It Should Be Different

Dr. Braden Manns
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The It Should Be Different podcast explores the challenges Canadians face in accessing quality health care, reveals the behind the scenes workings of the health care system, and offers real solutions for improving health care. Dr. Braden Manns, a kidney specialist and former health system leader, blends insider insight with patient and clinician stories and welcomes some of Canada’s most experienced health care professionals to a conversation about the health care crisis and how we can fix it.

Episodes

  1. 5d ago

    Why does it take so long to see a specialist? What makes a great referral system?

    Professional dancer (and Braden’s niece) Kate Manns describes developing severe, unpredictable migraines after a kidney transplant, then waiting two years to see a neurologist. Braden Manns and family physician/health system leader Dr. Rick Ward discuss why Canadian specialist referrals are slow and opaque, relying on fax, non-communicating records, and informal networks to choose specialists, with long waits pushing patients to emergency care. They outline solutions: centralized access/triage hubs that track wait lists and route patients to the right specialist and shortest queue, and rapid specialist advice services (e.g., Specialist Link) that provide call-backs within two hours and can avoid about half of face-to-face referrals. They address patient choice, physician autonomy, payment barriers, and the need for collaborative, bottom-up change supported by primary care organizations and operations staff. Resources Canada’s median health-care wait time hits 28.6 weeks—second longest ever recorded Specialist Link by the Numbers Effects of a single-entry intake system on access to outpatient visits to specialist physicians and allied health professionals: a systematic review   00:00 Kate’s Migraine Ordeal 02:46 Why Referrals Stall 03:34 Inside Referral Workflow 06:15 Choosing The Specialist 08:08 Central Triage 12:39 Specialist Link Advice 16:49 Does Phone Advice Work 20:00 Patient Choice And Ego 24:31 Scaling And Incentives 29:41 Accountability And Autonomy 34:17 Hope And Wrap Up 36:31 Final Takeaways   Note from the host:  I'd love to hear your thoughts in the comments, or you can find me on X, Instagram, or TikTok at bradenmannsyyc. Please leave a review on the podcast on Apple, Spotify, or your podcast platform of choice. Don't forget to check out my new book, "Dying for Care," available now for pre-order on Amazon,Indigo, and Sutherland House. I'll be donating all proceeds from this work to the Center for Health Policy at the O'Brien Institute for Public Health at the University of Calgary.

  2. 5d ago

    Why are Canadians dying in ER waiting rooms? What are the fixes *outside* the ER?

    Emergency physician Dr. Paul Parks (@pfparks on X /@pfparksy on Instagram) joins the podcast to explain that dangerous ER wait times are driven largely by problems outside the emergency room, especially access block from admitted patients who can’t move to inpatient beds. Dr. Parks describes extreme waits (including hours for chestpain), ERs operating with most beds occupied by admitted patients, and hospitals running at 120%+ capacity. Key causes include long-term underbuilding of acute-care capacity, workforce shortages after the pandemic, and many“alternative level of care” patients stranded in hospital due to insufficient long-term care, supportive living, and home care—at far higher cost than community care. Dr. Manns and Dr. Parks discuss overcapacity protocols, the need for integrated command-and-control across hospitals and sectors, and stronger accountability tied to transparent benchmarks. Resources Learn more about Dr. Parks at www.paulparks.ca Emergency department wait times in Canada: Insights from a health system perspective (CIHI report) EM:POWER: The Future of Emergency Care CAEP report Edmonton Journal Op-Eds by Dr. Parks   00:00 ER Waits Put Lives at Risk 00:17 Meet Dr Paul Parks 01:58 ER as System Safety Net 03:09 Real Wait Time Horror Stories 05:00 Access Block and Gridlock 07:13 Why Hospitals Run Over Capacity 09:54 ALC Patients and Missing Care Options 15:10 Planning Failures and Political Cycles 18:04 Workforce Shortages After Pandemic 19:51 Overcapacity Protocols Explained 23:13 Hallway Care Tradeoffs 23:37 Load Leveling Across Hospitals 25:07 Accountability Disaster Command 28:11 Unassigned Recommendations 30:51 Fixes Inside The ER 31:28 Flu Season Warning 32:58 Elevator Pitch One Year Fixes 35:51 Three Year System Rebuild 37:14 Primary Care Versus ER Gridlock 40:57 Advice For Patients Waiting 43:12 Tell Your Story, Be Kind 46:13 Closing Reflections And Thanks   Note from the host:  I'd love to hear your thoughts in the comments, or you can find me on X, Instagram, or TikTok at bradenmannsyyc. Please leave a review on the podcast on Apple, Spotify, or your podcast platform of choice. Don't forget to check out my new book, "Dying for Care," available now for pre-order on Amazon, Indigo, and Sutherland House. I'll be donating all proceeds from this work to the Center for Health Policy at the O'Brien Institute for Public Health at the University of Calgary.

  3. 5d ago

    Why are Canadians dying in ER waiting rooms? What are the fixes *inside* the ER?

    Dr. Braden Mann interviews Dr. Catherine Varner, a Toronto emergency physician, researcher, and deputy editor at the Canadian Medical Association Journal, about worsening ER wait times across Canada and what improvements can realistically happen within emergency departments. Dr. Varner explains crowding is multifactorial and describes“access block,” where most ER beds are occupied by admitted patients awaiting inpatient beds in hospitals running over 100% capacity, forcing others to wait in chairs, hallways, or improvised spaces. She outlines triage using the Canadian Triage Acuity Scale (CTAS) and the risks of patient deterioration in overcrowded waiting rooms. Key bottlenecks like ER boarding, hospital capacity limits, and staffing strain contribute to burnout and nurse turnover. Potential ER-level gains include geriatric-focused transition teams and stronger home-care supports, but Dr. Varner argues most of the solutions need to happen outside the ER.   Resources Emergency physician burnout and attrition in Canada: a longitudinal study CMAJ podcast Emergency department wait times in Canada: Insights from a health system perspective (CIHI report)   00:00 Why ERs Are Overcrowded 02:24 Access Block And Boarding 04:02 Inside Triage And CTAS 06:32 When Waiting Turns Dangerous 08:41 Patients And Staff Under Strain 12:37 Staffing Peaks And On Call Limits 15:40 Burnout Survey Wake Up Call 18:59 Who Ends Up In The ER 21:03 Addictions And Mental Health Complexity 22:44 Where Patients Get Stuck 24:20 True Bottlenecks In Flow 26:49 Nursing Skills And Ward Care 29:14 What Actually Helps Inside The ER 32:06 Home Care Lessons From Norway 33:28 Why Triage Doctors Fall Short 35:45 Advice For Patients And Wrap Up   Note from the host:  I'd love to hear your thoughts in the comments, or you can find me on X, Instagram, or TikTok at bradenmannsyyc. Please leave a review on the podcast on Apple, Spotify, or your podcast platform of choice. Don't forget to check out my new book, "Dying for Care," available now for pre-order on Amazon, Indigo, and Sutherland House. I'll be donating all proceeds from this work to the Center for Health Policy at the O'Brien Institute for Public Health at the University of Calgary.

  4. Season 1, Episode 1 Trailer

    Introducing "It Should Be Different" with Dr. Braden Manns

    The It Should Be Different podcast explores the challenges Canadians face in accessing quality health care, reveals the behind the scenes workings of the health care system, and offers real solutions for improving health care. Dr. Braden Manns, a kidney specialist and former health system leader, blends insider insight with patient and clinician stories and welcomes some of Canada’s most experienced health care professionals to a conversation about the health care crisis and how we can fix it. About Dr. Manns: Dr. Braden Manns is a practising physician and Associate Vice-President of Health Research at the University of Calgary. Dr. Manns has a medical degree from the University of Toronto, and specialty training in Internal Medicine and Nephrology from the University of Calgary. He also has a Master’s in HealthEconomics from York University in England. He has published more than 500 research articles, many focused on improving Canadian health care. He served as a vice-president in Canada’s largest single health system. With his researchexpertise, and practical experience, he’s now determined to reveal the root causes of Canada’s healthcare crisis and share solutions.

  • 1 Trailer
    3 Episodes

Trailer

About

The It Should Be Different podcast explores the challenges Canadians face in accessing quality health care, reveals the behind the scenes workings of the health care system, and offers real solutions for improving health care. Dr. Braden Manns, a kidney specialist and former health system leader, blends insider insight with patient and clinician stories and welcomes some of Canada’s most experienced health care professionals to a conversation about the health care crisis and how we can fix it.

Information

  • Creator
    Dr. Braden Manns
  • Years Active
    2026
  • Episodes
    4
  • Rating
    Clean
  • Copyright
    © Dr. Braden Manns
  • Show Website
    It Should Be Different

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