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Beyond the Breaking Point: Ontario’s Healthcare Emergency

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFP, DipSportMed CASEM, FCFP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

is a comprehensive family doctor working in Manotick, Ontario, Board Director of the College of Family Physicians of Canada, Chair of the General Assembly at Ontario Medical Association and Director for Longitudinal Leadership Curriculum at the University of Ottawa Undergraduate Medical Education. Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Past Chair Section of General and Family Practice Ontario Medical Association, Bruyere Foundation

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Abstract: Ontario’s healthcare system faces an unprecedented crisis characterized by chronic underinvestment, operational deficits, and systemic collapse. This analysis examines the current state of healthcare delivery in Ontario, where over 90% of hospitals operate with structural deficits, emergency departments experience wait times exceeding 59 hours, and surgical backlogs have reached 250,000 patients. The Financial Accountability Office projects a $21.3-billion funding shortfall by 2027-28, while critical staffing shortages—including 26,000 registered nurses below national averages—compound operational challenges. This crisis represents not temporary strain but fundamental system failure requiring immediate, sustained intervention through strategic investment in infrastructure, personnel, and operational funding mechanisms.
Key Words: Healthcare crisis, Ontario hospitals, nursing shortage, healthcare funding.
Financial Emergency: Over 90% of Ontario hospitals operate with structural deficits, with many relying on credit lines for basic operations and payroll
Critical Access Barriers: Emergency department wait times reach 59.4 hours in some regions, while 1,850 patients receive daily treatment on stretchers due to bed shortages
Workforce Crisis: Ontario faces a shortage of 26,000 registered nurses compared to national averages, with recruitment failing to match attrition rates
Infrastructure Deficit: Current hospital bed expansion plans fall 13,800 beds short of projected needs by 2032, failing to address population growth and aging demographics
Triage Geography: Healthcare access increasingly depends on geographic location rather than clinical need, indicating system-wide capacity failure
Hallway Medicine Normalization: The acceptance of substandard care delivery locations reflects dangerous adaptation to crisis conditions
Burnout-Attrition Cycle: Healthcare worker departures consistently outpace recruitment efforts, creating self-perpetuating staffing shortages
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Law and Ethics, Healthcare crisis, Ontario hospitals, nursing shortage, healthcare funding
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Stroke Imaging in Primary Care: A Practical Guide for Family Physicians

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

Medical Director, Journal of Current Clinical Care and www.healthplexus.net, Radiologist, Orillia Soldiers’ Memorial Hospital, Adjunct Clinical Lecturer, Departments of Medical Imaging and Family Medicine, University of Toronto, Toronto, ON.

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Abstract:
Stroke remains a leading cause of mortality and long-term disability, with optimal outcomes dependent on rapid recognition and timely intervention. Family physicians play a crucial role in the acute stroke care pathway, from initial assessment to long-term secondary prevention. Understanding contemporary stroke imaging protocols, recognizing early signs of cerebrovascular events, and knowing when to initiate urgent referral can significantly impact patient outcomes. This review provides family physicians with practical guidance on stroke imaging principles, current best practices, and clinical decision-making frameworks to optimize care for patients with suspected acute stroke.

Key Words: stroke, imaging, cerebrovascular events, patient outcomes, acute stroke.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
Rapid Referral Over Time Windows—Modern stroke care extends treatment windows up to 24 hours with imaging guidance. Family physicians should refer ALL suspected stroke patients immediately, regardless of time from onset.
Recognition and Referral, Not Diagnosis—Primary care role is rapid recognition using simple tools (facial droop, arm weakness, speech difficulties) and immediate transport coordination—not comprehensive evaluation or imaging interpretation.
CT Excludes Hemorrhage, Doesn’t Confirm Stroke—Non-contrast CT’s main purpose is excluding bleeding, not confirming ischemic stroke. Normal CT should never delay referral for suspected stroke.
Advanced Imaging Guides Treatment—Multimodal imaging (CT + angiography + perfusion) identifies large vessel occlusions for thrombectomy and estimates salvageable brain tissue for individualized treatment decisions.
Time Windows Don’t Exclude Patients—Advanced imaging can identify treatment candidates many hours after traditional windows—don’t use time to exclude patients from specialist evaluation.
Watch for Subtle Posterior Strokes—Isolated dizziness/vertigo in older patients may be posterior circulation stroke, especially with coordination or visual symptoms.
Check Blood Glucose Only—Correct abnormal glucose before referral—hypoglycemia mimics stroke and hyperglycemia worsens outcomes. Skip other tests to prioritize speed.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Radiology, stroke
Disclaimer: 
Disclaimer at the end of each page