Car chases, gun fights, moonlight romance, and riveting drama are all things you won't find in this episode! However, you will find important information regarding Bill-36 in B.C. How will it affect healthcare providers? How will it affect the public? Find out now on the Recovery Machine Podcast!

#bill36 #healthprofessionsbc #drugaddiction #drugpolicy

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Welcome everybody to Recovery Machine.

I'm your co-host, Nathan.

Join as always by my co-host and your co-host.

Corey, how you doing, Corey?

Hey, I'm doing

all.

How are you doing?

Good.

Uh, I don't know.

I, I don't feel very good today.

I'm filled with anger.

Mm-hmm.

, and, uh, I've been doing good with anger for a while, so it's, I'm

just trying to, uh, let it be and kind of examine it from an, uh, an

observer's point of view if possible.

That something I've been working on with meditation is to try to step back

and, uh, just really look at my thoughts as they come along, and then kind of

from a point of kindness, examine them and take them for what they are and

then learn from them as they come by.

But, ever since yesterday.

I, I felt very locked into my body and, uh, unable to step back.

And then I realized that there's an interesting thing happening there

where the more frustrated I become with the world in general, and

that's partly to do with, I think, researching the topic that we mm-hmm.

researching here.

Mm-hmm.

, but that frustration tends to, uh, accumulate.

And then I become, I have this kind of smoldering like, uh,

anger I guess, and, uh mm-hmm.

what it wa what it makes me want to do is use drugs.

It's, uh, it's interesting how it, it's such a clear path from

fear, anger, and then hopelessness, and then from hopelessness to

like, just fuck it, you know?

Yeah.

And.

Yeah.

I mean, it's not, I'm not the type of guy, I don't believe I'm at the

point in my life where even if I did go and use a whole bunch of drugs, I

could probably get myself out of it.

Uh, that's not, I don't think it's ever healthy to try to use

drugs to, it's, I feel the same way about any kind of behavior.

But I mean, same with drinking, right?

There's a difference between celebrating and, uh, trying to escape your problems.

Mm-hmm.

. And, uh, that's what I feel like doing.

I've put myself in a position where I don't have access to.

Um, those things are not easy to obtain.

At least they're not at arms, within arms reach.

And that's kind of the best thing.

I think.

Um, it might be, might be trouble for me to have those things just laying

around when I'm feeling like this, but it is a, it's something to pay

attention to, I think if, mm-hmm.

you are a person who has had problems with drugs in the past, such as myself,

and I believe you as well, Corey.

. Corey: Yeah.

You know, it's, it's such a, I can relate to how you feel in the last 24 hours

and it, it, it's not the first time with either with you or with other friends.

I have where once you kind of say it, you realize that

you're on the same wavelength,

And that's one of the cool things about saying it.

That's one of the benefits of saying it, is that you, you are vulnerable

and then you end up usually, hopefully learning about other people.

And, and it lets other people share that too, because I have had sort

of similar feelings and it's just been, uh, specifically just some

stress over, over, uh, childcare of my four-year-old and stuff.

That's not about me.

Nothing that I kind of, it's not a personal thing, it's just sort of.

The approach of the school and kind of what to do next about it and what the

next steps will be, and not liking the, their delivery of that information and

created a lot of, a lot of stress in me.

A lot of like stressful thinking about like the uncertainty and, and feeling some

distrust there, feeling some angst there.

But what I really noticed in myself, and this has been over the last little

while, is that I always used to describe, like, my reaction to tension and stress

as being in my chest and being in like, you know, the center of my body.

More, what I noticed lately is that it's much more in my head.

Hmm.

But that, that feeling of stress is much more like, feels like, um, not a, not a

conventional headache, but it feels like an actual cloud or obstruction within my.

Interesting.

Which is not a good feeling.

. No.

Is it clouding your ability to think coherently?

Like does it feel like brain fog or does it just feel like a, uh, type

of, uh, angst, like a mental angst?

Uh, I would

say, well, I, I would say both.

Both brain fog, um, in that it's like I feel locked into like a,

a pretty negative perspective.

Yeah.

Um, and unable to kind of like, and I, and maybe there's part of that

is the solution is that you can't necessarily think your way out of

it.

No.

No.

You can't.

Sometimes there's a limit to the intellect

and part of that is that you have to kind of, uh, sometimes feel your way

out of it or physically work your way out of it, or express your way out of it.

But it won't necessarily come with like a physical, like, uh,

with just like a cognitive, okay.

I just gotta think this through.

Yeah.

Cause that, at least for me

yesterday, that wasn't working.

It's really interesting that you say that because I, I was just, last

night I was considering cognitive behavioral therapy and Me too.

What a useful tool it is.

Mm-hmm.

. And yet it is limited in that, I think, uh, it's almost a trap to

believe that you can think your way out of this problem entirely.

Yeah.

And, and by this problem, I mean, negative thinking in general, or this

feeling of, uh, kind of angst or, you know, the human condition where you

extend yourself out into the future and, and feel anxious about that.

You can do the brain training with those pathways and that's fine, but it's the,

at some point you've gotta look at that kind of, uh, thought behavior, emotion

cycle and step back and just be okay with not knowing what's gonna happen and

realize that you're not in control of.

, even those things all the time, and you just can't be mm-hmm.

and that's okay.

Mm-hmm.

. Mm-hmm.

. So that's what I believe is the, is the answer is taking like a, almost like a

blind faith approach to it and stepping back and realizing that if you acknowledge

the feelings that are happening, whatever it is in your life that are

causing those feelings, then eventually some grace will appear and you'll

kind of be able to get back on track.

Mm-hmm.

, but it requires a faith in the system of this reality or, or whatever God

you believe in, or, or, you know, some kind of, uh, spiritual faith of some

sort, I think, to, to do that, right?

Mm-hmm.

, Corey: and then it, it's like the old

that I've heard from people in, in the community and have experienced myself.

It's one thing to do those pieces of maintenance when you're feeling

okay, but pulling yourself through that fog or congestion or whatever

you wanna call it, and saying, okay, now I'm gonna do that maintenance.

Now I'm gonna go and lift weights for an hour, or I'm gonna just scribble

out some piece of art to just see what comes out and like pushing

through and doing those things.

This is the critical time to, to put that into practice.

And so I, it is, you know, last week I did, I had had a really good week with

getting back into some weight lifting and doing some, working out at home and stuff.

And then yesterday we ended up being too busy of a day.

As you know, the day sort of got away from me, but like, I've got

time today gonna make that happen.

Cuz now's the time to really put that into practice.

Yeah.

Yeah.

It's always, uh, yeah, I've, I've noticed that especially with like, I,

I have the most resistance to doing, uh, like cardio training cuz it's,

I think mentally it's harder, right?

Mm-hmm.

. Mm-hmm.

, um, , and it's always when I'm like, you know what?

I don't even think I can do it.

I feel too, I'm too tired.

I, I just, you know, I'd rather take a nap or whatever.

But that is exactly the time when I need to get out there and run or, or do

something that gets a blood because it, it is, uh, you're right, it's tough when

you, uh, you try to apply these things when things are not as bright and cheery

and I don't know, maybe it's, uh, I'm finding this time of year, I, I know it's

a, you know, we talk about it a lot or whatever, but I, I really thought that,

that January had like 45 or 50 days in it.

Yeah, . It was the longest January on record for me.

I mean, it was just like, I, I, what am I in a time dilation here?

I don't understand what's going on.

It's on and on and on.

But here we are, . Yeah,

no, it's so true.

I had the same thought about it.

Like, uh, in looking at our kind of tracking the, some of the

podcasts from the month of January and then being like, oh my God,

we got 10 days left in this month.

Yeah, . We still have five days left in the month.

Yeah, no, it's true.

Yeah, I think that's probably a fairly common experience, right.

for sure.

Yeah.

Good opportunity to thank all our new listeners as well.

We've, uh, definitely got a little more traction now on the audio side, and we're

starting to see some, uh, some solid data as far as, uh, lots of shares going

on, on, on Facebook and stuff like that.

Mm-hmm.

that is, uh, really appreciated and it, it definitely encourag us, encourages

us to, uh, continue what we're doing.

Even the people who, who aren't happy with some of the things we're saying, we are

fine with that because we make mistakes and, uh, we have different ideas about

different things in the world of recovery.

And, uh, so do other people and that's all fine.

We're here to, we're here to

learn.

Totally.

And I might be wrong, but I think that today's topic might

be a, a divisive topic as well.

Nathan . Well, it's an interesting one.

What we're gonna do today is talk about Bill 36.

This was a bill that was passed quietly last year.

They've been working on it, I think as far back as, I suppose you

could say, maybe 2018 or earlier.

Mm-hmm.

. And, uh, what the bill is about is basically regulating the regulators.

Yeah.

So we're talking about colleges for healthcare professionals

in British Columbia.

So there's, I think, 20 in existence, uh, 25 potentials, something like that.

And these are bodies that are self-governed.

So like, uh, using my own college as an example, the College of Pharmacists,

they're tasked with basically licensing pharmacies, licensing pharmacists.

They make acts and guidelines for us to follow as far as

practice policies concerned.

Their number one mandate is to protect the public.

So I guess what the, what the idea is here is that they're,

they're looking to modernize the, uh, health Professionals Act.

So it'll be the Health Professionals and Occupations Act.

and there's a few stages that took place over the last few years where

they gathered information to do this, uh, to move forward with this.

So I think it was November 24th last year, it, uh, received royal

ascension, which is, uh, that's pretty, that's pretty heady governmental,

uh, verbiage there, uh, royal asce.

So that means it became a, uh, became an act, and then we're waiting to

hear there's gonna be a date of implement, uh, implementation for this.

So it, it's going to affect every healthcare professional in British

Columbia in some way, shape, or form.

We've both looked at this and we've kind of, uh, just to get a better understanding

of how the, the bill came about, how it got passed, what the province is

trying to do, and ultimately how we're looking at it from a, uh, healthcare

professional point of view, just because obviously that's where our experience

lies, but there's also concerns with the way, the way this is tilted and,

uh, that might be a point of contention, but we'll, we'll kind of move through

it and, and go for some pros and cons and see what everybody thinks about it.

Yeah.

You know,

this is, the timing of, of this, of us doing this

discussion is so interesting.

I, I live in the Fraser Valley and there are two spots within

my daily drives that I take that have been over the last two years.

A year and a half maybe have been consistently, uh, labeled with graffiti.

And the, the graffiti is, is consistently anti anti-government, anti-vaccine,

primarily anti-vaccine, I would say in these two different spots on my

drive that i'll, and usually some poetic message about the harm of

the vaccines and stuff like that.

And interestingly, this week, those pieces of graffiti have

been replaced with large antibi,

36 graffiti . Wow.

And this

morning, you know, there was a, probably a, a 10 foot long

strip in this entryway into the city that, you know, stopped Bill

36 with a big skulling crossbones.

So kind of interesting, this to me that says this is such a politically

loaded, divisive issue much more.

I mean, it's much more than meets the eye.

And it's mu it's so much about the politics in Canada right now, the politics

of healthcare and the influence of politics on that than just like, , oh,

we gotta clean up these regulators.

So, and this is where the, the discussion I think in, in social media and stuff

will probably come in and we welcome that.

But I think we want to just sort of be, we have, you and I have our

own, it is no shock or surprise that we are not necessarily

friends of the regulators mm-hmm.

Yeah.

On this podcast that we've been very critical of, of these,

some of these regulatory bodies.

Yeah.

And have, and have said before this bill passed that we want to see

changes and want to see reform.

But that doesn't mean we're not gonna pick this apart and let the

government off easy with this either.

Cuz I think it, there's both sides to this for sure.

Yeah.

Yeah.

Absolutely.

Uh, , I've been, I don't know how many, it probably, when they started looking into

this was probably when I really started reaching out across Canada, trying to

understand who was in charge of these, these colleges and, and what possible

ramifications or reprimands they could.

Receive from, uh, some sort of an oversight body.

And I was told that there really wasn't anything in place but

that something was coming.

So that was, I think, as far back as 2020.

And since that time, I've heard, I've, I've been in contact with people

who were closer to these regulatory affairs and, and they kind of echoed

that same belief that, that something was coming and it was probably gonna

be bad news for some of the colleges.

Mm-hmm.

, whether this Bill 36 Health Professionals and Occupations Act is bad news.

I think it will, it will depend very much on how this is rolled out.

So I guess what got this going is, uh, public criticisms mainly about,

this is hard to understand from a, a healthcare professional's point of view.

Believe me, it's.

if you're on the ground and the amount of flack you receive for every complaint that

is valid, it's difficult to calculate.

Mm-hmm.

, I mean, people are wild and they're especially wild when they're sick,

hurting, or have been waiting for a long time or just found out they

have to pay for something they don't think they have, they should pay for.

So . Nevertheless, the belief is that the current colleges, uh, under

the Health Professions Act, has enabled cultures that can sometimes

promote the interests of professions over the interests of the public.

What do you think when you, when you hear that as a, uh, a motivator for this bill?

I see a lot of

truth in that statement.

I think there is a, a, what comes across as a, uh, first

of all, a lack of transparency.

, Nathan: there's a huge

Yeah.

Which there's several parts of this, of this document that get

into that peaceable transparency.

I think that there's a self-serving nature that it comes across and, and in

thinking about my own experience with, with dealing with the regulatory body,

that it was, that they were protecting the profession to the utmost and then

protecting the public, protecting me was not a, even though I was a part of the

profession that wasn't their interest.

And that's okay.

That's not their mandate.

Yeah.

But I think it, it certainly fe felt that the protection of the image of

the profession and then interests of the profession were first, and then the

piece about protecting the public was second at the time that I went through

that.

Yeah.

That's a, that's a really good way to parse this out because.

I think it's, it's hard for me when I look at this and, and I see the idea that, uh,

the interest of the profession is coming.

First.

I, when I, when I read that, at first I look at it and I say, well, you're

talking about the interests of the people who are in the profession.

But that's, that's not really what it is.

No.

That the colleges don't, I, I, as far as my dealings with the, the College

of Pharmacy are concerned, I am simply a statistic that spits out money.

That's it.

That's all I am to them.

Mm-hmm.

, they know how many there are of me, , and they collect a tremendous amount of fees.

And for that money, you get very little and they're at no time in my career

have I ever felt that my college was there to protect me as a professional.

No, never.

No, no.

Same.

Quite the opposite.

But the idea that they want to protect the image of the profession so that

they can continue to exist as an entity, that feeling is palpable.

Yeah.

, and I can only speak towards a, I, I mean, I've had dealings with, uh, you know,

mostly the, the College of Pharmacy, but also a lot with the, um, the College of

Nurses and, and midwives, and not so much with the College of Physicians, although

I do pay attention to what goes on there.

And I think they could maybe take a little bit of blame for some of this

, uh, especially with their, uh, wildly inappropriate judgment on the conflict

of interest scenario with monitoring, backing up the, the clinic down at the

coast there, that was, it was an obvious conflict of interest the way they had

their, their clinic set up there, and the public did complain about that and

the college backed them up, so, mm-hmm.

So if you are not prepared to do what you're supposed to do, which is

regulate your members in a way that is ethically sound, then you can

expect to have some concern raised.

Maybe that's indicative of, of some of the types of actions that have

led the province down this path.

. Yeah.

One of the things they're gonna do here is Amal amalgamate colleges.

Mm-hmm.

. So they want to bring the, well, the total number of, uh, professional disciplines

is 25 in this province, and they're going to make six colleges outta that.

Yeah.

So they'll be regulating some professions that were not regulated,

and then there'll be amalgamating.

Uh, there's two big amalgamations, and then they're also

grouped everybody together.

And I guess, uh, we, we can look at that a little bit closer in a bit here.

But the other concern they had is that the colleges are not meeting changing

patient and family expectations regarding transparency and accountability.

. And finally they just used the word inefficient.

Mm-hmm.

and, uh, the inefficient one is, is at a level now where I

would say it is not sustainable.

I just looked at the College of Pharmacists financials for 2021.

They take in over 10 million a year, but they have less than a hundred members.

Mm-hmm.

, there's a less than a hundred people working there, but they're

taking in 10 million in just fees.

Yeah.

So you do the math on that and you look at, uh, they have their building lease

there, they have their investments, they have everything on there.

And it's like, that means that every single person, regardless

of whether you're a receptionist or uh, the c e o, every person is

making much more than a pharmacist.

Yes.

What's the justification for that?

Yeah.

I, what are they doing?

You know, why are we.

, why would a, uh, college registrant pay them for the

services that we're receiving?

If it's the public that they're mandated to protect, then

let the public pay for them.

Yeah.

You know, if you're gonna be that wildly inefficient, then guess what?

Maybe the government's gonna come in and, and, uh, police you.

That's mm-hmm.

, that's kind of, I, I like, I, I understand why there would be concerns.

Right?

Sure.

And the same thing has happened within nursing is that those fees

have went up and up and up every year.

They amalgamated with the midwives prior to this bill

amalgamated with practical nurses.

They have, you know, there's over 40,000 registered nurses in the province.

Um, 50, 59,000 members now in that, in that thousand members.

Yeah.

So, yeah, I mean, they are taking in a large sum of money.

That is way over and above.

Like, I don't know how much union dues are in comparison, but I can't

imagine that they're that much.

One of the things I, I thought when looking at this new bill is that if

these colleges are amalgamated and you end up with, you know, instead

of six different colleges, say four, like the naturopaths, uh, Chinese

herbal medicine acupuncturists, can't remember, there's a few that are being,

uh, put into like a natural Yeah.

Healthcare group psychologist.

What's another one?

Yeah.

So if, if everybody goes into this, this group, and they're talking about

streamlining the process, when I hear the word streamlining from a government,

uh, body, I, I mean there's a little bit of cynicism that automatically

comes up there, but let's say they do what they're gonna, they say they're

gonna do, and instead of, uh, a combination of maybe 200 members over

six colleges, they get it down to 50.

So the vast majority of the money and dollars you are spending in

fees, when those go to the college is for those people's salaries.

It dwarfs everything else by, it's, it probably 90% of

their expenses is salaries.

Mm-hmm.

. So if we're to see a streamlining occur and through these amalgamations

we drop from 200 employees down to 50, I, I don't know what they're doing

in there most of the time anyway.

Honestly, I can't imagine that the, they process everything so slowly, it's wildly

inefficient, but let's say they're able to continue doing what they're supposed

to do with the quarter of the workforce.

That means we should see if your college has been amalgamated, we,

you should see a drop in fees.

If you don't see a drop in fees, then right away there's a problem.

Yeah.

Yeah.

And

I

guess time will tell.

We'll have to see with, with particularly these amalgamated bodies, the, where there

are, uh, it's a whole pool of colleges.

It'll be very interesting to see what happens to the fees there.

You know what the Caden report, which is the, the report on these governing

bodies that kind of led to this bill, it criticized the, the lack of transparency

for the public in regards to timelines,

And that was, you know, that's one that we're really quite familiar with.

And, and the concern is that the public makes a complaint about,

about a, a pharmacist or a nurse.

And then they don't hear, and they don't hear, and they don't

hear, they don't get the update.

They don't know when the investigation is gonna happen,

and it goes on and on and on.

Well, this is true for, for both sides, that there has been a, a lack

of transparency yet in terms of being the person on the other side, being

the professional on the side that needs to answer to the, to the college.

There's usually quite a strict time to respond, like, oh yeah,

re respond to this email within.

40 hours, 48

hours, something like that.

Or you know, please send your, um, you know, your letter response, which

is a, if you've been investigated by the college, your letter of response

is kind of your singular piece of, of voice and your singular time

to, um, kind of make a, a rebuttal.

There's a strict timeline there, but there hasn't been a timeline.

no.

In the process otherwise, and no timeframe where they say we

are, we will be accountable.

We will conclude our investigation within 60 days or, or whatever it may be.

Mm-hmm.

. So that's one where I hear Okay.

Some accountability there.

Uh, in terms of your just timeframes alone, that seems like a fair request

to make of, of these governing bodies.

is super fair request.

Uh, sorry to cut you off there.

I just, Nope.

Do you have any faith, like looking at, looking at this, and it's one

thing to put uh, a bunch of words down on paper about what's gonna happen,

but can you imagine any circumstances where they reduce the members?

Like they're, they're gonna leave the College of Pharmacy alone as far as it,

it will stand alone, but there won't be any more elected members on the board.

Right?

So that means that the government is gonna decide who sits on the board and

it's going to be half public and half professionals because they want the

all appointed by the government though.

That's right.

Yeah.

So I guess the, the, the part that's difficult to believe is that you're

going to make that change to an already wildly inefficient entity.

and then expect them to adhere to guidelines regarding time and

communications with the public.

Mm-hmm.

, my question would be, what happens if they don't?

And how soon do you affect ? How soon do you expect these changes

to come into, uh, into play?

Mm-hmm.

, Corey: this was maybe the most,

that whole document to me.

Like the idea of looking at how these boards are, are made up.

Fair enough.

The idea, and this is where I can empathize with the public

criticism, that like, hold on here.

All of the members will be appointed by the government, by the Ministry of Health.

It's hard not to feel cynical

about that.

Yeah.

Because aren't you then just facing the same problem?

I mean, is there anybody out there who thinks that the government is all

of a sudden gonna turn into a super efficient, non bureaucratic monster?

Right.

Well,

no, for sure.

And.

Additionally, is there any, anyone out there who doesn't think that there will

be some political motivation in the assignment of people to a given board?

Of course, a and particularly given that substance use and drugs are,

are a big, have become in the last couple of years, a big political

issue and drug policy and safe supply and legalization and all that stuff.

Or decrem rather, what will happen to these boards if, if there's a

change in politics in the province.

And right now we have a, we have a, a new premier, a rel, you know, within

the last couple of months here, a new premier, but the same party that's,

that's been in power for some time.

Mm-hmm.

, if that mm-hmm.

. if and when, cuz this is what happens in politics is there

will be a, a another shift.

What will happen to those boards, and I don't, I'm not claiming to know the

answer here, but potentially those boards could be then replaced by a much

more anti-drug or conservative base.

And that will assuredly influence the board decisions, the review

decisions, the decisions on penalties or, or, um, restrictions that are put

on workers or nurses or pharmacists or whoever who are found to have

developed an issue of substance use.

There will be an implication that goes that

far down.

I think certainly, for example, look what would happen if we just moved Alberta's

regulation bodies over to bc Right?

And they took over overnight.

Yeah.

Imagine the different outcomes you'd have with healthcare professionals.

And the other thing that is interesting to me is that this does seem like a.

It's a very public safety centered, at least that that's how it comes across

is that this is all about public safety.

Will that translate to more healthcare professionals being dismissed?

I mean, it seems like they're really stepping up the, the wording,

especially like they're gonna take a hard line stance on, uh, accusations

of sexual misconduct for sure.

Mm-hmm.

and culturally, uh, discriminatory practices.

And those are serious issues that, that of course, need to be addressed.

My concern would be one of kind of fair and, and due process, and I'm sure that's

one thing that comes with the territory when you're working for one of these

colleges, is you're probably inundated with a, an absurd number of complaints.

Uh, just volume wise, and then you have to go through all those complaints.

And I would imagine that from what I've seen, 90% of those are just

people who are angry at the doctor or dentist or psychologist, or because

they didn't agree with a diagnosis.

Whatever.

People, when they get upset, they tend to complain.

And many times it's not a, um, you know, the, the healthcare professional acted

like a human being and did the best they could with the, the situation.

So I don't know if there'll be more of a no tolerance kind of, uh, aspect to that.

And if so, How does that factor into the equation when we're looking at a

doctor shortage, a pharmacist shortage, nurses who are just walking off the

job, how do we maintain the structure of the healthcare system if there is

going to be a stricter, less nuanced approach to these types of complaints?

Yeah,

really good question.

And I'm not sure that they have been concerned about that this whole time.

Like just this year we are seeing, you know, that they're, they're looking at

expediting the process of getting licenses for newcomers to Canada who ha have

that certification or have that license.

And now they come to Canada and, and it's usually a bureaucratic

nightmare to get through that, to get licensed to work here.

So they've said that they're gonna commit to improving that.

Other than that, I, it hasn't seemed that they've been concerned about

people walking away from the profession.

And that change probably says to me that, that will continue

and potentially get much, much.

more prominent that there will be more

people

walking away, I would think.

Yeah.

, I thought it was interesting that they brought an expert in from the uk mm-hmm.

to do this, uh, to do the 2018.

Um, Harry, uh, was it Caton?

Caton, yeah.

Yeah.

So this guy's an expert in college, uh, regulatory affairs and it's fuel

for the conspiratorial fire because there's, there's a lot of, uh, kind

of talk, at least in social media about how the UK is our future.

If you look at what's happening with the UK's medical healthcare system,

it's slightly ahead of us in its decay, but heading towards the same end,

which is inevitable privatization.

Mm-hmm.

. And there is concern that some of.

Pressure that's being put on their medical system.

Undue pressure is from parties who are interested in moving that forward faster.

So I thought it was interesting that you would bring somebody over from the place

that is having the exact same problem as us, only they're further down the road.

to do that study here.

Mm-hmm.

just a, just a funny coincidence and I'm sure there's nothing there, but,

and looking over the guy's work, I, I thought he, everything that

he, that he said was, was accurate.

I'm not sure what got them interested in the dental college, but there

must have been something there that, that got them going cuz.

They're the first ones they looked at.

Oh, yeah.

So his kind of summation of what was going on, there was a very articulate, polite,

general statement, which equated to, there is a potential for a lot of corruption

here in that there's, uh, maybe protection of the, the entity of the college

itself that doesn't serve the public.

There is efficiency problems throughout.

There is too many board members, there is too many committees, there is too

much, uh, there's too many colleges, uh, for oral health professionals.

I mean, so that's fine.

I just thought it was funny that they, they brought somebody in from

the UK if people knew that maybe there'd be some eyebrows raised there.

did you get a chance to go over his report a little bit there?

A bit, yeah.

Specifically going back to the idea that, you know, one of the concerns

that was raised in the report was that, that people, that on these boards that

make that do the review process end up making the decisions about licensing

or about any kind of penalty paid by the, by the professional, was that

the profession, the professionals who work within that profession, so the

pharmacists who then sit on the board of the College of Pharmacists, that

they are paid more than the public members, there are more of them.

So there is an, a power imbalance there.

Mm-hmm.

. So one of the recommendations again was that, that there's equal pay

between public members of the board and professional members of the board.

And that a better sort of balance is struck.

Right.

The other recommendation was that there would be, particularly for

these, he spoke to the, like the, the amalgamated colleges that there would be.

Sort of subcommittees that would look at the interests of each specific profession.

So if there was a, um, an occupational therapist, for example, who an

issue arose with or a complaint arose with, there would be people

that had a specific approach to the occupational therapy profession.

I had concern when I initially read that and then going back to reread

that they had said, well, no, no, we would, we would set something up so

that there could be some oversight of these specific professions.

How do they know that the members of the public that are sitting

on those boards have enough of a background in healthcare even to, to

be able to make judgments like that?

Right.

So

I, I think that's the.

Uh, I guess they're just saying that they would, they would

be, um, so they're gonna set up another committee to make sure

that that committee is, uh, yeah.

Okay.

Okay.

And there's a few examples of that where, where, where the bureaucracy

is being, um, uh, fortified . Right.

Well, this it's being simultaneously paired down and fortified

. Nathan: That's right.

I guess, uh, I'm just gonna quickly, uh, go over the information that we have for

amalgamations so people know if they're listening, what, who's going where.

Sure.

Uh, the College of Doctors and, uh, physicians and surgeons is

not amalgamating with anybody.

They're, they're staying put, college of Pharmacy is staying put.

The amalgamations that we know about so far are for the, they're gonna put the

dieticians, occupational therapists, opticians, optometrists, physical

therapists, psychologists, and speech and hearing professionals under one banner.

And that's a large banner right there.

There's quite a bit of, uh, quite a difference between a

optometrist and a psychologist.

Yeah, huge.

Another one they're gonna do is chiropractors, massage therapists,

naturopathic physicians, traditional Chinese medicine, and

acupuncturists into one regulator.

That one feels

a little bit more cohesive.

I don't quite understand how you're going to put all those

colleges together and then pair them down and get more work out of them.

I guess that's my concern.

Mm-hmm.

, like, how do you get these people who are sitting in these very cushy positions

where there's, there hasn't been anybody watching them work for a long time.

Right.

They, they just, I mean, I don't know if they have any kind of,

uh, oversight as far as how much they're supposed to get done.

Mm-hmm.

, but based on the timelines that I've seen with colleges, there appears to be nobody.

There's nobody cracking the whip, basically.

Yeah.

And, uh, how do you navigate that if you're trying to implement this bill?

You know, you're taking, let's see, there's one too.

There's like, say you're taking seven different colleges that exist, and

these are small colleges with, uh, probably not many people in them, but

say there's, let's, uh, conservatively say there's 70 people working.

Mm-hmm.

. So you're gonna pair that down.

Maybe cut half the jobs, you're down to 35 and now you're taking care of,

you're gonna have people there who don't know a thing about the other

members of the other professions.

The other professions.

For sure.

Yeah, for sure.

So that'll be a bit of a challenge for them.

Not saying it can't be done and it sh uh, I'm not saying it shouldn't be done.

I think the idea of scaling it for economy and then getting rid of the superfluous

employees, I mean, I'm sorry, but you had your chance, you had a long time here.

And it looks to me like there's a lot of just, I don't know

where this money is going.

That's, that's a huge concern for me.

Yeah.

Why are my fees going up?

And I don't, there's no changes.

I mean, the last thing, uh, the last rumor I heard is that the college

fees are going up for pharmacists because they wanna renovate their

building because the dentists renovated their building across the way.

Mm-hmm.

like this kind of stuff.

It doesn't build faith, it doesn't build trust.

Right.

It doesn't.

And just in the interest of, of fairness, The unions, in my

opinion, have done the same thing.

The nurses union has certainly done the same thing.

They, their, our fees went up when they were building a, a

splashy building in downtown

Vancouver.

Yeah.

And this is always a problem, isn't it?

I very much believe that we are heading towards a situation here

where it may be required that all healthcare care professionals come

together under one banner and have one union that protects us all.

Because the way things are going here, eventually we will have no say in what

happens with our professions at all.

Mm-hmm.

, um, if, you know, if these types of processes become corrupt or become

politicized to the point where it's, I mean, it's already not great, right?

I mean, it, it's been not great for a while.

And it's hard to, it's hard to look at this and be optimistic as far as, uh,

you know, when the government talks about streamlining and amalgamating,

I think centralization of power, I think bureaucratic inefficiency.

And I scratch my head wondering how on earth they're going to, like, they

haven't even put a timeline forward yet.

They've been working on this five years.

Yeah.

So do you, in, in those things that you think of, do

you think of accountability?

Does tighter governance and more governance over a group of bodies,

does that equal more accountability?

Are those things mutually exclusive?

Well, policing a profession is tricky, right?

It's not like policing the public where we've got reams

and reams of data to draw from.

It's kind of a niche sector, so you need people within that

sector who are representative of the profession and are reasonable

and do care about public safety.

Mm-hmm.

. But there also has to be some concern for the livelihood of the, the profession.

And that doesn't mean that you have to protect members who are not treating

the public well or treating them with the discrimination course, or, or all

the crazy things that that happen.

Most healthcare professionals, I think, are in this province especially are, are

good people who generally want to help.

Mm-hmm.

, they work very hard and most of them are not paid enough.

Uh, nurses, doctors come to mind, you know, even with the, uh, the

new contractor getting, or I, I.

I don't know if it's gonna be enough, if, I guess it depends on how this is

going to be implemented and, and what kind of fairness is gonna be exercised,

because I don't, I see a lot of talk about protecting the public, which is great.

I want, I, you know, I want my parents to be able to go, uh, and see a doctor

in their hometown and, and not have something crazy happen because that doctor

is either not qualified or up to some billing scam or, you know, like we have

to have, somebody's gotta be watching out and making sure that outliers are, are

reprimanded or taken outta the system.

That's, that's gotta happen.

But if you make the environment so inhospitable for professionals to work,

and we've already got a problem with, uh, paperwork in this province as far

as, you know, they're, they're trying to rectify that with the, the new physicians

deal where they're, they're getting paid for some homework and stuff, but

I mean, physicians are smart people.

They'll, uh, , they're not, they know what, what they can get elsewhere.

And if, if these policies are implemented and it's heavy on the public side and, you

know, every single complaint is taking an extra, you know, if, if a public member

can go in and complain about their doctor and then that doctor has to write a two

hour report to defend themselves when they've done nothing wrong, guess what?

Yeah.

Your doctor's gone.

Yeah.

They'll, they'll go to another province or they'll go to the states.

Why would they stay here?

Right.

So, , that's, uh, that's concern I have about whenever you, I mean,

we, we've already had a problem with bureaucratic paperwork and

this province is rife with red tape.

It's way over the top.

So if this turns out to be a real streamlining process and it

actually does cut through some of that, then kudos to them.

I just, I personally don't have a lot of faith when I see a p uh, an amalgamation

into a government entity like this.

Yeah,

yeah, I agree.

It seems like simply a, a transfer of bureaucracy

kind of, right?

Uh, yeah.

That

we will, that, that the process within the regulatory bodies might be

smoother this way, but the process to establish the boards, to oversee them,

that part will still be, still be loaded.

I.

I wonder if that will end up just sort of balancing out and we won't see a

big difference in terms of timelines, in terms of efficiency, unless it's,

this is usually the case, right?

Yeah.

Unless there's a big political shift that could influence it one

way or another, then I think it could change, change timelines, but

it might just kind of balance out.

It usually is a wash when they do stuff like this.

Um, only the, the people at the bottom get a little more taxed, right?

Mm-hmm.

. So what I would expect to see is within about five years, they've got

this implemented, the government is now overseeing these colleges and

our fees will somehow be higher.

Yeah.

You know, , oh yeah.

This is, that would be the unsurprising outcome here.

But, uh, just to quickly give a summary of what they're trying to accomplish

with this new, uh, modernization of the healthcare providers act into the

healthcare providers and occupations act.

So they're looking to, we've already talked about the amalgamation process.

One of the goals will be to streamline that process.

So we'll, once we have a timeline for implementation, we'll, we'll keep an

eye on that and see how that goes.

They want to bring in a new oversight body, and we're gonna put in a

sound effect for oversight body.

I think ForSight Buddy.

. Corey: Yeah,

. Nathan: Cause it, uh, yeah, it's, uh,

term, but , this is to be, this is where you'll see your fees, by the way.

This is what's gonna happen.

So this body is to be funded by the colleges.

So now the colleges get a taste of what we've been dealing with.

Right?

Ah-ha.

Now the college will get, will pay to be policed, but will the college pay?

No.

They will shift that money back to us because that's

where their money comes from.

Without question.

Yes.

So this new , and there's more so the oversight body, uh, is going

to conduct routine audits and regulatory on regulatory colleges.

I'm hoping that also includes financial audits because as a member of a col,

as a, a healthcare professional, that's, that's a big concern.

I wanna know where my money's going.

Yeah, I think it'll be more to do with safety and protocols, but you never know.

So the oversight body is going to process and investigate complaints about the

regulatory college's actions and policies.

Now that is probably going to be more from a public point of view.

I don't know how involved they'll be with.

Professionals complaining about the, uh, regulatory colleges.

If there's an avenue for complaints, then I've got about, uh, I've got a

backlog log of about 200 . So, um, and I will be sending them all Yeah.

, because I, I would, there's things that need to be addressed from mm-hmm.

long time ago till now.

Mm-hmm.

, uh, many, many complaints.

So, we'll, we'll see what happens there.

And the other thing they did with, they're, they're separating.

So normally the college would've taken care of the investigation of a

complaint towards a, a professional, and they would've been responsible

for the disciplinary action.

Right now, now they're separating it.

So the college is going to initiate the investigation and the

disciplinary side of it was going to be supported by the oversight board.

What do you make of that?

It's interesting that they think, again, this, this tells me that they

think that there's shenanigans going on where the healthcare professional

is being protected by the college.

You know, it's not the case.

, it's not the case.

, I mean, maybe, maybe that's happened where a, where somebody had a friend

on the board or something like that.

I'm sure that's happened in the past, but largely were treated like cattle, right?

Mm-hmm.

I mean, they, they do the ver the minimum that's required by law that

they can get away with, and that's it.

So, I, I don't, I'm not entirely sure what they think they're gonna do other

than there seems to be concern about, you know, if they're talking about

transparency issues and they want somebody who's being investigated, if

they want the public to be involved in that investigation, as in they get access

to that person's name, credentials, work history, uh, what happened

during the event and stuff like that.

Then that's gonna be, that'll be a court case, right?

Mm-hmm.

, I mean, that's a privacy act violation.

. Corey: And what, what's

gonna be?

Well, that's the thing.

Yeah.

Right.

One of the reasons, like, uh, David Eby is, uh, is poor

guy's already up for a recall.

Mm-hmm.

. But, uh, that's one of the concerns that, uh, and of course this

recall is politically motivated.

It's being headed by a guy who was trying to get elected in the

first place, blah, blah, blah.

Mm-hmm.

. But that guy does have a point, and that this does, if that's the angle

they're taking, then you're getting into privacy act issues again, where

you gotta remember that everybody is innocent till proven guilty.

So, and that should include, you know, people who are being accused of

professional conduct issues or whatever it might be for things like that,

which are the majority of what the college is gonna face in complaints.

I think the, the people involved in that have a right to confidentiality

until a decision is made.

If it's a, a grievance that is bad enough that it needs to

be made public, that's fine.

I mean, there should be room for that.

But that's a real touchy one as far as, uh, human rights goes, you know?

Yep, it is.

And again, this is the whole debate about who are they protecting

first, the public or the profession.

Seemingly, when you look on any of these colleges, any of them, if you

look on their websites, you can see, uh, who's being investigated and

some details of or, or even more.

There's some that are quite thorough, unless there's a, a medical

diagnoses that makes it so that their privacy is, should be maintained.

It's all on there and it's on there before, at this time.

It's on there before there's a conclusion that's been reached.

Unless

you have a good lawyer.

That's right.

So to me that says that the, right now, that is the motivation

of that is to protect the public.

Mm-hmm.

and not the other way around.

Yes.

I, I would agree with you there.

They're gonna create an independent discipline tribunal that will be the,

uh, the entity that, that oversees that.

And that'll be, that will be an interesting thing if they do make

that more, like, if it becomes more accessible to the public and transparent

again, as long as it's within the, the confines of the normal judiciary system.

As in, you know, if there's a grievous accusation and there's good evidence

to suggest that it's, it's true, then, you know, maybe it can be a

little more fleshed out in the public.

But

will that include the nurses, midwives, physicians, and pharmacists?

Will, will, is that oversee all governing buddies?

I believe it does, unless that entity that looks at discipline is

enormous, that will get bogged down so quickly if now all are being funneled

through the same spot, won't it?

Like the, looking at the, the, the board who looks after discipline for nurses.

That board is bogged down.

That board is, is completely, I think, drowning in complaints and

in, in, in disciplinary issues.

And that's part of why, or so they claim, and that's why it takes so long

too, is that there's a lot of them.

But if, if they're all going through the same place, I

imagine that is, uh, traffic jam,

. Nathan: I, I would see that

I'm, and again, I, I don't know how, when you say streamline and you're

talking about reducing the number of people who are working at these

places and yet somehow getting more productivity out of them, I'm a little

confused as to h Like it's these, these types of documents always.

It's like they have all the information there.

They have the reason why they're making the decisions, but the implement.

and maintenance of those decisions so that a document like this

can, can be pragmatic and useful.

That's the part that I don't see, and I, I guess I, we can hope that when they

have a timeline, perhaps they'll have, uh, implement, uh, implementation strategy

so that we can take a look at how they're going to actually regulate this process.

Right?

Yeah.

So we don't have to put a, another level of regulation on the regulators

who are doing the regulation . Right?

Yeah.

So what we could do is, uh, did you have, uh, just a, a kind of

summary of your pros and cons?

I can give you that.

Yep, sure.

Let's hear what you got.

So for me, a

pro, again, we should preface this by saying this is if it is

implemented and proves to be working as they claim that it will work.

if it

meets its goals.

So we're, we're giving it the benefit of the doubt

for the sake of the exercise.

We'll give it the benefit of the, of the doubt.

Yeah.

Uh, that said, we will also highlight some concerns, but if it meets its goals, then

the idea of more transparency Absolutely.

A pro for me.

Agreed.

I'll, I'll hand it back to you.

What would be your first

pro?

Well, I've said it for years.

The colleges need to be policed.

They need to be audited, they need to be held accountable.

I can't believe that we've went this long, allowing these entities to

function the way they have with the misappropriation of power and funds.

And it just, it, it's strange to me because other countries generally have

some kind of a structure in place to, to allow for self-governance, but to alway

also kind of keep an eye on it and make sure that things don't get outta hand.

And we haven't had that.

So if this is implemented properly, it's a no-brainer.

It should have been done a long time ago.

Yeah.

. Corey: I think another pro

balance within these boards.

Personally, I, I don't think it's a bad idea to say, to say, we're gonna

pay the public members the same as what the, the private members are

who sit on these, on these boards.

That's the pro there.

The con there to me is that these boards will be entirely

appointed by the government.

Yeah.

That doesn't make sense to me.

No.

I think, and it not only is, does it not make sense, but it is just

setting up for potentially being

abused and misused.

Yeah.

And politicized further, like you said.

Yeah.

This country is heading towards a pendulum swing here of epic proportions, and if

that means that all of a sudden bcs.

Back under blue governance . Then there will be significant, I could

imagine, like you said, significant changes to this very quickly.

But yeah, we'll cross that bridge when we get to it.

I guess the other thing I like here is just.

It's personally very satisfying to me.

And, uh, it makes me not a very good person.

It's, uh, it's a terrible thing to say , but I love that the colleges

are going, they're going to get a, a taste of their own medicine.

Yeah.

And I have to take these, these small delicious victories.

Even if they might be, they might turn out to be just as, uh, crazy.

And I think at, at least, at the very least, they're gonna be subject to the

same ambiguous, non-existent guidelines where they're gonna be expected to follow

rules that they can't find, you know, and then be reprimanded when they don't.

I, I could see that happening very easily and, uh, I will

not lose any sleep over that.

No, we'll put it that way.

No.

I

think some, a pro would be some reorganization of some

of these smaller colleges might.

I could see, and, and to be honest with you, I'm kind of like naive about

what the, what the college of, of like naturopathic medicine and Chinese medicine

and massage therapy and stuff like that.

Like that's out of my, my realm.

Mm-hmm.

. But to me, I could see restructuring that as making some sense if they're,

if these boards are that small, if the regulatory bodies are that small, which

presumably they are, I think a con is that they have probably, for a variety

of reasons, not wanted to touch the, the doctors, the nurses, and the pharmacists.

And so you're leaving three pretty muscular entities there and will that

in fact create more of a, an imbalance between those three and all of the rest.

I think that imbalance was probably already there, but

will this perpetuate that?

I wonder?

Yeah.

I wonder too, the only upside of that is, like I said, economy of scale.

I mean, if those guys are paying, um, uh, who's, somebody gets really shafted.

There's a, I can't remember which one it is.

It might be, there's some little college that pays a crazy high.

It's like $2,400 a year, something fees.

They should see a reduction.

Wow.

Yeah.

It's, it's wild.

And they only have like a few members, right?

Mm-hmm.

. So those ones that are being amalgamated, if you are a member of those colleges,

uh, or being regulated by them, I would expect to see some reductions in fees.

So watch for that and let us know if you don't, because if there's no

economy of scale, then I, I don't know how that's gonna be more efficient

for anybody, but, but we'll see.

There's more to be, uh, learned here.

Yeah.

Again, as we have talked about so many times on this podcast that.

. There's such inconsistency with the disciplinary process that

individuals that you and I know, including myself, get handled one way.

The next person gets handled a different way.

The next person gets a whole other set of rules applied.

The next person hasn't heard back . Mm-hmm.

and and so on and so on and so on.

So for everyone to go through a more centralized, for lack of a better word,

disciplinary panel, there might be some consistency that's created there.

Yes.

We should all be screwed equally.

the, well, this is right.

The con of that is that A will be potentially a bottleneck.

It may actually take MO more time, and B, depending on the political will now,

that these boards will be influenced by, directly by politics, that there will be.

equal screwing or some un , a lack of fairness or, um, an influence of an

anti-drug mindset, et cetera, et cetera.

There's just an endless list of, of things that could go wrong with that.

Mm-hmm.

, but it could also create some consistency.

It could, yeah.

Uh, and that's what we would, we would hope to see if we could

get a little more consistency.

I think the biggest thing is time.

Right.

If we could get, I mean, if you rob a bank, you have a Right

to a fair and timely trial.

Right?

Right.

So, you know, I mean, there has to be some kind of, there has to be some

kind of standards that are set and met as far as timelines are concerned.

And I think, I mean, if they could make that better, just that

alone would really help healthcare professionals who are dealing with,

uh, substance use, uh, use issues.

Yeah.

Generally speaking, the amalgamation of power, especially into government bodies,

is, in my opinion, an overall negative.

Uh, I'm always leery of centralization, and this is no exception.

Mm-hmm.

, but giving it the, uh, the benefit of the doubt.

We'll, we'll see.

I believe the transition will take years.

Like, uh, they could set a date two years maybe as a target.

Mm-hmm.

and, uh, I, yeah, we'll, we'll see.

I'm not sure what the transition stage will look like as far as how

professions are dealing with their day-to-day on the ground level.

Mm-hmm.

is there going to be, now they're saying up until the implementation

date, the old Health Professions Act will be in place and the

colleges will be business as usual.

But I can't see that really being the case if, you know, you've got

half your staff that knows are getting relieved of their duties.

I, I was just gonna say that you're gonna see, uh, uh, there'll be a

transition period of probably fairly extreme flux where I would expect.

all momentum to nearly come to a e either a stop or a crawl, right?

Yeah.

Until the next group of whatever this is gonna be, takes over.

So that's something to, that I'm a little leery of.

And, uh, I'll be keeping a, an eye on.

I just hope that they keep healthcare professionals in mind here.

Mm-hmm.

, I, I also wonder about morale, like just the, the timing of this change

that is loaded with concern, loaded with conversation, with argument.

You would think that in some of these professions, the overall

morale will, will be impacted

by this.

Yes.

Absolutely.

At a time where it's, where it's pretty tough to be a healthcare worker.

Absolutely.

I don't think there's been a tougher time than No, no.

And has government, has faith in the government ever been lower?

Probably not.

Probably not.

So they're asking for a large scale grain salt here.

Yeah.

, you know?

Yeah.

And we'll see.

I think in theory this is a, a bill that has a potential to

make things better for everyone.

Yeah.

Except the, it'll probably make things worse for the colleges, but

they brought that on themselves.

Sure.

So, and the

other part, you know, just for our listeners, this is

a, what, a 272 page document?

Something like that.

Like

it's a monster Bill itself.

Yeah.

It is huge.

And, uh, yeah, it's, I mean, they passed it in like just a little over a month.

So, does anyone read these things?

? I was just

gonna say, you and I, you and I were focused on,

just on this specific issue.

There's more to the bill than just stuff with the colleges, but, and a

lot of people's concerns is also around the potential for privatization, which

is a, a whole separate episode maybe.

Mm-hmm.

. Um, but yeah, just to think about having to sit down and read all 272

pages and then like, make sense of it and feel comfortable and confident

with the material and, and then vote

on it.

I.

, you know what I was thinking would be a good thing.

This would be a good Jo, uh, job for, uh, chatbot, right?

Get chat g p t in here and say, chatbot, read this 237 page document

cuz it's, it's written in legalese.

Right?

Translate it to English and summarize it in one page, please.

Yeah.

. Corey: You know what I mean?

Great

idea.

Yeah.

Maybe chat bot can help us here.

chat bot if you're listening, get to work.

. I think we can leave it there.

Corey, what do you Yeah,

I think so too.

I mean, we've, um, covered a lot here.

Mm-hmm.

picking up quite a bit of time and, uh, and there's just, there's, we could

break it down for a long time and I think a lot of it has to be left to

we'll see.

Yeah.

And I re I realize this is a little bit out of our, our normal wheelhouse

as far as, you know, this is much more into regulatory affairs than we get.

But we both thought it was important to cover this because the impact.

will eventually be felt at the level of the, the individual

who's stuck in the machine.

So that's why it's important for us to keep track of these

things.

Oh yeah.

We, you and I have been, have been critical of regulatory bodies since

we started this and before, and uh, this is the first time we've seen

it actually moved into legislation.

So

it's, it's big.

It is.

Yeah.

So we'll see what happens.

Yeah.

That's all we got.

Thanks for your input, co-host Corey, and, uh, you as well.

Of course.

We will see everybody next time.

Yep.