merely agreed with the optics of the situation. I have no idea what kind of a dr he is, but from your posts, it seems a complete waste of time to relay all your info to an assitant, then have to relay it again to the dr, who reads something off an i phone. so what happens if the you say something to the assitant which doesnt get relayed back to the md?
i'd much sooner deal directly with my dr, then 6 people in between.
just sayin.......


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 12:14 pm 
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philipw wrote:
The only time I have ever heard bad things about COull was from other doctors.

Patients loved him.

Phil


probably the most interesting post in this whole thread.....I wonder why others Doctors felt that way?......


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 12:26 pm 
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Joined: April 18th, 2010, 8:28 am
Posts: 64
Quote:
Funny how all his patients here have nothing bad to say about him, eh?


My wife's grandmother was his patient until last week, when she found another doctor. She hated him, and his practice. She said she had never been treated so poorly in her life, and she is 82 years old. I don't know all the details, but a few weeks ago, she almost had me write a letter to the editor in the Guardian to complain about him.

So...there was one patient with something bad to say about him.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 12:44 pm 
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linetwig wrote:
hey, i merely agreed with the optics of the situation. I have no idea what kind of a dr he is, but from your posts, it seems a complete waste of time to relay all your info to an assitant, then have to relay it again to the dr, who reads something off an i phone. so what happens if the you say something to the assitant which doesnt get relayed back to the md?
i'd much sooner deal directly with my dr, then 6 people in between.
just sayin.......

I'm glad you have a doctor like that.

There are thousands of Islanders who don't even have a family doctor, let alone one with that kind of time.

Dr. Coull tried to implement a system (one widely practiced with great success elsewhere) that allowed him to handle a caseload equivalent to three or four family doctors in a province with a dramatic shortage of family physicians.

After my experiences with my last two family doctors, I loved Dr. Coull's passion for the practice of medicine and his cutting edge use of technology to not only improve service to patients but to keep himself abreast of medical knowledge.

Anyway, I hope that the Province can use that $500,000 as a small down payment on the cost of bringing in three or four "traditional" family doctors to the province to replace Dr. Coull (anyone know what the average annual billing is for a family doctor?) ... and having apparently abandoned a methodology that would have allowed all Islanders to have access to a family physician if they had been able to convince a few more doctors to embrace 21st century family medical practices, I don't think that 3 or 4 new doctors will be enough.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 12:46 pm 
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I don't doubt that an 82 year old had trouble embracing modern family medical practices.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 1:20 pm 
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I think this kind of practice is the way of the future. We already see it in other professions. You don't sit down with the dentist for 30 minutes anymore while he picks away at your teeth. The hygienists clean your teeth and take a look at them and let them know what they found. Then the dentist comes in, takes a look and let's you know what's up. This is how my last dental appointment was anyway.

I suspect some older patients would be upset because they don't just deal with the doctor for their whole appointment. There is no need for a doctor checking your heart rate, blood pressure and other simple tasks that can easily done by another health care professional. Other professionals should handle the tasks that they can handle and then let the doctor come in at the end to use his expertise. It saves the doctor a lot of time which frees him up to see other patients. I've never dealt with this doctor at all, but it sounds like a much more efficient service.


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 Post subject: Re: Dr. Coull leaving the province
PostPosted: May 21st, 2011, 1:48 pm 
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Joined: May 21st, 2011, 1:33 pm
Posts: 66
Thanks for some of the kind comments.

We are very upset by this decision. Sorry to any patients who were in in the last couple of days. We could not say anything as (1) we only had confirmation of their decision on Wednesday and (2) we had a peer-review audit set for Friday morning and could not announce anything until after that.

Basically, we just did not expect them to say no to our offer of a pilot. The medical society was behind us, Health PEI had seemed very interested, and it was a great deal for them.

- we would have been cheaper per patient than the other providers (salaried and fee-for-service)
- we can prove our quality with lots of computer data
- they know we are saving them money by providing more care in the community and reducing hospital admissions
- we were building the infrastructure they need to make their new model of care work (which they have been struggling to do for at least 10 years).
- we only needed $7 per patient/month for 6 months while we negotiated the details of the 3 year pilot.

The $500,000 was not a pilot just for us. It was the Patient Access to a Family Physician Pilot project which was set up to get more people a family doctor. It started before I arrived, is open to all PEI doctors, and is still going on.

In fact, ironically, the $500,000 may be payable again to the doctors that take on our laid-off patients.

Our management team were devestated when they rejected our offer.

If there was any way to keep going we would - but even if I work for free we still can't pay all the staff.

They did offer to let me stay on a 'normal' family physician but:

1. I'd have lost 90% of my staff.
2. I'd have to give up 80% of my patients.
3. I'd have to 'dumb down' the care we provide.
4. I'd have lost my license to be a doctor in the UK (as the General Medical Council consider the PEI system of family practice to not be adequate). Or I'd have had to spent 8 weeks a year in the UK working to keep my modern skills and license.

I just can't face that option. I can't sit here and give patients bad care for the next 20 years in a system that is going bankrupt when I know we could have done so much good here - better care for less money - if Health PEI had let us. It's just too depressing.


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