July 9, 2025 • 29 mins
Dr. Michael Koren sits down with Dr. Allan Rosenfeld, a Canadian physician specializing in occupational medicine. The two doctors explore some of the realities of Canadian healthcare by moving through Dr. Rosenfeld's career in family practice, occupational medicine, and his personal use of the healthcare system. Dr. Rosenfeld offers candid insights that challenge common perceptions by discussing wait times, physician compensation challenges, and some differences between the US and Canadian healthcare models.
Contact Dr. Rosenfeld at occdocc@rogers.com or (905) 828-6016. His book is titled "Holocaust Lumber" and is available on lulu.com
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Announcer (00:00):
Welcome to MedEvidence, where we help you
navigate the truth behindmedical research with unbiased,
evidence-proven facts.
Hosted by cardiologist and topmedical researcher, Dr.
Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr .
Michael Koren, the executiveeditor of MedEvidence! and it's
always fun to do a podcast withan old friend, and I have that
opportunity to do that todaywith my friend, Allan Rosenfeld,
who is a very prominentphysician in Toronto, Canada,
and Allan is an expert inoccupational medicine and we're
gonna have a little conversationtoday talking about his path to
(00:34):
occupational medicine and alsosome insights in terms of the
Canadian healthcare system,which I've learned a lot about
over the years from Allan.
So, Allan, welcome toMedEvidence!
Dr. Allan Rosenfeld (00:45):
Thank you.
Thank you, Mike.
Dr. Michael Koren (00:54):
So let's just start off by kind of giving
everybody a sense for yourbackground.
Tell them we grew up, we wentto school and how you got into
this whole occupational medicinebusiness.
Dr. Allan Rosenfeld (01:00):
Sure, I was born in Toronto.
I went to medical school at theUniversity of Toronto.
I graduated in 1984.
I did a family medicineresidency at McMaster University
, which I completed in 1986.
Dr. Michael Koren (01:15):
All amazing programs.
Yeah, very, very prominentprograms.
Dr. Allan Rosenfeld (01:21):
It was unique.
I then went on to do my diplomaof occupational health and
safety from McMaster Universityin 1993.
And then I got my fellowshipwith the Canadian Board of
Occupational Medicine in 2007.
During that time I set up a.
I started a family medicinepractice in a suburb of Toronto
in 1988 and continue to do thatuntil 2023, two years ago when I
(01:46):
closed the practice.
So I was on staff at one of thelocal hospitals we were
responsible for.
We were MRPs for our patients.
We assisted in surgicalprocedures on our patients
Dr. Michael Koren (01:56):
Say MRPs tell people what that means.
Dr. Allan Rosenfeld (01:58):
Most responsible physician.
So those patients that wereadmitted were our responsibility
.
We would use consultants asneeded, but ultimately they were
our responsibility.
So I was in a call group.
We did rounds On weekends I'dsee patients.
At nights I'd get calls to seepatients.
So I did that for many years.
About five years into familypractice, the Ontario government
(02:20):
decided that there wasover-utilization by both the
health professionals and thegeneral population, that their
budget was being busted and theydecided, if overutilization
continued they were going to godirectly into your accounts to
withdraw month to month, basedon how much overutilization it
was and this was Bob Rae was thepremier at the time.
(02:43):
So I came home and I talked tomy wife.
I said look, I'm working reallyhard.
I was doing 10-hour days plusgoing to the hospital to see
patients and at the end of themonth I was seeing withdrawal on
the fee-for-service depositsthat I was getting.
So I got frustrated.
I grew up with a familybusiness, which I'll talk about.
(03:03):
We ran a lumberyard and Ithought I love medicine, I love
patients, I love being withpeople, I love being a family
physician, but I need anotherniche.
So that's when I went back toMcMaster in 1993 and did my
diploma of occupational healthand safety.
Dr. Michael Koren (03:19):
So interesting,
Dr. Allan Rosenfeld (03:20):
I grew.
Companies reached out, Ideveloped a name for myself.
Unfortunately, a prominentoccupational physician not far
from my practice passed away andI picked up a lot of his work
and it just grew from that pointon.
Dr. Michael Koren (03:34):
Well, good for you, good for you.
So let's unpack that a littlebit.
So Canadian medicine issomething that we talk a fair
amount about in the UnitedStates, and it's usually as a
criticism of US medicine, quitefrankly.
And I've learned from you overthe years that there are pluses
and minuses to the Canadiansystem, and you've mentioned one
(03:54):
of the minuses, certainly fromthe physician standpoint.
But maybe you can flesh thatout a little bit for the
listeners and people that areviewing this podcast.
Well, there are two models inOntario, which is the province
that I practice in.
One model is a fee for service,so you see somebody, you get
(04:17):
paid.
The average fee for the familyphysician was about $35 per
visit.
I think it's a little more now.
And the payer is the government.
Dr. Allan Rosenfeld (04:20):
Yeah, the government is the payer.
As long as the patient has aprovincial health care number,
the doctor is guaranteed to getpaid Sometimes not what you bill
for, but you're guaranteed toget paid.
Patient does not pay anything.
The other model that we have iswhat's called family health
organization or family healthnetwork, which means the doctor
is paid a retainer based on thedemographics and the numbers of
(04:44):
patients that he or she has intheir practice.
So, for example, if the doctorhas 2,000 family practice
patients and they're mostlyelderly, they'll get paid more,
and if they have 2,000 patientsand they're 25-year-old men, the
fee is less.
There's also bonuses for doingcancer screening and
immunizations and things likethat.
(05:06):
So colonoscopies, pap smears,and so there's bonuses in that
kind of model as well.
So I practice in thefee-for-service model.
More and more doctors are doingthe family health model, which
the government likes becausethere's more understanding of
what the billing is.
So for me, a family for service.
Some days I could go in and see20 people.
(05:28):
Other doctors would go in andsee 100 per day, and so the
government was pushing, I felt,most physicians to do the model
where they were on this familyhealth network.
My family doctor right now, whoI've only seen once, is in that
kind of a practice.
I found that the hours werelimited.
A lot of these clinics bring innurse practitioners to take up a
lot of the work they have paidfor by the government or the
(05:50):
clinic.
The model's been changing so Ihaven't even kept up on it, but
you know it's fee-for-service.
When you're seeing 40 to 50patients per day, really I felt
lent to.
It was really hard to be a goodfamily physician when you're
seeing that number per day.
On the other hand, with theFamily Health Network my read is
a lot of the doctors see veryfew patients.
(06:11):
It may not be true for allclinics and I don't want to talk
for all doctors, but I've seenclinics where the doctors are
seeing 10 to 15 per day.
My daughter has several peersthat have gone into medicine
family practice in their early30s.
We talked about the other dayabout five family doctors in
their early 30s who worked theFamily Health Network group and
(06:33):
after doing it for two to threeyears departed.
Even when they had bought thepractices.
They couldn't continue it.
A lot of the young familydoctors are finding other niches
as well.
So if they do family practice,they're doing it two days per
week and then they're findingother niches like palliative
care, like Botox, cosmeticdermatology, things like that
Dr. Michael Koren (06:51):
I see.
Interesting.
So from the patient perspective, I know that there's been some
pluses and minuses.
The plus may be lower costs andthe minus may be waiting lines
for certain procedures orimaging and not getting access
to things that people might haveaccess to in the US.
(07:13):
I don't know if you want tocomment on that.
Dr. Allan Rosenfeld (07:16):
You're correct.
So nobody pays.
You can come to Canada as a newrefugee immigrant and you're
here three months and you're nowcovered by the Ontario Health
Insurance Plan here, so you'recovered.
If you're lucky enough to finda family doctor, you don't pay
for anything.
You pay for notes, return towork, notes, forms, things that
aren't covered under the OntarioHealth Insurance Plan, but you
(07:39):
don't pay for anything.
And even if you've been livinghere 60 years or you've been
here three months, it's the samelevel of care that's provided
and offered to anybody thatcomes here.
The negative, and I'll talkabout an example for me I was
playing hockey in late Decemberand I sustained a concussion in
men's pickup ice hockey, if youwant to believe that.
I had warned the guy off a fewtimes about being reckless.
(08:01):
Anyways got hit.
I, um.
I went to the emergency roomthat I had been on staff on as a
family doctor, not recently buttill about 15 years ago, and I
knew the doctor who was working,numerage the the uh, it was the
one doctor.
There was 190 patients in queuewaiting for one physician this
(08:21):
is a 72 year old er physician ERphysician who I knew because I
had dealt with him in the pastwhen I was doing family practice
and it was about a nine-hourwait to see a physician and
that's not unheard of.
My spouse was recently inhospital for a medical emergency
.
She was admitted, the care wasrelatively quick to see the
(08:44):
physicians but there were nobeds so she lay in a gurney in
the eMERGE hallway for 36 hoursbefore getting a bed and that's
common.
When you walk through theeMERGE there's people sitting on
floors, lying on floors.
So the access to care can bequite limited.
Access to investigations likeMRIs, ct scans, can be limited,
(09:04):
especially if it's a subacute orchronic medical problem.
But if it's acute, you walkinto a EMERGE with chest pain
still pretty good.
You have various cancers stillpretty good.
So if it's a really acute thing, you'll get seen.
You go in with a migraine,headache or a subacute or
chronic issue.
You may wait hours and hoursand hours.
(09:25):
The other problem I found as afamily physician and one of the
reasons I left family practicetwo years ago is that the
paperwork was becoming untenable.
It was all the paperwork.
The specialists refused to dopaperwork so it was all falling
on the family physician.
You weren't really paid for itor you could bill whatever
nominal fee you wanted that yourpatients would pay.
But I was finding patients thathad been admitted under the
(09:48):
care of specialists um werecoming back to see me in my
office and the follow-up withthe specialist was at times
months later.
And these were complex internalmedicine cases, uh, complex
cardiology, psychiatric cases,where I I mean in my practice I
refer people first to see apsychiatrist.
They'd wait nine months
Dr. Michael Koren (10:09):
Ooh my goodness
Dr. Allan Rosenfeld (10:10):
-and that's , that's not unheard of six
months to a year.
Then I'd get a consult backfrom the psychiatrist telling me
try these three drugs, thesethree drugs.
And, uh, you know, if you needto have me see them again, just
call the office again.
You have to go back in the inqueue.
Now there are better systems toget people in, but that's and I
know they exist and they areavailable, but that's kind of
what I was seeing.
(10:30):
Orthopedics, uh, geriatrics,psychiatry.
The wait to see uh specialistsis extremely prolonged,
especially for geriatrics andpsychiatry.
My son has an impingement ofhis left hip.
Um, the wait time to see anorthopod and get it dealt with
is probably two years by thetime you see the ortho and they
get referred, you're like so inCanada, like we do provide
(10:53):
healthcare to everybody,nobody's turned away.
But you have to wait a longtime at times, unless it's
really acute like chest pain,cardiac stuff or stroke.
But it's a long wait and I havepatients who refuse to go to ER
because they don't want to wait, especially elderly.
They don't want to wait that 9,10, 12 hours Every emerge here
(11:15):
is just security everywhere,because I gather they've had
patients that have just losttheir minds in these emerges.
So the system is, in Ontario atleast, is buckling, to say, to
put it nicely.
At least that was myperspective from two years ago.
Um, even getting family doctorsto complete forms in
occupational medicine is attimes problematic, so a lot of
(11:38):
we're hiring nurse practitionersto do the work they don't want
to do and um, so yeah it's, it's.
it's a bit of um chaos and Idon't see how it's going to be
fixed in the short term.
The current governmentgovernment I do not think values
family physicians for sure theydon't value them.
I don't know how it's going toget fixed unless we privatize,
(11:58):
and I don't think thatprivatization will occur in the
near future.
Dr. Michael Koren (12:02):
Got it?
Yeah, interesting perspective.
Not what we hear in the USmedia very much about the
Canadian system.
Canadians are well known fortheir patience, but even
Canadians have some limits interms of patience when it takes
two years to see an orthopod.
So interesting perspective.
One of the other things thatcomes up is using a Canadian
(12:23):
pharmacy.
So drug costs are quite high inthe US, as you know, and often
they're less in Canada.
Do you have any insights intothat?
Should US citizens and UShealth care patients be
concerned about using Canadianpharmacy?
Dr. Allan Rosenfeld (12:39):
I haven't ever had any issues with that,
Mike.
I mean the pharmacies.
There's two big pharmacies here.
It's almost like a monopoly.
There are small independentsbut there's two huge ones in
Ontario and I haven't had anyissues with distribution of any
medication.
Some of the drugs that, forexample, I take ranitidine.
It's no longer, it's not sorry.
(13:03):
Health Canada supports the useof it.
In the US they do not.
So there's drug differences interms of what we carry.
I've never seen an issue withany pharmacy.
There is, I think, a conflict ofinterest.
Maybe that's not the right word,but the pharmacists here are
also paid to do what's calledmed checks and that means if
somebody walks in and they're onthree medications or more, from
(13:25):
what I understand, thepharmacist can pull them aside
and review the medications andtalk about any potential drug
interactions or complications orside effects.
And they're paid by the OntarioHealth Insurance Plan and I
think it's $65, something likethat, which is more than I would
get for assessing somebody forcongestive heart failure or
post-surgical, and it would takeprobably less time.
(13:46):
So I feel like the twopharmacies here.
They're good.
The pharmacists that I've dealtwith are very professional.
They're very hardworking andthey work pretty hard by the
companies they work for, but Ihave not had any issues with and
I can't see if an Americancomes here to get their
medications.
I think they can be comfortedthat they're probably going to
(14:08):
get good care from thepharmacists and the medications
are what they are.
But keep in mind, we won't getevery medication that you have
there
Dr. Michael Koren (14:14):
Just for the listeners,
ranitidine is a drug for stomachacid and it's called an H2
blocker and it's been replacedby proton pump inhibitors by and
large, but it's a good oldgeneric drug that probably works
pretty darn well.
Dr. Allan Rosenfeld (14:31):
It works amazing and yet I question
Health Canada as to why the USpulled it.
Every other country in theworld, except for two or three
countries, has pulled it and aslong as they do ongoing checks
of that drug, and when it's at apharmacist, they test the drug
for NMDA, which was a potentialcarcinogen when the drug was
(14:52):
overheated or left in shelvesand got hot.
So not all the drugs that youhave and I would say a large
portion that you have are notsupported by our healthcare
system or supported by HealthCanada, and some that are are
not
Dr. Michael Koren (15:05):
Supported, meaning they don't pay for it,
yeah?
Dr. Allan Rosenfeld (15:09):
in Canada over 65, ontario Drug Benefit
pays for drugs that are on thebenefits Not all drugs, but drug
that's manufactured drugs thatare on benefits.
So after 65 you don't have topay for medications, except the
first month you have to pay a$100 retainment stipend.
So drugs are covered over 65.
Dr. Michael Koren (15:15):
Yeah, in places where they found very
(15:35):
very low levels of carcinogens
Dr. Allan Rosenfeld (15:37):
Correct.
Dr. Michael Koren (15:38):
-and for that reason there was some concern
about continuing to use them.
Dr. Allan Rosenfeld (15:42):
Correct.
Dr. Michael Koren (15:43):
But if you happen to be on ranitidine,
there's probably no great acuterisk.
Talk to your healthcareprovider about it.
But that's the reason why it'sbeen quote pulled from certain
parts of the world.
Dr. Allan Rosenfeld (15:55):
Right, and there's famotidine hydrochloride
, which we call Pepsid which inthe US on the shelves is called
Zantac, which is the trade namefor ranitidine, is now available
and it's another H2 antagonistwhich is supposed to be as
effective but did not work forme.
Dr. Michael Koren (16:10):
Gotcha, okay Well in any events.
So moving on to your career,which I find super fascinating,
tell us a little bit about whatyou do as an occupational
medicine expert.
Who your customers?
What's your day-to-day like?
And you mentioned that you'vemoved out completely from family
medicine and is it good livingYou're supporting yourself?
(16:31):
Tell us a little bit more abouthow things are going.
Dr. Allan Rosenfeld (16:34):
So occupational medicine is not
covered by the government.
They're trying to get it,they're trying to get a code for
billing through Ontario healthinsurance, but it's not covered.
So I went back, did mypostgraduate training.
I then developed relationshipswith various corporate clients,
industrial clients, so it's amixture of lots of stuff and my
son, who's trained in Australia,is now working with me as well,
(16:56):
and my daughter, so it's afamily business.
It's got her MBA and she runsthe business side of it and so I
deal with.
I guess there's two major, threemajor aspects to it.
We do pre-employment exams, socompanies that are hiring
employees that are concernedabout baseline hearing, baseline
pulmonary function testing,whether there's a baseline
(17:17):
medical illness or physicalillness that will make them
incapable of doing the jobthey're being hired for.
I do aviation medicals forTransport Canada, so I examine
pilots for Category 1, which iscommercial, and Category 3,
which is um, private pilots.
I I do work with health canada,so that's canadian server board
as agency and transport safetyboard um which be compatible
(17:41):
with your TSA um.
I do disability management forshort term for lots of the
clients.
I've been with some clients 30years plus, which which in my
area, anybody that lasts morethan six to eight years because
it's very political, especiallydisability management.
I've been with two clients one30, one 20, and one 16 [years],
(18:02):
which is unheard of, so I pridemyself on the fact that I have
longevity with these corporateclients.
I stick to medical.
I never get don't get pulledinto the political stuff, but I
understand that it exists.
We also do medical surveillancefor a number of employers.
So what that means is Ontariohas a number of substances,
which are called designatedsubstances or chemicals, which
(18:23):
are being used in themanufacturing process and
they're known to be biologicallyharmful if levels in the body
go up beyond a certain point.
So we do blood testing, urinetesting, pulmonary function
testing.
We do hearing screening if theemployer has a lot of noise, and
that's also a big part of ourbusiness and we've been growing.
(18:46):
We have contracts with UScompanies that do a lot of work
out of Toronto, where a lot ofthe work is, and so we do
medicals for marine medicals forcompanies out of the US that
have employees here, and so,yeah, so it's been growing and I
developed expertise in it.
Now I have my son working withme and my daughter working with
me.
Dr. Michael Koren (19:04):
That's exciting.
Dr. Allan Rosenfeld (19:05):
It is very competitive.
We have to go into RFPs, whichis requests for proposals, we
have to put in bids, and it'scompetitive, but I would say
it's been relatively successful.
Dr. Michael Koren (19:21):
I've heard very positive things about your
business success and your acumen, so congratulations on that.
Dr. Allan Rosenfeld (19:25):
And it's not covered by the government.
So I can go in and set the tone, the price Keeping in mind
there's competition.
I can set the price.
The price keeping in mind,there's competition, I can set
the price, the fee schedule.
Dr. Michael Koren (19:35):
Well, good for you, and it sounds like
something that gives you greatsatisfaction from a number of
perspectives.
Dr. Allan Rosenfeld (19:42):
The medical surveillance it absolutely does
when I can pull somebody out ofthe workplace where there's
been exposure.
And we're looking at chemicalslike isocyanates, asbestos, lead
recently.
So examples of things webenzene is another one we have a
client with.
So it's great if I can actuallymitigate any potential risks to
employees.
Dr. Michael Koren (20:04):
Well, in our show notes we'll definitely put
a contact number and informationto get in touch with you and
your company about any kind ofoccupational medicine issue.
Or if you want to just statewhat the best method is to get
in touch with you and yourcompany about any kind of
occupational medicine issue, orif you want to just state what
the best method is to get intouch with you, please use this
opportunity.
Dr. Allan Rosenfeld (20:20):
You can reach me through our email
address at OCCDOC.
Occdoc, it's easy.
Occdoc at Rogers R-O-G-E-R-Sdot com, and my office number in
Canada is 905-828-6061.
As I said, we do have contractswith US companies as well.
Dr. Michael Koren (20:39):
That's great, so let's segue a little bit.
The other thing that'sincredibly impressive about you
is you've actually written abook about your path and it's
fascinating, and maybe you canshare a little bit of that
journey and what led to writingthe book with the audience.
Dr. Allan Rosenfeld (20:56):
So early on in my career I was a medical
consultant on a televisionmedical drama show called Side
Effects with the CanadianBroadcasting Company.
It lasted two seasons.
I actually contributed astoryline to season two.
It was canceled about halfwayinto season two.
It was at the same time thatMichael Crichton was doing ER
(21:17):
and I think it was Chicago Hopewas the other big medical show
that was going on.
So I got into writing.
I wrote for a number of medicalmagazines and journals.
I won an award for best shortstory in one magazine.
One story was picked up bythree magazines.
It was called Cardiologist fora Day where I was on an airplane
and somebody had some cardiacevent and I brushed up to the
(21:38):
front and I pushed the two guysaside and, unbeknownst to me, I
had just graduated and one was acardiologist and one was a
thoracic surgeon.
I was like get out of my way.
So some of the stories arereally sad, some are funny, and
then I kept writing.
I, my parents, were newimmigrants to Canada after the
(21:59):
Holocaust.
They came to Canada in 1951.
They were sole survivors oftheir familias, after the
Holocaust.
Dr. Michael Koren (22:03):
What area of Europe did they come from?
Dr. Allan Rosenfeld (22:03):
They came from from Poland.
Ukraine and my dad wasUkrainian, my mother was Polish.
My mother would have been 100yesterday.
She died at 98.
So I wrote a book of shortstories 30 short stories.
That's called Holocaust Lumber.
(22:24):
I can show you that cover there, if you can see it and I
self-published.
I probably sold 5,000 books.
It's available on lulu.
com as an ebook.
I've had people from all overthe world that have read it and
been touched by it.
I have about a dozen super fanswho write me emails every few
(22:46):
months to say why aren't youwriting more and how much the
book touched them.
It's really a first-generationCanadian book in a lot of ways,
about being a child offirst-generation Canadians and
all the expectations that wereput on me to be successful and
to be a physician, becausenothing they wanted more than
(23:08):
for me to be a doctor, and oneof the stories talks about that
that my mother was in aconcentration camp called
Majdanek, which I visited in2012 with my wife, and she said
and maybe she was herperceptions were inaccurate, but
she said that she thought thedoctors were treated better by
the nazis during world war ii inthe concentration camp.
So I got pushed and pushed andpushed to be a physician.
(23:31):
That's one of the stories, andso I wrote the book into a play
for the Jewish CanadianPlaywright Contest in 2019, and
I finished third out of 25.
It's my first time ever writinga play, so I take a lot of
pride in the fact that the bookis sad.
(23:52):
It's funny.
It does touch a lot of people.
At times, some people arereally taken with it.
Recently, I've had two highschool acquaintances that I
haven't literally seen in 50years reach out to me via Gmail
and tell me how much I like thebook.
I was at a wedding a year agoand a woman comes up to me.
(24:12):
She's probably in her mid-80sand she says is it you?
I had no idea who she was.
I go what do you mean?
She goes.
Are you Allan Rosenfeld, theguy that wrote that book?
I go, yeah, she goes.
Oh my God, can I sit down withyou?
I read it four times.
My book club has read it, soI've gone to book clubs as well.
Two library systems in Canadabought 20 copies the Mississauga
(24:33):
Library and Cape Breton in theEast Coast.
I actually went to Nova Scotiaand spoke at Pier 21, which is
in Halifax, about the book.
There were 400 people there,including politicians.
You could have heard a pin drop.
(24:53):
And then we flew up to Sydney,Nova Scotia, which is about five
hours north and north of NovaScotia, and the RCMP, about 300
people.
So I take a lot of pride inwriting a book.
I've almost finished the secondbook.
It's more of a wonder year.
It's the coming of age, sex anddrugs and bullying and all the
things that kids in the areathat I grew up in had to deal
with.
(25:16):
So yeah, and it's a lot ofreason as to why I became a
physician and why I actuallyleft family practice to run a
business like occupationalmedicine was because of that
lumber yard.
Dr. Michael Koren (25:27):
That's a tremendous story.
Thank you so much for sharingthat.
That's wonderful and I'lldefinitely have to get a copy of
the book and read it myself.
Fascinating stuff.
So again, terrific comments,and I love that you share that
with the audience.
Some of it's very personal.
(25:47):
I know it's probably a littlebit hard to share, but that's
wonderful that you have
Dr. Allan Rosenfeld (25:51):
I just want to point out, we talked
aboutthe healthcare system inOntario.
We have extremely intelligent,dedicated doctors and nurses and
staff at our hospitals who workso hard in such long hours, and
they certainly are not thereason that the healthcare
system, from my perspective,struggles.
They are amazing and myrecently a family member's care,
when she did eventually get onthe floor and even in the eMERGE
(26:14):
, was spectacular from theperspective of the medical care
and the nursing care.
Dr. Michael Koren (26:19):
I'm going to conclude with one last thing is
again to thank you for yourparticipation, Thank you for
sharing these great insights andalso point out to the audience
that you're doing this undertremendous emotional distress at
the moment.
And I say this because I knowthat Allan is a passionate
Toronto Maple Leafs fan.
And for those of you that don'tfollow hockey, the Toronto
(26:43):
Maple Leafs have been one of thehard luck stories of the
National Hockey League in thatthey have not won the Stanley
Cup since 1967.
They are in the playoffsplaying the Florida Panthers.
I happen to be in Florida as wespeak.
I'm not a Florida Panther fan,but I am a Floridian, so I have
that allegiance andunfortunately Toronto is facing
(27:04):
an elimination game today inFlorida, so you must be on edge
right now.
This must be very, verydifficult to even talk to me,
given the circumstance.
Dr. Allan Rosenfeld (27:15):
You know I can't even, I don't even want to
talk about it, like my, one ofthe things in the book that I
wrote is hockey.
Maple Leaf hockey was soimportant to new immigrants
coming to Canada.
They identified with ourculture and our country through
the Maple Leafs so I grew upwith it from the time I was five
or six years old, so watchingan organization and watching a
(27:35):
team that continues to stickwith the same group nine years
out and always eliminating great, great hockey players.
I play hockey, great hockeyplayers, great young men, very
talented, but they're not builtfor the playoffs, so I don't
want to talk about it.
Florida is an amazing team andthat's what we should be trying
to reach.
Dr. Michael Koren (27:56):
Well, one thing I will say is I remember
growing up in New York and I wasa hockey fan still a New York
Rangers fan and I used to watchthe Rangers play in Toronto on
TV and I noticed that everybodyin the arena was wearing sport
coat and tie and I thought itwas interesting how formal
(28:16):
people were in Toronto evengoing to a hockey game.
Now that, unfortunately, haschanged.
When I was watching the game onWednesday two days ago, I
noticed that finally, people inToronto are now wearing jerseys
like the rest of the world whenthey go to the game.
But it took a little while.
Dr. Allan Rosenfeld (28:30):
Yeah, well, I think a lot of those season
tickets are corporate throughcorporations, and so, yeah,
that's why.
But I was at a game I was atthe Ottawa game where they lost
4-0.
We were sitting row two Again.
The power, the speed, thefinesse of that game.
Those kids take a beating, butI don't know, I think it's over
tonight, Mike.
I think it's over for the Leafstonight.
Dr. Michael Koren (28:51):
Okay, well, I'll be rooting for you, my
friend.
Thank you Well, Allan.
This has been delightful.
Thank you for being part of theMedEvidence family, and we'll
definitely bring you back totalk about something else
relevant to your many areas ofexpertise.
Dr. Allan Rosenfeld (29:05):
Thank you so much.
Thank you for having me.
Announcer (29:07):
Thanks for joining the MedEvidence podcast.
To learn more, head over toMedEvidence.
com or subscribe to our podcaston your favorite podcast
platform.
Welcome to MedEvidence, where we help you
navigate the truth behindmedical research with unbiased,
evidence-proven facts.
Hosted by cardiologist and topmedical researcher, Dr.
Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr .
Michael Koren, the executiveeditor of MedEvidence! and it's
always fun to do a podcast withan old friend, and I have that
opportunity to do that todaywith my friend, Allan Rosenfeld,
who is a very prominentphysician in Toronto, Canada,
and Allan is an expert inoccupational medicine and we're
gonna have a little conversationtoday talking about his path to
(00:34):
occupational medicine and alsosome insights in terms of the
Canadian healthcare system,which I've learned a lot about
over the years from Allan.
So, Allan, welcome toMedEvidence!
Dr. Allan Rosenfeld (00:45):
Thank you.
Thank you, Mike.
Dr. Michael Koren (00:54):
So let's just start off by kind of giving
everybody a sense for yourbackground.
Tell them we grew up, we wentto school and how you got into
this whole occupational medicinebusiness.
Dr. Allan Rosenfeld (01:00):
Sure, I was born in Toronto.
I went to medical school at theUniversity of Toronto.
I graduated in 1984.
I did a family medicineresidency at McMaster University
, which I completed in 1986.
Dr. Michael Koren (01:15):
All amazing programs.
Yeah, very, very prominentprograms.
Dr. Allan Rosenfeld (01:21):
It was unique.
I then went on to do my diplomaof occupational health and
safety from McMaster Universityin 1993.
And then I got my fellowshipwith the Canadian Board of
Occupational Medicine in 2007.
During that time I set up a.
I started a family medicinepractice in a suburb of Toronto
in 1988 and continue to do thatuntil 2023, two years ago when I
(01:46):
closed the practice.
So I was on staff at one of thelocal hospitals we were
responsible for.
We were MRPs for our patients.
We assisted in surgicalprocedures on our patients
Dr. Michael Koren (01:56):
Say MRPs tell people what that means.
Dr. Allan Rosenfeld (01:58):
Most responsible physician.
So those patients that wereadmitted were our responsibility
.
We would use consultants asneeded, but ultimately they were
our responsibility.
So I was in a call group.
We did rounds On weekends I'dsee patients.
At nights I'd get calls to seepatients.
So I did that for many years.
About five years into familypractice, the Ontario government
(02:20):
decided that there wasover-utilization by both the
health professionals and thegeneral population, that their
budget was being busted and theydecided, if overutilization
continued they were going to godirectly into your accounts to
withdraw month to month, basedon how much overutilization it
was and this was Bob Rae was thepremier at the time.
(02:43):
So I came home and I talked tomy wife.
I said look, I'm working reallyhard.
I was doing 10-hour days plusgoing to the hospital to see
patients and at the end of themonth I was seeing withdrawal on
the fee-for-service depositsthat I was getting.
So I got frustrated.
I grew up with a familybusiness, which I'll talk about.
(03:03):
We ran a lumberyard and Ithought I love medicine, I love
patients, I love being withpeople, I love being a family
physician, but I need anotherniche.
So that's when I went back toMcMaster in 1993 and did my
diploma of occupational healthand safety.
Dr. Michael Koren (03:19):
So interesting,
Dr. Allan Rosenfeld (03:20):
I grew.
Companies reached out, Ideveloped a name for myself.
Unfortunately, a prominentoccupational physician not far
from my practice passed away andI picked up a lot of his work
and it just grew from that pointon.
Dr. Michael Koren (03:34):
Well, good for you, good for you.
So let's unpack that a littlebit.
So Canadian medicine issomething that we talk a fair
amount about in the UnitedStates, and it's usually as a
criticism of US medicine, quitefrankly.
And I've learned from you overthe years that there are pluses
and minuses to the Canadiansystem, and you've mentioned one
(03:54):
of the minuses, certainly fromthe physician standpoint.
But maybe you can flesh thatout a little bit for the
listeners and people that areviewing this podcast.
Well, there are two models inOntario, which is the province
that I practice in.
One model is a fee for service,so you see somebody, you get
(04:17):
paid.
The average fee for the familyphysician was about $35 per
visit.
I think it's a little more now.
And the payer is the government.
Dr. Allan Rosenfeld (04:20):
Yeah, the government is the payer.
As long as the patient has aprovincial health care number,
the doctor is guaranteed to getpaid Sometimes not what you bill
for, but you're guaranteed toget paid.
Patient does not pay anything.
The other model that we have iswhat's called family health
organization or family healthnetwork, which means the doctor
is paid a retainer based on thedemographics and the numbers of
(04:44):
patients that he or she has intheir practice.
So, for example, if the doctorhas 2,000 family practice
patients and they're mostlyelderly, they'll get paid more,
and if they have 2,000 patientsand they're 25-year-old men, the
fee is less.
There's also bonuses for doingcancer screening and
immunizations and things likethat.
(05:06):
So colonoscopies, pap smears,and so there's bonuses in that
kind of model as well.
So I practice in thefee-for-service model.
More and more doctors are doingthe family health model, which
the government likes becausethere's more understanding of
what the billing is.
So for me, a family for service.
Some days I could go in and see20 people.
(05:28):
Other doctors would go in andsee 100 per day, and so the
government was pushing, I felt,most physicians to do the model
where they were on this familyhealth network.
My family doctor right now, whoI've only seen once, is in that
kind of a practice.
I found that the hours werelimited.
A lot of these clinics bring innurse practitioners to take up a
lot of the work they have paidfor by the government or the
(05:50):
clinic.
The model's been changing so Ihaven't even kept up on it, but
you know it's fee-for-service.
When you're seeing 40 to 50patients per day, really I felt
lent to.
It was really hard to be a goodfamily physician when you're
seeing that number per day.
On the other hand, with theFamily Health Network my read is
a lot of the doctors see veryfew patients.
(06:11):
It may not be true for allclinics and I don't want to talk
for all doctors, but I've seenclinics where the doctors are
seeing 10 to 15 per day.
My daughter has several peersthat have gone into medicine
family practice in their early30s.
We talked about the other dayabout five family doctors in
their early 30s who worked theFamily Health Network group and
(06:33):
after doing it for two to threeyears departed.
Even when they had bought thepractices.
They couldn't continue it.
A lot of the young familydoctors are finding other niches
as well.
So if they do family practice,they're doing it two days per
week and then they're findingother niches like palliative
care, like Botox, cosmeticdermatology, things like that
Dr. Michael Koren (06:51):
I see.
Interesting.
So from the patient perspective, I know that there's been some
pluses and minuses.
The plus may be lower costs andthe minus may be waiting lines
for certain procedures orimaging and not getting access
to things that people might haveaccess to in the US.
(07:13):
I don't know if you want tocomment on that.
Dr. Allan Rosenfeld (07:16):
You're correct.
So nobody pays.
You can come to Canada as a newrefugee immigrant and you're
here three months and you're nowcovered by the Ontario Health
Insurance Plan here, so you'recovered.
If you're lucky enough to finda family doctor, you don't pay
for anything.
You pay for notes, return towork, notes, forms, things that
aren't covered under the OntarioHealth Insurance Plan, but you
(07:39):
don't pay for anything.
And even if you've been livinghere 60 years or you've been
here three months, it's the samelevel of care that's provided
and offered to anybody thatcomes here.
The negative, and I'll talkabout an example for me I was
playing hockey in late Decemberand I sustained a concussion in
men's pickup ice hockey, if youwant to believe that.
I had warned the guy off a fewtimes about being reckless.
(08:01):
Anyways got hit.
I, um.
I went to the emergency roomthat I had been on staff on as a
family doctor, not recently buttill about 15 years ago, and I
knew the doctor who was working,numerage the the uh, it was the
one doctor.
There was 190 patients in queuewaiting for one physician this
(08:21):
is a 72 year old er physician ERphysician who I knew because I
had dealt with him in the pastwhen I was doing family practice
and it was about a nine-hourwait to see a physician and
that's not unheard of.
My spouse was recently inhospital for a medical emergency
.
She was admitted, the care wasrelatively quick to see the
(08:44):
physicians but there were nobeds so she lay in a gurney in
the eMERGE hallway for 36 hoursbefore getting a bed and that's
common.
When you walk through theeMERGE there's people sitting on
floors, lying on floors.
So the access to care can bequite limited.
Access to investigations likeMRIs, ct scans, can be limited,
(09:04):
especially if it's a subacute orchronic medical problem.
But if it's acute, you walkinto a EMERGE with chest pain
still pretty good.
You have various cancers stillpretty good.
So if it's a really acute thing, you'll get seen.
You go in with a migraine,headache or a subacute or
chronic issue.
You may wait hours and hoursand hours.
(09:25):
The other problem I found as afamily physician and one of the
reasons I left family practicetwo years ago is that the
paperwork was becoming untenable.
It was all the paperwork.
The specialists refused to dopaperwork so it was all falling
on the family physician.
You weren't really paid for itor you could bill whatever
nominal fee you wanted that yourpatients would pay.
But I was finding patients thathad been admitted under the
(09:48):
care of specialists um werecoming back to see me in my
office and the follow-up withthe specialist was at times
months later.
And these were complex internalmedicine cases, uh, complex
cardiology, psychiatric cases,where I I mean in my practice I
refer people first to see apsychiatrist.
They'd wait nine months
Dr. Michael Koren (10:09):
Ooh my goodness
Dr. Allan Rosenfeld (10:10):
-and that's , that's not unheard of six
months to a year.
Then I'd get a consult backfrom the psychiatrist telling me
try these three drugs, thesethree drugs.
And, uh, you know, if you needto have me see them again, just
call the office again.
You have to go back in the inqueue.
Now there are better systems toget people in, but that's and I
know they exist and they areavailable, but that's kind of
what I was seeing.
(10:30):
Orthopedics, uh, geriatrics,psychiatry.
The wait to see uh specialistsis extremely prolonged,
especially for geriatrics andpsychiatry.
My son has an impingement ofhis left hip.
Um, the wait time to see anorthopod and get it dealt with
is probably two years by thetime you see the ortho and they
get referred, you're like so inCanada, like we do provide
(10:53):
healthcare to everybody,nobody's turned away.
But you have to wait a longtime at times, unless it's
really acute like chest pain,cardiac stuff or stroke.
But it's a long wait and I havepatients who refuse to go to ER
because they don't want to wait, especially elderly.
They don't want to wait that 9,10, 12 hours Every emerge here
(11:15):
is just security everywhere,because I gather they've had
patients that have just losttheir minds in these emerges.
So the system is, in Ontario atleast, is buckling, to say, to
put it nicely.
At least that was myperspective from two years ago.
Um, even getting family doctorsto complete forms in
occupational medicine is attimes problematic, so a lot of
(11:38):
we're hiring nurse practitionersto do the work they don't want
to do and um, so yeah it's, it's.
it's a bit of um chaos and Idon't see how it's going to be
fixed in the short term.
The current governmentgovernment I do not think values
family physicians for sure theydon't value them.
I don't know how it's going toget fixed unless we privatize,
(11:58):
and I don't think thatprivatization will occur in the
near future.
Dr. Michael Koren (12:02):
Got it?
Yeah, interesting perspective.
Not what we hear in the USmedia very much about the
Canadian system.
Canadians are well known fortheir patience, but even
Canadians have some limits interms of patience when it takes
two years to see an orthopod.
So interesting perspective.
One of the other things thatcomes up is using a Canadian
(12:23):
pharmacy.
So drug costs are quite high inthe US, as you know, and often
they're less in Canada.
Do you have any insights intothat?
Should US citizens and UShealth care patients be
concerned about using Canadianpharmacy?
Dr. Allan Rosenfeld (12:39):
I haven't ever had any issues with that,
Mike.
I mean the pharmacies.
There's two big pharmacies here.
It's almost like a monopoly.
There are small independentsbut there's two huge ones in
Ontario and I haven't had anyissues with distribution of any
medication.
Some of the drugs that, forexample, I take ranitidine.
It's no longer, it's not sorry.
(13:03):
Health Canada supports the useof it.
In the US they do not.
So there's drug differences interms of what we carry.
I've never seen an issue withany pharmacy.
There is, I think, a conflict ofinterest.
Maybe that's not the right word,but the pharmacists here are
also paid to do what's calledmed checks and that means if
somebody walks in and they're onthree medications or more, from
(13:25):
what I understand, thepharmacist can pull them aside
and review the medications andtalk about any potential drug
interactions or complications orside effects.
And they're paid by the OntarioHealth Insurance Plan and I
think it's $65, something likethat, which is more than I would
get for assessing somebody forcongestive heart failure or
post-surgical, and it would takeprobably less time.
(13:46):
So I feel like the twopharmacies here.
They're good.
The pharmacists that I've dealtwith are very professional.
They're very hardworking andthey work pretty hard by the
companies they work for, but Ihave not had any issues with and
I can't see if an Americancomes here to get their
medications.
I think they can be comfortedthat they're probably going to
(14:08):
get good care from thepharmacists and the medications
are what they are.
But keep in mind, we won't getevery medication that you have
there
Dr. Michael Koren (14:14):
Just for the listeners,
ranitidine is a drug for stomachacid and it's called an H2
blocker and it's been replacedby proton pump inhibitors by and
large, but it's a good oldgeneric drug that probably works
pretty darn well.
Dr. Allan Rosenfeld (14:31):
It works amazing and yet I question
Health Canada as to why the USpulled it.
Every other country in theworld, except for two or three
countries, has pulled it and aslong as they do ongoing checks
of that drug, and when it's at apharmacist, they test the drug
for NMDA, which was a potentialcarcinogen when the drug was
(14:52):
overheated or left in shelvesand got hot.
So not all the drugs that youhave and I would say a large
portion that you have are notsupported by our healthcare
system or supported by HealthCanada, and some that are are
not
Dr. Michael Koren (15:05):
Supported, meaning they don't pay for it,
yeah?
Dr. Allan Rosenfeld (15:09):
in Canada over 65, ontario Drug Benefit
pays for drugs that are on thebenefits Not all drugs, but drug
that's manufactured drugs thatare on benefits.
So after 65 you don't have topay for medications, except the
first month you have to pay a$100 retainment stipend.
So drugs are covered over 65.
Dr. Michael Koren (15:15):
Yeah, in places where they found very
(15:35):
very low levels of carcinogens
Dr. Allan Rosenfeld (15:37):
Correct.
Dr. Michael Koren (15:38):
-and for that reason there was some concern
about continuing to use them.
Dr. Allan Rosenfeld (15:42):
Correct.
Dr. Michael Koren (15:43):
But if you happen to be on ranitidine,
there's probably no great acuterisk.
Talk to your healthcareprovider about it.
But that's the reason why it'sbeen quote pulled from certain
parts of the world.
Dr. Allan Rosenfeld (15:55):
Right, and there's famotidine hydrochloride
, which we call Pepsid which inthe US on the shelves is called
Zantac, which is the trade namefor ranitidine, is now available
and it's another H2 antagonistwhich is supposed to be as
effective but did not work forme.
Dr. Michael Koren (16:10):
Gotcha, okay Well in any events.
So moving on to your career,which I find super fascinating,
tell us a little bit about whatyou do as an occupational
medicine expert.
Who your customers?
What's your day-to-day like?
And you mentioned that you'vemoved out completely from family
medicine and is it good livingYou're supporting yourself?
(16:31):
Tell us a little bit more abouthow things are going.
Dr. Allan Rosenfeld (16:34):
So occupational medicine is not
covered by the government.
They're trying to get it,they're trying to get a code for
billing through Ontario healthinsurance, but it's not covered.
So I went back, did mypostgraduate training.
I then developed relationshipswith various corporate clients,
industrial clients, so it's amixture of lots of stuff and my
son, who's trained in Australia,is now working with me as well,
(16:56):
and my daughter, so it's afamily business.
It's got her MBA and she runsthe business side of it and so I
deal with.
I guess there's two major, threemajor aspects to it.
We do pre-employment exams, socompanies that are hiring
employees that are concernedabout baseline hearing, baseline
pulmonary function testing,whether there's a baseline
(17:17):
medical illness or physicalillness that will make them
incapable of doing the jobthey're being hired for.
I do aviation medicals forTransport Canada, so I examine
pilots for Category 1, which iscommercial, and Category 3,
which is um, private pilots.
I I do work with health canada,so that's canadian server board
as agency and transport safetyboard um which be compatible
(17:41):
with your TSA um.
I do disability management forshort term for lots of the
clients.
I've been with some clients 30years plus, which which in my
area, anybody that lasts morethan six to eight years because
it's very political, especiallydisability management.
I've been with two clients one30, one 20, and one 16 [years],
(18:02):
which is unheard of, so I pridemyself on the fact that I have
longevity with these corporateclients.
I stick to medical.
I never get don't get pulledinto the political stuff, but I
understand that it exists.
We also do medical surveillancefor a number of employers.
So what that means is Ontariohas a number of substances,
which are called designatedsubstances or chemicals, which
(18:23):
are being used in themanufacturing process and
they're known to be biologicallyharmful if levels in the body
go up beyond a certain point.
So we do blood testing, urinetesting, pulmonary function
testing.
We do hearing screening if theemployer has a lot of noise, and
that's also a big part of ourbusiness and we've been growing.
(18:46):
We have contracts with UScompanies that do a lot of work
out of Toronto, where a lot ofthe work is, and so we do
medicals for marine medicals forcompanies out of the US that
have employees here, and so,yeah, so it's been growing and I
developed expertise in it.
Now I have my son working withme and my daughter working with
me.
Dr. Michael Koren (19:04):
That's exciting.
Dr. Allan Rosenfeld (19:05):
It is very competitive.
We have to go into RFPs, whichis requests for proposals, we
have to put in bids, and it'scompetitive, but I would say
it's been relatively successful.
Dr. Michael Koren (19:21):
I've heard very positive things about your
business success and your acumen, so congratulations on that.
Dr. Allan Rosenfeld (19:25):
And it's not covered by the government.
So I can go in and set the tone, the price Keeping in mind
there's competition.
I can set the price.
The price keeping in mind,there's competition, I can set
the price, the fee schedule.
Dr. Michael Koren (19:35):
Well, good for you, and it sounds like
something that gives you greatsatisfaction from a number of
perspectives.
Dr. Allan Rosenfeld (19:42):
The medical surveillance it absolutely does
when I can pull somebody out ofthe workplace where there's
been exposure.
And we're looking at chemicalslike isocyanates, asbestos, lead
recently.
So examples of things webenzene is another one we have a
client with.
So it's great if I can actuallymitigate any potential risks to
employees.
Dr. Michael Koren (20:04):
Well, in our show notes we'll definitely put
a contact number and informationto get in touch with you and
your company about any kind ofoccupational medicine issue.
Or if you want to just statewhat the best method is to get
in touch with you and yourcompany about any kind of
occupational medicine issue, orif you want to just state what
the best method is to get intouch with you, please use this
opportunity.
Dr. Allan Rosenfeld (20:20):
You can reach me through our email
address at OCCDOC.
Occdoc, it's easy.
Occdoc at Rogers R-O-G-E-R-Sdot com, and my office number in
Canada is 905-828-6061.
As I said, we do have contractswith US companies as well.
Dr. Michael Koren (20:39):
That's great, so let's segue a little bit.
The other thing that'sincredibly impressive about you
is you've actually written abook about your path and it's
fascinating, and maybe you canshare a little bit of that
journey and what led to writingthe book with the audience.
Dr. Allan Rosenfeld (20:56):
So early on in my career I was a medical
consultant on a televisionmedical drama show called Side
Effects with the CanadianBroadcasting Company.
It lasted two seasons.
I actually contributed astoryline to season two.
It was canceled about halfwayinto season two.
It was at the same time thatMichael Crichton was doing ER
(21:17):
and I think it was Chicago Hopewas the other big medical show
that was going on.
So I got into writing.
I wrote for a number of medicalmagazines and journals.
I won an award for best shortstory in one magazine.
One story was picked up bythree magazines.
It was called Cardiologist fora Day where I was on an airplane
and somebody had some cardiacevent and I brushed up to the
(21:38):
front and I pushed the two guysaside and, unbeknownst to me, I
had just graduated and one was acardiologist and one was a
thoracic surgeon.
I was like get out of my way.
So some of the stories arereally sad, some are funny, and
then I kept writing.
I, my parents, were newimmigrants to Canada after the
(21:59):
Holocaust.
They came to Canada in 1951.
They were sole survivors oftheir familias, after the
Holocaust.
Dr. Michael Koren (22:03):
What area of Europe did they come from?
Dr. Allan Rosenfeld (22:03):
They came from from Poland.
Ukraine and my dad wasUkrainian, my mother was Polish.
My mother would have been 100yesterday.
She died at 98.
So I wrote a book of shortstories 30 short stories.
That's called Holocaust Lumber.
(22:24):
I can show you that cover there, if you can see it and I
self-published.
I probably sold 5,000 books.
It's available on lulu.
com as an ebook.
I've had people from all overthe world that have read it and
been touched by it.
I have about a dozen super fanswho write me emails every few
(22:46):
months to say why aren't youwriting more and how much the
book touched them.
It's really a first-generationCanadian book in a lot of ways,
about being a child offirst-generation Canadians and
all the expectations that wereput on me to be successful and
to be a physician, becausenothing they wanted more than
(23:08):
for me to be a doctor, and oneof the stories talks about that
that my mother was in aconcentration camp called
Majdanek, which I visited in2012 with my wife, and she said
and maybe she was herperceptions were inaccurate, but
she said that she thought thedoctors were treated better by
the nazis during world war ii inthe concentration camp.
So I got pushed and pushed andpushed to be a physician.
(23:31):
That's one of the stories, andso I wrote the book into a play
for the Jewish CanadianPlaywright Contest in 2019, and
I finished third out of 25.
It's my first time ever writinga play, so I take a lot of
pride in the fact that the bookis sad.
(23:52):
It's funny.
It does touch a lot of people.
At times, some people arereally taken with it.
Recently, I've had two highschool acquaintances that I
haven't literally seen in 50years reach out to me via Gmail
and tell me how much I like thebook.
I was at a wedding a year agoand a woman comes up to me.
(24:12):
She's probably in her mid-80sand she says is it you?
I had no idea who she was.
I go what do you mean?
She goes.
Are you Allan Rosenfeld, theguy that wrote that book?
I go, yeah, she goes.
Oh my God, can I sit down withyou?
I read it four times.
My book club has read it, soI've gone to book clubs as well.
Two library systems in Canadabought 20 copies the Mississauga
(24:33):
Library and Cape Breton in theEast Coast.
I actually went to Nova Scotiaand spoke at Pier 21, which is
in Halifax, about the book.
There were 400 people there,including politicians.
You could have heard a pin drop.
(24:53):
And then we flew up to Sydney,Nova Scotia, which is about five
hours north and north of NovaScotia, and the RCMP, about 300
people.
So I take a lot of pride inwriting a book.
I've almost finished the secondbook.
It's more of a wonder year.
It's the coming of age, sex anddrugs and bullying and all the
things that kids in the areathat I grew up in had to deal
with.
(25:16):
So yeah, and it's a lot ofreason as to why I became a
physician and why I actuallyleft family practice to run a
business like occupationalmedicine was because of that
lumber yard.
Dr. Michael Koren (25:27):
That's a tremendous story.
Thank you so much for sharingthat.
That's wonderful and I'lldefinitely have to get a copy of
the book and read it myself.
Fascinating stuff.
So again, terrific comments,and I love that you share that
with the audience.
Some of it's very personal.
(25:47):
I know it's probably a littlebit hard to share, but that's
wonderful that you have
Dr. Allan Rosenfeld (25:51):
I just want to point out, we talked
aboutthe healthcare system inOntario.
We have extremely intelligent,dedicated doctors and nurses and
staff at our hospitals who workso hard in such long hours, and
they certainly are not thereason that the healthcare
system, from my perspective,struggles.
They are amazing and myrecently a family member's care,
when she did eventually get onthe floor and even in the eMERGE
(26:14):
, was spectacular from theperspective of the medical care
and the nursing care.
Dr. Michael Koren (26:19):
I'm going to conclude with one last thing is
again to thank you for yourparticipation, Thank you for
sharing these great insights andalso point out to the audience
that you're doing this undertremendous emotional distress at
the moment.
And I say this because I knowthat Allan is a passionate
Toronto Maple Leafs fan.
And for those of you that don'tfollow hockey, the Toronto
(26:43):
Maple Leafs have been one of thehard luck stories of the
National Hockey League in thatthey have not won the Stanley
Cup since 1967.
They are in the playoffsplaying the Florida Panthers.
I happen to be in Florida as wespeak.
I'm not a Florida Panther fan,but I am a Floridian, so I have
that allegiance andunfortunately Toronto is facing
(27:04):
an elimination game today inFlorida, so you must be on edge
right now.
This must be very, verydifficult to even talk to me,
given the circumstance.
Dr. Allan Rosenfeld (27:15):
You know I can't even, I don't even want to
talk about it, like my, one ofthe things in the book that I
wrote is hockey.
Maple Leaf hockey was soimportant to new immigrants
coming to Canada.
They identified with ourculture and our country through
the Maple Leafs so I grew upwith it from the time I was five
or six years old, so watchingan organization and watching a
(27:35):
team that continues to stickwith the same group nine years
out and always eliminating great, great hockey players.
I play hockey, great hockeyplayers, great young men, very
talented, but they're not builtfor the playoffs, so I don't
want to talk about it.
Florida is an amazing team andthat's what we should be trying
to reach.
Dr. Michael Koren (27:56):
Well, one thing I will say is I remember
growing up in New York and I wasa hockey fan still a New York
Rangers fan and I used to watchthe Rangers play in Toronto on
TV and I noticed that everybodyin the arena was wearing sport
coat and tie and I thought itwas interesting how formal
(28:16):
people were in Toronto evengoing to a hockey game.
Now that, unfortunately, haschanged.
When I was watching the game onWednesday two days ago, I
noticed that finally, people inToronto are now wearing jerseys
like the rest of the world whenthey go to the game.
But it took a little while.
Dr. Allan Rosenfeld (28:30):
Yeah, well, I think a lot of those season
tickets are corporate throughcorporations, and so, yeah,
that's why.
But I was at a game I was atthe Ottawa game where they lost
4-0.
We were sitting row two Again.
The power, the speed, thefinesse of that game.
Those kids take a beating, butI don't know, I think it's over
tonight, Mike.
I think it's over for the Leafstonight.
Dr. Michael Koren (28:51):
Okay, well, I'll be rooting for you, my
friend.
Thank you Well, Allan.
This has been delightful.
Thank you for being part of theMedEvidence family, and we'll
definitely bring you back totalk about something else
relevant to your many areas ofexpertise.
Dr. Allan Rosenfeld (29:05):
Thank you so much.
Thank you for having me.
Announcer (29:07):
Thanks for joining the MedEvidence podcast.
To learn more, head over toMedEvidence.
com or subscribe to our podcaston your favorite podcast
platform.
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