Cuts to Health Care in Ontario

Screen Shot 2014-03-23 at 8.21.06 PM

Happy at work delivering babes in Kenya – I absolutely love what I do!

Today I’m switching gears a bit – instead of my usual work/life/training discourse, I want to talk about the Ontario government’s proposed cuts to health care. For my newer readers, I’m set to graduate from medical school this May. For my out of province and international friends, here’s a quick run down of how health care is paid for:

In Canada, we have universal health care, which means that people can access clinics and hospitals for free, as long as the services they need are “medically necessary” (i.e. no free Botox here, sorry). Doctors bill the government a certain amount of money for each patient they see, based on how complex the patient is. Each province is responsible for its own doctors, and each has slightly different agreements that outline how much they pay for different services.

This year, the Ontario government has proposed a significant cutback of 5%  to healthcare spending, and as an “MD-to-be” I feel like this is really important to talk about. The Ontario Medical Association just accepted a 4% cutback in 2012, which is estimated to have saved the government more than $850M.

This article is a pretty good overview of what your family doctor bills when he or she sees you in the office in Ontario, and the costs associated with running that family practice. To summarize it here, quite bluntly, a doctor needs to see 4 patients per hour to cover the lowest average overhead of a clinic and earn a yearly salary of $138,000. This calculation was done assuming that the doctor takes 4 weeks of vacation and actually sees patients for 40 hours/week – it does not include lunch breaks, phone calls, reviewing labs/xrays, coordinating patient care, or any of the countless other things that I have to do in a day.

Now, I’m sure you’ve all been to see the doctor at some point in the last year. Would you be happy if she spent 15 minutes with you? What if you were elderly, with complex medical history and on lots of medications? What if you were struggling with mental health issues and needed someone to talk to? Suddenly, only spending 15 minutes with a patient seems ridiculous. Actually, I could argue that in some ways, it’s not safe.

So if I can’t see so many patients in a week, and my overhead is as low as possible, that leaves me with a decrease in my salary. I know that $138k is a lot of money, but I’d also like to look at what it took to get me there. In Ontario, you are required to do at least 3 years of undergraduate school before you can go to medical school (I did 4, but we’ll leave that last year out). The total cost of tuition was $7,000 per year ($21,000). I’ll also exclude textbooks, extra resources, exam fees and the cost of actually living. Then, I went to a three-year medical school (the fastest you can earn an MD in these parts). That cost me just under $75,000 in tuition alone. The program is full-time for three years, so there is no opportunity for summer work to offset these costs. I also paid for living expenses, transportation, textbooks, medical equipment, administrative fees, and parking, all of which were mandatory. I would estimate that the cost of my education thus far is in excess of $110,000 in textbooks and tuition alone. In fact, there is lots of data to support this: the average medical student graduating in Ontario carries $121,000 dollars in debt.

If this scares you, you’re not alone. Even banks, which traditionally provide market-rate lending to professional students, have noted that the fees to go to medical school are climbing faster than doctors’ salaries. In response, they have capped the amount of money they’re willing to lend to students, for fear of their inability to pay it back.

Setting aside the issue of the sheer monetary cost, let’s consider for a moment the personal cost required to become a physician. While my peers graduated from university and went on to find jobs, I had to relocate to continue to study. This delayed my earning, and separated me from my family and friends. Throughout medical school I have not been able to take vacation except for a few days over Christmas, so I have not been able to travel, relax or even sleep as much as the average adult. Going to university for 9 years (4 undergrad + 3 MD + 2 (minimum) residency) means that I have delayed any reasonable lifestyle or income by a decade.

Now, Ontario wants me to work overtime, rush my patients along, carry impossibly high debt, and somehow start a family/life 10 years late to the game, on a salary of $138,000 before taxes. No way.

For more commentary from medical students and residents about cuts, see this article. If you’d like to talk to your Ontario MP about cuts, please find the OMA’s advice about doing so here! Thanks so much for taking the time if you’ve read this far! If you’re curious about a much more complex overview of how physicians are paid in Ontario, you can tackle that issue here.

Training on the Road Part 3: Nutrition

California Chicken, Veggie, Avocado and Rice Bowls | halfbakedharvest.com

Getting my act together: Made this for dinner on Tuesday night after practice

Welp. I have struggled with nutrition so. so. much. while traveling these last few weeks. Good news: most of this criss-crossing the country will be done a week from tomorrow. Bad news: I’m not the best at when I’m at home, either. I talked about packing for training, and when/how to work out, so now I’m tackling the nutrition struggle.

On January 1st (how does that seem so long ago!?) I made a resolution to make better foodchoices. Working out a lot means that I can eat a lot of whatever I want and stay pretty much the same size. It doesn’t mean that I should do that, though.

So, what am I going to do? I think the first thing that stands out to me is that I didn’t attack this resolution with the organization or plan that I normally use. I just said, ok I’ll be better! And then proceeded to change, well, nothing.

So, stay tuned for another post that details my plans for nutrition. For now, here are a few of the roadblocks (no pun intended) I’ve encountered while traveling and how to be successful with your nutrition on the go.

IMG_2301

Roadblock 1: No healthy choices

If I had any spare time I would totally start a chain of healthy fast-food restaurants in places like hospitals and airports. Why can I get a burger+fries+pop as a “value meal” but a tiny cup of carrot sticks costs $5.99?

To combat this, I’ve been trying really hard to think ahead about where I’ll be all day and what my choices will be when I get there. If there’s no healthy ones, I bring my own. Usually this means carrying an extra bag with cut-up veggies, fruits, my favourite pumpkin bread of the moment, assorted bars, or turkey jerky. If I’ve been away from home for a few days, I’ve tried to find a grocery store to restock (thanks Whole Foods in Vancouver, for the awesome orange and grapefruit slices!)

IMG_2339

Roadblock 2: The meal is provided… and you don’t want to eat it

I talked a bit about how I’m traveling around for job interviews right now. These are usually at least half-day affairs, and the programs are kind enough to provide breakfast or lunch in most cases. Just in case I sound like a spoiled brat, I do want to say that I really appreciate the gesture. The only problem is that after 2-3 weeks of sandwiches with creamy sauces, pasta salads and doughnuts, I’m dying for a vegetable. Any one.

I really haven’t found a good solution here. Usually I pick at something small under the pretence of being nervous, which from a social perspective most people seem to think is reasonable. But practically? I’m almost never too nervous to eat and if it’s been more than 4 hours since breakfast I’m definitely hungry. So far, I’ve been eating larger breakfasts that have lots of protein to keep me full. The green blast smoothie with extra protein (above) from pure juice bar + kitchen in Waterloo is really awesome. I also keep snacks in the car so I can eat something right after I’m done. Not ideal, but it sort of works.

IMG_2249

The best PB cup ever. And Amazon delivers them right to my doorstep…

Roadblocks 3 + 4: Jet lag/scheduling/missing meals & accountability

For those of you who know me in real life, it’s pretty clear that I would never forget to eat. But I definitely get too busy to eat, and my body absolutely feels best when I’m on my normal schedule.

Combine weird scheduling with the fact that I also love treats (I just can’t help it sometimes!) and my meals are way off. I think that balancing macronutrients is really important for weight management, energy levels, and body composition. Personally, I am for a 50/20/30 breakdown for carbs/fat/protein. It is HARD to get that protein in for a carb lover like me :)

My answer for this one is myfitnesspal. Tracking my meals reminds me that I’ve already had too much sugar for the day, and the app encourages me when I log foods that contribute to my goals. I also get pop-ups on my phone when I haven’t logged a meal.

That’s all I’ve got, kids. Planning ahead, protein, protein, protein and tracking my eats. What are your strategies? I need all the help I can get!

Week 4 of Training

FullSizeRender-1

I’m loving my Believe training journal from the awesome Oiselle!

Hey chickies! It’s hard to believe week 4 is already over, but I really didn’t get much training in. I’m happy with some nutrition progress though! I’ve also been thinking about some early targets for race times, which I hope to share soon. Here’s a quick breakdown of this week:

Wednesday: 5 mile treadmill run at the hotel in Winnipeg. It was in the pool area, and so unbelievably hot. Definitely rode the strugglebus on this one.

Thursday: Snuck in a treadmill run at the Goodlife in the YYZ airport! 3.1 miles @ 7:42 min/mi. I was super happy to be able to squeeze in this short run.

Friday: Run on an ancient treadmill at the hotel in Vancouver… there was no distance marker but the Garmin said 2.7 mi? I only had ~20 min to run so maybe that’s about right.

Saturday: Red eye from Vancouver + morning interview + longggg afternoon nap = no workout! Rest day :)

Sunday: Back in Aurora for a gently hilly and cold but perfectly sunny 10 mi at 8:30 min/mi average pace. I felt awesome other than some pain in my ankles. Could have pushed harder but just enjoyed a longer run.

FullSizeRender

 Late night treddy run – 5 sweaty but feel-good miles

Monday: Still having ankle pain on the right side but had a great treadmill progression run (7.2 –> 8.0 mph) for 5 mi at 7:53 min/mi average pace.

Tuesday: I’m not working/interviewing/traveling today, so I’m taking the chance to catch up on errands/groceries, and get some good training in. I’ll be doing a recovery run this morning, and then a swim/run brick with the Koalas tonight. Hoping for a total of 8 mi and 2000 m.

Total: 33.8 mi running + 2000 m swim. I’ll take it!

How did your week go? Did you get some good miles in?

Weekend Notes

Screen Shot 2015-01-25 at 11.42.02 PM

Today was my first interview and travel-free day this week, and it. was. blissful. I woke up sinfully late at 10.30, did a bit of laundry and repacked while snacking for breakfast. Then, I picked up a coffee and drove to my parents’ place in Aurora.

When I got here, it was -10 deg but beautifully clear and sunny, so I bundled up and headed out for my long run. It was really good to be back outside, and I like running long because it lets me get into my thoughts. 10 mi later, I felt great.

In the evening we celebrated my cousin’s confirmation with tapas-style sliders, mac and cheese, and other snacks. Definitely a fun way to refuel!

While I’ve been on the go this week, here are a few things I’ve been reading, in case you’re interested…

Love these ideas for a healthy dinner – mixed bowls are my fave.

I’ve been thinking lots about nutrition (detailed post to come)

Lena Dunham’s book Not That Kind of Girl. My favourite line: “there is a certain grace that comes with having your heart broken”. Amen to that.

I kind of felt like this was obvious, but it’s nice that it’s out there.

Also: watching GIRLS (I can’t get enough. This show speaks to me on so many levels!) and – guilty pleasure – Scandal :)

What are you up to?

Training on the Road Part 2: Workouts

You planned, you packed, and somehow you’ve arrived in one piece. Great! Now, all you have to do is figure out what your workout’s going to be, where you’re gonna do it, and how you’re going to fit it in. Yikes.

IMG_2311

On the schedule: long ride. What I did: not a long ride :)

Over these past few days, I’ve tried really hard not to beat myself up about missed workouts – and I did miss just about every one of the workouts that were planned. I did manage to do a quick run + abs most days, so I think that brings me to my first point:

1. Do what you can

Obviously while traveling you won’t have the time or equipment to do everything you normally would – I think that’s ok. You need to be realistic about how much you’re planing to travel and what that will mean for your training goals.

IMG_2309

5 mi – thanks Goodlife YYZ!

2. Upgrade your memberships

Lots of popular gyms, like Goodlife, where you might already have a membership, have plans that allow you to use any gym in the country. I asked about this and was given a few weeks at a nominal cost. It allowed me to sneak in a quick run at the airport Goodlife while waiting for a delayed flight – that’s 5 more miles than I would have done otherwise!


IMG_1923IMG_1942

Beautiful views while running with the Kitsilano Running Room ladies

3. Use free trials + community groups

Local run groups in Vancouver were a total lifesaver! By the time I was done with work and itching to run, it was dark out. Combine that with not knowing the city, and I was a bit wary of going for a run. The running room has free Run Club community runs every Wednesday and Sunday – this is an awesome way to run safely, meet other runners and get to know the city!

Similarly, I was able to take advantage of classes at spin and yoga studios by using a free trial. Since I was only going to be in the city for a day or two, I could just go to a different class every day. This just takes a little googling ahead of time.

Screen Shot 2015-01-23 at 9.32.12 PM

Click the photo to download these workouts from Women’s Health. They have an app too!

4. Tearaway cards

You know those little workout cards that come in magazines like Self or Women’s Health? Keep a stack of them in a small ziplock baggie. They’re often designed to use body resistance only, and I’ve found that you can get a really good strength workout in that way!

5. Make friends with youtube

Of course, if your hotel has wi-fi, your options for workout videos are pretty endless. Some of my favourites are here, here and here!

That’s all I’ve got :). 

How do you fit in workouts on the go? 

Training on the Road Part 1: Packing

Hello! It’s pretty fitting that I’m writing about packing light while sitting in the tiny island airport in Victoria. The airfield is sunny and there are lots of little prop planes scattered around, one of which is supposedly going to bring me to Vancouver in an hour :).

Screen Shot 2015-01-21 at 9.54.35 AM

The first challenge I faced when thinking about fitting in training on this trip was definitely packing. Bringing anything more than a carry-on bag was out of the question, but I’m also a chronic over packer.

IMG_3289

5 weeks into a backpacking trip, I’m about to tip over!

Over the years of travelling, I’ve gotten better at figuring out how to do it lightly. I don’t love the idea of rolling my clothes (I find they wrinkle!) but I have come up with a few tricks of my own.

Tip 1: Plan ahead

I always, always make a list of things I need to pack before I travel. This means I almost never forget things, and also that I now have a bunch of pre-made packing lists ready for different types of trips! For example, I have beach, cottage, camping, business and sightseeing lists that have been made and edited over the years. Sometimes I also gave these to the guys I dated to make sure they would remember everything too :).

IMG_2068.JPGIMG_1167.JPG

 

 

 

 

 

 

 

 

Once I know what I need to bring, I plan the details of the outfits. If I’m packing, it’s totally normal for me to have outfits scattered everywhere! When I pack by outfit, I’m sure that I have something to wear for each event I have planned. I do this for simpler things, like races and 24-hour call shifts as well.

IMG_1116.JPG IMG_0405.JPG

The key ideas here are:

  1. Reuse pieces. The same pair of jeans, or shoes for example, goes a long way! The more space you save here, the more you have later!
  2. Modify your destination if you can – I only book hotels with some kind of fitness centre, which means there’s almost always a spin bike or treadmill I can use
  3. Ziploc baggies! These are awesome for sweaty workout gear or dirty laundry. I just pop it in, squeeze all the air out and zip! Instant space saver. I’ve also used these to separate outfits when I’m packing a giant backpack. The freezer baggies easily fit a pair of shorts, tee, accessories and underwear.

Tip 2: If you can, keep it simple

Packing as a girl is complicated. Every outfit seems to have different shoe, outerwear and underwear requirements. Add the fact that I’m always cold and need a million layers, and the pile grows quickly. So, I’ve learned to cut corners, especially when it comes to workout gear. My go-to list is 1 pair of running shorts, 1 pair of running tights, a sports bra, a tank, a long sleeve top, and my bendiest, most easily packable racing flats (I’m obsessed with my Saucony FastTwitch 6’s) . I also bring the standard garmin, HRM, and headphones. But that’s it, I mean it. When I’m taking short trips, I don’t bring swim stuff, sport glasses, extra hair stuff, or anything else. I usually run without socks, so those are out too :).

For workouts, that leaves me with one outdoor outfit, one indoor outfit, and the associated technology. How does that get me through 3 weeks? These babies! When I finish a workout, I toss my sweaty clothes in the hotel sink, add some detergent, rinse and hang them up! The next day we’re good to go again.

Tip 3: Leave some wiggle room

IMG_0815

#jesustakethewheel

Sometimes, you plan outfits, reuse what you can and still have too much stuff. In that case, I always force myself to take something out. I know that when I’m frantically packing to catch another flight or tired and ready to come home, I’m not going to want to try to overstuff my suitcase.

And that’s it! Make a list, plan simply, prepare to reuse things and be realistic!

Where are you heading next? Any tips for packing light?

Training for Worlds Week 3: An Adventure in Adaptability

c570159287276f88c7fbba5621dd9706

What a week. I finished my time on ICU and travelled a bunch, so suffice it to say that my workouts did NOT go according to plan. That’s ok, though. I’ve learned that sometimes life gets in the way a bit and I try not to freak out about it.

Honestly, though? Sometimes I think I could write a book about this craziness :).

Wednesday: Went out for dinner with a few of the residents after a late night at work. Got home around 10 and squeezed in a 30 min HIIT workout on the bike. Attempted a 5k treadmill run afterwards but was too tired. Total: 30 min on the bike, 10 min on treadmill.

Thursday: Worked late and packed – no workout!

Friday: Surprise! I needed an emergency root canal. I got on a plane right after and when the cabin pressure changed after takeoff, I had the worst pain I have ever felt in my life. No joke, it took 2 tylenol3 and 2 extra strength advil for me to get it under control. No workout.

Saturday: 6 km run on the hotel treadmill + abs in Vancouver, BC

Sunday: Finally a nice 14 km run on the Galloping Goose and Lochside trails in Victoria, BC

Monday: First flight out cancelled, so it was super late by the time I was settled. Rest day!

Tuesday: 7 km on the hotel treadmill in Edmonton, AB and a quick ab set at the hotel in Winnipeg, MB.

I’m not going to add up the volumes this week, because let’s be honest, with this much traveling it’s nowhere near what it needs to be. Just going to keep trucking and doing what I can!

As always, you can follow along on Strava if you’d like:)