Kelly McParland: Canadian doctors share national sense of disgruntlement

We were shocked, surprised. We were taken off guard, lamented Alberta Medical Association president Dr. Michael Giuffre. I would say our relationship is not good Why is this the first time in Albertas history that weve had an imposition on physicians? Why has this gone so sideways? The deal provides a one-time 2.5 per cent lump sum payment based on 2011-12 billings and annual cost-of-living adjustments for the next three years. Horne acknowledged the doctors wanted considerably more, but Alberta, despite its comparatively enviable economic position maintains it cant afford more. Just last week Premier Alison Redford announced the government had no choice but to borrow money for long-term projects, ending its reign as Canadas only debt-free province. The province says the deal is worth $463 million for the doctors, but the AMA said Tuesday that when other elements are accounted for it is out more than $200 million, and refused to accept the contract . We think that [Horne] will think through what he has done, said Giuffre, who is demanding new talks. He will see the effect its had on physicians. I can tell you that I have received hundreds of emails and hundreds of phone calls from very angry physicians that will not tolerate the imposition. Ontarios 25,000 doctors spent the summer making similarly belligerent noises after the government imposed $338 million in fee cuts, but ultimately agreed to a contract that theoretically freezes overall pay while reversing some of the imposed reductions. The OMA also pledged to find $100 million in savings, but some doctors argue the agreement will end up costing the province more money because it doesnt block physicians from earning more by seeing more patients or providing more services. If you clamp down on some fees like the annual physical, then lots of studies show that quite logically doctors will start billing for other things. You dont have to prescribe any malfeasance to this reality, said Dr.

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Canadian doctors divided on assisted suicide

Only 16% of Canadian doctors would assist in euthanasia

“I do think that Canadians and Canadian physicians are actually quite deeply divided on this issue and we certainly heard in our deliberations that there seemed to be many different viewpoints about how we should approach this,” said association president Dr. Anna Reid, after a panel discussion on the issue. “This is the reason we’re having the debate society is leading the debate and we feel as physicians we need to actually start finding out what our members feel.” Federal Health Minister Rona Ambrose, who spent the day at the convention, acknowledged that doctor-assisted suicide is an emotional issue for many Canadians, but she said her government isn’t planning changes to laws that make euthanasia and assisted suicide illegal in Canada. “You know all of us think about the issue because we have elderly grandparents and elderly parents and I think it is on the mind of many because Quebec has introduced their legislation,” Ambrose said. “Parliament voted in 2010 to not change its position on this issue so, at this time, we don’t have any intention of changing our position. It’s not surprising that these kinds of debates are happening within the physician community.” The Quebec government plans to hold public hearings in the fall on its controversial right-to-die legislation, which was tabled earlier this year. The bill essentially outlines the conditions necessary for someone to get medical assistance to die. The legislation followed a landmark, bipartisan committee report tabled in 2012 that suggested doctors be allowed in exceptional circumstances to help the terminally ill die, if that is what the patients want. The federal government says it will review Quebec’s legislation, setting the stage for a possible showdown between Ottawa and the province’s sovereigntist government. Quebec argues that delivery of health-care services lies within provincial jurisdiction and maintains it is on firm legal ground with the bill the first of its kind in Canada. The president of the Quebec Medical Association was involved in Monday’s debate, saying his province is ahead of the rest of the country on the issue. “Medical aid in dying is a medical service that’s within the continuity of life care. It’s aimed at helping the patient die under strict conditions at the patient’s request,” said Dr. Laurent Marcoux. “It’s not legalizing euthanasia for us it’s something new. It’s a way to care for the patient at the end of his life.” Former senator Sharon Carstairs said euthanasia and assisted suicide have been studied at the Senate level with little success in developing a consensus.

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Canadian Medical Association votes against motion to debate doctor-assisted death

We have to talk about it,a she said. The debate was so contentious, delegates couldnat reach agreement on the wording or language, referring a motion to replace aphysician-assisted suicidea with aphysician-assisted deatha on all future communications from the doctorsa group to the board of directors. One doctor argued the word asuicidea can provoke the same negative emotions as aabortiona and arape.a However, Dr. Robin Saunders, outgoing chair of the CMAas ethics committee, said it is time doctors acall a spade a spade.a aMedical aid in dying is, in fact, euthanasia,a he said. aThat is the term we should be using.a Canadaas Criminal Code makes it an offence to counsel, aid or abet another person to commit suicide, punishable by up to 14 years in prison. Federal Health Minister Rona Ambrose said this week that the government has no intention of reopening the debate. Nine private members bills seeking to decriminalize doctor-assisted suicide have all been defeated. But recent court cases, the proposed Quebec law and a rapidly aging population confronting its own mortality are pushing the issue into the public conscience. aThe baby boomer generation is starting to reach this inevitable crossroads in their lives,a Saunders said. aThis cohort a perhaps more than any other a is used to having control. aShould physicians remain steadfastly committed to one of the most fundamental tenets of ethical practice a namely, to respect the value of human life, and not actively participate in (physician-assisted death) and euthanasia a or does the physician have the moral responsibility to relieve suffering even if by doing so death is hastened?a Dr. Pierre Harvey, of Riviere-du-Loup, Que., said the CMAas mandate is to be leaders in health care. aGive me one good reason why, as leaders, we should not confront this inevitable question that has to be discussed everywhere in Canada?

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Canadian doctors divided on assisted suicide

The July 2011 CMA online survey that was completed by 2,125 Canadian doctors is considered accurate within plus or minus 2.1% 19 times out of 20. The CMA survey found that: 44% would refuse a request to assist a death, 26% were unsure how they would respond to a request, 16% would assist a death, 15% refused to answer the question while 16% stated that they were asked to assist a death within the past 5 years. Click “like” if you are PRO-LIFE ! A similar survey by the Canadian Society of Palliative Care Physicians (CSPCP) published in November 2010 found that of the CSPCP members who responded to the survey, the overwhelming majority 88% were opposed to the legalization of euthanasia while 80% were opposed to the legalization of assisted suicide. The CSPCP survey also found that 90% of responding members would not be willing to participate in the act of euthanasia while 83% of responding members would not be willing to assist a suicide. The Postmedia article reported that Dr. Sandy Buchman, past president of the College of Family Physicians of Canada, said that while the debate is important, its more urgent to improve end-of-life care in a country where only one-third of Canadians get access to palliative care, which is sort of national shame, in my opinion. I get requests from patients to end their life and to hasten their death, he said. And I kind of feel like, right now, Im off the hook. I can work very hard at trying to relieve their symptoms, without having to face that ethical dilemma of, Can I end a persons life? He said the issues behind a patients request for a hastened death need to be addressed. Maybe their symptoms have been poorly managed up to that point. Maybe theyre suffering too much pain, or theyre feeling isolated.

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Canadian doctor: Zdeno Chara deserved 80 games for Pacioretty hit, condemns NHL violence

“When I saw that picture I thought, well, he could have been dead. He was unconscious on the ice and I thought well naturally they will punish this guy,” Harvey said, adding that Chara should have been suspended for 50 to 80 games. EIGHTY. GAMES. We continue: “The owners have a financial interest in tolerating and promoting violence and we need to be a counterweight,” he said. Ive always found this to be such a strange argument. Ive watched the NHL for over 25 years. Ive actually been waiting for them to begin promoting violence in a way that would connect with casual American fans who only speak three languages in sports: Scoring, gambling and violence. And since the NHL will never have the first and Americans dont wager on the second, the third option was always the best. Yet for decades, the NHL ran away from violence while the NFL, pro wrestling and MMA captured huge market shares by embracing it. The NHL has a winking acceptance of fighting, for example, as part of the game. Does it promote it? It doesnt ignore it.

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Jonathan Kay: Canadian doctors explain why so many of us die badly

Tony Ding/KRT

Palliative care is often seen by the family as equivalent to pulling the plug. We have a curious system of deciding how aggressive we should be with a patient care, Dr. McDermid, cited above, later wrote. We ask the patient [first], and if he or she is incompetent or too sick, we ask the next of kin, power of attorney or other representative. Although [doctors] can override the decision based on medical futility, they tend not to, for multiple reasons. For one, [doctors] dont have time to get into a long process with the family. Theres also the threat of a complaint (especially a time-consuming complaint involving the College of Physicians and Surgeons) or (though not so much in Canada) a lawsuit. [For instance] I have been threatened by a lawyer (when I was completely exhausted at midnight), to bring his dying [91-year-old] father to the ICU immediately, or else he would take action. So I did, and the father died with all the lines and tubes you mentioned [in your article]. Most families are reasonable, but very often they want everything done to save their aging and dying relatives, Dr. McDermid elaborated. There is often a dysfunctional family dynamic [whereby members] do not agree on what should be done. If there is one vehement outlier in the family who wants everything, we often acquiesce to that persons demand. Often, guilt possibly stemming from neglect prior to the onset of a sudden illness plays a major role in the inclination to over-treat. Dr. Travis Carpenter, an internal medicine resident at the University of Toronto, told me that much of the problem is rooted in the fact that patients family members are often unrealistically focused on the hypothetical benefits of aggressive treatment. They are also, however, completely ignorant to the almost-certain costs. For elderly patients in the ICU and on the ward, [aggressive end-of-life interventions often require] chemical and physical restraints to provide treatment. These measures can be extremely distressing to the patient and for health care providers, Dr.

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Canadian Association of Gastroenterology: Open Letter to Canadians

New Data Concludes Wait Times for Patients With Gastrointestinal Disease Are Increasing Across Canada

That’s far longer than the 3 weeks Canadians have told us that they’re willing to wait. Frankly, four months is unacceptable. It is time we got our priorities straight. Surprisingly, in developing its wait list reform of the Canadian health care system, Paul Martin’s government overlooked digestive disease. The Canadian Association of Gastroenterology has sent a call to action to Prime Minister Paul Martin, urging him to include digestive disease as a health-care priority and ensure Canadian patients obtain necessary and timely access to our specialists. Canadian gastroenterologists are already out of the starting block. The Canadian Association of Gastroenterology has done its homework, talked to patients, and is now armed with information that will be crucial in improving the Canadian health care system. We have developed 24 recommended targets for medically-acceptable wait times for gastroenterology, based on a study conducted by nearly 200 Canadian GI specialists who captured data on 5,500 patient visits. We are ready to work with Canadians to make Paul Martin’s government pay attention. We are not looking for handouts. The simple infusion of federal dollars into the health care system is a band-aid solution. We must now go further, as a society. The Canadian Association of Gastroenterology proposes to work hand-in-hand with Paul Martin’s government to develop the creative strategies that will finally allow us to bring wait times to acceptable levels. The federal government’s wait time initiative must be adapted in the face of current realities. We can no longer accept the unnecessary prolongation of suffering. The lives of Canadians are at risk.

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These states consume very little of the natural gas themselves, transferring it to other states with much higher natural gas demand. For example, Canadian natural gas entering through the states of Washington and Idaho supplies about one-quarter of the natural gas demand in Californiaaa state that gets over 55 percent of its electricity generation from natural gas. Natural gas is also used heavily in Californiaas buildings sector and for industrial uses. The state of Washington most likely gets all its natural gas demand from Canada. Source: Energy Information Administration, http://www.eia.gov/dnav/ng/ng_move_poe1_a_EPG0_IRP_Mmcf_a.htm Montana serves as a point of entry for Canadian natural gas and pipes most of the Canadian gas it receives to North Dakota, who in turn pipes it to Minnesota and South Dakota. Both Wisconsin and Illinois benefit from Canadian natural gas coming by pipeline from the Dakotas and Minnesota. Illinois uses three-quarters of its natural gas supplies in the residential and commercial sectors, heating homes and offices, while Wisconsin uses slightly less of a percentage in those sectors (about two-thirds). On the east coast, Vermont is entirely dependent on natural gas from Canada to meet its demand. Interestingly, Vermont was also the first state to ban hydraulic fracturing , which combined with horizontal drilling in shale structures, has made the U.S. the largest producer of natural gas in the world. Maine gets its natural gas supplies mainly from Canada and sends a large amount of natural gas to New Hampshire, who uses it to supply its own demand and also pipes supplies to Massachusetts. Massachusetts also receives domestic natural gas shipments and imports liquefied natural gas (LNG) from Trinidad and Tobago and Yemen via its LNG terminals in Everett, Massachusetts, and its Northeast Gateway terminal. Massachusettsa demand for natural gas is relatively high among U.S. states, using its natural gas supplies mostly in the buildings sector to meet residential and commercial demand, but also to generate electricity and for industrial uses. New York also receives natural gas imports from Canada, but receives a large amount of its natural gas from the Marcellus shale in Pennsylvania. Seventy percent of New Yorkas demand is used in the buildings sector. Oil and Petroleum Product Imports from Canada The majority of the crude oil imported into the United States from Canada comes via pipeline. There are, however, Canadian crude oil and petroleum products arriving by ship to the East, West, and Gulf coasts and more recently, shipments to U.S.

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Canadian Oil and Natural Gas Imports: How Important Are They?

Colonoscopies are among the medical tests for which professional fees face a cut of 10%. Pointing to new initial data gathered in April 2012 from the Canadian Association of Gastroenterology Survey of Access to GastroEnterology (SAGE), Desmond Leddin, Lead of the SAGE, says “a comparison of data from surveys performed in 2005 and 2008 shows that wait times for patients with gastrointestinal disease have increased across Canada.” “This CAG national survey information combined with the new fee structure in Ontario gives us cause for concern about patient safety,” says CAG President Dan Sadowski. “With evidence in hand that patient wait times have been increasing over the past seven years, we can’t support any government decision – in Ontario or elsewhere in Canada – that results in reduced access to, or longer wait times for, important medical procedures including colonoscopy, which can prevent and reduce cancer rates.” About 20,000 Canadians are diagnosed with colon cancer every year. Of that number, one-third will die of the disease. Notwithstanding these statistics, the CAG and OAG agree that cancer screening is a success story in Canada, and that prevention and early detection by access to colonoscopy is key to reducing the burden of the disease. The proof rests in the release of statistics on May 9 by the Canadian Cancer Society on the decline in deaths from colorectal cancer due to increased screening. “We have made important gains to reduce national rates of colorectal cancer through colonoscopy screening programs,” says Dan Sadowski. “We are concerned that the Ontario government’s decision to cut professional fees will have two bad outcomes. The first is that longer patient wait times will grow even longer due to a drop in access to cancer screening procedures. The second is that it may open the door to similar policy decisions in other regions in Canada. In both cases, it is the patient who will bear the brunt of these decisions.” Links:

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Canadian woman survives 12 days in the bush

New Data Concludes Wait Times for Patients With Gastrointestinal Disease Are Increasing Across Canada

Related Content Before reappearing last week, she was last seen on July 14 on the north end of the O’Chiese First Nation reserve, according to a statement from the Royal Canadian Mounted Police in Rocky Mountain House, Alberta. She escaped an attack and vanished, it said, emerging 12 days later. The woman’s uncle said she suffered head and pelvic injuries and will need to undergo reconstructive surgery on her jaw. Her feet are also in bad shape as she had no shoes, he said. The woman remains hospitalized. She survived by drinking river water and eating berries, according to a report by The Canadian Press. Citing RCMP Cpl. Nick Munro, it said investigators believe that the woman was in a truck with four other people when it got stuck. Three of them went for help. When they didn’t return, the woman and a man started walking. He allegedly then hit her in the face and attempted to sexually assault her, The Canadian Press said. The woman reportedly fled and got turned around. She was eventually found by an oilfield worker on a dirt road, The Canadian Press said. He called authorities. Kevin Roy Gladue, 36, is charged with aggravated assault, sexual assault and obstructing a peace officer, the RCMP statement said.

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Colonoscopies are among the medical tests for which professional fees face a cut of 10%. Pointing to new initial data gathered in April 2012 from the Canadian Association of Gastroenterology Survey of Access to GastroEnterology (SAGE), Desmond Leddin, Lead of the SAGE, says “a comparison of data from surveys performed in 2005 and 2008 shows that wait times for patients with gastrointestinal disease have increased across Canada.” “This CAG national survey information combined with the new fee structure in Ontario gives us cause for concern about patient safety,” says CAG President Dan Sadowski. “With evidence in hand that patient wait times have been increasing over the past seven years, we can’t support any government decision – in Ontario or elsewhere in Canada – that results in reduced access to, or longer wait times for, important medical procedures including colonoscopy, which can prevent and reduce cancer rates.” About 20,000 Canadians are diagnosed with colon cancer every year. Of that number, one-third will die of the disease. Notwithstanding these statistics, the CAG and OAG agree that cancer screening is a success story in Canada, and that prevention and early detection by access to colonoscopy is key to reducing the burden of the disease. The proof rests in the release of statistics on May 9 by the Canadian Cancer Society on the decline in deaths from colorectal cancer due to increased screening. “We have made important gains to reduce national rates of colorectal cancer through colonoscopy screening programs,” says Dan Sadowski. “We are concerned that the Ontario government’s decision to cut professional fees will have two bad outcomes. The first is that longer patient wait times will grow even longer due to a drop in access to cancer screening procedures. The second is that it may open the door to similar policy decisions in other regions in Canada. In both cases, it is the patient who will bear the brunt of these decisions.” Links:

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A Canadian doctor diagnoses U.S. healthcare

CANADIAN DOCTORS DEMAND MORE PAY

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer. Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices. Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery.

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has really contracted a lot with some of the practices the HMOs have adopted recently, so there just arent the opportunities there, Mr. Grant said. When the Canadian dollar was 65 cents, U.S. salaries looked terrific. When its near par, its not so good we now have been seeing a reverse flow, there are more physicians coming to Canada than leaving Canada. That shift may give provincial governments the political leverage to bring doctor remuneration in line with increasingly tight budgets. A report also released on Tuesday from the conservative Fraser Institute suggests healthcare costs in Canada are growing at faster rate than shelter, food and the average income. A family of two parents and two children with an average income of more than $113,000 can expect to pay more than $11,000 in taxes to the countrys publicly funded system. The fact is, Canadian families pay thousands of dollars in taxes every year to cover the cost of public health care insurance. And that cost rose 1.5 times faster than average income over the past decade, said Nadeem Esmail, Fraser Institute director of health policy studies. Physician pay is a tricky matter that is difficult to compare directly: doctors are essentially contract employees for their respective provinces. Each province negotiates a fee per service provided. Doctors then have to pay for their own overhead, including rent and administrative help. A report for the Canadian Institute for Health Research found that doctors made, on average, $307,482 in 2010-11. Physicians in Alberta were paid the most. Ontario doctors came in second, while those in the Atlantic provinces and Quebec earned the least. However, those figures didnt take doctors costs into consideration.

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Doctor salaries have shot up 30% in past decade over fears of physician shortage, brain drain to U.S.: report

The School of Public Policy, University of Calgary/Handout

In Ontario, Canada’s largest province, 15,000 doctors have been staying away from their offices or refusing to perform some services, such as prescribing drugs by telephone. Some 5,500 general practitioners in Quebec, the second largest province, are threatening to close their offices for a day next week. At issue in both cases is the official schedule for fees that doctors are supposed to charge for medical services; talks between the provincial governments and the medical associations on new schedules have produced no agreement. There is a similar clash in Manitoba, and over the last four years doctors have shown discontent at times in almost every province. Officials speak of the Canadian health system as ”one of the best in the world,” but the Canadian Medical Association says the system is underfinanced. Doug Geekie, spokesman for the association, said Canada was devoting to health care 7.2 percent of its gross national product, the sum of all goods and services produced. He said that among Western nations only Britain spent less than this and that the United States devoted about 10 percent of its G.N.P. to health care. Ottawa Cuts Contributions With inflation running high and the federal Government anxious to keep its deficit down, the 10 provinces, which are responsible for their own health systems, are undergoing a particularly tight financial squeeze this year. Ottawa has cut the rate of growth of its contributions to the provinces for health care by about 15 percent. Well before the cuts, doctors’ incomes were losing ground to those of other professional groups, the Medical Association says. It cited tax figures indicating that between 1971 and 1977 lawyers, dentists and accountants increased their incomes at a much faster rate than doctors.

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UK Doctor’s Horrifying Admission Reveals How Sick & Disabled Babies Are Put on ‘Death Pathways’, Deprived of Food & Fluid for 10 Days

‘Doctor Who’ Season 8 Spoilers: Peter Capaldi Revealed as Twelfth Doctor

They say it is a form of euthanasia, used to clear hospital beds and save the NHS money. The use of end of life care methods on disabled newborn babies was revealed in the doctors bible, the British Medical Journal. The previously mentioned doctor wrote of the pain of watching the slow, forced deaths of newborn babies. One babys parents decided to put their infant on the pathway because of a lengthy list of unexpected congenital anomalies, according to the doctor. (Photo credit: Shutterstock.com) (Photo credit: Shutterstock.com) Heres some of what the doctor wrote in the medical journal [emphasis added]: The voice on the other end of the phone describes a newborn baby and a lengthy list of unexpected congenital anomalies. I have a growing sense of dread as I listen. The parents want nothing done because they feel that these anomalies are not consistent with a basic human experience. I know that once decisions are made, life support will be withdrawn. Assuming this baby survives, we will be unable to give feed, and the parents will not want us to use artificial means to do so. Regrettably, my predictions are correct. I realise as I go to meet the parents that this will be the tenth child for whom I have cared after a decision has been made to forgo medically provided feeding. [] Like other parents in this predicament, they are now plagued with a terrible type of wishful thinking that they could never have imagined.

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UK Doctors Horrifying Testimony Reveals How Sick & Disabled Babies Are Put on Death Pathways

Like the Doctor himself I find myself in a state of utter terror and delight. I can’t wait to get started.” Outgoing Doctor Matt Smith had a pre-recorded message for the new commander of the TARDIS. “I wish my successor all the best and say good luck and good on you for getting it, because I know he’s both a huge fan of the show and a really nice guy,” Smith said. The 55-year-old Scottish actor hails from Glasgow, and is best known for playing the sardonically profane political insider Malcolm Tucker in the BBC series “The Thick of It.” The UK comedy series created by Armando Iannucci focuses on the inner-workings of the British government. Capaldi is known for expertly delivering sarcastic, expletive-ridden insults in the series, which quickly made his character a fan favorite. The hit show also spawned a feature film spin-off titled “In the Loop,” in which Capaldi reprised the role of Malcolm. Capaldi is also known for his many film, television and stage roles. He was featured in the 1983 film “Local Hero” alongside Burt Lancaster, and in the zombie flick “World War Z” with Brad Pitt. He also won an Oscar in 1994 for his short film “Franz Kafka’s It’s A Wonderful Life.” According to BBC News , Capaldi was also in Doctor Who– he played the smaller role of the Roman merchant Caecilius in the 2008 episode “Fires of Pompeii.” After a string of young doctors, (Matt Smith, David Tennant,) the 12th iteration of the Doctor will harken back to earlier Doctors, who were of a more advanced age. BBC News reports that Capaldi is the same age as the first Doctor, William Hartnell, who was also 55 when he was cast in the role in 1963. Steven Moffat, the executive producer and lead writer of the show, said that Capaldi as the the Doctor is an “incendiary combination.” Capaldi was reportedly cast as the Doctor after a secret audition at Moffat’s house. Moffat disclosed that he had considered Capaldi as the Doctor in the past, and is thrilled that the time has finally come for Capaldi to play the part. “One of the most talented actors of his generation is about to play the best part on television,” Moffat said.

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