Thank you for that excellent question.
As a practitioner of family medicine, you can have an enhanced practice. You don't have to go back to medical school, but rather undertake a two to three month-long practicum, and then be supervised by your peers, i.e., doctors who do this type of work, for a three-month period. After these two three-month periods, a doctor is able to practise in a different area than family medicine.
I also have my own practice. My pager does not buzz at 2:00 a.m. for my practice patients. They are not hemorrhaging, they are not choking and they are not crying out in pain at 2:00 a.m. They are in a very stable condition and suffer much less, overall. I would say that it's almost a hospital practice in a home setting.
When we work at the hospital, we are woken up at night for our patients who have been hospitalized. The same thing goes for home-based palliative care. I really want to underscore this point: patients whose condition is unstable and who need complex medical care need to have a doctor on call 24 hours a day, otherwise they will just keep on going to the ER.
I would like once again to say thank you to Dr. Downar. This is the biggest medical crisis the health care system is facing everywhere in Canada.
If only you knew, Dr. Downar, how much worse it is in the province of Quebec.
Our statistics on deaths in the home show this, because we only have 12% of deaths taking place in the home. It is a very low percentage, compared to what we see elsewhere in Canada, which is 30%.