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
First year medical student Tim Rozovsky founds new association for local Jewish medical students
By MYRON LOVE In the face of a concerning surge in antisemitism over the past nearly three years, I am happy to report a good news story in that regard. Tim Rozovsky, the founder of the new Jewish Medical Students’ Association of Manitoba, reports that he and his fellow Jewish students enrolled in the University of Manitoba’s Max Rady College of Medicine are not experiencing any significant issues involving antisemitism.
Hopefully, the matter of the notorious Med school Valedictorian who used his podium to attack Israel was a one-off.
“My goal in forming the Jewish Medical Students’ Association of Manitoba,” says the first year medical student, “was to create a safe, supportive environment for my fellow Jewish medical students.”
He reports that the current first year class at the school has eight Jewish students – an increase over more recent years – with maybe a dozen more in the other years.
For a new medical student, Rozovsky already has an impressive resume. He was born in Russia and grew up in Israel. After the completion of his army service in 2018, the then-22-year-old rejoined his parents, Dr. Katya and Alexander, who had moved to Winnipeg a few years before.
Prior to coming to Winnipeg, Rozovsky had completed a personal trainer program out of The Academic College at Wingate in Jerusalem. Some readers may know the young man from his work as a Master Personal Trainer at the Rady JCC.
Shortly after arriving here, he enrolled in a kinesiology program at the University of Winnipeg. He graduated with a BKin Honours in 2023 and did post graduate work at the University of Manitoba. Last fall, he received his MSc in Physiology and Pathophysiology – earning two gold medals, along with 32 awards and scholarships in the process.
Rozovsky says that it was his mother who inspired him to pursue a career in medicine. Dr. Katya Rozovsky is an associate professor at the University of Manitoba and an attending radiologist, specializing in pediatric diagnostic imaging.
(Tim also adds that his wife, Irina Gelzin, whom he married about a year ago, is training to be a nurse.)
Insofar as the Jewish Medical Students’ Association of Manitoba is concerned, Rozovky reports that the group gets together multiple times a year. One of its programs was a joint Chanukah celebration with the Jewish Physicians Association of Manitoba.
There was also a joint program with the Christian Medical and Dental Students’ Association of Manitoba.
“More recently, we have been helping prospective Jewish medical students with their applications,” he says. “Hopefully we will be able to get together over the summer with the incoming Jewish students.”
As to his own future plans, Rozovsky notes that it is too early for him to be deciding on a specialty. “My goal,” he says, “is to work hard and get good grades and become the best doctor that I can be.”
Local News
Gray Academy to Represent Manitoba at National Reach for the Top Competition
By NOAH STRAUSS Posted June 6) Gray Academy’s Reach for the Top team is headed to Moncton, New Brunswick, to represent Manitoba at the National Reach for the Top tournament.
Reach for the Top is a Canadian school league that quizzes teenagers on a variety of different topics, from science and history to pop culture. Reach started out in 1961 in Vancouver, where a local CBC station broadcasted the new show; it eventually became a national broadcast starting in 1966. Alex Trebek, who famously hosted Jeopardy!, started out by hosting Reach for the Top.
Gray Academy’s very own team, made up of Grade 7 and 8 students, will travel to Moncton, New Brunswick, to compete as Team Manitoba. By winning the provincial Reach tournament, they secured their spot in the national competition.
Faculty members at Gray Academy are very supportive of the program. The Jewish Post spoke with three different staff members at the school. Coach and high school teacher Danielle Miller says she is excited for the trip; although she will not be accompanying the team herself, shehas coached them all year.
“This year we had over 20 students come to the club to join us, they practice twice a cycle at lunch,” Miller said. Due to the large turnout this year, two teams had to be formed. At lunch practices, students split into two teams of four where each player has a buzzer. The two teams compete to see who can answer the most questions correctly.
One of the two teams did exceptionally well at various tournaments throughout the year and will be traveling to nationals as the sole team representing Manitoba.
Co-coach Micah Doerksen described Reach as a great academic competition where young minds are tested on various topics through quick,fast-paced questions.
High school guidance counselor Lindsey Leipsic said, “We have athletes, non-athletes, we have students who are really involved and students who are not as involved at school, and we have quiet leaders, and we’ve seen friendships be built in Reach.” Some of her favorite memories of Reach involve seeing students from across Winnipeg come to Gray Academy and bond with one another. Lev Chisick, who is competing at nationals, agreed, saying, “Moncton is going to strengthen our school spirit and make us a better team.”
As the junior team makes their way to Moncton, the senior team will head to provincials. Later this week, students from the senior team will travel to Virden, Manitoba, to compete at the provincial level. The team qualified after placing high enough at their most recent tournament, which took place at St. Paul’s.
Confidence is high as the school heads into these final tournaments. When Nath Goldenberg, who is also competing at nationals, was asked what he is most looking forward to, his answer was short and sweet:“Winning.”
Local News
Team Schvesters teammates Benji Harvey, Kim Gray once again among top ten fundraisers in this year’s CancerCare Manitoba Foundation Challenge for Life event
By MYRON LOVE This year’s annual CancerCare Manitoba Foundation’s Challenge for Life walk at Assiniboine Park is scheduled for Sunday, June 13 – and, once again, in terms of fundraising, Team Schvesters is sitting in second place overall – having raised just over $30,500 as of May 26 – which is $5,000 more than the team members had raised by the same time last year.
As well, team members Benji Harvey and Kim Gray are once again in the top ten among individual fundraisers. Harvey this year sits in fifth place, having raised a little over $16,000 as of May 17 – while Gray has raised just above $8,000 – putting her in seventh place.
Harvey reports that, -over the past 18, years participating in CancerCare Manitoba Foundation’s Challenge for Life, she has personally raised $180,000 for cancer research, while her team as a whole has brought in $367,000. In discussing her success as a fundraiser, Harvey says that she has made a lot of friends over the years and believes in giving back to the community.
The “Schvesters” are the Greenfeld sisters: Harvey and sisters Lesly Katz and Debra Lewis – the daughters of Lil and the late Ike Greenfeld. Two of the sisters are cancer survivors.
There is one other team member – in addition to Kim Gray. Judge Rocky Pollack first joined Team Schvesters in 2023. After a year away in 2024, he returned last year. Pollack lost his wife, Sharon, to cancer in 2014 after a multi-year struggle.
Nancy’s Nightingales has been a top 10 community fundraising team for Cancercare Manitoba and the Challenge for Life since its inception in 2008. As a team, they have walked together since 2006 when they walked 60 km in two days in the Weekend to End Breast Cancer.
Last year, the team – including Louise Raber, Joanne Katz, Rhonda Youell, Connie Botelho and Harriet Lyons – finished fifth in fundraising. So far this year, the team is again sitting in fifth place –having raised just under $12,500 (as of May 26) – a couple of thousand dollars more than last year, and just about $300 behind the fourth place team.
The Nightingales are named after a nurse who is a cancer survivor- and a friend of Louise Raber, Nancy’s Nightingales team leader.
“Our goal, as always, is to raise at least one dollar more than last year,” says Raber.
Team Jason’s Journey team leader Jason Gisser has experienced a more intimate and longer-lasting relationship with cancer than many of the other Challenge for Life participants. He was first diagnosed with cancer when he was 18. “I am a proud cancer fighter, having lived and battled a chronic cancer diagnosis for the last 23 years,” he said in an earlier interview. “I participate in the Challenge for Life not only to give back for the care and treatment which I have and continue to receive through CancerCare Manitoba, but to ensure that others do not have to endure the journey which I have endured.”
This is the ninth year that Gisser has taken up the Challenge for Life. His teammates are returnee Nora Fien, as well as friends Danial Sprintz, Wendy Martin White and Jason Roberts, also his mother, Judge Freda Steele. He has personally raised about $5,500 this year, while the team as a whole has raised just over $7,000.
“The Challenge for Life is great opportunity to raise valuable dollars for cancer research and treatment,” Gisser notes.
Readers can make donations to their preferred team by going online to CancerCarefdn.mb.ca and click on Challengeforlife.ca.
