“So we’re actually very lucky, and Montreal has a very rich history, not only in medicine but in the sciences in general. Starting with McGill University, but more currently, University of Montreal also was considered a world-renowned research-based institution. Montreal is a great place, not only to be a physician, but if you’re in the basic scientists, sciences, excuse me, you have four major universities that do about hundreds of millions of dollars of research.

A lot of this is funded by the government, in what would be called seed rounds or angel investments. There could be more venture capital, which I think is the point of this video. But in terms of starting up, I think a lot of science-based companies here learn to be very efficient with the money that they have. And for that reason, Montreal is known to punch above its weight class when it comes to producing research, given the size of the city and the amount of capital that’s available.”

“I am trained as a family physician. I probably spend, I would say, 80 to 85% of my time doing that job. But the thing I find most interesting is actually side projects. So as I mentioned previously, there’s something called from bench to bedside, i.e. the research bench to the clinical bedside. And a lot of that is done by small companies or people trying to start up with new ideas of how to integrate technology, particularly into healthcare.

And so you need that clinician’s perspective on what the, perhaps on a medical EMR, what the screen looks like in front of a doctor or how patients would respond to having things put on their chest or on their arm. So I get to participate a lot in those type of companies, everywhere from medical marijuana to wearables.”

“So originally when I started consulting, I don’t work with the industry anymore, but with the company I was working with it was, again, basically to set up guidelines. How is this supposed to be prescribed? How do patients react? What’s the government gonna say? So a lot of companies literally just need that type of information and that insight, something you couldn’t Google search, per se.

And originally it was considered more of a growth industry, but now that marijuana is legal the relevance of medical marijuana is much less, although there is quite a bit of research. One of the foremost researchers in the application of marijuana for pain management, Dr. Mike Weir, is at McGill University, and he also works, I think, for one of the big firms. If I’m not mistaken, it’s Tweed.”

“Venture capital money, particularly for angel investing, the first what would be called six rounds of getting money is difficult, to say the least. Here in Montreal it hasn’t been well-established as, say, our counterparts in Toronto, or of course Silicon Valley that everyone talks about. But that being said, the money that does come in from the government, in terms of grants specific for research, tax benefits for starting companies that are doing basic scientific research, the environment in Montreal is excellent for that. And although there is a lot of paperwork, like there is with things, the money is definitely there to at least get yourself up and running.”

“Why did you decide to go private so early in your career? So actually, they’re linked. So I didn’t actually decide to go private in my career. I had no choice. I was one of those that was left out of the quota system, my first year working, so I did not have a license to practice on the island of Montreal. I had already grown up in Sherbrooke, wasn’t interested in going back, wanted to stay in the city.

So I started working in private, which actually was great. I do public healthcare now. But having experience both in the private sector and public has actually improved my public practice, ’cause I was able to bring certain things like lowering wait times, efficiencies, just customer satisfaction, those type of attitudes to the public clinic. That has turned out to work very, very well for us.”

“Private practice tends to be slower. It’s a slow-paced day. But you get a lot of satisfaction ’cause you do get to spend up to 30 minutes with a patient. You really get to not only review their entire health profile, but you tend to get to know them a little better as well. What I’ve done in my public practice is I’ve kind of divided it into two parts.

So I still, for my own personal patients, get to spend that type of time, get to know them and develop that rapport which is the best part about being a doctor. But at the same time I get the hustle and bustle of a walk-in clinic, where I can see up to 30 people in a half-day. Cuts down the time per patient, but the medicine obviously is very interesting.”

“The reason it’s so great to be in downtown Montreal, to have this practice, particularly for the walk-in clinic is that you meet people from all walks of life who are doing so many different things. And one of the first questions we have to ask every patient is what they do for a living, as that obviously affects their health a lot. So you almost have a bit of a pulse on the economy, in a sense that a lot of people are very proud of what they do. They’ll go on my computer screen and show me their websites. They’ll show me their restaurant and all this. I get great invites too, which is not bad after work.

And so you see when the economy’s not doing well, what people are coming to see you for. And even when the economy is doing well, people are still coming in and telling you about what they’re doing. And you know, I meet Brazilians, Colombians, people from Europe, Germany, lot of France, England, Australia, New Zealand, all over the world. Lot of Americans coming up, particularly for the video game industry. And so they tell you their little stories, why they came to Montreal. And so it’s a great way to just understand what’s going on. And the downtown location of our clinic really allows me to enjoy that aspect of the practice.”

“There’s a definitely positive sentiment, I would say. There’s a lot of hungry people, I would describe them, who have gotten experience elsewhere around the world. Particularly in my field, just in my group of friends, I know multiple that have trained in England, France. I have one coming back from Korea. Many have gone to Harvard, Stanford, some of the big names in the US, and they’re all coming back here to Montreal. I would think the central reason would probably be affordability, where we have such a metropolitan city but you get to live at probably half the price as you would in Toronto or Vancouver and New York.

There was a period, I would say three, four years ago, where people felt kinda down. And like I said, you kinda get that sense when you’re in clinic that things just aren’t going well in general, I would say, economically in the city. But I would say over the last two years there’s this general optimism towards a lot of companies opening a lot of contracts, international contracts as well that a lot of my managers or CEOs get and they tell me about. And basically just very happy that there’s money coming into the city, and a lot of opportunity outside of the city, but with their roots coming here for Montreal.”

“As many of you might know, this is the first time in half a century where we’ve elected a government not based on whether Quebec should stay in Canada or not. It was more of a make Quebec better again kind of philosophy. So I think that reflects the general population, not just people from outside, but la Quebecois souche as you would call them, also acknowledging that it is a global economy, a global market, and Quebec and Montreal specifically has a great role to play in that. So I feel the politics of the past have consistently been dying down, as we’ve seen in both federal and provincial elections. And I think that’s the first stepping stone to moving both Quebec and Montreal forward in that way.”

“One of the great parts about Quebec, I don’t make it a habit to quote Parti Quebecois politicians, but one thing they are right about is that Quebec is a unique territory. We have a strong French culture and base, which I think is a huge advantage. And with having the United States and English Canada at our borders is a huge advantage, because it does get a lot of different types of influence. Plus we’re already known to have more of a European flair as well.

That, combined with the cultures here, Arabic is gonna surpass English as a second language in Montreal, and we know that’s a growth economy. People aren’t talking about the brick so much anymore as much as Africa. And being in Montreal you have access both to the Commonwealth through England, and the Francophonie. And if we’re talking about Africa particularly, which is where I’m actually consulting in now as well because healthcare is one of the first things a lot of governments invest in when they start doing well, about half of the top five economies in Africa are part of the Francophonie. And so Montreal is well-poised to take advantage of the growth economies of the future.”

“We were one of maybe three immigrant families in the area I grew up, which was heavily French-Canadian. And I was fortunate enough that we integrated very well and learned a lot about the culture. I was fortunate enough to be invited to and participate in a lot of what’s important to French-Canadians. So for me I’m definitely sympathetic and understand very well the reason they want to protect the culture and the language. And to be direct, I’m very okay and would actually encourage that.

The reason I think it’s an advantage, one of the terms we hear a lot about is diversity is our strength. What I like about Quebec is the French culture and language. It is actually something that unifies all of us. Whether you’re from Brazil or you’re Anglophone, Francophone, or from Europe, Africa, et cetera, the acknowledgement keeping the value of the territory is something that actually brings us all together, that we can all share and celebrate. And it’s a good foundation to mix in other things, like as I was saying before, your other cultures into. But I do think it is important to have a strong base that does identify as one.”

“Our neighbor used to help me with my French homework so that I would do better in school. And French-Canadians were very happy to invite me onto the soccer team and to watch hockey games. My favorite food to this day is poutine. In fact, one of the main reasons I couldn’t live to leave the city is I don’t know what I would do if I couldn’t have a poutine at least once a month. It is essential for my diet.”

“Look, there’s no such thing as a bad poutine. They’re all good in their own heart. The secret which I think really determines a great poutine from a mediocre one, per se, is the cheese. The cheese curds coincidentally come from my home area of the Eastern Townships. It’s fresh, it’s clean, and you know it’s good when it’s nice and squeaky when you’re chewing on it.

So some places put some mozzarella or different types of cheeses or not fresh cheeses. That’s just unacceptable when you’re making a poutine. The second is the St. Hubert sauce, that classic brown sauce. That is definitely open to a bit more flavor. You could add Indian spices to it. You could add Italian spices. And so that one you have a little bit more leeway. But there’s not much leeway for the cheese. And of course the last and most important ingredient is the French fries. And they need to be thick, greasy, and chewy. Not too crunchy, not too soft. They gotta be just perfect.”

“There’s a definite frustration, I would say, about Quebec healthcare in particular. But that is also something I’m optimistic about. There are two things that I would say patients hate the most about our system. The first is wait times while waiting to see a doctor, and then the second is wait times to actually see specialists or get imaging done, et cetera.

The third thing, there’s a lot of comments about bedside manner as well. So what I would say to those people is that be patient, hold tight. I’ve noticed that there’s kind of a divide between the old guard and the new set of not just family physicians, but physicians coming into the profession as well that have a very different attitude and very much like technology, believe in efficiency, were taught it more in school as well.

Our attitude towards patients as customer service I think is getting better. And as these kind of older clinics are closing down, the ones where you still see the paper files in, you will see a lot more clinics like mine, where we’re paperless and we’re even trying to move forward in terms of getting rid of fax machines and all these kind of old things, and to really accommodate the new generation of patients with a new generation of doctors.

I already have patients using Skype to talk to medical professionals. I have so many patients that ask me, am I gonna be able to come into your office with my iWatch and just touch your screen and you’ll know everything that’s going on? And it’s exciting to have patients engaged like that in their healthcare, which kind of inspires us as physicians to want to integrate that kind of stuff in our practice. Because not only does it make more fun for us, more pleasurable for our patients, but it does improve healthcare in the long run. So although for any Quebecer’s watching who might be a bit déçu, as they would say about our current state of healthcare, I would definitely be optimistic about the future.”

“If you compare us to our closest neighbor in the United States, healthcare really is a business, so the customer comes first. And there are advantages, in terms of wait times, customer experience, without a doubt. There are disadvantages to the fact that to provide that type of care is extremely expensive. And you can look at the numbers.

Because you’ve spent more money on healthcare doesn’t mean you’re actually getting better care. One example I could give is Sainte-Justine Hospital here in Montreal. It can stand toe-to-toe with the other top children’s hospitals of the world. The difference, maybe it’s not as pretty as the other ones. But you have the brains, which when it comes to your health is probably the most important thing.

And Canadian healthcare, and Quebec more particularly, yes, there is a lot of money that’s invested. It could be more efficiently used, without any doubt. But you get the fact that when you get sick, you don’t use your house. And so there are compromises to be made. And I think as a society, despite our discomfort with some of the services provided, overall people do, get better care, and more consistent care in our system.

If I were to present you an ideal model, it would probably be a mix of the two. We don’t have the best, as we’re probably very inefficient in our model because we’re not thinking like a business. I would say in the United States it’s too much of a business, which leaves out a lot of people from healthcare. And so some sort of hybrid, which we have models in the world in England, Singapore, Switzerland, tend to work very, very well.”

“I would never imagine that Montreal will ever be a Toronto or a New York or a London or Paris, but I don’t think that is our goal either. Those big cities, world-class cities have huge advantages, mostly along the lines of the amount of money or the economic prowess. But I find culturally in Montreal that is not as much of an importance.

A general joie de vivre, which is a well-known philosophy here, is very important. And I’m happy being a Boston or a secondary type of city, but be the best type of secondary city. And what that reflects is we have good real estate prices. The city is very livable. And for, particularly in my field, in the sciences, whether you’re a doctor or a researcher or even involved in a startup, this is great ’cause it means you get all amenities of any of these world-class cities, but you get it for living like what I would say a normal human being.

People living in Toronto, I’ve worked there and it’s a struggle, even if you’re in the middle class. Particularly as a family physician, people do talk about their finances with me, and it’s the pressure that it puts. When you have a million-dollar mortgage, it’s tough to go out and enjoy a beer on a terrace. When you spend two hours in traffic, it’s tough to go out, to have the energy on weekends to take your family to the park.

I would never want Montreal to be a New York City, per se. My kind of passion would be that Montreal reaches its greatest potential, and there’s definitely room for improvement, but I think we’re headed in the right direction.”

“A few of your other speakers have talked about the artificial intelligence community here in Montreal. So that’s actually big news for medicine, because particularly for research, artificial intelligence with the combination of big data, I know these are kind of coined terms, but are essential for actually accelerating and improving research protocols.

Right now it can take years to develop drugs or technologies that need to be or that can be integrated into the medical field. With having a bustling kind of startup community here in Montreal, they’re gonna be looking for places to test their artificial intelligence or their technologies. And Montreal has two billion-dollar hospitals in the downtown core, which are juggernauts on the research side of the business, both for Canada, but internationally as well.

So having the AI community, and even the video game community has its applications in surgery, in terms of how to manipulate certain things on a screen, and for surgeons to practice kind of virtual reality surgeries, in terms of training. There’s so much of this research going on elsewhere as well, but in Montreal it’s a great place to have these kind of neighbors, if you will, to help advance particularly medicine, per se.

I’ve also heard of Lufa Farms. There’s a big industry, or I would say a trend, in terms of urban agricultural development. I’m not sure of the CEO’s name, but again, he studied here in Montreal, decided to stay. And his products do sell for a premium, but what’s great, again in Montreal, is culturally, people aren’t sensitive to a bit of a premium to pay for socially-conscious ideas like agriculture. Vegan restaurants, I would even put that. I mean, in Montreal it always comes back down to food, right?”

“A lot of times, for instance for myself, when I’m reading about the market in the United States or in other places in Canada, another part of, I would say the uniqueness in Montreal or Quebec is that people aren’t as price point sensitive for certain products, if they get the feeling that they are doing something right.

So if you’re Walmart, perhaps, in the United States, 72 cents more for a certain product would definitely affect their bottom line and their decision-making process. But I feel in Montreal people do pay a little bit more for a restaurant that buys their food locally. They will pay a little bit more for a cleaning product that perhaps won’t pollute the water. And so I think, as I alluded to before, it’s great for businesses that do have a kind of social entity, a place to grow, because you at least have customers that will support you in those very difficult first years.”

“The other great thing, particularly in Montreal or Quebec in general, is our cheap education, compared to our counterparts. So both for companies and for people themselves, to get well-educated is not gonna break the bank, despite what some of the protestors might tell you. And so that’s great, because we have a really, really strong workforce. Not only do you have a well-educated workforce, but you also have a healthy work source.”

“I was always a big fan of history. It was actually one of my favorite subjects growing up. So I remember learning about how Alexander Graham Bell went through Montreal before he developed the phone at Harvard. Dr. J. Naismith, the inventor of basketball, was in Montreal before he went to Massachusetts to invent the sport with peach baskets.

Power Corp, the Desmarais family, another great business story from Quebec. The Saputo family, they are literally the kings of cheese. And Aldo as well, if we’re talking about fashion. In my industry in particular is Valeant Pharmaceuticals, which is a big international player. So for me, what makes me proud is I like seeing Montrealers come up with companies that are staying here, that are growing here, and really have an international presence.

I forgot to mention Couche-Tard as well, one of the second-largest food companies on earth. CGI, seventh largest telecom company. So I feel like the roots are there and it’s getting better. I haven’t even mentioned video game or Element AI. There’s just so much stuff coming now, and a lot that was established before. That’s what really motivational, when I pick up the newspaper and I hear about Quebec brands and Quebec companies really making it on the international scale.”

“My name’s Dr. Paul Budaraja. I’m a family physician, and I’m lucky enough to have a practice here in downtown Montreal, where I get to meet lots of different people from different industries. I actually grew up in the Eastern Townships, in a very small area, a French-Canadian town, Sherbrooke, if anyone’s heard of it. But moved to Montreal when I came to medical school. And I opened my clinic three years ago, and it’s been going well ever since.”

“Enchanté, mon nom est Dr. Paul. Je suis médecin de famille ici au centre-ville. J’ai une petite clinique boutique, ça fait trois ans qu’on est établi. Je ne viens pas de Montréal originalement, je suis né à Sherbrooke, Québec, mais j’ai déménagé ici, c’est fait plus de dix ans et j’étais très content de rester. C’est une des meilleures villes au monde.”

“Alors quand j’ai fini l’école de médecine, ou ma résidence particulièrement, je n’étais pas un des chanceux qui ont eu genre le billet d’or, on peut dire, pour pratiquer sur l’île de Montréal, puis j’avais déjà passé la plupart ma vie à Sherbrooke, je n’étais pas intéressé à retourner en région, je voulais rester en ville.

Ma première expérience en médecine, ici au Québec, c’était au privé. Alors j’ai fait ça pour un an, puis après ça, j’ai ouvert une pratique publique où je travaille toujours. Pour moi, c’était un grand bénéfice de commencer au privé parce que je pense qu’il y a, je dirais, une frustration en général avec l’état de notre système de santé. Surtout pour les temps d’attentes pour voir un médecin, pour les imageries et mêmes pour voir des spécialistes.

Aussi, j’ai beaucoup de patients aussi qui parlent de la qualité du service qu’ils reçoivent, aussi. Pour moi, cette expérience au privé, j’avais la chance, avec mon partenaire aussi qui était au privé avant, d’emmener ça au public, l’intégration des dossiers électroniques, de diminuer les temps d’attentes, on travaille beaucoup avec une compagnie, Bonjour Santé, qui est très innovative.

Il a même un projet en intelligence artificielle maintenant pour intégrer dans les cliniques. Puis on voit, surtout avec nos patients, qu’ils sont très contents de voir ces choses, s’ils ont besoin des résultats ou des choses comme ça, ça peut-être envoyé à un e-mail sécurisé, leur médecin peut intégrer comme leur Apple watch dans leur médecine, ça les rend heureux qu’il y ait vraiment plus du contact avec le médecin et que la technologie est présente dans leurs soins.”

“En général, en capitalisme, le client n’en demande jamais trop, c’est nous qui peut-être ne sommes pas capables de provisionner ce dont il a besoin. Oui, si on parle d’un contexte d’un système public qui a des fonds limités, des fois les attentes des patients ne sont pas en ligne avec ce que le système peut provisionner.

Dès que ce n’est pas privé, ça veut dire qu’on doit partager les services. Puis, ça devient plus difficile d’avoir le genre d’expérience que tu vas avoir en Floride, quand tu es en vacances, où tu rentres à l’urgence, c’est onze minutes puis le médecin te voit, puis c’est comme t’es au Four Seasons Hotel. Mais en même temps, c’est important de dire qu’on dépense beaucoup sur notre système de santé ici au Québec, au Canada en général, et il y a des places où on peut améliorer, et à mon avis, la technologie c’est une des choses qui va aider beaucoup à améliorer l’expérience.

J’ai déjà des patients qui utilisent skype pour avoir des conseils d’une infirmière, puis les dossiers électroniques qui étaient quelque chose qui était poussé par le gouvernement, en fait. ils ont donné des subventions pour nous, comme médecins de famille, d’intégrer ce genre de technologie à la pratique.

Alors, je suis optimiste pour le futur, dans le sens que je pense que la vieille façon de faire les choses en médecine est en train de prendre une retraite dans les prochaines années. Puis la nouvelle génération, je trouve, de médecins, ont une meilleure attitude, d’un, envers les patients de 2, en matière d’intégration de la technologie. Je pense que la technologie va aider beaucoup. Alors je suis optimiste que ça va améliorer, mais c’est quelque chose qui prend un peu de temps.”

“Pour moi, Montréal ne sera jamais Toronto ou New York, mais on ne veut pas être une ville comme ça. Absolument, il y a des grands avantages, surtout sur le côté économique, mais on est très chanceux ici à Montréal d’avoir une bonne philosophie de la joie de vivre. Puis, pour moi, je veux que Montréal réalise son meilleur potentiel, mais ça ne veut pas dire qu’on doit être une ville comme Londres ou Paris.

Pour moi, je trouve qu’on est plutôt un Boston français, on a des bonnes institutions d’éducation, ce n’est vraiment pas cher d’être bien éduqué ici au Québec. Oui, on a des bonnes compagnies qui viennent et qui viennent de Montréal, puis les gens qui travaillent pour ces compagnies peuvent avoir une vie ailleurs de ce travail.

En comparaison, je sais, j’ai des amis à Toronto, juste le fait d’être dans le trafic ou d’avoir une hypothèque de 1 million de dollars quand tu es quelqu’un de la classe moyenne, ça met beaucoup de pression sur ta vie puis ça a une grande influence sur ta santé aussi. Nous, comme Montréalais, on est très chanceux d’avoir cet équilibre ici.”

“Pour moi, comme immigrant, ou je dirais le fils d’immigrant, j’étais très chanceux de grandir dans une partie du Québec qui n’était pas multiculturelle. Alors, mon expérience est peut-être très différente de celle de quelqu’un qui était en ville. Pour moi et ma famille, on était très chanceux que la communauté nous a accueilli. Puis on a eu la chance d’être intégré dans la culture.

Mon père est un grand fan des Canadiens, il ne manque pas un match. Même s’il est anglophone, il regarde toujours les matchs sur RDS parce que c’est comme ça qu’il a appris le hockey. Mes voisins m’aidaient avec mes devoirs en français parce qu’ils voulaient que je réussisse à l’école et j’ai réussi pour entrer en médecine, et c’est surtout à cause de ces personnes-là qui m’ont aidé en français, et aussi à intégrer et comprendre la culture.”

“Pour moi, la raison qu’on est chanceux, pourquoi le Québec est unique, c’est qu’on a une forte, je dirais, base de culture québécoise, avec une langue qui nous unit. Alors ce ne fait aucune différence si tu viens de l’Europe, l’Afrique, l’Amérique du sud ou même les États Unis, c’est vraiment le français puis la culture québécoise qui nous met ensemble.

Je sais, surtout dans les autres territoires, qu’ils parlent beaucoup que la diversité c’est notre puissance, et oui on a toujours ce multiculturalisme ici au Québec et surtout au centre-ville de Montréal, mais pour moi, cette base de français nous donne une bonne fondation ici. Mais les plusieurs cultures tous fonctionnent je trouve en français ici, mais ça nous donne l’opportunité d’exporter notre expertise et même la culture pour des économies croissantes comme en Afrique, au Moyen-Orient, en Inde, en Chine, etc. Je trouve qu’on est chanceux d’avoir ce genre de multiculturalisme. C’est un peu différent que les autres villes je dirais anglophone.”

“Je dirai qu’à Montréal, le fait que tu peux vivre bien, peu importes l’emploi que vous faites, c’est notre meilleur, je dirais la meilleure chose de la ville. Beaucoup de gens sont partis, des bons cerveaux qui sont allés dans le reste du Canada ou même aux États Unis etc. Mais je trouve que les gens reviennent, surtout je pense, la situation politique est beaucoup mieux.

C’est la première fois dans un demi-siècle que les Québécois ont voté, pas sur la ligne de la séparation, mais pour un parti qui a juste vraiment parlé de comment améliorer le Québec. Il va toujours y avoir des gens qui vont dire des choses qui sont un peu, je dirais frustrés peut-être, et c’est correct. Mais dans ma pratique, comme j’ai mentionné, je parle beaucoup avec les gens de différentes cultures, des Québécois, des gens d’autres parties du monde.

Il y a un optimisme, en général, qu’on est sur la bonne voie, surtout pour la croissance économique. Et comme j’ai dit, c’est une bonne place où vivre, c’est une bonne place pour avoir une famille, et t’as la chance de parler au moins deux langues, who doesn’t like that?”

“Pour moi, une des choses qui m’inspirent, c’est quand je lis sur les entreprises Québécoises qui réussissent, pas juste ici, mais dans un contexte global. Alors l’histoire de Bombardier est intéressante, celle de la famille Desmarais et Powercorp. CGI, c’est la septième ou sixième plus grande firme en télécommunications au monde.

On parle beaucoup de Couche-Tard aussi, qui est genre le deuxième ou troisième plus grand en aliment. Et maintenant on parle des nouveaux comme, il y a Element AI, la Lufa Farms. Des compagnies vraiment Québécoises qui ont commencé ici, qui ont eu leur croissance ici à Montréal, mais qui ont eu un impact global. J’aurais mentionné SNC Lavalin, mais c’est un peu difficile de parler d’eux maintenant.

Mais même eux, c’est une des plus grandes firmes en construction. Pour moi c’est ça que j’aime faire, d’ouvrir le journal le matin et de voir des compagnies Québécoises qui ont leurs racines ici, qui ont eu vraiment un impact global.”