and Britain looked at the number of ads in six highly read journals from the three countries over a six-year period. Pharmaceutical ads took up almost as much space as peer-reviewed editorial content in the two Canadian publications the Canadian Medical Association Journal (CMJ) and Canadian Family Physician, they concluded in the online journal Plos One . That was several-fold more than the ratio of ads to articles in the U.K.s British Medical Journal and Lancet, and the U.S.-based New England Journal of Medicine and Journal of the American Medical Association, they said. At most, advertising in the non-Canadian journals represented about 20% of the space taken up by editorial content. Everyone was surprised by that finding, said Dr. Persaud. It did not come as a surprise, though, to Dr. John Fletcher, editor-in-chief of the CMAJ. Canadian journals have traditionally relied more on advertising than their counterparts in Britain and the U.S., even though the volume of ads has been declining, he said. The edited content of journals provides information about medications, which makes you wonder why we also needs ads Some of the added revenue also stemmed from a previous requirement that pharmaceutical companies include detailed prescribing information with their ads, which could sometimes occupy two or three pages at the back of the journal, said Dr. Fletcher.
Canadian doctors say fee cuts, pay inequalities will spur exodus
The result was a major reshuffling of the pool of money paid to doctors, with some like radiologists seeing major drops in their fees and others such as neurosurgeons graced with increases. Perhaps the most-cited inequity involves fees for some eye operations, such as cataract removal. New technology makes them faster to carry out, but in many provinces the payment has stayed the same, resulting in something of a windfall for ophthalmologists. The reaction to the recommendations was swift. The losing specialties voiced outrage, predicting harm to patients and a mass flight out of the province. As had happened when B.C. and Alberta went through a similar process, nothing ever came of the report. Comparing Canada to other countries is tricky, given the different methods of paying doctors and varying costs of living. A 2009 report by the Organization for economic co-operation and development (OECD) tries to even it all out, relating doctor pay to each nations average worker salaries. It puts Canadian specialist doctors at 4.7 times the average wage, higher than all but Germany and Holland, with the U.K. at 2.6 times and France 3.2. The report does not include the U.S. Surprisingly, some figures suggest this country is now more generous. Ms. Matthews office cites statistics from the provincial Institute for Clinical Evaluative Sciences and the MGMA Physician Compensation Survey in the States that indicate Ontario family doctors make $143,000 more on average than U.S. counterparts, radiologists pull in $203,000 more and cardiologists $141,000 more.