In Episode 2 of Stably Unstable, I sit down with two American emergency physicians, Dr. Johanna Bischof and Dr. Derek, who made one of the biggest decisions of their lives — leaving the USA to move their families to Canada and practice emergency medicine here.

This isn’t a political debate.
It’s a raw, honest conversation about medicine, money, safety, family, burnout, and what it actually feels like to practice on both sides of the border.

We talk about:

🔹 The realities of practicing Emergency Medicine in the USA and Canada
🔹 Treating patients who can’t afford care
🔹 The emotional toll of insurance barriers and massive medical bills
🔹 Gun violence in the ER — and whether you normalize it over time
🔹 When they first started contemplating leaving America
🔹 The risks of uprooting their careers and families
🔹 The licensing process to practice in Canada
🔹 The political climate and how it showed up inside the emergency department

And then we get into the practical questions:
🇨🇦 What is Canadian “socialized medicine” actually like to practice in?
💰 Financial tradeoffs — do they feel richer or poorer?
🏥 Does the average middle-class patient receive better care in the U.S. or Canada?
👨‍👩‍👧‍👦 How family planning and safety factored into the move
❗ What Canada was genuinely worse at than they expected
🔄 Would they ever go back?

If you’ve ever wondered what it’s like to practice medicine in another system…
Or if you’re simply curious about how healthcare really works beyond the headlines — this conversation is for you.

Dr. Eric Grafstein is an emergency physician, health system leader, and one of my longtime professional mentors. His work has profoundly shaped how emergency care is delivered—both for patients and for the clinicians working inside the system.

He has been practicing medicine for over 40 years and has held some of the most influential leadership roles in emergency medicine in British Columbia, including serving as the Regional Head of Emergency Medicine, overseeing 13 emergency departments across the province.

In this conversation, we dive into some of the most pressing issues facing emergency medicine and healthcare today, including:
-Burnout among healthcare workers
-Substance use and moral distress in medicine
-Emergency department wait times and system strain
-Public trust in healthcare—and how we begin to rebuild it

This is an honest, thoughtful, and systems-level conversation about what’s breaking, what still works, and what needs to change if we want a sustainable future for emergency medicine and healthcare as a whole.

Whether you’re a healthcare worker or someone who’s ever needed an emergency department, this episode offers rare insight into how the system really works—from the inside.