It was a good feeling to reach page 11 of the 22 pages of text as I sit here just before dinner. Perhaps a couple more pages later. The families were quite large in the 1800s and into the 1900s. Interesting really; I do not know the sociology of the peoples of the British Isles so no ideas on why the families were consistently so large. Coming from a family of nine myself in the mid 1900s I suppose I shouldn't be that surprised but it was not really common to have large families by the mid 1900s. I did write my life story for my children.
I tried to get Edward to write his Life Story the last few years of his life and finally the last winter he sat with me and I typed what he told me. I need to work on that and will but I think I need space before I do that to think about what he told me. I knew him from the time he was 22 years of age until he was nearly 78 when he died so a good portion of his life but twenty two years of childhood is a long time although his mother used to tell me stories about him and I need time to think about that and write it all down.
I was surprised to see Alberta give Nurse Practitioners the ability to set up a clinic though. I think my thought of having all the Medical Students do the second year of Family Medicine and then work for two years as Family Medicine Practitioners before returning to do their chosen residency and keep that up for even a decade or two would quickly alleviate the problem of not enough Family Doctors especially as the number being trained is increasing. It is the same argument that I used for not having pharmacists do more than extending prescriptions that are commonly used by a patient to take that strain off the family doctor's office. I do not think having them consult beyond the side-effects of drugs is a good idea. A Nurse Practitioner has had more training of course but still they have not had the in-depth clinical training that a Family Doctor receives. I do not think it is a good step actually. You often have Nurse Practitioners working in a Family Medicine Clinics here in Ontario which is a great idea especially for new mothers, teenagers and seniors who just need more instruction or assistance than is available in the short appointment with Family Doctors.
I did send my idea off to the Premier here in Ontario and received a reply. I also forwarded it to Health Canada because I am on a Stakeholder group there. If there was good discussion through the winter I think they could start this fall and just have all the PGY1s go into PGY2 as Family Medicine residents since the rotations are primarily in the offices of Physicians and in the Cities where there is a shortage of Family Medicine it would be a bonus to getting more people into the office and fewer people going to Emergency. Initially I thought that three to five years of working as Family Medicine Specialists would be needed to bring down the number of patients without a family doctor but I did some tabulations and came up with two years as making a good difference and you would keep having those two years for quite a while and then they return to do their residency for which they have already been selected as that is ongoing now. If any Residency Programs absolutely have to have an entrant then they could simply pick the individual that they feel they need but I think it would mostly be Toronto that would find that to be an absolute necessity. There isn't always a new intake each year into every Residency Program except for the global ones like Internal Medicine which then lead to other specialties. It would put more pressure on the current teaching staff and residents to carry a heavier load but I suspect they are up to it; to help to expand the system until the larger Medical School classes produces more Family Physician Specialists. It is by far the best specialty in that it deals with the entire body and if our Family Physicians only had more time I am sure they could provide a lot of interesting papers for journals on the cases that they see.
I was the Administrative Assistant for a Residency Program for a few years and it is the regular rounds looking at patients, discussing their care, recognizing particular manifestations of disease and I was in hematopathology so working together with the physician reviewing the laboratory results with all that feedback. It is an essential part of training that a Nurse Practitioner does not receive like these residents do. It is so very important really; I think it is not responsible to provide anything but the best care that we have available at all times.
There was an article the other day mentioning that some Family Physicians would come back into the system and perhaps they could take on a supervisory role.
On to the 12th Generation and perhaps tomorrow will see me complete it; I am ever hopeful.. I think perhaps it is amazing that I have never been in Court (except one time I was called for Jury Duty but not selected to even go in for the selection in the court room). I have never sued anyone; I have not been sued. I have never been a witness. Maybe there are a lot of people like me but most people I have met have been in court at least once.
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