Thank you. It's good to see everybody today. It's a really a really good day It's a little overcast outside, but it's a really good day for us. I think and we're Very pleased to be here today. I want to respectfully Acknowledge the history customs and culture of the Musqueam of the Squamish to the Slewa tooth first nation on whose Traditional lands and home we meet today Joining me today is Dr. Ramnik Dasanj the president of the doctors of BC who will hear from in a few moments We're obviously this is a very significant day For people who care about primary care in BC. It's a transform Formational announcement we're making today in May as All of you will know Premier Horgan and I met with the doctors of BC We committed to working closely together to support doctors in our province through a collaborative multi-phased approach in August together Dr. Dasanj and I announced stabilization funding of 118 million to support family doctors with overhead costs this stabilization funding Made a significant difference and it has been as close to fully subscribed as such a program can be 107 million dollars of that 118 million dollars is has gone out or is going out the door in the Few days to come we've had a very high rate of Participation in the program and we're very pleased about there's still 11 million dollars We sent out and we'll expect that to happen in the next few weeks as the remaining Doctors take part in that program and clinics take part in this program It's working that program and I think it provided in interim support as we work together On a longer-term solution and it's because of this work together this collaboration that we're here today Together with doctors of BC and BC family doctors We've developed a new patient model and have a new tentative physician master agreement This payment model for family doctors will help perfect and strengthen BC's health care system by helping to attract new family doctors and Retain existing doctors by supporting our health care workers including doctors We are helping patients get better access to the health care that they need and that's what matters most Making sure patients get access to that care this new payment model Which will be available to family doctors beginning February 1st 2023 Provides another option for family doctors that makes a departure from the fee-for-service model under which doctors are paid Primarily on the number of patients they see in a day This brand-new model takes into account five factors Including the time doctors a doctor spends with a patient the number of patients a doctor sees in a day The number of patients a doctor supports through their office the complexity of the issues a patient is facing an Administrative cost currently paid directly by family doctors It would give family doctors a more equitable payment option one that better recognizes their value in providing primary care Full-service care to patients Importantly it will help maintain their business Autonomy giving them more flexibility to create the kind of practice that works for them And most importantly for their patients It was respect to the tentative physician master agreement I'm happy to announce that the province and the doctors of BC have reached a tentative physician master agreement This agreement includes several commitments that will better support doctors as they care for patients It also reflects the desire and commitment of the doctors of BC the government of BC and BC health authorities Working together in the interests of patients The tentative agreement fosters stronger collaboration and reduces the barrier to barriers to doctors in the delivery of care to their patients The tentative agreement supports our continued collaboration on key priorities to improve health care including gender equity reconciliation with indigenous people and workplace safety The tentative agreement we've reached addresses work doctors complete after regular operating hours by addressing improvements to existing Alternative physician payment contracts and increasing Improving and increasing access to health services for patients will continue to be the focus of doctors of BC and the Ministry of Health Working groups over the coming months This includes how to best attach patients with complex needs a provincial rostering System to ensure patient care continuity a provincial patient survey and how best to incorporate into the new model other Services that family doctors provide outside of clinics This is all part of refocusing and our continuing efforts to to develop and improve our primary care strategy In January as our BC pandemic entered a new phase We said it was time to renew rebuild and strengthen our health care system and the actions We're taking including achieving this critical agreement this work together come from hard work And from working so closely with doctors of BC and BC family doctors to find solutions that strengthen our health care system That renew its essential function and that build on our support for doctors and for the patients who count on them So far our efforts have produced significant results in June We started working with resident doctors and new to practice doctors and for incentives to bring them in to ensure that that group of doctors who was entering in to To family practice in BC would choose full-service family practice I'm happy to report so far 62 dot new physicians have signed contracts and 68 are in discussions about suitable clinic placements in the terms of the contracts 151 in total have expressed interest in these incentives put that in context that number had typically been for those contracts 25 in a year a health human resources strategy that will train Recruit and retain health care workers while redesigning the health care system in BC So it works best for patients and health professionals alike creating new residency positions 128 at the 40 new undergraduate medical seats They should say an 88 new residency positions at the University of British Columbia And of course the work we're doing to create a new medical school at Simon Fraser University in Surrey All of these initiatives are part of and build upon our transformational and refocus primary care strategy It's my honor now to to introduce dr. Desans to say a few words about this Exciting day for patients in BC for family doctors in BC for all members of the doctors of BC Thank You kindly minister I am excited to be here today as we announced two major developments that we believe that will move us forward In a significant way to meeting some of our health care challenges I want to thank the provincial government in particular minister Dix the premier and deputy health minister Stephen Brown for what has been a true collaboration The announcements today have been shaped by the voices of physicians in this province Physicians who care passionately about caring for their patients They told us clearly what they need so that they can provide quality care and be Responsive to all of their patients needs This will not happen overnight. There is still much work to be done, but I believe today. We are at a milestone The new physician master agreement That will be going to our members for a vote in the next few weeks It is by far the best agreement negotiated for physicians in Canada this year And I believe it is one of the best that has ever been negotiated here in BC It allows us to target funding to areas that need it most so that we can ensure physicians Both family doctors and specialists are recruited and can stay in their communities and also have the tools and resources To provide the level of care to their patients on a personal note I'm particularly proud of the commitment within the agreement to address gender equity Across the profession and to integrate cultural safety and humility into all of our work our new family physician model Co-developed by doctors of BC BC family doctors and the provincial government represents a set seismic shift in the way we practice in BC It is a model unique in Canada bringing together the best of a range of payment models It addresses rising business costs. It recognized the value Physicians provide when delivering Longitudinal care and it will compensate us for the time spent on evening and weekend administrative burdens Our hope is that this new payment model will not only stabilize longitudinal family practice But help make it both sustainable and rewarding Everyone deserves a family doctor and this new option is a significant step to help make that goal a reality As I said, there's still much work to be done Not just to improve the issues that are facing the doctors but to meet the challenges of the entire healthcare system BC's doctors are leaders and champions for our patients With our partners will continue to work hard on behalf of all of our patients at the end We needed hope and light for our patients and for the physicians that are responsible for providing the care I am very excited and thank you very much for having us here today Thank you, Dr. DeSange. It's been a pleasure working with you Pleasure for our teams. It's been exceptionally Hard work, but I think people will agree that hard work together Building out all of our goals together of team-based care of providing better care for patients of of Fully integrating the role of doctors in that and also and principally for our patients What this means is that we're making family practice the priority it should be We're responding to what dr. DeSange and others have called a broken system by Restoring the value to family practice that is required by building out a system of Locums to ensure that people have care when and where they need it of ensuring that episodic care Is more closely connected to the overall health care system that patients are better linked to community care This will mean better care for patients together That was the principal goal of the ministry of health and the government of bc That was the principal goal in all of this work together of the doctors at bc And I think that we have achieved some of those goals. There is a lot of work to go come This is one element This is a key element, but one element of our overall health human resources plan that you've seen in recent months But it shows what we can do As we continue to work together with all of the people in the system and with patients as well commitment action Collaboration they have they make possible what we can achieve together in our health care system Over the last two and a half years We've been dealing with two public health emergencies and it has had profound effects on everyone On every single person in bc I think our system has shown An ability to respond to that that has been remarkable We face challenges together and we have to take the same approach Commitment to public health care commitment to our patients. That's what today's agreement is all about We're happy to take your questions Thank you minister as a reminder for media on the phone. Please press star one to enter the queue That's star one to ask a question for any reporters in the room Please line up at the microphone provided and wait to be called Please make sure to provide your full name and outlet media will be limited to one question and one follow-up We'll start on the phone today with bender sojin ctv. Please go ahead Hi there. Um, so you mentioned that this is good news for people who are waiting for a family doctor. Can you Uh, maybe provide that link to people with regards to uh, you know in february when this comes into A fact how many more family doctors you expect to see and then how patients will actually get access to them so this um, this uh strongly supports Uh our family practice system so it Stabilizes and supports existing practices allows them in their terms to build out team-based care So that's important because our obviously all those who have Care and ensuring that that system is there for the future and replaces a previous system of Payment to doctors that's important for them It provides incentives and supports for people to choose full-service family practice to choose taking on patient panels of 1250 and serving their patients in the community ensuring that that option Is equal to other options that new family doctors can provide and as we build out more options As we add to our primary care networks as we add to our system And systems of episodic care It ensures that people will choose these these into the future The core of a successful healthcare system is excellent primary care Is people in the community doctors and nurse practitioners and nurses and allied health workers providing excellent care in the communities That's how you respond In and improve as well all of the other services you provide in acute care and ambulance care and all the other services you provide So what you're going to see is um is I think And we've already seen this in the response to the initiatives we took together in an interim way The new to practice contracts and the Stabilization package we put forward in august the willingness and the commitment of family doctors in bc to respond to the needs of their patients And finally a rostering system I think we've had Because of the model we've had in place over a long time And I think both the government and the doctors recognize it A system that is was highly Diffused and difficult to understand for patients So what we're going to put in place together over the next six months is a rostering system That allows people who want a family doctor to have a place that they can connect and then get access to one A lot of our information about who has and who doesn't have a family doctor is based on federal government surveys And they those surveys lose the patient in the process We've put the patient at the heart of this agreement And that's why I think it'll be a better deal for patients and for people choosing full service family practice Binder did you have a follow-up? I do yes, thank you And just with regards to the rostering system with about a million people estimated to not have a family doctor How will people be given priority? In terms of getting access into a family doctor. Well, there's two sets. I think of of patients in that as you know In 2003 There are about 300 000 people without a family doctor in bc By the time I became minister of health as well over 900 000, right? So it tripled and you recall efforts to address that I want to be to I won't be partisan here So I won't mention the various announcements that guaranteed everyone to have in election campaigns by that government That guaranteed everyone to have a family doctor the number of people without one tripled in that time It went it stabilized in the first couple years of ministerial health has been affected by the pandemic so That's what this what you're seeing here Is a focus on patients A focus on the care given to patients a stabilization of our existing network of family doctors Family practice doctors are their ability to build out their practices effectively incentives to ensure that Becoming a full service family doctor is there for people So what we're going to see is a system that better cares for people that focuses on the care And that was a priority for doctors of bc and for ourselves And so you're going to see a system that responds better to people That builds out the number of family doctors and allows people to To access them by a provincial system We sometimes in certain divisions of family practices have excellent ways of linking people to doctors now But we don't have a provincial system. We're going to have that now Build out for the six first six months So we build out a new system of payment that I think is going to be very positive for family doctors And then we're going to Ensure that there's a rostering system in place so that you know, you don't have to search around You don't have to phone doctor by doctor that you'll be able to connect with our system of family doctors better So it's it's a it's good news for patients in that sense We haven't had this before and it's obviously good for doctors as well I don't know if you want to add anything I'd just like to add that this new payment model is a new way of doing things We're listening to the concerns of many of our family doctors that have left practice or have been contemplating actually leaving Many physicians across the province had actually given me a deadline of wanting to leave practice because the conditions were so hard This new payment model enforces the support it bolsters support for physicians Providing the longitudinal family practice care that they have been to their patients So really stabilizing the efforts on the ground and our hope is that we're going to be able to Retain the physicians we have but also recruit more doctors a lot of our new graduating family doctors or have them Incentivized to go into residency to choose family medicine because there's a different way of doing things And we know that we've heard that the burdens and the one patient and one visit and one problem And we're hoping that this support in this payment model will allow physicians to get back to doing doctoring And also be compensated for their administrative burdens and tasks Many colleagues are charting long into the night and on the weekends and taking away from their own time with their families But this puts patients first it allows patients to actually Attach with their family doctors and will build capacity with the existing family physicians on the ground If we make their working conditions easier and the ability for them to be able to teach within their Clinical settings and to actually bring in more supportive staff and work towards team-based care Then we're actually doing the best we can for our patients and minister Dix is right. This is the first time We've ever implemented such a change Thank you Our next question is for Richard Vestman global news. Please go ahead Minister we obviously have cautioned around politicians making promises about you know how many People may be without a family doctor But are there going to be any benchmarks built into rostering here in terms of how quickly you'd like to see Those million people place with a family doctor Well, I think one of the issues I think And this is a technical question But when we say that there are people without a family doctor And the numbers that's in response to something called the Canadian community health survey Which is a survey conducted by at a national level and as you know That was in the in the low 300,000 range in 2003 and it tripled in the years between 2003 and 2017 This in spite of the fact That a commitment was made in multiple election campaigns by that government that everyone would have a family doctor So what this is what this change is about is a fundamental change And it's foundation Foundational to all the other things we're going to do one rostering systems treat people as individuals So it's not your response to a survey that might come to somebody from the federal government and allows us to estimate It allows you to engage with the system it treats people as individuals And so it then sets benchmarks for practices and allows people to access primary care in the same way As one accesses other health care services when you need emergency care you go to the hospital You know what to do and whatever the challenges might be in the hospital You know what your role is and what you're to do This allows I think and empowers patients So we're going to be setting new benchmarks finally having benchmarks in bc and a system that's linked together We've agreed to work together to have a system that responds adequately to the interests of patients We've had over time a fairly diffuse system This is a deal. This is an agreement agreement with doctors that that I think promotes Primary care promotes it as a career for doctors again, and we'll bring more Doctors into the system but richard. It's only one part of it. We need to take action and we have To increase residencies and this agreement supports that by allowing family doctors to support new doctors Community and to be adequately paid for this people sometimes say well, why don't you just have more residencies? Well, they require is a serious and important educational process that needs to be supported by existing doctors This agreement supports that we need to address barriers to internationally educated doctors and to build out team-based care And allow doctors to work more easily with other professions to provide more care and to increase attachment in their clinics This is these are exciting and foundational changes that are going to allow us to succeed in many of the other things It's not 50 strategies But it's it's in fact in this case 70 strategies linked together and this is important and foundational to that Richard did you have a follow-up? I do one of the big challenges obviously is about regionality You know in some areas like here in victoria age is a fact of the populations older They have more reliance on family doctors in metro vancouver. You have in many areas a growing Population in the north you have areas where you know if one family doctor retires it may mean an entire community is not Served so how does this model address the challenges around? regionality in british columbia and aside from that There's a change as well around Nurse practitioners. Can you speak to that and how does that factor in and and if dr. DeSanche can weigh in whether they're all worries because I know there have been in the past From seeing a greater role for for nurse practitioners in the primary care system I think on the latter I would say That there is extraordinary support in collaboration our system With between doctors and nurse practitioners Compared to any time in the past I I think that's just true That you know when I became minister of health we were last in canada in number of nurse practitioners per capita One of my predecessors george abbott had really created and as minister of health had led The establishment of nurse practitioners in bc But we were last in canada and we've dramatically increased the number of nurse practitioners such that I think it was It will by the end of this political mandate have tripled And so that role will continue in all parts of our health care system What this system does it it has been historically very difficult In the 2000 family practices less so in the UPCC's or the health 30 clinics But where generally speaking people have been paid in the same way But it's difficult when you have a system of independent contractors And other people coming to the system who are paid differently and and and it's been hard to bring those together This breaks down some of those barriers allows Family practices to build out their support from nurse practitioners and nurses in such a way That we're going to be able to offer that team-based collaborative care in more ways On that we've had right now in bc 58 primary care networks and there'll be a There will be an ability through them to do that So I think this is building out team-based care in practice And I think the work that doctors and nurse practitioners do in particular and and registered nurses And allied health workers together is going to be enhanced by this agreement and it builds confidence in that And and I think the the new payment model only strengthens that idea So you're going to see nurse practitioners and doctors working together more because We're going to be facilitating that and we can do that and build that out with confidence and I'm I'm very proud of that and we've got to continue to build that out. It's been a challenge, of course In the last number of years which remind people our primary care networks have added 1,200 people to the primary care system to support better care for people who have a family doctor now And those who want one we've added The urgent and primary care centers so those are important with respect to the the Regional elements of this it's true people have different demands and different needs But you know Some things are common We're seeing an increased complexity of patients everywhere as we have an aging population For a long time for example, Surrey, which is obviously critical community in bc was the youngest community in bc Well now through the 2036 it's going to meet the provincial average in terms of age In fact the demands in Surrey for care are going to increase And that is why we're building for example a new cancer care center at the new hospital in Surrey So I think you're going to see that increase in that aging population equalized across the province But you see in this agreement and we haven't got into all of the details of it more supports for rural care And that the changes we're making in practice some of which actually started in smaller and rural communities are now bringing Turban centers are going to are flexible enough to meet the needs of everyone because you're right Some communities that are younger need more episodic care and need to connect that care into the system Some younger people don't really feel they need a family doctor. Maybe when we're 27 and we're in very good health we may not see that but we may if we're You know playing frisbee football or something and injure our legs suddenly need care And need rehabilitation care over a period of time And so those communities will need to strengthen out episodic care younger communities You can imagine what some of them Might be in bc. I think nelson's probably an example of that and you have communities such as victoria that have A lot of seniors who really will require a full service family doctor Or nurse practitioner or someone providing care and a full service clinic to support them with their varied health needs now bc has Extraordinary levels of public health One of the longest life expectancy of our country in the world are very few places on earth Switzerland and japan maybe two of them which have longer life expectancy But that means we have more and growing demands than our health care system So we have a flexible arrangement which will improve care in in rural bc improved care in urban bc And allows the doctors to focus on care More than they ever have before Thank you rigid for the question. I'll just respond and reiterate some of minister dick's remarks for the latter part of the question Absolutely, there's a role for nurse practitioners and many of our allied health care professionals to help provide Team-based care and we know that to manage all of our patients needs in this province It cannot be done alone And what i'm hoping is this new payment model is the anchoring is the foundation to create the condition In which our patients can get the best type of quality care that they deserve We need health care equity across the province and we also understand that our rural and remote Communities their needs need to be met I've met with many of our communities across the province and what I can tell you is That rural and remote voice is always at our table as well at doctors of bc So whatever we are building our hope is that the new future Is upon us and this transformational change will have the needs of everyone And that's why i'm also hopeful about the physician master agreement that it's building in health care equity These concepts as we know are so essential that Every patient Deserves a family doctor and to anchor in the supportive system of primary care This looks like the way to kind of move in this direction And really transform the way that we've been able to provide the care for our patients in the community And again alongside us we would benefit from all of our nurse practitioners Our colleagues that can work alongside us and within their scope of practice Alongside ours, but now we're having conditions that will allow us to provide the type of care that we all train to provide So this is again a very exciting time for us and there is still much work to do But this is a start and we appreciate the collaborative efforts of this government Our next question is from Amy Smart, Canadian Press. Please go ahead Hi Amy Hi, I just have a question about the rock strength system. Will it be a first come first serve basis? Or will there be a way to prioritize urgency? Well, we'll get the family doctor first Yeah, and we'll certainly be building on we expect that rostering system to be in place the middle of next year as we work through these extraordinary changes and Obviously that takes some time. We have such systems in place now But obviously what the priority will be in part be provided by people who Who require a full service family doctor? And so we want to ensure that their Their needs are met and that they'll have a place to go To get access to care and that's important and so we'll have Inevitably there is a prioritization that occurs in that and that's the first thing The second is for people who may not want that but need their episodic care to be better integrated And so both of those things are going to happen and we're going to use our places of episodic care whether they be walk-in clinics and And and urgent primary care centers and others to to build out attachment across the board So I think that will certainly be providing more details on rostering But that is a it's a significant change to find to lay out who's attached Who who's attached to a particular clinic and then be able to see where the opportunities are for people to Both add to add a family doctor and to and to find have one place they can go to do so So I think all of that is of value inevitably in the system if you need care And you've gone to an emergency room or gone to an urgent primary care center or other or a walk-in clinic or other place And you clearly need Full-service family practice that will obviously you'll obviously have the other places you can link in as well So the rostering system is new. It's something that we've wanted to do for a long time I think together and it's a it's a key aspect for patients in what we've agreed to today And did you have a follow-up? Yes, one of the measures that you say will be compensated is the complexity of the patient. How do you measure that? Oh I'm going to ask Dr. DeSanche who deals with complexity of patients a lot to talk about that because it's an important part of the agreement but I I think Here's here's what I'd say That There are ways and we've been I think as a system trying to do this for a long time Someone in my circumstance who has Type 1 diabetes. I'm walking in with type 1 diabetes to every appointment I go and see Dr. DeSanche and whatever's bothering me on the day and whatever I need to see the doctor about on the day And that adds to the complexity. It's the reason why people with chronic disease really need Um a full-time healthcare practitioner to support them and to understand when they walk in so I don't have to explain Oh, I'm a type 1 and here's somebody here's what's happening. They know because they have those results We're seeing an increasing complexity of patients across the board And so there are ways and what you have is a detailed system of measuring complexity of patients If you have for example Um a patient roster that's dramatically older or has a very significant group of people who have Let's say mental health and substance abuse issues by definition You have to spend more time with those patients But the overall patient population is also increasing in complexity and this agreement reflects that And so at different times We may have Significantly different needs of our healthcare system. We always need it at different times those needs may be More intense for whatever reason we're diagnosed with a chronic disease Obviously our whole maternity system Is the requirements of that is we're younger we require we have different needs than if we get Into our teenage years So I think what you need and what we have is a flexible model that Focuses us on the needs of patients and allows doctors to focus on care But there are lots of ways to measure complexity We have them in the agreement and I'll ask doctors to speak a little bit about how she does it in her practice Thank you for the call And just not to get too much into the details of the agreement But the understanding that all healthcare systems around the world, especially primary care Healthcare systems and the evaluation of them and we've got in canada obviously all of our research and healthcare policy Abilities to be able to look through either msoc scores, which may not Maybe irrelevant to everyone listening. I may not know the details of that But really what you look at is exactly that some of that minister Dix just spoke of is that that time with the patient What is the chronic condition or the disease and how does that burden the patient? But also the needs of based on how many consultations they mean need or how much The the time they take with you in your clinic office setting and it's not necessarily just on aging But we've known that many of our aging populations and our geriatric populations do have needs for more time And the assessments in your office take a little bit longer But also I could say that the opposite for some of our Younger patient populations with complex either they've got Some conditions that require a lot more work and effort or some of our BC cancer patients that need more time and Those are the issues and conditions that are Systemically built an assessment on a diagnosis code that physicians will input sometimes into their electronic medical record or To look at through the msp billing guide that there's an opportunity to look at those individual codes and the Complex care required by that patient or how many times that patient may have accessed the emergency room or the primary care setting or required diagnostics or tests and and that's where we look at that data and that's when we look at chronic complex Patients we are not saying everyone does deserve care and access to primary care And that is our hope is to build a foundation to really Work into the preventative aspect because right now we need to anchor all those patients that don't have a physician But we also need to recognize our need for health care prevention And to focus on wellness and well-being of our patient populations along with our public health experts and our People that are doing this work, especially in our pediatric populations our mental health populations and our female populations and again like Minister Dix has said in our physician master agreement We actually have embedded gender equity and this is the first time we're seeing this and hopefully even the fee for service schedule We can modernize that payment schedule to reflect the needs of All patients and that is what i'm saying is building on health care equity. This is a milestone for that Question is for mollum Palmer think over son. Please go ahead Um, hi, I just wanted to check uh based on the answers we've had so far you're Not you do not have an estimate Of how many family doctors this will add to the number we have now And you do not have an estimate Of how many patients who do not now have a family doctor We'll be able to get one as a result of these changes. Is that correct? Uh, I think I think the answer is yes and no We know from the changes we've made already that uh, that these these new arrangements are going to increase the attractiveness Of family medicine and a family practice and a full-service family practice We've seen that already with our new to practice contracts. We've seen that in the work we've done with our stabilization fund So we've seen the impact of that Secondly, um, I think that uh, what we see is that uh, and you don't know Exactly how something's going to work, but this is only one part of a number of measures So this is foundational this improves and incentivizes family practice and improves things for patients as well by building out Team-based care for them And so I expect this will lead to more people and more doctors practicing for longer being So existing doctors being stabilized in their in their practices and attracting new people To full-service family practice. So our expectation is that that will significantly increase things, but it is not A one-step response to a broader problem. We have a health human resources plan that has 70 items in it We need to address residency spaces this agreement supports that by by ensuring that those Doctors who are supporting residency programs are properly remunerated and allows us to do what we've done Which is expand out residency programs when you dramatically increased by 128 at ubc The number of spaces when 92 of those doctors stay in bc, you know, that's going to mean more for full-service family practice So, uh, the goal of this agreement in connection with the actions we're taking on internationally educated doctors The actions we're taking with respect to training more doctors and and the focus on family practice and equalizing Family practice against other kinds of medicines. It's going to have a very very positive effect We can't be exact. I think that's what you're asking about what that effect will be But we know that it will be positive and it'll provide more care and support our primary care system So that's the intent. That's the goal all of the indications show that it is going to significantly improve things This is an improved investment in that system And the other part of rostering is it will allow us to more clearly monitor the effects of that on the system So if you're asking This agreement does this mean x number of new patients will be attached to a family doctor You can't say that and guarantee that for sure because we will have to see how it happens in practice But we will know we know For a fact that will make things much better both for patients and for doctors and it's going to have a positive effect But we can't just do this. We have to do all of the other things that we're proposing There are 70 actions in our health human resources plan. We have to do all those things together So it's building brick by brick in response to this massive period of demand on on the health care system of pandemic And the overdose public health emergency In that context we have to keep doing that. So this is one important action. It's foundational We need to do other things as well Fine, did you have a follow-up? Yes, please. I'm still trying to understand the The new model payment for a full-time fte full-service family physician. So The 385 thousand Is is that a max? because I also Think I heard I think as I read it that Um They're not there's a there's a minimum number of patients you have to see but there isn't a max and so if you exceed the Basic hours or the number of patients or the number of counters or all three Can you go above that and is there any ceiling on that? well There are as you know, uh, if you look at it's published every year. So everybody knows there's no Secrets and in what we pay doctors as individuals or collectively We know that there are doctors who work Very long hours and are very focused on that and and they That group of doctors will also be supported by them So we don't want a situation where someone is committed to doing that for their patients And is restricted in some way from doing that and so that that's the idea But we're very specific and the new payment model and we'll go through it because I think we did that in the In the briefing Vom but we didn't do it in as great a detail here is based on providing 1680 hours work 1250 patients of average complexity So a doctor who might have higher complexity might have fewer than that conceivably And that's one of the elements of the agreement 5000 encounters a year And what this does is and as a goal it equalizes family full-service family practice against other types Of medicine so you're right It may be possible if a doctor works well beyond that for them to earn more than that and that would make sense but this Links the the amount doctors get paid to the care they provide And it's very important based on the previous question to understand this If you're in a fee-for-service system your economic interests would be supported by having a very average patient base For not not necessarily and patients sometimes complain about this They say I have very complex needs and I'm going to need to see my doctor for a period of time And I have a difficult time finding a doctor they might say for that reason I think many doctors make allowances for that and we know that this happens every day in the system So what we have is a payment model based on the work done and based and focused on care That addresses doctors issues around overhead So if you're going to do that the fee-for-service system says you get a fee for service to do more services You get paid more that system hasn't been working for patients hasn't been working for doctors for some time This provides a base Structure that says this is the work you do and this is your remuneration There will be some people who it might work and you can work as little as 0.2 For example one day per week and obviously if you work 0.2 you get paid less If you want to work more in the system and provide more care That we don't want to limit that because that's care for patients Patients and all those patients who are both unattached and attached to get the care that they need so This is this is The base it lays out a base and it provides an alternative And it is I would argue significantly we would expect Very significant number of doctors to take on This new program And there may be some who stay on fee-for-service, but this is I think An arrangement that doctors themselves co-designed And I think addresses the needs of the system. So what you're talking about Vaughan, you're quite right That is the base you can do more than that if you do more work than the base And of course if you're working say 0.2 hours you would a week you would get paid less than that Our next question it's from April. Let's check news. Please go ahead Oh, hi, thanks very much. Um, my first question is for a colleague who's working up island today She's wondering how this agreement Will make a difference if at all for rural hospitals like Port Hardy where The er has been closed there since Friday evening because of staffing issues and isn't going to open again Till tomorrow morning in addition to what you're announcing today what else is being done to improve health care in places like Port Hardy So it's different in different communities, right the issue In clear water say has primarily been a nurse issue And you'll note that there hasn't been closures in clear water as we've worked through those issues The issue in clear water was has been in part An access to housing issue when we try and solve problems And we've worked with the local community there To get housing temporary housing for people coming in and to support that emergency room the issue in in northern northern and vanker island communities has tended to be access to doctors and and really the core primary care Doctor in a community Such as port Hardy and such this point Port McNeil is one of the things we've had in mind In the various elements of this agreement and You know, I've been told not to do 15 minute answers So I'm not going to do that in this case although I although We certainly will Be happy to brief on that questions, but this supports Primary care doctors working in small communities in large There's specific arrangements to support health care in rural bc to support The mo cap program which is important for many communities in bc And I think it's in general supporting that core Of primary care doctors who also in many communities the core of providing emergency services and In smaller hospitals such as in port Hardy So I think in that sense it will be supportive of that But again, it's not one answer but many to dealing with health human resources. We have added 38,000 people net to the health care system 600 new family doctors in five years and yet We've also added dramatically to the demands on the system and we're living through two public health emergencies So we have to continue to do that work in some communities This agreement will be very helpful in other communities where the issue around the emergency room is not doctors but nurses We have to take other steps as well Do you have a thought Yeah, um, when I I think maybe for dr. Desange, um, obviously one of the key goals here is connecting people with with family doctors But I'm wondering for those British Columbians who do already have a family doctor. What sort of real Changes if any will they notice once this new payment model comes into effect? Thank you for that question I think an immediate sigh of relief which i'm hearing from many of my colleagues who just Are watching probably this briefing this morning and also may have received my president's letter that went out this morning from doctors to bc I've been hearing already and I think the moral distress that when we speak of and the burdens and the administrative Tasks that in a day that you're inundated with lab results or diagnostic reports or that pull you away from your patient encounters And for all those physicians that have needed to be compensated for the time because maybe it takes longer Or they work at a different pace than some of my other colleagues I know I was one of them And to be able to be compensated for a block of time and to be able to take that time with your patient if need be As well as seeing them with their complexities and really getting time and building space for even your clinical teaching without having to take another Break or Allowing the capacity to change so really a renewed sense of hope and optimism that A lot of family doctors have been facing and addressing the overhead and the rising costs of business is a major one in this new payment model And also another way of allowing our family doctors to know that we've been listening We did some robust engagement Early summer and we've been doing that through our divisions of family practice across the province for many years And I feel that finally they have been heard and we've listened carefully and co-created this model with a lot of significant input From the physicians on the ground. They've been telling us what they need to be able to serve their patients better And I truly believe that this is the way forward I think that when we think about primary care and health care systems and What we need to build in the 21st century in this province to be evidence to be able to be a reputable Healthcare system that provides the needs for all of our patients. This is the first step And I really am Truly excited in barking on this journey because I truly think that our patients Will see a little bit more livelihood and a breathing room with the locum The commitment to locum coverage for our physicians that have never never been able to take Time off or step away from their office because of the needs and the demands on them This will enable them to have a healthier working environment And that's all we can hope for is to create better working environments and conditions that foster better care for our patients Because we know healthier physicians and doctors make healthier patients and this is the way that we need to be working For our final question today, we're going to come back to the room. Please go ahead Question for Minister Dix in English and in French, if you please To what I understand doctors were paid before 30 to 40 dollars per visit. Can you help us understand How much they can get now under this new system? So this is a change We went we're going from a fee for service system Where your payment depended on the number of services you provided all of which had their own fee codes So they're different fee codes for different services But you're you're not in the wrong range there when you're talking about what you're talking about So it depends it depended but Really your ability to make A living and to pay your administrative costs and your staff and everyone else involved Depended on the number of services you provide Number of services that you are remunerated for by a specific fee for each service Here we're changing the dynamic significantly There was an alternative previously which tended to be contracts So you were salaried and there was and between those two options There was not a lot of flexibility, right? And so This changes that it focuses the payment on the care provided the hours of work provided The patients attach the complexity of those patients So it creates a whole number of new factors that aren't just about Having a large number of people come through the practice and providing them with care care care care Individually it pays for the continuum of care The work doctors do outside of the direct care for patients And it and it also allows them to get supported for the complexity of their patient panel So we have a minimum patient panel We have a minimum number of hours worked every year a number of visits that need to be provided But it gives doctors more flexibility. They're not simply paid If they want to increase their salaries by bringing more patients through or taking more time at the practice and providing You know, what is not cookie cutter care? Because that's not the care doctors provide but is paid before like cookie cutter care And so this is a fundamental change. This is an option that allows Doctors to continue to run Their medical practice with independence But recognizes the work that they do and it is a I think a fundamental change from a system That's been 80 fee for service In terms of msp billings Right up to recent years has gone down a little bit in the last couple of years But the most fee for service problems to one where a lot of doctors are going to be working on this new model I think that's good news for patients and everywhere else I would say in French that we currently have a system that pays a doctor specifically for a service For a service for 10 years, 27 hours, a visit individually or whatever There are different fees for different services. It's a little bit complicated to develop together now This is going to change We're going to put the focus on care Give to the people who visit To the people, to the patients This is essential in a system where we want a transformation So it's not fee for service actually A fee for each service But we're going to pay for hours to work For the complexity of the people who receive the care of a doctor In general And who will also give support Support for administrative fees for doctors So it's a model that puts the focus on the patients And not on a almost industrial system To give them care It was okay in the past And it was also an exit from the doctors in the past But it's the doctors themselves with us Who have said that this system doesn't work, doesn't work anymore And it needs a change And this is a fundamental change in this system Question for Dr. Dossange You said often that you wanted to abandon the fee for service system How satisfied are your members now? And how many do you hope will opt for this? And also what will happen after three years? I think my hope is we've built what they've asked for In a sense of the most desirable outcome When we think about the care that our patients deserve And the conditions that we deserve to work in So I'm hoping that there will be great uptake I think a lot of it is going to be telling our members Not all of our physician members are yet aware of it So we have to speak about the process And what it looks like And how we switch on February 1 Like Minister Dick says, this is not a contract And this is not the fee for service But it's a middle road in which we can provide the ability And opportunity for physicians to work in a new way And really that's considering all of the burdens And the tasks we're hearing about the indirect care So checking your labs, speaking to your consults And really organizing all of the needs and demands From your office work And being able to be compensated from that As opposed to doing it on the side of your desk Or when you take it home later in the evening Or also noticing that the renumeration for the time That you're spending for your patients So the base rate, hourly rate And then encounter rate on top of that To really acknowledge that time that you're spending For patients and their complexity of care And also again to address the rising costs of business I know that from many of our members That heard even of the stabilization in term funding That Minister Dixon and I announced earlier this year That was really hopeful for many of the physicians On the ground and what I really want to reiterate Today is that people that feel the value Family physicians have eroded the sense of their value For their patients over time because of the working conditions And unfortunately some of the systems Compensate transactional care And what we are trying to provide is this real attention To the need for longitudinal primary care And family medicine and the needs of that All citizens and all of our patients In this province and this country deserve that type of care Someone to look after all of their needs And their family needs and know them well In a relationship based setting Also to prevent things from happening From knowing their genetics and knowing their history And anchoring whatever virtual supports we're providing For care into this longitudinal family practice Because we know that those physicians know their patients Best and it also simplifies care with our specialist Colleagues when you're consulting There's someone else that's championing that care And that fine thread that links you all together So to be able to provide that support I really will be looking forward to meeting Many of my colleagues this week And the weeks coming up to see the robust uptake And really that hope and optimism Of shifting into a new way of doing things We've all known what it takes to provide quality care We learn it, healthcare systems Many of us are interested in it How to reform this primary care system And here we are, we're here with the new dawn And hopefully thinking that we're leading into this With intention for our patients And to serve their needs higher than all other priorities We know that they need our help And as physicians, we do that in our clinics We do that in our hospitals And allow us to be able to be inputting into the way That we actually are compensated and valued for our time Thank you very much Dr. DeSange I just want to say, you know I think what we're doing today is both historic And foundational And it is there In place to allow us both to stabilize And support our current practices To make it more attractive for people to come family doctors We've already seen how that works To reflect the growing complexity Of primary care needs of people As we get older, our needs become more complex This agreement does that To support healthcare provision in rural and remote communities The agreement does that But it's not anything more than one step But a foundational one This transformation of our primary care system That we've worked on together Is critical It will require continued investment And effort in other areas To ensure that we add medical school spaces We're doing that To ensure it's easier And we support team-based care Which we're doing And we need to do more of To provide better care to people So this is one step It's a foundational step And it's good news for patients today And it's good news for Not just now For doctors now But in the future The new payment model is simply put A much better arrangement Than continuing on in fee-for-service And we're confident That it's a much better arrangement for patients And we're going to see progress On all of the issues we make together One agreement doesn't solve All of the issues that we face But again, it allows us To take all of the measures we need to take together To improve access for those who are unattached Those who need episodic care And those who are already attached To get better care And better fundamental care in the province And that's the work we have to continue to work on This is one step But I would say it's a pretty big step And it's one that people have been waiting for For a long time And we got here Because we worked together And we're going to continue to work together To make sure the needs of patients Living in communities big and small Around BC Get the care they need in primary care That helps us them stay healthy And it helps us also In providing all the other care we do In our health care system I want to thank you all for joining us today And I look forward to seeing you soon We'll take a picture


For more videos and people's struggles, please subscribe to our YouTube channel. Nearly three years ago in 2019, the people of Sudan ousted long-time dictator Omar al-Bashir after months of sustained mass protests. Bashir had come to power through a coup almost 30 years ago. The uprising that led to his overthrow was built on the protests and resistance that developed against his rule over the decades. Last year on October 25, 2021, Sudan witnessed another coup this time by the Sudanese military junta. In response to people's outrage that followed this coup, the military heavily cracked down on protesters. In the months since then pro-democracy protesters have been regularly mobilizing. Over 3,000 have been injured from military action and many have been killed. The Sudanese people who are on the streets are feeling a sense of deja vu as years of progress made after Bashir's ouster seem to have been reversed. What happened in the period between the overthrow of Omar al-Bashir in 2019 to the military coup in 2021? Where does Sudan's fight for democracy stand today? 2019 April. Protests against the Bashir regime had intensified across Sudan since December 2018, which came to be termed as the December Revolution. On April 11, the Sudanese army decided to step in and oust Bashir. But while celebrations were underway across the country, the army announced that it would be taking over control instead of handing power to civilian forces which the people had been demanding. The army stated it will rule the country for a period of two years following which elections would be held. Civilian groups were not willing to accept a military government after just pushing out a dictatorial regime. Civilian protesters represented by the declaration of freedom and change forces continued their protests and pressured the military council to work out a plan to transition into a civilian government. But the military was not ready to give up all power. As negotiations began and faltered multiple times, the military continued to brutally repress protests, injuring and killing several protesters. On June 3, in a particularly brutal crackdown in capital city Khartoum, the rapid security forces and the toruous paramilitary force killed over a hundred people, injured more than 700 and raped many men and women. Still, the civilian forces remained undeterred in their resistance. The key demand of the civilian opposition was a transition period during which the former regime could be uprooted from the state structures and personnel guilty of human rights atrocities could be punished. The final goal was to establish a government under full civilian control. However, before the civilian forces could accomplish this, the centrist and right-leaning parties among the civilian alliance compromised with the military to form a transitional government. In August 2019, the Sovereignty Council was formed, which was the highest body in the transitional government. Five of the 11 members in the Sovereignty Council were from the military. The head of the military junta, General Abdul Fateh al-Burhan, was made the head of the Sovereignty Council and the president of the country. General Mohammed Hamdan Dagalo, the head of the rapid security forces, was also appointed to this body. The Sovereignty Council, including the military members accused of being responsible for the Khartou massacre, were granted immunity from prosecution. For the post-prime minister, the civilian opposition selected a politically unaffiliated economist Abdullah Hamdoq for the transition period. 2020. In October 2020, after almost a year of negotiations and delays, Sudan's transitional government and the armed rebel alliance, the Sudanese Revolutionary Front, signed a peace deal. The deal sought to end the civil war, which had been going on for decades in the regions of Darfur, Blue Nile, and South Kordofan. The deal stated that members of armed rebel groups would be integrated in the National Army. As a result, the RSF also became a part of the extended joint forces in Sudan. Many militia groups which were not incorporated in the RSF were formally dismissed by the government under popular pressure. But no serious efforts were made to disarm and rehabilitate them. 2021. Since the peace deal had been signed, it was assumed that the violence would come to an end. So in March, the United Nations African Union Mission in Darfur handed over control to the Sudanese Joint Forces and began to withdraw from the country. But as the withdrawal began, multiple waves of violence hit Darfur. The Sudanese Joint Forces left in charge were not very willing to fight the armed militias in defense of the civilians. The peace deal had not provided any solution to the root causes of the violence in the region. But alongside the escalation and violence, a parallel process of strengthening progressive mass movements was also underway. On September 21, a section of the military attempted a coup. The coup was allegedly led by a faction in the army which continued to support the Islamist regime of former dictator Omar al-Bashir. This led to a further intensification of civilian protests. These protests which were being led by the groups including the Sudanese Professionals Association, the Neighborhood Resistance Committees and the Sudanese Communist Party since the formation of the transitional government were directed not just against the military. They were also against the civilian heads in the transitional government and the centrist political parties in the ruling alliance. The protestors alleged that these civilian sections made compromises and failed to stand up to the military. By this time, the cost of living was continuing to spiral out of control. The civilian section of the transitional government had no control over the businesses owned by the army. Prime Minister Abdullah Hamdok revealed that up to 82% of the economy was being controlled by the army. Protest leaders felt that the purpose of all this was to make lives unlivable for the people in order to spread disaffection against the transitional government. When the masses were sufficiently desperate, the army would be able to step in to bring the situation under control by dissolving the government and usurping full state power again. On October 25th, the military stage a successful coup. The Prime Minister and civilian leaders in the transitional government were arrested. President and Army Chief Abdul Fatal Burhan announced the dissolution of the transitional government and declared a state of emergency. Internet connectivity was suspended 2022. But the people of Sudan have not accepted this military rule. In the over four months since the coup, civilians have been regularly organizing massive demonstrations. Several nationwide march of millions have been organized in the face of brutal military oppression and crackdown. By March 1st, 85 people had been killed and 3200 injured since the October coup according to data compiled by the Hadrian organization. Children are also not being spared by the security forces. Over 200 children are said to have been detained since the coup and subjected to all forms of violence. The mass resistance against the junta is being spearheaded by a network of over 5200 resistance committees that were organized in neighborhoods across Sudan during the course of the December Revolution. On February 28th, the Khartoum Coordination of Resistance Committees proposed a long-awaited charter for the establishment of the People's Authority. This document puts forth a militant roadmap for the transition of the current military rule to full civilian democracy. This charter rejects all calls including by the US and UN to negotiate with the military and demands nothing short of a full civilian government. This government will be tasked with prosecuting the generals who led the coup and the civilians who collaborated with them. It will also hold to account the political parties which shared power with the army from mid-2019 in the transitional government. The charter aims to reform the state security sector by dissolving the various militias and forming a single national army that is answerable to the civilian government. It calls for freeing of the economy from army control and also calls for a review of the decades of neoliberal reforms enacted under the Bashir regime. The military group might make it seem that the civilian forces are back to where they started but their unity is stronger than ever and it is that much harder for the junta to break down the people's spirit of resistance. At the same time divisions and fissures appear to be widening within the army. There have been reports about Burhan fearing that he himself might be replaced by another coup. Despite the widespread repression, protests are continuing with increasing participation. The civilian groups are resolute about continuing this movement until democracy is established in Sudan.


Hey Psych2Goers, do you have a crush? Maybe you're unsure about how you feel about them. I mean, is it lust or is it love? Well, here are six signs to help you decide if you are indeed in love. Number one, you can talk for hours together. Does time fly by when you're with your crush? Maybe you've been seeing each other for a while and every time you see each other it's deep conversations that last for hours. Being yourself is easy around them. So could this be something more? Well, this is the first step. This can be a common sign of love. Being able to communicate with your partner openly is very important for healthy relationships. So if you can talk with your partner honestly and stay true to yourself, the signs are looking good. Number two, you're connected on an emotional level. How emotionally connected are you to your partner? One thing that sets love and lust apart is an emotional connection. Physical attraction can be important, but emotional attraction is what fosters a healthy relationship. If you find you love your partner's personality, spirit and mind, you may just be in love with them. Number three, you can spend time with each other without being physically intimate. When you're about to go on a date with your crush or partner, are you excited to get to hear from them and spend time with them?  Well, if you're in love, you're in love with more than just the charming smile of theirs. If you're in love, you get excited with just the idea of being able to be around them again and hear about their day. Of course, physical intimacy can be strong between the both of you, but emotional intimacy is just as powerful when you're in love. Number four, you don't feel judged by them. Do you often have a hard time feeling judged by others? Has this feeling suddenly gone away with your partner? Any strong worries of judgment are gone around them. You're simply at ease. This can be a telltale sign that you are falling in love. Number five, you want to open up about the past. Is it difficult for you to open up about your past to others? With other romantic partners, you just couldn't open up like you do with this current partner. This is a great sign that you are in love. This means that you want to build an emotional connection with them, not just a sexual one. If you find yourself suddenly spilling secrets of your past, you could be in love. And number six, you understand each other. The best couple simply understand each other. If at any time they are confused or not understanding each other, they talk it out with an honest conversation. They try to see your view on things. They actively listen to what you have to say, whether it's about some exciting news or your bad morning at the office. They are there for you, and you're there to listen to them as well. Love is more than just a feeling, it's a connection and an understanding of one another. Simply put, you just get each other, and it looks like you may love each other as well. So, do you relate to any of these signs? Let us know in the comments down below. We hope you enjoyed this video and if you did, don't forget to click the like button and share it with a friend. Subscribe to Psych2Go and hit the notification bell icon for more content like this. And as always, thank you so much for watching.


Hey guys, it's Nate, AKA The Foot Accountant. Welcome back to the channel. The time has come, all right? It is that time inside of FIFA 21 Ultimate Team. We're nearing Black Friday, and the market is crashing. People know what is coming, and every single year they sell before it happens, at least the past couple of years. And we have this thing called the Black Friday Market Pre-Crash, which is exactly what we were happening and seeing right now in this game. It's crazy. Some of the price drops that we've seen, I want to talk about what is happening, why this happened, and what could happen in the next couple of weeks as we actually head into the promo. We're still like two weeks away from Black Friday, but it's all the preparation beforehand, which makes a lot of the prices go down, because people think, hey, prices are going to go lower, but everybody actually sells ahead of time, and most cards really go and hit their lowest, especially if it's a very meta and OP card, as we have learned in the past few years. They hit their lowest point before Black Friday actually comes because people start buying them back for their teams once they hit a low point, and then when the day actually comes out, so many people are actually thinking about buying those cards specifically. So let's talk about Black Friday, and especially what is just going on in the game today. Now, of course, a lot of this panic started early on Saturday because late in the night on Saturday, we saw a huge drop on the market because of a leaked pack code. I guess the pack code was leaked or shown for this team of the week upgrade SVC, and we know how this goes almost every single time it is released in FIFA. We know what happens, right? People think they're going to pack the Rashford. They think they're going to pack the Messi. They think they're going to pack those types of players, but actually what happens is all that panic selling happens, they don't pack those cards, some of those cards rebound, but a lot of coins are still drained off the market because this SVC is not very expensive to complete, but it does cost you 20,000 coins, about to do. 83s are not really high right now. They didn't rise up too much after the SVC was actually released. 83s are still around 1.6, 1.7K for most of them. Now those might rise up a little bit. People might stock a few of these up or continue to do these because these are out, but this is what caused the first part of the crashing today, and then of course, what I talked about earlier this weekend was since I was a little bit scared about the lack of buyback and a lack of buying power that we saw, lack of motivation to buy cards Friday night after the new promo drop and then after the new content drop, that to me signaled that we were headed down really far this weekend. And as you can tell right now, not many people are even selling cards or listing cards on the market. 2.8 million live transfers, I think is pretty low for the PlayStation, even though we're in like the dead of night. That seems pretty low to me. So I think what a lot of people did today was they literally just sold cards. And that's why you saw all these prices get really, really low. A lot of people were selling today because they were in the mindset that you wanted to sell your cards before Black Friday actually happens and before it comes out, so that you save yourself some coins and you'll be able to buy those cards cheaper as we get closer. But in fact, as we saw today with some of these price drops, they were so massive. I was actually telling some people to buy some cards today, right? This Mbappe card dropped from 1.55 mil about a week and a half ago all the way down to 1.33. He was 1.33 mil, he's up about 30,000 coins and I think it makes sense. Ronaldo is under 1.4, Neymar is at a million coins flat. And again, we'll talk about this stuff a little bit in this video and what I've been talking about on stream earlier today is just that some of these cards that are super meta, super high rated, they're not gonna get packed that much and the majority of their price drop comes from all this panic selling. I wanna talk about as well is does the market go lower today on Sunday and will we see our normal Sunday night into Monday, Tuesday, Wednesday market rise with squad battle rewards and most people knowing that hey, I need to buy my team in that time period. So we'll talk about that a little bit as well. But again, the biggest thing today that really dropped this market was this team of the week upgrade and just the panic that we saw in that, right? If we take a look at some team of the week cards from today's stuff that was kind of bouncing up down crashing on the market, where's Firmino? Firmino's a decent example. I actually bought a Firmino today in the market crash before 6 p.m. UK, before the SBC was released, bought this card at 205,000 coins like right here. He bounced back to 220 and I didn't sell right away. So I actually had to only sell for like 215. But there was some of this action today, right? There was some panic selling and then a rebound. Rashford was another great example. His inform was down to like 630,000 coins, sorry, 730,000 coins on the PlayStation and he bounced back. He went, yeah, went down to 738 and he bounced back to 777.80. So not a huge bounce back on a lot of stuff but that's often what you see with a repeatable SBC like sometimes the base icon or mid icon SBCs or other team of the week upgrade packs. When they come out, what you see is people sell because they know it's coming, they panic sell because they think they're gonna pack the card and then they have to go buy that card back when they don't pack it. That's why you saw a bit of a rebound on some of these. But the rest of the market is still going down, right? The rest of the market is still going down. We could look at all the indexes. We could look at all the prices. This popular page I'm flipping, somebody described it earlier today as a bloodbath and I think that is 100% correct. So let's talk about if you have a Neymar and Bape, Veran, Sun, Metacard or maybe a Joe Gomez, maybe somebody like Martial, maybe somebody like a Ben Yetter in your team or Lucas or Dembele, what do you do in those different scenarios? Because it's almost, it's a lot different thinking about some of these low tier cards versus some of the high tier cards. How much more panic selling can happen? Are they almost at their lowest? Should you sell now? Should you buy now? For most of this stuff right now, I would not recommend selling. If it's a card that you have in your team, right, that you are gonna be trying to sell to then buy back at a hopefully cheaper price in two weeks from now around Black Friday. Like if it's a card that you have in your team, like right now, let's say that you have Kylian and Bape in your team, you bought it for like 1.45 million coins for this weekend league, right? And right now you're like, dude, my Kylian and Bape is down 100,000 coins. I'm losing 100K right now if I sell this card. My advice to you would be, why would you sell this card right now for 1.35 million where he is basically at his lowest that he's been since the beginning of the year? Why would you sell it now if there's really not much of an opportunity for him to go that much lower because the people that have this card, this guy isn't getting packed by pack supply, right? He's getting packed a little bit, but not that much. Most of the price drop that you saw today was just people clearing out their clubs and clearing out their teams because they think prices are going lower. But in reality, for some of this really high meta stuff, it might not. This might be the lowest couple of days that we see before Black Friday because with all the people that sold these cards today, I don't even know how many of Bapis are still left in people's squads. I don't think there's that many because so many people sold them today. They took the cash on a lot of these cards. So I was even telling people, what was it on Xbox and on PlayStation? Like 1 million coins flat for Neymar was a price that popped up plenty often today. Right now it's 1.018 and on the Xbox, I think he was about 830,000 coins. I think that's a buy. I honestly think that was a buy for Neymar today. I think in Bapé and the low 1.3s is a buy as well. Christiane Ronaldo in the 1.38 range, 1.37. Maybe a little bit lower than that if you can. On the PlayStation is a buy as well. Those are a couple of cards that right now with all the panic-tilling and the percentage point of a drop off that we have seen today, I'm fine with you guys buying them because this is the other thing that I wanna talk about, right? If you look at some graphs like last year, or if we look at some graphs from last year on a guy like killing in Bapé, correct? Let's talk about this. So this is one thing I wanna make a point about Black Friday as well is that some of these cards, even though they're super-duper hyped and super meta, we're gonna have content that comes a week or two weeks after Black Friday that is probably going to make this market fall down even further because Footmiss, that's a huge coin drain promo, right? Team of the group stage last year killed the market. Team of the year nominees. All that stuff in December, it was one huge landslide. If we look at all these graphs in December, which we'll look at in a bit, or right even here you can see, December was one huge landslide of a month where cards kept dropping into Team of the Year because of all the content that was coming out and that's probably gonna, it could happen again this year, so. But again, what I wanna show you here is, look at this in Bapé card, right? So in Bapé last year, three weeks before Black Friday was 1.1 mil, he peaked there. First week in League of Sell-Off with the first promo of Road to the Final, right? He drops down to one million coin, drops down 150K, and then boom, the next weekend, he drops down again another 100,000 coins from one mil to 900K. His lowest point, I remember it specifically, in FIFA 20, was on that Saturday. He was actually under 900,000 coins on that Saturday on the PlayStation. And then of course, during that week of Black Friday, he went from 9.15 back to 9.40 and then peaked the weekend after Black Friday, almost at a million coins, so. And then the week after that he was 8.80 again. So you really didn't save yourself that many coins by buying this early because of the drop-off that happened, but we're not worried about that yet. What I wanna just talk about again is, instead of trying to buy always at the absolute lowest price, it's gonna be so hard for you to be on the market to try to time when the absolute lowest price is for any of these cards that you may want to buy to upgrade your team or to put in your team around the Black Friday timeframe, whether that's because you're getting fever points to open on packs or whether you're just waiting for the market to drop more so that you can buy players at a lower price than what they were before.  You're gonna be waiting on it so long, you might miss the buy time, you might be too early on the buy time, stuff like that. So what I recommend doing is buy in the low dip, right? Not on the absolute lowest of the lows, but buying in that low dip will save you and will make sure that if you're buying in that low dip, especially if it's a meta card, right? Like one of these Mbappes, one of these Neymars, a Veran, a Conte, 360K for this dude, cheap, Ronaldo, cheap, Mane, cheap, De Bruyne under 200K, ridiculously cheap, right? Buying in the low, right? In the low dip and not at the absolute lowest point is one thing that you can do and one concept that you can keep in your mind that will save you some stress, honestly, and save you a lot of questioning and a lot of wondering and thinking through things on this game, right? Kevin De Bruyne right now, 190,000 coins, right? I talked about Mbappe, Neymar and possibly Ronaldo being buys right now in this game. This card is probably a buy in my opinion too, right? Really high rated cards that people really want for their teams. Now this De Bruyne has kind of just been dropping all year and I just wonder if it's people would rather use other cards in this game that have higher amounts of pace than De Bruyne. So this might not be the best example, but let's use Mbappe for our example, man. This Mbappe card is literally, this is the best card in the game, right? This Mbappe card has not been 1.3 mil since day one Friday, 1.3 million coins. Went to 1.4, went to 1.5 and has been trickling upwards around 1.5 ever since. Now he's back down to 1.33, right? This would be in that low. I honestly think this is in that low. I don't know how much panic selling there is left to go around on guys like Mbappe, Neymar, Ronaldo, Conte would be another one. The really high tier meta, meta, meta players. Van Dyke would be one that I'd possibly say there might not be much panic selling left. Messi is interesting because he is out of packs right now, but I still feel like this card, you know, it's dropped off a lot today. I feel like you might be able to get this in a 500K range though. You might be able to get this under 600K just because there's not as much hype this year for Messi, but for some of these really top tier meta cards, I would not be opposed to some of you guys if they're high rated and if they're meta to be buying them this weekend, to be buying them on this Saturday night into Sunday where the market is just so stinking low. So just keep your eyes on some of that stuff. If a price makes sense to you, seeing this Neymar out of million coins, you used to think, yeah, this guy was 1.1 mil, and now you see him at one mil, down 100,000 coins, if you wanna make that, if you wanna pull that trigger for your team, be my guest. Now if it's a lower rated card, right? Like a Joe Gomez, or even a little bit of a Ferlan Mendi, I talk about this, or I talked about Lucas Mora or Ben Yetter, these types of cards, yes, they're very OP, yes, they're very meta, but they're also very low rated and they're gonna get hammered with pack supply and that's what this Black Friday promo is, it's the first lighting rounds of the year, pretty much. So some of these lower rated cards are gonna get smashed with supply as well and then that's gonna be tough to come back from. Some of these cards might rebound a little bit, but that first couple hours of the pack supply that actually happens on Black Friday as well for the low rated cards is deadly, it's huge on the market. So again, I can show you guys like Cisoco as well. This is the FIFA 19 version of Musa Cisoco, a card that was 50,000 coins before Black Friday came around, right? He dropped down from 51,000 coins, went back up to 33, and then Black Friday comes around and he's dropping, dropping, dropping. This is the actual day of Black Friday right here. He drops off a cliff from 12,000 coins and then over the next couple of days, he's down to 8,000. Even being as meta of as a card as he is, he dropped down that much in that week. He did rebound a slight bit, but just be careful with low rated cards like an Alfonso Davies gold card would be somebody who I would say be very careful with. Now, Ferland Mendy last year, I've got his graph up. This is FIFA 20, Ferland Mendy. He got panic sold all the way down a couple of days before Black Friday happened and he shot back up, but this is still the best left-back card in the game. The 83 rated, he's gonna be less packable this year.  Why would you sell if it's already dropped off so much? Now for other cards that you maybe are wanting to buy for your team, if you're liquid right now and you're like, yo, when's the best time to buy because I've got my coins and I wanna buy the team. If it's a lower rated card, like maybe Pogba, Martial, Fernandez, Van Dyke, not Van Dyke, but some of the lower rated cards, I do feel like you could see a little bit more of a drop on some of the stuff that's not as super meta in the coming days. So maybe you hold off on buying some of that stuff right away because I feel like those prices will maybe continue to stay lower longer than a guy like Mbappe, Neymar, or Ronaldo would just because there's more demand for those and they're less common on the market, less common to find and to pack and to buy up, so there's less supply. And then same things for out of pack special cards, I would wait on some of those as well. One of the big things that comes with Black Friday is the best of team of the week. So obviously if you're somebody who wants messy inform for your team, obviously this guy is really cheap for this stage in the game. 1.45 mil, so he's actually really, really low at the moment, but this guy could possibly go even lower in the next two weeks and in the panic selling leading up to Black Friday because he is gonna be possibly re-released back into packs and that's what a lot of people are gonna be expecting for a card like this. A high rated inform, another guy that could be in best of team of the week might be 86 Rashford, 89 Bruno Fernandez, right? Some of the higher rated informs that are the most meta in this game could be re-released as a part of that Black Friday promo and that is something that could drop those prices even more. So again, what I would do right now is if you see prices tonight, now we'll talk about out of packs cards again here for a second, this video is gonna go a bit longer, it is what it is, there's just a lot to talk about. So again, I mentioned Sunday night which is tonight, squad battle rewards. I think there are some of these special cards, rule breakers, maybe some of the road to the finals, maybe some out of packs informs that these guys have absolutely just dropped off a cliff today as well. There is a possibility that some of these cards still rise up into the Monday, Tuesday, Wednesday timeframe because people are just used to buying their teams and all the people, think about all the people that just sold off their teams from this weekend league, they're seeing these low prices and some people are just gonna buy the cards back because they're gonna realize, hey, this is getting low and I just wanna buy it back for my team because I wanna use this card and it's low enough that I'm happy with the price. So you might see a bit of bounce back on some out of pack specials from tonight into Monday, Wednesday, I do think that is possible. If you're gonna see a bounce back in any area specifically, definitely watch these rule breaker cards because they are super duper rare, they are super duper hyped up, a lot of people like to use these and some of these guys' drop offs are, they're literally mental, right? La Porte was 520K, he's now 455, Andre was 100,000 coins Friday night, he's now 78, Douglas Costa, some of these cards are lower than what they were when they were in packs, for goodness sake. Like this card linking to the player of the month, Levadosky, that could come out any time, he was never under 400,000 coins when he was in packs and the dude is under 400,000 coins right now. So just keep an eye on some of the stuff. If you wanna try a little bit of a quick flip, that is something you could do. These cards as well, wow, Griezmann bounce, he's 550, Rashford's up a bit, Zakaria's up a bit. Some of these cards have started to bounce a little bit, some people are investing in these row to the finals, team one. Out of packs and because we're gonna be having these cards with Champions League games on the horizon that same week of Black Friday, there's gonna be more eyes turned towards these and these are gonna be very rare items. So if you see more price, like if Griezmann goes back to 510, 500K, that could be another buy point, Klosterman like 320 or under, you could have another flipping possibility with some of these row to the finals as well. But honestly boys, what I would do right now is if you're trying to make coins inside of this game, you can trade with these special cards. You can expect a little bit of a bounce back. These cards are still going to fluctuate, right? We'll take a look at my transfer target at the moment. We were watching a lot of Ones to Watch cards today as well. I think I actually have a Leroy Sanay on my transfer list. These Ones to Watch are gonna bounce around as well. I know we have international games over the next couple of days, so that means multiple games for the multiple nations that are playing. So just keep an eye out, yeah, 3-3-30? How much is Sanay right now? Is Sanay actually 3-38? Is that the lowest one? 3-38's about to expire. I think I bought one for 3-33 earlier today. I don't know if he went lower than that, but just watch these OTW cards because this could be a way that you trade in the next coming days as well. Whoa, Sanay was in the three teams. He was 317,000 coins, so he's bounced back already. But Germany, I think, has another game on Tuesday. Monday or Tuesday, they have another game, so like, Wales is playing. There's a lot of Ones to Watch cards that have games, so keep an eye on that sort of stuff. That could be somewhere where you flip some cards in the coming days just because of, that's kind of what's going on, and that'll be an option. Wow, Leroy Sanay is back to 3-44 just like that, so these really meta cards that are OTWs, you can still see fluctuations on this week as well. It's a scary time to be on the marker right now, right?  People can't sit on their coins forever. People are going to be buying some of these cards for their teams. They're gonna be trying cards out because the prices are so cheap, they're gonna get interested in it, so just be careful with that. And I still think you see a little bit of a drop off on some of the rest of the market, possibly next Friday. We could have some big content coming, and that's not a leak or anything, it's just possible that we could have some big time content coming. So we'll talk about that as the leak does, or as the week does move on. We're gonna have a lot more specific tailored Black Friday videos coming this week looking at what happens to special cards, what happens to gold cards, icons, and all sort of stuff like that because Black Friday is a big time where a lot of coins are injected on the market and some stuff flies after Black Friday. So we'll talk about that as well, but of course you guys know what's happening right now. The market's crashing, it's in shambles, but you know what, we freakin' move, we're still gonna make coins, and it's gonna be fun when we find that low time to buy cards, buy our teams up if you wanna do that, or just invest for a rise after Black Friday, and it's gonna be a good time. So if you did enjoy this video, smash the thumbs up on it, comment down below if you have any questions, and subscribe to the channel if you're new. It's been Nate the Foot Accountant, catch you guys later, peace out.


Hey everybody, it's Hari Swaminathan from optiontiger.com. Recording this swing trade that we did today, I had sent out an alert this morning for Nvidia. It was already up about $363 in the pre-market and we got into this trade on Nvidia for, let me see, this is Nvidia right here. The trade price was $4.15 and this morning it went up an absentee alert that if the profit was more than $400 then I would take it off and as you can see right here Nvidia is, we sold it at $525. So basically about $1.15 on five contracts that would be about $550. So that was a good trade that we closed today and then yesterday we have opened CMG which is a little down right now and Apple also and I'd given an alert for Adobe also but Adobe is down a little bit today but we are still in profit. Apple is recovering quite well, now it's almost a break even just about $85 down. So that's the update on the swing trading signal service closed Nvidia at $5.25, got in at $410 and closed it at $5.25. So now we are 11 out of 12 winners on the swing trade signal system. This started early March, end of Feb actually and so we've closed 11 winners out of 12 I believe in the swing trading signal service. Thanks.


Hello and welcome to the session. In this session we discuss the following question which says, find the sum of the series 2 plus 5x plus 8x square plus 11x cube plus m star n to n pounds. Hence write down the sum to infinity with x less than 1 numerically. First of all let's see what is a mathematical geometric series. The general or standard sum of such a series is given by a plus 3d whole into r plus a plus 2d whole into r square plus a plus 3d whole into r cube into d and this whole into r to the power n minus 1 plus and so on. A mathematical geometric series found by multiplying the corresponding terms of an a p and a gp.  Let's now move on to the solution. We are supposed to find the sum of this series to n terms to write down the sum to infinity of the series with x less than 1 numerically. Now the given series which is 2 plus 7 plus and so on e gp which is 1 plus x plus x square plus x cube plus and so on Mathematical geometric series the corresponding terms of the a p and gp. Now the series is trig series as the given trig series is given by minus 1 the whole into 3 and this whole multiplied by x to the power n minus 1 and this whole into x to the power n minus 1. This is the nth term of the given mathematical geometric series. Now we suppose we equal to plus and so on plus for the geometric series the multiplying both sides for x we get x into sn is equal to we equal to and this whole into x to the power n minus 1. So here we x to the power n minus 1 like by x give us minus 1 the whole into x to the power n minus x. The whole into sn is equal to 2 square gives us 3x minus 1 into x to the power n minus 1 x to the power 3n minus 1 minus and this whole into x to the power n minus 1 which is equal to 3 into x to the power n minus 1 power n minus 1 and this minus 1 the whole into x to the power n. Now as you can see this is the geometric series. Now we will find out the sum of this geometric series x cube plus and so on 2x to the power n minus 1 of this geometric series is equal to the first term which is 3x into 1 minus the ratio that is x for x to the power minus 1 terms.  This is the sum of the series to n terms as we can say that the series is equal to 2 upon 1 minus x x into 1 minus x to the power n minus 1 and this whole upon 1 minus x to the power n and this whole upon 1 minus x. Sure x is less than 1 to infinity. This infinity is the sum of the series limit minus 1 the whole and this whole upon 1 minus x to the power square minus 1 this whole in 1 minus x. Now as limit n tends to infinity and x is less than 1 so this x to the power n minus 1 would be 0 or n would also be 0. This is equal to 2 upon 1 minus 0 the whole upon 1 minus x to the power square minus x into 0 or you can say this is equal to 2 upon 1 minus x to the power 1 minus x infinity equal to 2 upon sum of the series to infinity. This is the answer for sum of the series to n terms. Hope you have understood the solution of this question.