What Is Canada Doing?! | These New 2024 Changes Will WORSEN The Doctor Shortage

[@nxtgenmd]

Let's Keep Our Doctors In Canada 🇨🇦 💪 Like the video if you thought that it was helpful and please share your thoughts below - even if you disagree :) All the best everyone

[@DennisBolanos]

6:54 In case anyone was curious, this phenomenon is called “human capital flight” or “brain drain”.

[@cardiacmyxoma4073]

I'm so glad you're bringing light to this topic. I'm a third-year medical student in Ontario and have been considering the move to the US for quite some time. This latest news regarding capital gains has made that decision easier. I don't quite see the purpose of staying to serve a country that continues to claw back on reimbursements and benefits for physicians.

[@nxtgenmd]

It's frustrating for sure. The paradox here is that if we don't speak out about what's going on, then nothing changes for the better... and if we do speak out, often nothing changes for the better anyways 😅 There's a lot about the field and my job that I love, but I think that it's incredibly important for you and everyone else to be able to choose where they want to work. Like with every other field, the only way to keep the best applicants around is to incentivize the positions

[@mikescar2]

I am not an expert in this. But it should be noted that the USA taxes all capital gains, while Canada only taxes a certain % of capital gains. This tax change is taxing a higher number of capital gains, and it only really impacts people making a very high amount of investment income each year. Or to put it more simply, if you are paying the higher capital gains tax that is proposed, then chances are you are in the top 0.01% of Canadian earners, and therefore, you likely won't notice at all. As far as I am concerned, if someone wants to go practice in the USA, then you should be going to school there, and leaving spaces in Canada for those that want to stay here.

[@SuperPompey77]

Canadian government just knows how to tax. They do not have any other solutions. They have overpaid government staff and politicians have huge wages and increasing tax is the only way they can keep up with union contracts. What industry does Canada have? We export our lumber and gas and then import (buy it back) with huge mark ups (one of the reasons why house prices are high). We have to pay Carbon tax now because we want the earth to be cleaner and to control the climate, but we still mine coal and sell it abroad, so basically say we are not making the earths atmosphere bad, but get other countries to do it instead. We ask Saudi Arabia to hurry up and increase the production of oil so the we can try keep prices reasonable at the pumps. Basically making ourselves look great, yet really not doing anything to clean the air at all, but claiming we are so hence the carbon tax. The only real industry we have our the Banks. Thats all we really have. If I were you, and the government continues to raise taxes on doctors, move to USA. Good luck and wish you all the best.

[@Runningmaster2025]

Much respect Doctor for being a family physician. Love your transparency. Practising Medicine should be rewarding not exhausting

[@alexandrutrifan9490]

Hi! MS3 here from Montreal considering applying to FM partly for all your advocacy work towards that specialty (so a thousand thank yous). My little issue with this whole debate is that I can clearly see how this is a problem for family doctors who are already getting paid less than their fellow specialists (plus they have their overheads, the costs of running their practice, etc) thus the argument of incorporating yourself and hoping to have a retirement plan via your corporations. However, 1. Specialists in the majority get paid more and the examples you talked about in this video (neurosurgeons, cardiothorac surgeons, cardiologists...) get paid even more, often in the 600k (at least here in Qc), don't have overhead fees, don't have to pay for setting up their practice. And YET, they still have a negative speech towards Canada's way of managing taxation and everything. I totally agree with you that in the grand scheme of things, it disincentivizes medical students to apply to lower paid specialties like anything primary care, but on the other hand, I can totally see why we as doctors are seen greedy by the population when some specialists making above 500k would threat to leave for the USA just because they will be taxed more and they could make more money there. At the end of the day, we as a society chose to be more socialists and to allow the poorer to be treated like the richer, and when you're making 500k+ per year to be a doctor and treat everyone and anyone, getting a little bit more taxed should not be an issue (IMO). Any specialist will still be able to retire comfortably in Canada, just like a lot of family docs are doing (if you have proper financial literacy) Thank you for making these videos and shining a light on the amazing specialty that is Family Medicine 🎉

[@nxtgenmd]

I really appreciate the comment and the thoughtful discussion :) Also, I'm glad that you are thinking about family medicine. Best of luck with your training. I have no arguments for anything that you're saying - at the end of the day, if someone believes that they should give more than half of their income to the government, then I think that they are welcome to do so. However, regardless of specialty, doctors working in Canada will be choosing to sacrifice their income. Doctors are often seen as greedy, and yet lawyers, bankers, professional athletes, actors, and many others that dwarf the salaries of even the hardest working surgeons will be exempt from this generalization for some reason? I think that for the last 5 years where I've looked at the data, burnout has increased among physicians, healthcare shortages in the country have worsened and the cost of living has increased. The job isn't easy, and many of us could have chosen to get into a different field. I want to keep the hardest working and brightest people in medicine so that patients can receive healthcare and so that innovation can be funded.

Love your videos and your well-rounded perspectives. Canada needs you and doctors like you! Makes going through a health crisis and taking responsibility for our own health that much easier. So appreciate the commitment and sacrifice you all make. I wish you smooth sailing as you open up your office and practice. :)

[@nxtgenmd]

Thank you very much :) All the best to you as well

@@nxtgenmd thank you 😊

[@Lexiegrey-r9x]

the healthcare system in Canada is so stupid that I am not even gonna bother applying to med schools despite working SO HARD for 4 years in undergrad. ill probably turn depressed

[@AbjectReply]

Wasn't expecting a plain bagel shoutout! Love him as well. One thing that is hard to fight is the "Doctor's are greedy and overpaid" narrative that commonly gets brought up, especially in regards to this recent bill. It's hard to succinctly explain the various financial pressures that Doctors experience (debt burden, higher taxation rates, delayed earnings, lack of traditional pension, overhead costs) in a way that resonates with your average Canadian when all they see is "Doctor's make $300k a year". Thanks for making great content explaining these changes!

[@cardiacmyxoma4073]

Exactly. When folks hear "doctors make $300k a year", they think that $300k gets deposited into their chequing account. Wrong! Deduct insurance, deduct overhead, deduct taxes, deduct licensing fees etc. What you're left with is certainly not worth the 10-15 years of training that doctors have. This is why we often hear that one should not go into medicine for money.

[@nxtgenmd]

I gotta shout out the Canadian creators 💪 Plain Bagel's videos are awesome I hear you. I'm not trying to fight the narrative at all - people can disagree with how much doctors get paid, although I think that if many knew the whole story, there might be a different narrative The common ground here is that if you don't pay doctors properly (or tax them into a crater in this case), then you don't get some of the best doctors in the world to stay in a place where they are needed. On a related note though, the next time someone bring this up to me, I'll simply suggest that we take the funding from the Toronto Maple Leafs and redirect it to the doctors to cover the difference... at least we get better results 😅

[@lesleyt7438]

Canadian grad engineer here. I moved to FL right after graduation. Best decision ever.

[@harmeetsingh6795]

Hi Dr Calcango , what is your take on Alberta allowing NPs to set up independent clinics and is paying them very high for just a roster of 900 patients.

[@nxtgenmd]

Hi :) It's a hard topic for me to break down for sure. Advocating for others to get paid less doesn't do me much good at all. The best that I can do is demonstrate the value of a properly trained family physician and help show people how to be successful in the field. I think that there's been a lot of devaluing of the family medicine profession lately. Straight out of residency, I'll be building up a full practice, working rural ED and managing patients in a nursing home... this is not the norm in family medicine right now, but it is something that all family doctors are trained to do. My focus should probably be on showing the provinces why we should be incentivizing properly trained family doctors to work hard. I know that this doesn't address your question directly, but I also understand that everyone's going to advocate for themselves and the government and the public will decide who they deem to be the most worth it in terms of taxpayer dollars

[@fashionfruit99]

I have more friends who are in FM migrating to the states.....with all of the new changes being implemented for Physician Assistant, Nurse Practioners, Pharmacisits ( as in inc scope of practice, work protocols, prescribing protocols, income) ..FM is difficult to sustain. Yes there are some of us who have a passion for family medicine, however the respect, job description, and overall work life balance is not appealing to many. On the other end, my other colleagues whom are specialists are content with living in Canada and work-life balance....day and night diff within the medical profession depending on what type of physician you are

[@lunan1810]

fascinating discussion! I always enjoy your videos! It seems like a common sentiment among pre-med students is the desire to pursue medicine to help others, rather than for financial gain. Yet, it's also important to acknowledge the need for doctors to be compensated well for their work. After all, many of us knowingly choose this path, so are we truly making sacrifices, or simply exercising our choices? This discussion prompts me to ponder whether those opting to practice in the US or abroad are motivated primarily by financial considerations or by the desire to make a difference in people's lives.

[@BbTenn]

It doesn’t have to be one or the other. There’s nothing wrong with wanting to be well-compensated for doing an unusually difficult job that most people cannot do.

[@lunan1810]

@@BbTenn This way, we can differentiate those who pursue medicine for genuine reasons from those who are not meant to be in the field and take spots away from truly compassionate applicants. Many are frustrated with med students or doctors who are in med for the wrong reason!

[@BbTenn]

@@lunan1810Wanting to be well-compensated doesn’t mean you’ll be a bad doctor, no more than being empathic ensures you’ll be a good one.

[@balinderkumar2200]

U r our mentor

[@Bobbybebe]

Hey great videos, keep it up!! I was wondering if you made a video about why you decided to pursue family medicine compared to other specialties

[@nxtgenmd]

Thank you very much :) I don't know if I've done a dedicated video on why I chose this specialty specifically, but it might be a great first video for me to get out week 1 of working as a staff physician in my office. I like generalist medicine, building longitudinal relationships with my patients and being about to provide preventative care. I hated surgery LOL - fair enough, they probably hate family medicine. There's something for everyone and I think that you can be very successful in family medicine if you do it correctly

[@mikescar2]

I am not an expert in this. But it should be noted that the USA taxes all capital gains, while Canada only taxes a certain % of capital gains. This tax change is taxing a higher number of capital gains, and it only really impacts people making a very high amount of investment income each year. Or to put it more simply, if you are paying the higher capital gains tax that is proposed, then chances are you are in the top 0.01% of Canadian earners, and therefore, you likely won't notice at all. So instead of paying tax on 50% of capital gains, you pay it on 67% of capital gains over $250,000. You are not paying 67% in tax. You paying tax on that amount. So if someone made $300,000 a year in the stock market, it amounts to an extra $4,400 a year. Sorry, but if $4,000 a year makes it enticing to move to the USA, then it is not taxes making one move.

[@rafihuddin-gd2zo]

Sir can help me please which university after 12class Bachlour Neurosurgeron degree program?

[@melannielang3446]

I am not a dr. I believe family dr should be paid more with all the work you guys do. As well things are going up in price your pay should go up as well. There a dr here in are area he delivers babies, put people to sleep during sugary and epidural, family dr as well work in the emergency room. I think that is crazy for one dr. There is times he falls asleep that scary. Are hospital over worked that one dr. Anyways my family and I think family dr should be better paid hands down. As well we could have dr come to more rural communities. If they get paid more We been thinking of moving to the usa. To actually have dr. What do you think on the province that are brining up dr pay like BC for example

[@CanadaMath]

46% income tax in Canada. Zero percent income tax in the Philippines . . . no that is not a typo. Zero percent.

[@MeMyPCandI]

If you are having a hard time affording food, Doc, maybe skip buying the hair gel.. needs versus luxury..

[@sistemasrbija]

Meanwhile surgeons and doctors from eastern europe are driving taxis and cleaning floors lol

[@alext7202]

Can a Canadian doctor work in Monaco?

[@nxtgenmd]

I have no idea, I've never looked into it unfortunately

[@mikescar2]

This is a complicated issue. The USA is so unequal, and doctors make way more there than doctors in almost any other country. This puts strain on Canada, being we are next door to the USA. It also brings up ethical issues, as many of the doctors in the USA perform services just to make more money, when it a test or service is not really needed. That is unethical to me. But from what I understand, Ontario doctors are the second highest paid after American doctors. And all the doctors I know seem to be doing very well in Canada. They live in the best neighborhoods in the city, in large homes, etc. They don't seem to be hurting. At some point, it just turns into greed, and if you have a good living here in Canada, and enjoy living here, then is making extra money, when you already make such a good income here, worth the move? Also, the higher taxes higher income individuals pay in Canada, help support much better public services and a more equal society in Canada. If I am lucky enough to be making such a high income that my taxes are higher, but supporting better overall public services and more just society. Then I will happily pay it. It comes down to what kind of society you would like to live in as well. When I lived in the USA, it was the only time period where I did not feel good paying my taxes. And that is because I did not feel my taxes went to funding good services, etc. It went to funding the bare minimum of service levels, and the divide between rich and poor was upsetting. Also, I read that the flow was actually reversed the last couple years, and more American doctors where coming to work in Canada than the other way around. Don't know if that is still happening. At the end of the day, it comes down to your values, what you want out of life, etc. But the USA is a huge outlier. We just happen to live next to it.

[@igor____]

The relationship between patients and physicians is based on humane concepts. And that's the way it should be. But there is a third party who is only interested in economic relations and profit without loss. That's it.

[@MegaFunnyvids4u1]

And funny enough, virtually none of them have MDs

[@igor____]

@@MegaFunnyvids4u1 Oddly enough they have both medical credentials and experience. But alas, no one needs them, except patients who wait 10 hours for emergency care. Or elective surgery for two years.

[@MegaFunnyvids4u1]

@@igor____ I am confident you don't understand the true woes of the medical field. Look up the vast difference between admin costs vs physician salaries over the past few decades so you're properly informed

[@igor____]

@@MegaFunnyvids4u1 I can see you're confident. I just don't understand what exactly? ) I'm saying that doctors study long hours, work hard and responsibly, sacrificing their families and personal lives. In the end, half of it is taken away from them by those who decide what they do and how they do it. We need to double the staff at a minimum to make care available, not squeeze everything out of those who work. But that's an added expense, isn't it?

[@MegaFunnyvids4u1]

@@igor____ I apologize, we're actually on the same page. As someone in medicine (where my confidence in this topic stems from), I wholeheartedly agree. My initial comment was referring to the fact that it's largely business admins who don't have medical knowledge that control, reap from, and abuse those who do (MDs). Your initial response confused me as putting the blame on physicians.

[@MeMyPCandI]

I love when rich people act and talk like they're working class.. except when it comes to Taxes.. awe shucks.. doctors finally paying taxes.. 😂

[@gourabsarker9552]

Sir what will be your new attending family medicine physician salary? Plz reply. Thanks a lot.

[@nxtgenmd]

Please refer to my previous videos about how much doctors earn. Thanks

[@Darkquark-u5]

They make on avg 180-200k minus 55-60% of that(which is abominably high income tax and now the capital gain tax, annnnddd the overhead of running a clinic, paying for staff etc. Most nurses and nurse practitioners earn about 70-140k the same as a family doctor after all things considered. A family doctor who has been in school for ages longer which has a much rigorous curriculum, then has to do the business side of things, and the pressure to single-handedly take on the failing Canadian healthcare system anddddd years of forgoing fun, family, etc. IT SUCKS BEING A FAMILY DOCTOR in Canada.

[@nxtgenmd]

@@Darkquark-u5 Hey Northstar :) Thanks for this - it is not easy being a family doctor, but I am not as pessimistic as other people on this front. You can do very well in family medicine if you are good at the business side. Many family doctors are not doing well though, and many clinics are closing down. I'm hopeful that I will be able to share tips on how to succeed in family medicine and make as much as specialists. I've done the math and it is possible. You need to work very hard and do things deliberately but I'm confident that that only way to get people into the field is to show them how to succeed. Upper range of family medicine salary is $500,000 + but this is a nuanced topic and most family doctors are not making this much money unfortunately

[@HR-sg7ug]

Are you still student or what? Without graduation you call yourself a doctor?