It’s Wednesday, which means Postcall is crackling into your morning like the comforting aroma of a KFC-saturated firelog.

(Yes, KFC made that. No, you can’t buy it, it was a limited edition.)

Did you know that today is X-Ray Day — also known as World Radiography Day? On Nov. 8, 1895, physicist Wilhelm Roentgen discovered mysterious rays while experimenting with electron beams. He didn’t know what the rays were, so he called them “X” — a placeholder. You’d think after 128 years, somebody would come up with a better name 🤷🏻‍♂️.

Here’s what we got this week:

• BC’s LFP model gets its report card 🧖‍♀

• ❤️‍🔥 We find out which ablation is best (for some afib)

• How a Baller solved the multiverse of doctor jobs 🪄 

• New study on whether virtual care helps divert patients from ED 🚑️ 

• 📱 Get a free iPhone 15 (somehow, not sponsored post 😲)

• Lonely Planet founder gives 5 travel tips learned over a lifetime 🛫 

Driving these numbers: Stocks kept climbing until Tues this week, ending the longest winning streak since January. While we hope for a soft landing, the Warren Buffett has some hard cash. US$157.2 billion to be exact, reported by his company Berkshire Hathaway.

BC GPs Get a Financial Glow Up 🧖‍♀ 

The results are in on the fresh pay model the BC government dropped for family medicine GPs, and spoiler alert: it’s zero to hero 🦸.

What happened: Last year, BC introduced the Longitudinal Family Physician model (LFP) to tackle the ongoing GP shortage in the province. In 2019 & 2020, BC's GPs were among Canada‘s lowest earners, averaging $308,399, before contributing 30-40% to overhead 💀).

The new compensation system factors in patient time, volume, case complexity, and office overhead costs. Under LFP, full-time GPs with a full panel of patients now earn at least $385,000. Gone are the days of the fixed $30-$40 per visit, whether the patient has a sniffle or a cloud growing out of their face. 

So how’s it all going?

Pretty good. “More than 3,800 family physicians have joined the model,” Health Minister Adrian Dix says. “It’s about 75 per cent of existing doctors.”

• A spokesperson for the Thompson Division of Family Practice says “Doctors were retiring and their patients were being orphaned. Now I see those, at least practices are being taken over.”

• Saskatchewan is also joining the trend, offering $20 million in one-time funding to GPs before transitioning to a blended capitalism payment model.

• Alberta's NDP leader, Rachel Notley, is pushing her province to consider a similar pay increase to keep their top-earning GPs, the highest-paid in the country.

Notley might not need to stress too much because, in a recent Halifax meeting, Canada's premiers pledged to support each other through collaboration and sharing innovative ideas. Premier Tim Houston said, Swiper, no swiping! ✋ to poaching healthcare workers from other Canadian jurisdictions. 

Yes but... It's still early so more data is needed for definitive conclusions on overall system impact. Some physicians are concerned it doesn't incentive day to day efficiency in FM clinics (meaning less patients get seen). At the same time, hospitalists may be pulled into primary care, leading to delays in hospital admissions (which are already a problem) in the short term.

Bottom line: It looks like BC’s pay model might become the new It-Girl of Canadian provinces, but whether others follow will remain to be seen. If you’re a BC GP, click here to see if the LFP model is right for you. — XOXO Gossip Girl💅.

This story was last updated on Nov. 9th, 2023 in the web edition to add additional POVs.

What patients might say this week 🙊 

1. “Did CRISPR get the green light?”

The CRISPR-based drug Exa-cel is safe for the treatment of sickle cell disease according to the FDA, representing the first-ever CRISPR-based therapy authorized for a genetic disease. Though currently pending approval, Exa-cel may become available as early as Dec. 2023. 

2. “Which ablation is best?”

A new trial published in NEJM has shown that pulsed field ablation is non-inferior to conventional thermal ablation in the treatment of paroxysmal atrial fibrillation. Pulsed-field ablation delivers microsecond high-voltage electrical fields, causing non-thermal irreversible electroporation and induction of cardiac cell death. Unlike other ablation strategies, it limits damage to tissues outside the myocardium. 

3. “It’s all in the wastewater.”

New wastewater data reveals that cocaine use is on the rise in cities like Montreal, Edmonton, Vancouver, and Toronto. This comes at a time when nearly half of accidental opioid deaths from 2020-2021 involved concomitant stimulant use.

Doctor Vollrath and the Multiverse of Doctor Jobs 🪄 

Every month we showcase a Baller physician. Doing cleft palate surgeries abroad? Baller. They started a sick side hustle? Baller. If you know of any Ballers in your life you want to nominate, let us know at [email protected].

Are you tired of using faceless social media groups to find career opportunities? So was Dr. Jordan Vollrath, a family physician from Alberta. But, unlike the rest of us, Jordan found his Infinity Stone — by founding Cherry Health, the growing platform for medical jobs. 🍒

What problem are you trying to solve with Cherry Health?

“When I was locuming, I found it really fragmented and all over the place, which caused a lot of administrative headaches. I wound up with some poorly administered clinics — one place took more than a year to actually pay me. You'd show up at some clinics and just sit on your hands for a week of not doing anything, because they didn't have any patients showing up.”

“So, we had the idea of a central medical network:

• Everything is standardized and easy to use, so it’s easy for an MOA (read: not a professional recruiter) to populate it.

• Every clinic profile and role has the details we doctors care about, like payment model, EHR software, and patient information.

• It’s free to post roles, search for jobs, and send messages back and forth.”

How did you start Cherry, and how do you balance it with medicine?

“My partner Max Kerz and I had the idea for the app. He came back in a week with the most impressive-looking Excel spreadsheet I'd ever seen in my whole life. We thought through the business model, and we did it part-time, a few hours a week at first, and it grew from there. Now I do about 1.5 days each week of medicine. The rest of the week is on Cherry.”

What advice would you give a doctor interested in building or starting their own business? 

“Find a good co-founder for the project. As a physician, chances are high that you were not trained in the skill sets of running a business (which is definitely the case for myself). So, I have a partner on that, who actually was well-versed and had a very complementary skill set. 

We were able to do a ton in a very short period of time, and I know I've seen several other physician entrepreneurs doing things alone and slowly. Don't be afraid to give up a slice of the pie if it grows the pie a whole lot faster.” 🥧

This interview has been edited for length and clarity. If you’re interested in learning more, check out Cherry Health. 🍒

🍔 Quick Bites

1: 🌰 Ontario will provide breast cancer screenings to those aged 40 and above — lowering the age from 50 — starting next fall. Health Minister Sylvia Jones said that the move will help with early detection, and an additional 130,000 mammograms will be completed in the province each year. (Note: People can already get regular mammograms and breast MRIs between the ages of 30 - 69 if they qualify as high risk.)

2: 🖥️ Virtual care clinics in Ontario had a limited impact on diverting patients from ER departments during the COVID-19 pandemic, a new CMAJ study shows.

3: 🇮🇱 Both Israel and the Hamas militants who control Gaza have rebuffed mounting international pressure for a ceasefire, even as the Gaza health ministry reports that at least 10,022 people in Gaza have been killed.

Taking the Pulse 🫀

Last Wednesday, family doctors across Canada voted strongly against a third year of training. At the CFPC AGM, more than 91% of the 2,775 physicians registered to vote approved a motion to "immediately cease the implementation of the third year in family practice program." Though the CFPC didn't commit to making changes, they agreed to "pause" the rollout. Hope they take it seriously this time 🤞.

Our readers echoed the CFPC members… 93% of Postcallers voted against the third year. (Interestingly, 17% voted for bringing back rotating internships/general licenses.)

Here’s what one Postcaller said about adding a third year of FM training:

Want to share your thoughts? Or have a personal experience to share? Email us at [email protected] and we'll include your anonymized comments in the next issue!

Postcall Picks ✅ 

💳️ Buy: Get the new 📱iPhone 15 or iPhone 15 Pro for FREE. How? Wealthsimple is running a promo: transfer $100K (or $200k for the 15 Pro) in assets to your WS account before Dec. 15, and they’ll send you an iPhone. You’ll just have to keep your assets with WS for a year. Get it here! (Conditions apply).

🛫 Travel: The founder of Lonely Planet, Tony Wheeler, has distilled 50 years of travelling into 5 major tips for you:

1. Always carry on. “Mishaps happen to even the most seasoned traveller, and you just have to roll with it.“

2. Travel for the people, not the politics. In Iran, “Diners would notice that he was eating alone and spoke English, and would invite him to join them at their table.”

3. Trust your research and instincts. “On a family trip in Guatemala City, the Wheelers set out at night in search of food. The streets were empty and unnerving. But the next morning, they discovered an entirely different city — vibrant, lively, safe.“

4. Explore “two streets over” from the main drag. “Everyone is in St. Mark’s Square,” he said (of Venice). “There are other parts of the city you can go to and find churches that are not crowded with tourists.”

5. Choose a train over a plane. “It was definitely a real change from 40 years ago.”

👀 Watch: Tired of scam callers pretending to be the Canada Revenue Agency, or some other organization trying to bamboozle you? Here’s how one YouTuber struck back (and saved an older woman from scammers who were destroying her life).

🕹️ Game ⛳️

First question: What is the act of delaying, or postponing tasks and responsibilities? (And no, the answer is not “playing Postcall’s weekly med-themed crossword puzzle.” 🤗 )

How’d you compare to last week’s two fastest times, 01:19 and 01:37?

Send the puzzle to your friends and co-workers! Or that uncle who watches Grey's Anatomy and claims he could do a tracheotomy. 🙄 

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