Local News
Another ex-Winnipeg physician chimes in on Canadian and American health care systems
By BERNIE BELLAN Elsewhere on this website we have a piece by Dr. Elisa Flaybush who, although she received her medical training at the University of Manitoba medical school, went to the US for specialized training in gastroenterology – and chose to remain in the US. You can read Elisa’s commentary on our Canadian medical system at “Manitoba trained Jewish physician now living in US laments state of medical care in Canada.”
That piece elicited quite a few views. Unfortunately, we do not allow comments on our website. (We get inundated with spam comments and it’s too time consuming to wade through them to find legitimate comments.) Interestingly though, we received a very thoughtful email sent to us through our “Contact Us” link from another former Winnipegger, Dr. Martin Koyle – who also chose to go elsewhere for specialized training – in his case, in urologoy, following his graduation from the U of M medical school. In Dr. Koyle’s case, however, after spending most of his career in the US, he did return to Canada – to teach and work first in Montreal and latterly in Toronto.
(We might also note that Dr. Koyle has been the recipient of many awards throughout his career, most recently having been selected as one of the American Urological Assocation’s 2026 Distinguished Award Winners.)
Following is Dr. Koyle’s piece, written in response to Dr. Flaybush’s piece:
Bernie: I enjoyed your dialogue with Elisa, whom I do not know. I must admit that my training and education in Manitoba more than prepared me for subsequent specialist training and spending the majority of my career in the USA, but returned to spend the last 10 years of my full-time career as Professor of Surgery at the University of Toronto Temerity Faculty of Medicine and Women’s Auxiliary Endowed Chair in Urology and Regenerative Medicine at SickKids. Like Elisa, I was not mentioned in Eva (Wiseman)’s book because, like Elisa, I never returned to Winnipeg to practice, but have returned multiple times to operate and serve as visiting professor.
Much of my 40-year career and success was because of the education and mentorship I received from Eva’s husband, Nathan, also Dr. Alan Decter, Dr. Luis Oppenheimer, and Dr. Harvey Chochinov, all Jewish. Certainly, many of my non-Jewish educators had major impacts on my development as well and I feel fortunate to have been lucky. Before I accepted a postgraduate residency training position at Harvard I had long discussions with Nathan and Alan, and looked at all alternatives. One of them said that the 3 most overrated things in the world were “homecoming, sex and Harvard Medical School!” After a few months back I replied to that comment, agreeing with the latter insight, but fervently disagreeing with comments regarding homecoming and sex! However, the Harvard reputation and networking opportunities paid dividends that I likely would not have garnered had I stayed in Manitoba to train and then eventually sought to seek other opportunities.
I too believe that the Canadian healthcare system is broken despite best intentions. Reality is reality. From the time of William Osler until my starting practice in 1984, medical knowledge was doubling in a linear fashion roughly every 7 years. Over the past few decades, with all the innovations and disruptions, biomedical knowledge now grows exponentially, every 2.5 months! Moreover, the number of medical specialties and subspecialties has gone from 40 to 150 over the past 4 decades. Moreover, in my parent specialty of urology, within 5 years of my subspecializing in pediatric urology, I had become a dinosaur, as urology over that short period had changed so dramatically. Routine x-rays were replaced by ultrasound, then CT scans, and then MRI was added. Hands on surgery became largely replaced by laparoscopy and now robotic surgery. New drugs, new guidelines, new metrics, litigation, peer pressure, the electronic medical record, and much more have increased the complexity even more… and the costs to boot! Since the system is based on taxpayer dollars, it is always playing catch up.
Elisa and I are proceduralists that cost the system money and much of what we do is therefore elective. In Canada, in order to see a specialist like her or me, you most often need a referral from a primary care provider, usually using an archaic methodology of FAXing a referral form and hoping a response ultimately reaches the patient. In the USA, if we don’t address a call or referral immediately and appropriately, whether in private practice like Elisa, or in an academic environment like me, we are quite likely to lose that referral base and even that entire practice. So, customer service in our competitive model is essential.
In my practice, I am salaried and see insured and indigent patients, who are all treated equally. In semi-retirement, we are constantly attempting to improve access in the hospital where I work. During my 10 years in Toronto – and I assume it’s similar in Manitoba, my practice felt like an impersonal, never-ending conveyer belt, with very little relationship with the referring provider or, sadly, the patient. The physician also was the one who bore the brunt of patient complaints for any delay or cancellation, despite having no control of the system in which I worked.
Elisa, being in private practice, likely has more control over flow than I do. I use allied health providers, nurse practitioners and physicians as a team to improve flow. They are underutilized in Canada and too much reliance is placed on the gatekeeper, the family doctor. Canada tries to play nice in the sandbox, so to speak, by thinking that all inhabitants of a given province or territory have equal access and equal care. However, many patients in Canada need supplemental insurance – which can be costly if not offered by an employer.
So healthcare is challenging. We are living longer, with more chronic conditions that can now be treated better and hence, prolong life. In the US as much as 25% of healthcare dollars are spent on prolonging the inevitable. In Canada there is far more emphasis on palliative care and hospice, far reducing end of life costs. There is much waste in both systems – with a lot of over management (mismanagement?). In the US it is as challenging as the Canadian system, but for different reasons. There is a profit motive in an open market system, whether that be the insurance company, the hospitals themselves, or the provider. Whether the government provides the dollars through taxes (Canada) or all those pieces that don’t necessarily fit perfectly in the American system, the bottom line needs to finish in the black.
So healthcare is broken, and while fair and equitable is a laudable human-focused goal, it is challenging to achieve in a never-ending playing field. Similarly, an open market system – as Elisa has suggested, works in many instances, but in order to provide for all, it is reliant on government (tax) dollars as well. With the changes in administration in the US, where there is fear that the Social Security and Medicare (federal care dollars for those over age 65 and those with significant conditions like kidney failure) pots are not being replenished as the population ages, and state support has diminished for Medicaid (support for low income), the system also faces mounting challenges as well.
Martin A. Koyle MD, MSc, MMgmt, MBA(cert.), FAAP, FACS, FRCSC, FRCS (Eng.), FRSM
Professor Emeritus, University of Toronto, Temerity Faculty of Medicine & Institute of Health Policy, Management, & Evaluation (IHPME)
Adjunct Professor, University of Minnesota School of Medicine
Faculty, IMHL & GCHM programs, McGill University, Desautels Faculty of Management
Email: marttch@me.com; marty.koyle@gmail.com.
Twitter:@MakMarttch
Local News
Shalom Residences Foundation to host third annual donor appreciation evening
By MYRON LOVE On Tuesday, June 16, Shalom Residences Foundation Inc (SRFI) will be hosting its third annual Donor Appreciation evening. Donors and other Shalom Residences supporters can look forward to chilling to the music of local singer/songwriter David Grenon (aka Soul Bear), who will be performing songs by Billy Joel, Elton John and other well-known artists.
Dr. Allen Kraut has organized the donor appreciation night while the entertainment for the evening will be organized by Karla Berbrayer.
For readers who are not yet familiar with Shalom Residences, the organization was originally created to care for intellectually challenged Jewish young adults. The vision was to provide them with a Jewish environment – strictly kosher group homes where all the Jewish holidays are observed and celebrated.
One of Shalom Residences’ objectives has always been to develop a community in which individuals with intellectual disabilities are fully included, self-actualized, and valued in all aspects of life.
The concept has been a remarkable success.
Shalom Residences was founded in 1980 by six far-sighted couples, including Thelma and Ernie Bronstein, Dolly and Zivey Chudnow, Min and Joe Fromkin, Roberta and Larry Hurtig, Elaine and Bobby Paul,
and Sybil and Frank Steele. Jim Gauthier was also among the original group of Zivey Chudnow’s friends who organized the first lottery dinner in 1982 to raise funds for the Shalom Residences with the view of establishing a foundation to sustain the homes long term.The original Shalom Home was a converted house on Cathedral Avenue.
“Thelma Bronstein’s determination and dynamism contributed to making it happen,” says Elaine Paul, currently Shalom Residences’ treasurer (and for the past 20 years, the organization’s leading fundraiser).
I remember the home’s official opening. This was shortly after I started writing for the Jewish Post. Rabbi Charles Grysman affixed the mezzuzah to the door frame.
Today, the organization operates six group homes housing 19 residents as well as 12 residents in supported independent living arrangements.
While the operations today are largely funded by the provincial government – which means that the residences have to be open to accepting non-Jewish clients as well (just over half of the residents are Jewish) – the Shalom Residences Foundation funding supplements the government contribution – providing financial support for increasing staffing levels when needed, as well as extraordinary expenditures and contingencies. The Foundation has also provided the down payment for the purchase of new housing when necessary. .
The necessity of fundraising was evident right from the beginning. Elaine Paul recalls that the first Manitoba Marathon – in which all the founding parents were involved – provided the funding for the mortgage at 175 Cathedral Ave.
“We worked with Helen Steinkopf and John Robertson to develop the marathon,” Paul remembers. ”For several years, Hy Kravetsky and I worked handing out water to the runners.”
Paul relates that it was Zivey Chudnow who was instrumental in starting up Shalom Residences’ annual fundraising. “Three of Zivey’s friends,:Norman Tatleman, Sam Ostrove, and Gary Levinson, asked how they could help,” she recalls. “Their idea was to have a fundraising dinner. We combined the dinner with a lottery. We sold 60 tickets at $1,000 a piece and paid out $15,000 to the winning ticket and lesser amounts to other lucky winners.”
The organization also held annual well attended fundraising teas.
Paul reports that, for years, Chudnow was Shalom Residences’ best fundraiser – with honourable mention to Avrum Katz, Frank Steele, and the late Joe Elfenbaum. Paul took over the role 10 years ago – again with honourable mention to SRFI board members, Dr. Allen Kraut, Peter Leipsic, Donna Chudnow, Jon Feldman, and Mickey Rosenberg.
In addition, the goal was, and remains empowering adults with intellectual disabilities to live meaningful, dignified lives in community-based homes in Winnipeg, enriched by Jewish values.
Charles Tax, the SRFI’s long time president, notes that in 2017, the organization created an endowment fund with the Jewish Foundation of Manitoba. “At the time, we transferred more than half of our assets to the JFM,” he says. “We continue to make contributions to our fund.”
He notes that the annual dinners came to an end with the 20230 Covid lockdowns. The donor appreciation evenings were started in 2023.
“One of our goals is to acquire one or two more houses in the south end,” Tax adds.
Readers who may be interested in attending the donor appreciation evening or otherwise supporting SRFI can contact the office at 204 582-7064 or via email (admin@shalomresidences.com).
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Local News
Debbie Maslowsky playing lead role in upcoming Dry Cold Productions musical
By MYRON LOVE For the past 40 years Debbie Maslowsky has been entertaining Winnipeg audiences – both Jewish and non-Jewish, with her acting and singing. Arguably Winnipeg’s queen of musical theatre is returning to the stage on May 13 in a lead role in Dry Cold Productions’ upcoming “Kimberly Akimbo”.
Maslowsky is enthusiastic about the Tony-winning production, which debuted on Broadway in November 2022. “It’s a gem of a musical,” she says of the production crafted by the musical team of composer Jeanine Tesori and lyricist David Lindsay-Abaire.
The subject itself is not – on the surface – uplifting. As Maslowsky describes it, “Kimberly Akimbo” is the story of a teenager suffering from a very rare condition – progeria – also known as the aging disease. The genetic condition causes children to age at an accelerated rate causing them to die of old age while still in their teens. For those readers who may recall Rabbi Harold Kushner’s book, “Why Bad Things Happen to Good People” – written years ago, Kushner was responding to the death of his own son from progeria.
In the hands of Tesori and Lindsay-Abaire though, Maslowsky notes, the show is about mindfulness and living day by day. In the production, Maslowsky explains, “Kimberly is trying to live as normal a life as she can despite her illness. Her life is further complicated by a dysfunctional family. Her parents are dealing with their own issues. Then there is the madcap aunt who develops a complicated and hilarious plan to make money for a family road trip, raise funds for choir costumes – with some left over for herself.
“The play is very funny,” Maslowsky comments, “but also poignant. Kimberly knows that she most likely won’t live much beyond 16. Therefore, she wants to live every day to the fullest. She wants to live every day in the now. At the same time, she doesn’t want to hide from reality. She doesn’t want special treatment. She also doesn’t want people – such as her parents – trying to pretend that everything will be okay.”
Maslowsky last appeared on stage in Winnipeg Jewish Theatre’s one-woman production of “A Pickle” in the spring of 2023. That was the true story of a Jewish pickle maker living in Minnesota who had to fight to get her pickles included in the state fair pickle competition, which tried to disqualify her because her pickles were made the Jewish way through a brining process that the non-Jewish judges refused to accept.
In the interim, Maslowsky has been focusing on her longstanding business as a trade show, conference and event manage,r as well as picking up some singing gigs. She reports that she began winding down her business last fall.
She speaks highly of her younger cast mates. “They are an amazing group of young people,” she says. “For some of them, this is their first show. I myself am still learning new things after all these years.”
Maslowsky will next be appearing in the joint Winnipeg Jewish Theatre-Rainbow Stage production of “Fiddler on the Roof” in September. “I played one of the daughters years ago in an earlier Fiddler production,” she recalls. “I feel like I am coming full circle.”
Dry Cold Productions was founded by Donna Fletcher and Reid Harrison (now retired) more than 25 years ago. The company stages a yearly musical theatre production – sometimes edgy – which has played on Broadway and is new to Winnipeg audiences.
The Dry Cold website cautions that “Kimberly Akimbo” contains “strong language (with frequent profanity), mature humour, and references to sexual activity”.
“Kimberly Akimbo” is scheduled to run May 13–17, 2026 at the Prairie Theatre Exchange. Tickets can be purchased by contacting Dry Cold productions online.
Local News
The second Bar Mitzvah: Better than the first
By GERRY POSNER As we pass down the corridor of life, there are certainly times we can identify as moments we will never forget. I had such a moment on April 11 at my second Bar Mitzvah, at the Shaarey Zedek Synagogue, shared with Dr. Ted Lyons, or E. A. as I called him over the years. We were celebrating this life cycle event at the very same synagogue as the first one, that is – the Shaarey Zede. For me, it was some 70 years ago or 25,557 days – from April 21, 1956 to April 11, 2026. The notion of returning to the original place of Bar Mitzvah 1.0 was too powerful a force, causing me to abandon my plan to do this in Toronto where my wife, Sherna and I have lived for the last 13 plus years.
It was quite the weekend. We started just before Erev Shabbat with photos of our two families on the bimah. Ted had his whole family there, including his daughter Mara, her husband Sheldon, and their two daughters, as well as his son Sami, his wife Rose, and their three kids, all of whom live In Calgary, not to forget his sister Ellen and her husband Howard Goldstein, from Toronto. Our three kids: Ari, Rami and Amira, all of whom live in Toronto, along with two of my grandchildren, as well as my brother Michael from Toronto were also present.
After the Shabbat service, we stayed on in the building for our Shabbat dinner. There were 23 of us, including Michael’s partner, Ruth Grubert, (formerly Mozersky), also a former Winnipegger, as well as Rabbi Mass,his son Ranan, Rabbi Carnie Rose and his wife Pauline. It was a warm group and the dinner was gobbled up and appreciated by all of us. We were all surprised when independently, the respective grandchildren of the Bar Mitzvah “bochers” presented both of us with a kind of tribute – funny and sincere in their affection for their Zaidas.
Then came the big day. It lived up to and even exceeded my expectations. It was a sell-out crowd. I was overwhelmed just at that fact. The only thing missing from the building was the electronic ark. The respective families all participated with aliyahs and indeed Torah readings by Sami Lyons and the 83-year-old Bar Mitzvah boy Ted Lyons. Now, “leyning” from the Torah was not something Ted had done at the first go-round 70 years ago. (In fact, almost all of us were deficient in that area).
One particular moment during the service was especially meaningful for Sherna and me. In the first part of the service, there is a prayer called “Mi Chamocha.” My son Ari had written music for that prayer several years ago and now he was at Shaarey Zedek, where he had his Bar Mitzvah long ago. This time though the clergy had arranged to use his music and to sing his melody. (It had been used many times previously, but without Ari. ) Not only that, he was invited to play his composition at the service as Cantor Leslie Emery sang it. Those few moments – as we watched and listened, at this – my second Bar Mitzvah, at a place where my parents had been members for years and whose names are on the memorial plaque in the chapel, well, that was powerful, to put it mildly.
Ted and his family had various honours as did my family. I was given the Haftorah to chant. Now, I have few talents, but I can chant a Haftroah (not the most marketable skill), so that was not that much of an obstacle for me. In fact, I rather enjoyed doing this part of the service. Rabbi Rose had also given me permission to deliver a D’var Torah on the portion of the week, “Shemini”, and to discuss the meaning of this, my second Bar Mitzvah. Once I had the mic and the stage, I was ready to go in spite of my wife’s protestations that it was too long. And, in fact, as I rolled along into my Haftorah, after about 10 minutes, my parter in the double Bar, Ted, came up from behind me where he was sitting, and nudged me gently, or to put it more accurately, gave me the hook, announcing that it was time to wrap up. It was kind of comical, in fact. I got a large charge from that sudden intervention. To top it off, as I had been speaking, I noticed a congregant on my left near the front who had apparently passed out. It was alarming to me at first, but the medics came and were able to revive this person. I was told later that other first words out of the mouth were “Has he finally finished?”
We concluded the day with a rather large kiddish luncheon highlighted at least for me by traditional party sandwiches, which were a staple of the kiddishes of my youth. I met with so many people of my past, which was a treat and a half for me. I was so into the moment that It was hard to get me out of the building.
As I reflect on the day and the service, I recognized that for all of us, we have times in our lives, whether it be an hour, a day or a week, that we will never forget. This day was for me one such moment. It is etched in my memory to be relived through the Youtube video now in my possession. The gift that keeps on giving, I say.
My first Bar Mitzvah was good, for sure. This one was far better. I knew what I was doing.
Post script (After Gerry had sent us his story, he sent us something else that he said should have been included in the story): True, Ted and I had the Bar Mitzvah no 2. But we only had it because there was one person who did the real work and yet received no credit. She made all the arrangements with the synagogue for both the Friday night Shabbat dinner and the kiddish lunch after the service. She dealt with various people in the synagogue and basically took charge of our simcha. I speak, of course, of Harriet Lyons. That I failed to mention her was due to my excess focus on the eating of the party sandwiches and not enough on the reason we had them in the first place. Harriet teaches the weaving of tallits, but she stands tall in the arranging of Bar Mitzvahs.