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Shouldice Hospital lands sold for redevelopment and public use
I wonder what this means for the future of the Shouldice Hospital. Seems like disturbing news:
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18 Replies
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Could there be resentment there toward MDs in private hospitals because in the general public hospitals MDs apparently are paid less while scheduled more work (something I picked up from a Canadian MD blog)? Off-hand I would suppose such happens elsewhere as well. But it could be more a factor in Canada based on the info in this thread, putting more scrutiny onto private hospitals. Hmm, ironically Shouldice might venture into be doing more mesh operations than it has been.
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Actually, now that I read more, that 2012 sale fell through (and it was indeed just for the clinic). Interesting to note is that it would have been to the same U.S.-based company (Centric Health) that in a roundabout way acquired Don Mills Surgical Centre. Shouldice remains privately held, but I’m not sure who the actual ownership group is beyond “Shouldice Hospital Ltd.”, with E.B. Shouldice listed as the board chair.
There are many options for hernia repair here, but not specialty clinics focusing only on hernias, unfortunately. The standard referral from family docs is to a general lap surgeon either at a clinic or public hospital, almost all of whom do mesh repairs.
There is a very old case study from 1983 that was revised in 2003, that might be worth a read: (https://coloradohealth.org/sites/default/files/documents/2017-01/ShouldiceHospitalLimited.pdf)
apparently in the past they contemplated expanding the facility or opening other facilities to meet demand, but AFAIK nothing came of any of that…and I know they used to have a consultation/follow-up clinic closer to downtown Toronto that closed many years ago.I agree that a lot of the demand for Shouldice might have less to do with tissue vs. mesh and more to do with it being a specialty centre…and after 70 yrs, there is volume simply from word of mouth and reputation (it was an extended family member in the healthcare system who suggested Shouldice to me).
I don’t know what the numbers are today, but they do get a lot of patients from across Canada, the U.S., and even international. In one of my admission cohorts, there were at least two from the U.S., one from the U.K., and one from South America.
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This reply was modified 2 years, 3 months ago by MarkT.
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This reply was modified 2 years, 3 months ago by
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I hope there will be a way to keep them going during that massive construction at their doorstep, or a way for them to relocate, but I doubt it.
There are other issues there. 4 full time surgeons retired over the last couple of years, and more are approaching retirement. Most of the young surgeons there appear to be part-time with jobs elsewhere doing other procedures.
I’m not sure what was sold exactly for only $14M in 2012. Maybe just the hospital without the land? It seems like the land was sold for $47.5M in 2016, and now resold for $188M. Nice real estate investment.
The interesting thing is that there is so much demand for this hospital. I think it’s mostly unrelated to tissue repair vs mesh. Canada is just very under-served in terms of medical providers and facilities. They would have a lot of demand even if they did lap mesh, which is something that was mentioned as an area of exploration by their chief surgeon.
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I believe Ontario had seven private hospitals grandfathered in, with three currently in operation. In addition to Shouldice, there is Don Mills Surgical Centre. I’m not sure what the third is, but AFAIK it is similarly a facility of limited scope.
The Ontario gov’t is looking to expand the public-private partnerships with private facilities billing the public system for procedures and physician fees, similar to Shouldice.
The talk is that by controlling funding, they could limit the extent to which talent is ‘poached’, prevent the private system doing ‘too many’ surgeries or operating entirely as it sees fit while still billing the public system, etc.. Whether that is truly the case remains a big question.
In Quebec, there is already a big private healthcare system that includes family medicine, sports medicine, physio, orthopaedics, gyno, GI, imaging, and non-emergency surgical units (including hernia repair). A lot of that is fully private though, so you pay out of pocket or obtain private insurance, while some family physician services are still covered by the public system and those docs can still refer out to specialists in the public system.
I wouldn’t necessarily worry about the construction impacting Shouldice operations. We build skyscrapers on tiny footprints in busy downtown cores without everything shuttering around them. While relocation is possible, and has been talked about since the initial sale back in 2012, I can’t imagine it would shut down. It has never been a big money maker. It was sold for ‘only’ 14 million in 2012, so ownership’s ROI expectations are presumably reflective of that?
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They are one of (I think) 3 private hospitals in Ontario. These were allowed to continue to operate when new private hospitals were banned in 1971.
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I was replying to Watchful directly, and indirectly to anyone who wondered about the term. It’s a business/financial term.
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This reply was modified 2 years, 3 months ago by Good intentions.
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This reply was modified 2 years, 3 months ago by
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@Good intentions, you’re so funny. 😀 You so wish to edify us but neglect to know your own language.
Please consult the OED before you float your misdirected claims. To wit, “cash cow” according to the OED means,
“a business, investment, or product that provides a steady income or profit: traditional cash cows like cars and VCRs.” Even without dictionary in your possession, if you cared to read my words, you would have known that I asked,”How profitable” had Shouldice been.But then again if you had cared, you would not have had a chance to edify us, would you? Ok, here’s a bone: “The earth is flat.” Let’s see what you can do with that. 😀
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But, on the other hand, where will the people with money and influence go if Shouldice fails? Rand Paul, for example.
It might be that there are reasons for the recent “Expert’s Consensus” paper from the Shouldice Hospital. Maybe they are laying the groundwork for expansion or a move. It will probably take years before Shouldice gets pressured out, but it won’t be a surprise if it happens.
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@Watchful, as always you come with interesting info; this time no exception. Wow, I have to say. The Canadian health care system keeps out non-state actors however enterprising they may be? But it begs a question: Shouldice Hospital is not private–it’s state owned? Or it is private but was begrudgingly allowed?
Gentlemen, you ran your discussion while keeping secret this vital information of Shouldice’s precarious legal status in Canada?! 😀 ALL BETS ARE OFF! Are you kidding me?
Considering the STATE, the POWERS TO BE, the MEDICAL PROFESSION, INTER-AGENCY RIVALRIES, I see little chance for Shouldice’s survival in Canada.
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Political lobbying is incredibly powerful. Oil, tobacco, pharmaceuticals, herbicides… Anything that has large quantities of money running through it is going to be lobbied for at the highest levels. Right or wrong don’t matter. Just the size of the stream of money.
“Cash cow” doesn’t necessarily have to do with profits. It’s the steady stream that matters.
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Plenty of demand, but it’s no cash cow. Hernia surgery doesn’t pay much, and most patients there are covered by the health insurance plans of the Canadian provinces. These pay little. Self-pay patients are a minority, and they don’t pay all that much either. I read that the place hovers around breakeven – sometimes a little in the green, and sometimes in the red.
Private hospitals aren’t even allowed in Canada. This one is one of very few exceptions that were grandfathered. In other words, once it’s gone, it’s gone.
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Gentlemen, let me assure you there’s no reason for alarm. If the Shouldice Method remains in high demand then in one form or another that hospital’s staff will continue to offer it. The only sticking point is if the new owner, the healthcare company, decided to phase out the SM, but it would defy basic logic to dispense with a cash cow. If demand is strong enough, SM will continue to thrive in one form or other. My question is: What is the demand actually and how profitable has the hospital been operated?
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These towers will not just materialize. It’s years of major construction with staggering amounts of noise, dirt, dust, and other pollution.
Who knows when the construction will start, and no issue until then, but during the years of construction, I can’t imagine how the hospital will continue operating.
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I think it will be fine. The grounds are quite nice, but the reality is that very few people made use of them. In the nicer weather (and before covid), patients could go for walks out there on their own or with visitors, but they certainly don’t need acres and acres of land for that.
What I would actually like to see is some updating of the hospital itself. It’s ‘quaint’, but could definitely use a refresh lol
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Ah ok Watchful, not sounding so good, looks like it’s going to turn out like my friends experience.
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No, it was bought by the city to do massive residential development plus some green space. The hospital building is supposed to remain in the shadow of the towers. Take a look at the plan:
Even though the hospital has a 16-year lease, I don’t know how they’ll be able to continue operating during this massive construction project of 5 towers of 18-35 floors in close vicinity to the hospital. This is Phase I, and it looks like there will be redevelopment of the block where the hospital is located in a future phase.
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I maybe dim and be totally wide of the mark but that sounds like the land has been purchased by the city (of Markham) to avoid the, massive, development and maintain green space.
On the other hand my friend who worked for a family run business that was then sold to a large conglomerate that ran it for a time, then redeveloped the site for housing leaving him out of a job, does ring a few alarm bells to me.
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The lands had already been sold to someone else a while back, with the hospital having a long-term lease (16yrs left acc. to the article). The hospital itself had been sold from the Shouldice family to a healthcare company back in 2012. Here is some earlier news on redevelopment:
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