A physician who has practiced medicine in both the United States and Canada has detailed significant differences between the two countries' healthcare systems, drawing widespread attention on social media. Dr. Ashley, a family physician currently practicing in Ontario, Canada, shared her observations on TikTok, contrasting her experiences in the U.S. with her current role.
Dr. Ashley noted that one of the most substantial changes was the number of patients seen daily. In her previous practice in the U.S., she saw 18 patients per day, with approximately 20-25 minutes allocated for each visit. This allowed for comprehensive discussions covering medical conditions, screenings, and patient questions. In contrast, she stated that in Canada, the standard visit time is shorter, although she affirmed that time is always made for critical health concerns and mental health issues.
Physician Compensation and Workload
Another key difference highlighted by Dr. Ashley pertains to physician compensation. In the U.S., she described working as a salaried employee with benefits, offering income stability regardless of the exact hours worked or patients seen. However, in Canada, her income is directly tied to the number of patients she actively treats. She explained that if she takes time off for vacation or illness, she earns no income during that period.
Dr. Ashley also discussed the potential for higher earnings in Canada by seeing more patients and working longer hours, but cautioned that this can lead to burnout. She cited the extensive paperwork, phone calls, follow-ups, and advocacy required for each patient as significant contributing factors to this burden, an aspect she felt was less pronounced in the U.S. with a smaller patient panel.
Systemic Differences
Dr. Ashley's video gained further traction when re-shared on X, formerly Twitter, sparking a debate about the two healthcare models. The notes accompanying the re-shared video summarized her points, characterizing the Canadian system as one where doctors are paid per patient, face potential income loss during time off, and are subject to burnout from administrative tasks. The post also contended that the Canadian system, funded through taxes for eligible residents accessing publicly funded health care services, faces challenges such as doctor shortages and long wait times.
Canada's healthcare system is described as a universal system funded by taxes, with each province and territory maintaining its own health insurance plan that covers basic standards for medically necessary hospital, physician, and some surgical-dental services. The U.S., conversely, operates with a mixed system that includes publicly financed Medicare and Medicaid alongside privately financed market coverage, rather than a universal system.