Career Location: Canada

[BLADEMDA]

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If I was finishing my residency today I would relocate to Canada. I would do a fellowship in Critical Care and plan on getting my Canadian "green card" plus medical license. Better yet, why not match into a Canadian Residency if possible.

Over a 25 plus year career the earnings potential combined with lower taxes makes being an Anesthesiologist in Canada the right choice.

For those who think I'm being crazy just take a look at Canadian Anesthesiology vs USA:

1. No AANA threat. Limited use of midlevel providers (rare in Canada)
2. Better starting salaries and 100% FAIR reimbursement for all work
3. No long partnership tracks
4. Better working conditions and less overall hours
5. Lower taxes than USA under Obama in 2014.
6. Do all Your own cases! (much better than supervising 4 rooms)
7. Lower/Less Malpractice concerns
8. More stable Currency and better run govt.


The biggest negative is the weather. So, buy a second home in th Florida Keys or somewhere warm.

Canada is the clear choice these days for a successful career in Anesthesiology.

 

[Consigliere]

Some may not agree that the biggest negative is the weather. Doing all your own cases may not appeal to many. I, for one, would give my left nut to find a position like the one you detailed. Perhaps I'll do a little research and find what Canadian anesthesiology is all "aboot."

 

[sevoflurane]

Honestly though... I like Canadians, I like Canada.

...but wouldn't move there over the USA.

 

[doctor712]

If I was finishing my residency today I would relocate to Canada. I would do a fellowship in Critical Care and plan on getting my Canadian "green card" plus medical license. Better yet, why not match into a Canadian Residency if possible.

Over a 25 plus year career the earnings potential combined with lower taxes makes being an Anesthesiologist in Canada the right choice.

For those who think I'm being crazy just take a look at Canadian Anesthesiology vs USA:

1. No AANA threat. Limited use of midlevel providers (rare in Canada)
2. Better starting salaries and 100% FAIR reimbursement for all work
3. No long partnership tracks
4. Better working conditions and less overall hours
5. Lower taxes than USA under Obama in 2014.
6. Do all Your own cases! (much better than supervising 4 rooms)
7. Lower/Less Malpractice concerns
8. More stable Currency and better run govt.


The biggest negative is the weather. So, buy a second home in th Florida Keys or somewhere warm.

Canada is the clear choice these days for a successful career in Anesthesiology.

Isn't Canada's medical system quite Socialized? And you're saying it's better than the US system for Anesthesiologists...? Hmmm. I thought a few years back it was on the BRINK of its own fiscal cliff.

The only place in Canada I could see moving would be Montreal. Hockey. Skiing in burbs. Francophones (that's another thread in and of itself, the hatred between Quebec and other provinces, some of my closest and best friends are Canadian, including my best friend). Vancouver I hear is no longer the city it was in the 1990s. I've been to all the Canadian majors, Toronto is...Toronto. At least Montreal has crepes and poutine. : ) Mais, je ne parle pas bien...

D712

 

[DrAwsome]

Isn't Canada's medical system quite Socialized? And you're saying it's better than the US system for Anesthesiologists...? Hmmm. I thought a few years back it was on the BRINK of its own fiscal cliff.

The only place in Canada I could see moving would be Montreal. Hockey. Skiing in burbs. Francophones (that's another thread in and of itself, the hatred between Quebec and other provinces, some of my closest and best friends are Canadian, including my best friend). Vancouver I hear is no longer the city it was in the 1990s. I've been to all the Canadian majors, Toronto is...Toronto. At least Montreal has crepes and poutine. : ) Mais, je ne parle pas bien...

D712

Canada removed caps on physician income given the huge shortage of docs they had, and specialists are doing quite well there. Blade is right in that they get reimbursed 100% for every case they do, so no unpaid ones, they are fee for service, none of this bundling BS crap, and they work less hours. If they want extra $$, they can work more. I do agree working conditions are better. None of the CRNA threats, liability is minimal, insurance is a few thousand a year. I am personally considering this (not in anesthesia) after training unless something radically changes here. That or TX which has a much better malpractice environment.

Ultimately it comes down to putting severe pressure on the gov to make them realize they can't function without us.

 

[doctor712]

Interesting. Makes it seem like I could have a nice 25 year career in Canada. The worrisome question is whether or not the Canadian gov is hip on allowing US docs come in and take either PGY spots or FT physician spots. If it were a sure thing, it's interesting. I just hate hearing about all the Visa Crap and hoops you need to hop through. When midway through a residency you can, in theory, be sent home. for whatever change in policy. To clarify for med students, to practice anesthesia in Canada it's 5 years PGY training. Correct?

D712

 

[BLADEMDA]

Interesting. Makes it seem like I could have a nice 25 year career in Canada. The worrisome question is whether or not the Canadian gov is hip on allowing US docs come in and take either PGY spots or FT physician spots. If it were a sure thing, it's interesting. I just hate hearing about all the Visa Crap and hoops you need to hop through. When midway through a residency you can, in theory, be sent home. for whatever change in policy. To clarify for med students, to practice anesthesia in Canada it's 5 years PGY training. Correct?

D712

Correct. Also, Canada has addressed its National debt issues and have abundant Natural Resources.

 

[leviathan]

We've got the most proven oil reserves in the world second only to Saudi Arabia.

To get an idea of salary projection here is a partial list of billing codes+reimbursements for anesthesiologists in BC. http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/pdf/8-anesthesia.pdf .

Also, Ontario currently will consider graduates of US medical schools with ACGME-approved residencies and US board certification without any requirements for any extra training. You would have to be 'mentored' for the first year which I heard is nothing but a person's name on a piece of paper that you can contact if you have questions about anything. http://www.cpso.on.ca/policies/policies/default.aspx?id=2352 (See 'pathway 3'.)

Hope that is helpful.

 

[EdPierce]

the way it got so good for doctors in canada is due to socialized medicine - its not a constant high volume, high turnover, whatever quality operation operation like it is here in the US. So, in that environment, there was never a time when the anesthesiologists there were desperate to be more productive. So CRNAS never got created/out of control. It seems like you are identifying the solution, but need to understand that the problem is not "evil obama" but a US system that is fundamentally flawed in that it is capitalistic, leading to a chain of reactions in order to sustain/make money that is not in the favor of the patient or the doctor but of the industry American medicine has become

 

[foxtrot]

Honestly though... I like Canadians, I like Canada.

...but wouldn't move there over the USA.

You might feel differently after 4 more years of this crap.

 

[DoctwoB]

So you hate obama "socialism" and want to move to a land of real socialism. Because that makes sense.

If anything Canada is a shining example of how a universal healthcare system can provide quality care while keeping docs well paid and happy.

 

[hoyden]

We've got the most proven oil reserves in the world second only to Saudi Arabia.

To get an idea of salary projection here is a partial list of billing codes+reimbursements for anesthesiologists in BC. http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/pdf/8-anesthesia.pdf .

Also, Ontario currently will consider graduates of US medical schools with ACGME-approved residencies and US board certification without any requirements for any extra training. You would have to be 'mentored' for the first year which I heard is nothing but a person's name on a piece of paper that you can contact if you have questions about anything. http://www.cpso.on.ca/policies/policies/default.aspx?id=2352 (See 'pathway 3'.)

Hope that is helpful.

Thanks

 

[BLADEMDA]

So you hate obama "socialism" and want to move to a land of real socialism. Because that makes sense.

If anything Canada is a shining example of how a universal healthcare system can provide quality care while keeping docs well paid and happy.

Our health care system is bad socialism with bad capitalism we call health insurance. The worst of both worlds.

Canadian health care is superior for Anesthesiologusts in terms of practice, malpractice, income and midevel encroachment.

As for Obama his version of socialistic medical care is Medicaid for all; that's not exactly the same system as Canada where Anesthesiologist receive fair compensation for his/her services.

 

[DrAwsome]

Our health care system is bad socialism with bad capitalism we call health insurance. The worst of both worlds.

Canadian health care is superior for Anesthesiologusts in terms of practice, malpractice, income and midevel encroachment.

As for Obama his version of socialistic medical care is Medicaid for all; that's not exactly the same system as Canada where Anesthesiologist receive fair compensation for his/her services.

I'm with Blade on this. Also have to realize that most Canadians also have limited services past certain ages (they don't have the 100 year olds getting ICU stays for months and hernia repairs, etc), they also are not usually morbidly obese, they are taxed a substantial amount, but it's also a much smaller country, so that plays a part. They also don't sue their doctors right and left and win multi million dollar settlements.

I also think that there is an understanding/acceptance that doctors should be well compensated, and it's like they are proud that their docs make good money, vs. here where people are jealous and want to cut salaries. Mind sets are completely different.

I think the answer to a lot of our $$ issues here is what Japan is doing-instituting a fat tax. I think it would be a multi billion dollar revenue maker. The gov wants to tax everything else, I don't see why taxing obesity is not a good idea-not only would it help with funding, but it's certainly something that people can indeed prevent. If you fall within a normal weight you won't have to worry about it!

 

[amyl]

how about st kitts? caymans? any idea how hard/easy it is to lisc there?
there is a small movement for texas to secede.... i know it sounds crazy and unconstitutional but thats what i thought about an executive mandate too.... I have to say, the republic of texas sounds good to me today.

 

[hoyden]

how about st kitts? caymans? any idea how hard/easy it is to lisc there?
there is a small movement for texas to secede.... i know it sounds crazy and unconstitutional but thats what i thought about an executive mandate too.... I have to say, the republic of texas sounds good to me today.

it is NOT unconstitutional

 

[DrAwsome]

how about st kitts? caymans? any idea how hard/easy it is to lisc there?
there is a small movement for texas to secede.... i know it sounds crazy and unconstitutional but thats what i thought about an executive mandate too.... I have to say, the republic of texas sounds good to me today.

Haven't they been trying to secede for decades now? Puerto Rico is trying to be added as a state.

 

[urge]

We've got the most proven oil reserves in the world second only to Saudi Arabia.

To get an idea of salary projection here is a partial list of billing codes+reimbursements for anesthesiologists in BC. http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/pdf/8-anesthesia.pdf .

Also, Ontario currently will consider graduates of US medical schools with ACGME-approved residencies and US board certification without any requirements for any extra training. You would have to be 'mentored' for the first year which I heard is nothing but a person's name on a piece of paper that you can contact if you have questions about anything. http://www.cpso.on.ca/policies/policies/default.aspx?id=2352 (See 'pathway 3'.)

Hope that is helpful.

What happens after the year of mentoring/supervision? Can I take the boards?

 

[periopdoc]

It is very true that the Canadian System now offers the promise of a better income to work ratio as well as increased job satisfaction etc in the coming years. This is not because somehow the Canadian System has been making significant improvements, rather it is reflective of just how far the American Medical System has fallen/ will fall given its current trajectory. Now there is no hope of reversing that trajectory.

I expected this and it is one of the biggest reasons I undertook a fellowship year. With five years of training under my belt, I am now eligible to sit for the Canadian Boards.

As I said when the final version of Obamacare passed

...The plan that ultimately went through will, IMHO, set in motion the most painful possible path to a single payer system. Ultimately everyone gets sick of paying the insurance companies for minimal coverage, has to pay out of pocket for real care, and realizes how much of their health care dollar is increasingly going to insurance administrative costs, then they will scream for a single payer system. In the meantime, the majority of the fiscal pain will be carried by physicians and patients, not hospital admins, insurance folks or politicians.

As I said at the time, I would have rather seen Obama successfully pass a single payer system, than the huge steaming pile of American Bureaucratic Horse S*** that ACA is.

Our health care system is bad socialism with bad capitalism we call health insurance. The worst of both worlds.

This is the exact truth (or will be in the very near future). The trajectory for the next 15-20 years is now irreversibly set. We will have neither a socialized nor a capitalist/ privatized system. Instead we will have a mixture of both in the worst possible way. The death knell for the old system has sounded, but the old system is not ready to die yet. There will be a high cost to pay to kill it off. That cost will be borne by physicians and patients.

Pssstt...Canadian healthcare is managed on a PROVINCIAL LEVEL, not a national one. This is where I'll end my analysis of your point, but please understand that basic fact and how they lack arbitrary expression of national power in coercive tax code to fund their program. I love everytime I hear an impotent, lazy comparison of Obamacare to the Canadian system as if its some sordid justification with what is going on here in the USA, because it demonstrates a fundamental lack of understanding of how both work.👎

Excellent analysis. Even in this thread (among those touting the strengths of the Canadian system) I think the subtleties of the Canadian PROVINCIAL System are somewhat lost.

- pod

 

[periopdoc]

But then again, I think they would require me to leave most of my guns on this side of the border.

Oh well, America... at least we have guns!

- pod

 

[hoyden]

But then again, I think they would require me to leave most of my guns on this side of the border.

Oh well, America... at least we have guns!

- pod

yet.

if the cycle continues - we won't

 

[doctor712]

So, here's the million dollar question: what are the avg salaries for PP and Academic docs in big city Canada (Toronto, Montreal, Ottawa, Calgary, Vancouver, The Peg)?

AND, will those salaries - if good - still be there in 15 years?

If all the above is good, then for those of you who live in cold cities, and don't need Arizona or Florida, Canada may be a GREAT option.

Not sure what income taxes are provincially or federally, but I do know some sales tax rates (Quebec) are hefty. At least on Cuban cigars. ; )

If anyone can chime in, please do. Wondering how far 300K Canadian goes when I hear my friends in Toronto talk about the INSANE housing prices in downtown Toronto...for example.

D712

 

[periopdoc]

In Canada pay is more provincially dependent than dependent on which city you live in. It will be higher in wealthier provinces who have good working relationships with their doctors unions and lower in provinces who are less wealthy and/or have contentious relationships between the provincial government and the doctors groups. So, for both reasons, you could expect to be payed higher in Calgary (Alberta) than in Vancouver (B.C.), assuming similar work loads. Taxes will also be lower in a place like Alberta due to industry friendly provincial policies toward natural resource development, not necessarily low, but lower. As a wealthy individual, you get more for your taxes in Canada than you do in the U.S.

The distribution of the cost of living, however, is very similar to what we see in the U.S. If you want to live in NYC/ Toronto, you are going to pay a lot more than if you want to live in Dallas/ Edmonton, which is more expensive than Colorado Springs/ Calgary. A small, remote, desirable location like Kalispell/ Fernie will be lower than the top two tiers, but things like travel etc bring the cost of living up a bit from a place like Colorado Springs.

The analogies aren't perfect, but you get the idea.

- pod

 

[periopdoc]

yet.

if the cycle continues - we won't

In my mind I included the final sentence "...For now" Somehow I failed to type it.

- pod

 

[secants]

What's the deal on if you have to still pay taxes to the US gov't if you're working in another country such as Canada?

 

[Laryngophed]

Correct. Also, Canada has addressed its National debt issues and have abundant Natural Resources.

Maple syrup for instance.

 

[periopdoc]

What's the deal on if you have to still pay taxes to the US gov't if you're working in another country such as Canada?

The Canada-US Income Tax Convention limits double taxation at the federal level. If, as a U.S. resident, you pay income tax in Canada (as you would in this situation) foreign tax credits and/or foreign earned income exclusion can be claimed on your US income tax returns to limit your tax liability.

This treaty does not apply at the state level. So, if you are living in California, or another state that has an income tax, you might consider a brief stop in South Dakota on your way to Canada. You can declare residency in South Dakota after maintaining a presence for something like 24 hours.

Back to the federal level, the folks I know who have done this, found out that the process is un-necessarily complex and cumbersome, and it does not completely eliminate double taxation especially for high wage earners.

A better bet is to become a Canadian Citizen and skip the double taxation problem entirely.


- pod

 

[deleted126335]

The Canada-US Income Tax Convention limits double taxation at the federal level. If, as a U.S. resident, you pay income tax in Canada (as you would in this situation) foreign tax credits and/or foreign earned income exclusion can be claimed on your US income tax returns to limit your tax liability.

This treaty does not apply at the state level. So, if you are living in California, or another state that has an income tax, you might consider a brief stop in South Dakota on your way to Canada. You can declare residency in South Dakota after maintaining a presence for something like 24 hours.

Back to the federal level, the folks I know who have done this, found out that the process is un-necessarily complex and cumbersome, and it does not completely eliminate double taxation especially for high wage earners.

A better bet is to become a Canadian Citizen and skip the double taxation problem entirely.


- pod

I am one of the cheapest, most tax averse individuals that I have ever known.

The thought of renouncing U.S. citizenship to lower a tax bill and save a few $ is abhorrent.

 

[pgg]

I am one of the cheapest, most tax averse individuals that I have ever known.

The thought of renouncing U.S. citizenship to lower a tax bill and save a few $ is abhorrent.

Yeah, we've had this thread before. Not something I'll ever consider.

 

[periopdoc]

Of course, I grew up with friends changing citizenship between the two countries like you would change your coat, so the idea isn't so foreign to me.

Given the chance I would obtain Canadian citizenship then reclaim US citizenship. You can't become a dual citizen starting with US citizenship, but you can if you are starting with Canadian citizenship.

Of course the dual citizen still faces the same tax issue.

-pod

 

[hoyden]

I am one of the cheapest, most tax averse individuals that I have ever known.

The thought of renouncing U.S. citizenship to lower a tax bill and save a few $ is abhorrent.

you do not have to renounce US citizenship - you will become a dual citizenship person - that's all.

Plenty of US citizens are dual citizens and I know one who has three citizenships

 

[hoyden]

as a person who has had at least three citizenships in my life to date I do not see any problems with getting additional one, if needed

 

[periopdoc]

The US State department has this to say about US Citizens seeking dual citizenship.

A U.S. citizen may acquire foreign citizenship by marriage, or a person naturalized as a U.S. citizen may not lose the citizenship of the country of birth.U.S. law does not mention dual nationality or require a person to choose one citizenship or another. Also, a person who is automatically granted another citizenship does not risk losing U.S. citizenship. However, a person who acquires a foreign citizenship by applying for it may lose U.S. citizenship. In order to lose U.S. citizenship, the law requires that the person must apply for the foreign citizenship voluntarily, by free choice, and with the intention to give up U.S. citizenship.

I have met many folks who added US citizenship to their Canadian citizenship to become dual, but all of my friends who went from US to Canadian citizenship had to give up their US citizenship. Those who came back are now dual.

The dual citizen, of course, has the same taxation issue as the solely US citizen.

- pod

 

[hoyden]

The US State department has this to say about US Citizens seeking dual citizenship.

http://travel.state.gov/travel/cis_pa_tw/cis/cis_1753.html

I have met many folks who added US citizenship to their Canadian citizenship to become dual, but all of my friends who went from US to Canadian citizenship had to give up their US citizenship. Those who came back are now dual.

The dual citizen, of course, has the same taxation issue as the solely US citizen.

- pod

Well, I have friends who added Canadian citizenship to their European ones and the process did not require any denunciation of those citizenships on their part. Seems strange that Americans have to do that. It does not mean I do not believe you it is simply strange.
While acquiring American citizenship one does not have to renounce any previous one. One couple is going to become triple citizenship in few weeks - their European one, Canadian one and now American one

 

[yesno]

So how realistic is it to do american residency+fellowship in anesthesia and then get a job in canada? Assuming that average salaries in Canada are higher, wouldn't it quickly lead to oversaturation of the canadian job market? Certainly, the number of canadian residency positions is supposed to reflect the number of jobs? If they let you move there, a canadian graduate will be out of work? What about other specialties? I do not know what specialty I am most interested in. But based on my research it seems that anesthesia salaries are not that different between usa and canada. But some other specialties like endocrinology are very very different. And it's obvious there is more job stability in Canada. So just because you are allowed to sit their boards, does it really mean that they'd want to hire you unless you have some connections?

 

[kazuma]

Unlike the College’s policy for ACGME-trained specialists,1 this pathway does not require that the ACGME residency be comparable in content and duration to a Canadian training program in the same discipline.

1 The policy for ACGME-trained specialists was rescinded by CPSO Council in November 2008 because applicants now have access to licensure under Pathway 3 and Pathway 4.

http://www.cpso.on.ca/policies/policies/default.aspx?id=2352

Correct me if I'm misinterpreting this statement, but after reading this pathway 3 statement, a fellowship or pgy5 year does not seem to be a requirement to work in ontario as long as you complete an ACGME residency program, are board certified in the US and then complete a "mentorship" in Canada.

 

[kazuma]

For Alberta:

http://www.cpsa.ab.ca/Services/Regi...icence/independent_practice.aspx#Requirements

"

Unrestricted practice permit (General Register)
Standard Route:* Candidates must have:

Evidence of*English language proficiency,
An acceptable medical or osteopathic degree,
The Licentiate of the Medical Council of Canada (LMCC),
Successful completion of a specialty residency programme in Canada or a postgraduate programme of specialty training outside of Canada of at least 48 months, and
Certification from the Royal College of Physicians and Surgeons of Canada (FRCP or FRCS).

"
Since anesthesiology in the US is 4 years in length (including internship) it seems that a fellowship is not required for a US grad who wants to practice anesthesiology in Alberta Canada.

 

[deleted307836]

Has anyone here considered completing a fellowship in Canada? For someone interested in moving there, that could be an interesting way of getting that additional year of training, if possible.

 

[periopdoc]

Not only interesting, but also an excellent way to get exposure to the Canadian system so that you aren't having to figure the system out in your first year practicing there.

I have a friend who did his cardiac anesthesia fellowship there. He is now eligible for the Canadian boards, but Canada does not consider him to have done a cardiac anesthesia fellowship.

- pod

 

[deleted307836]

Not only interesting, but also an excellent way to get exposure to the Canadian system so that you aren't having to figure the system out in your first year practicing there.

I have a friend who did his cardiac anesthesia fellowship there. He is now eligible for the Canadian boards, but Canada does not consider him to have done a cardiac anesthesia fellowship.

- pod

If he were to complete another fellowship, would both fellowships be recognized, or just the last one?

 

[doctor712]

duplicate post.

 

[doctor712]

The US State department has this to say about US Citizens seeking dual citizenship.

http://travel.state.gov/travel/cis_pa_tw/cis/cis_1753.html

I have met many folks who added US citizenship to their Canadian citizenship to become dual, but all of my friends who went from US to Canadian citizenship had to give up their US citizenship. Those who came back are now dual.

The dual citizen, of course, has the same taxation issue as the solely US citizen.

- pod

The US State department has this to say about US Citizens seeking dual citizenship.

http://travel.state.gov/travel/cis_pa_tw/cis/cis_1753.html

I have met many folks who added US citizenship to their Canadian citizenship to become dual, but all of my friends who went from US to Canadian citizenship had to give up their US citizenship. Those who came back are now dual.

The dual citizen, of course, has the same taxation issue as the solely US citizen.

- pod

There is a lot of gray area with Citizenship and Nationality. For people who hold more than one passport, you can have multiple nationalities but only one Citizenship. (my wife at the time got her dual US citizenship post 9/11, and I had some dealings with State). When you sign that form to be an American Citizen, you must state, as I recall, that you will fight and protect the US Constitution and no other G. If you do that, you cannot do the same for other countries - I believe that allegiance is part of one's citizenship. So, I think that someone can actually have a US Passport, and be ONLY a citizen of Spain, for example. Anyway, I'm not terribly clear on this all, but what I am clear on is the fact that if reimbursements continue to trend down when I practice, and the kids are in college anyway, I would happily move to Toronto, Montreal, Ottawa and practice medicine there. Vancouver too. Would I want to be stuck in the middle of Saskatoon, no, but for 450K (US), I would certainly pay off student loans for a couple years before returning to the US if the US option was only say 250-300K at the time. Gladly. A lot of people here have discussed BFE, so BFE US or BFE Canada, doesn't really mean much to me. It was 5 degrees this AM when I woke up, I don't mind seasons, including the frigid ones.

A curious question would also include whether or not Canadian academic institutions have similar tuition reimbursement as US med schools have. My friend paid for 2 kids to goto excellent schools, one an Ivy, being an academic and using the tuition remission benefit. That's 200K right there. An important calculation to consider domestically or internationally I would think...

D712

 

[doctor712]

Not only interesting, but also an excellent way to get exposure to the Canadian system so that you aren't having to figure the system out in your first year practicing there.

I have a friend who did his cardiac anesthesia fellowship there. He is now eligible for the Canadian boards, but Canada does not consider him to have done a cardiac anesthesia fellowship.

- pod

Is that because the Cardiac fellowship he did was PGY-5, which they consider the completion of their standard anesthesia training (per earlier posts)?

But he'd still be able to use that on his CV to fulfill a Cardio spot he is applying for I would think, yes? Aside from that, he can take Canadian anesthesia boards, but wouldn't get the additional board cert in cardiac anesthesia? Here in the US we have 4 or 5 areas in anesthesia to get the additional board, yes? (CCM, Pain, Peds...forgetting others, Hospice, Sleep) Is that going up in the coming years? Will Cards/Neuro/OB get BC here in future years, or no?

D712