Nikhil Joshi, M.D.
Doctor, Author, Leader
Nikhil Joshi is a young physician, writer, and speaker. He is passionate about furthering his ability to touch the lives of people positively.

An open letter to Andre Picard

An open letter to Andre Picard

Dear Andre,

We’ve only ever had the pleasure of knowing one another professionally. I was 17 reading your columns on my kitchen table. I remember thinking that your opinion on health care was gospel, as if every politician who read it would scurry to fix the problems in the system after your eloquent elaboration. Now after 13 years of post-secondary schooling and two days before my last Royal College exam, we share a terrible truth – that bureaucracy and an inability to utilize innovation are rampant in health care. Failure of imagination is our greatest sin.

I’m an adult internal medicine specialist finishing my subspecialty in allergy and immunology. It’s an exciting field that is revolutionizing the health of Canadians. We deal with complex diseases where the underlying pathophysiology is mind-boggling. How HIV compromises our immune system, what are the signs of life threatening immunodeficiencies, how can we prevent peanut allergies, are examples of the types of questions I have to answer in 2 days. I’m 31 and about to write another exam; a perpetual student with hundreds of thousands of dollars of debt. But seeing as how I survived lymphoma and chemotherapy, this doesn’t really bother me. There’s something else which troubles physicians deeply.

The decline of medicine and vilification of doctors is chilling for us. In such a short period of time, we’ve heard language concerning our profession that we haven’t in 100. Physicians in Canada are nervous- not merely about the tax changes, but because it reinforces the feeling that we aren’t wanted. That we are being bullied. We can feel it measurably in the air. One minute we’re fighting over vaccines, the next we’re getting hit in the guts by our Prime Minister.

There’s a rumour the circulated among physicians. During one of many acerbic rounds of negotiation between doctors and the Ontario government, the doctors had suffered a great defeat. An unsympathetic reporter remarked something to the effect of, ‘if you want to leave, there’s the door’. Challenging physicians to leave. Confident that they wouldn’t, because it’s too much work to uproot a family.

I realized then that what my colleagues had was a failure of imagination. I started to connect physicians with employment opportunities both within Canada and internationally. I want to help physicians become more mobile in their lives. I want them to see what possibilities await them in Thailand or the Okanagan.

Physicians in this country are going to move. They will move within the country: most are expected to exit Ontario and the Atlantic provinces for practices west. They will also go internationally: the US has a need for more physicians than we currently have in our entire country.

But why stop there? What about Figi or Bermuda? New Zealand or Nassau? Why must we only go to clinic, do paperwork, and die? If one could achieve work-life balance: wouldn’t you be a fool to say ‘no’?

Unlike my colleagues I know we’ve lost this tax debate already. Not because we’re being slandered by the people I voted for. Not because I know what’s being said in newsrooms and kitchen tables. But because I felt that thing I loved dying for a while now. I know medicine is bleeding, grappling with much larger issues from a society trying it’s best to destroy itself. Autoimmune diseases are part of my specialty.

All the best Andre,

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