An opinion from the other side of the border, in Canada. This is one of the most urgent problems facing healthcare now, I see an endless number of notes letters from our professional groups, regulatory authorities and personal insurers, with no attempt to start dealing with the problems! In Canada it is the shortsighted who do not accept that Canada’s single payor system has failed and is broken and beyond the ability of any central government or province to repair. Shortages of personnel takes years to replace and there is I fear an imminent exit of many near retirement practitioners!! Personally my workload during and since Covid has increased dramatically with more patients and increased responsibility due to lack of primary care to help do just that, primary care!! Skyrocketing costs static incomes have made practice often cost ineffective, I do not believe the patients we treat are aware of how serious the problem is, they have very high expectations!! We are a fragmented profession we have been divided and ruled, it is up to us to deal with that - there is nothing I can think of in healthcare that we the profession, control. The future is bleak lest we deal with that reality.