June 30, 2026

Frontlines of Canadian Emergency Care

1 hour

In this episode of On The Line, host Matt Gurney sits down with Dr. Brian Goldman, veteran emergency physician at Mount Sinai Hospital in Toronto and author of The Casino Shift: Stories from an ER on the Edge, for a candid conversation about the state of emergency medicine in Canada. (You can find it on Indigo's website, or, if you prefer, on Amazon.)

This episode is brought to you by BioCanRx, a federally-funded Canadian not-for-profit research network bringing cutting edge cancer immunotherapy research from Canadian labs to patients in clinical trials –– all in Canada.

Clinical trials are the way new drugs, including immunotherapies, are tested in patients around the world. It’s up to the developer of the drug to decide whether they want to trial it in Canada –– and many do. Health Canada, our national regulator, reviews and approves all Clinical Trial Applications, or CTAs, returning a decision within 30 days –– a similar turnaround time as the U.S. FDA and other major jurisdictions. If they approve, and if the trial receives research ethics approval, it can start enrolling Canadian patients. To submit a complete CTA, applicants must provide hundreds –– sometimes thousands –– of pages of data showing that a drug has a compelling chance of providing benefit, that it can be manufactured consistently, and that it’s safe to administer to trial participants.

This is especially hard for Canadian researchers because scientific studies that generate the necessary data aren't supported by many federal grants, which usually prioritize originality over real-world impact. BioCanRx helps Canadian researchers succeed in the CTA process, and so far they’ve gotten 16 therapies to trial.

But once a trial starts, how can Canadians learn about it, and where can they access it? That question and more next time. Visit BioCanRx.com to learn more.

Drawing on decades in one of the country’s busiest emergency departments, Goldman explains why today’s ERs are under extraordinary strain, and why the problems extend far beyond long wait times. They discuss the pressures facing doctors, nurses, and patients alike, the growing mismatch between demand and capacity, and why the old problem of hallway medicine is increasingly giving way to something even worse: chair medicine, with patients waiting for hours in chairs because there simply isn’t anywhere else to put them.

The conversation also explores the human side of emergency medicine. Goldman reflects on the emotional and psychological toll of working in an overwhelmed system, the stories that inspired The Casino Shift, and what keeps health-care workers coming back despite the mounting pressures.

This episode is also brought to you by the Forest Products Association of Canada. A stronger forest industry can help build Canada strong. We need more homes, faster and more affordably, and Canadian wood can be part of the solution. Light-frame construction, mass timber, modular systems, and other modern building methods can support housing, lower embodied carbon, and strengthen domestic supply chains. The same opportunity exists in schools, health facilities, community buildings, and public infrastructure. When Canada builds, Canadian materials and Canadian workers must be part of the plan. Learn more at fpac.ca.

Finally, Matt and Goldman tackle one of the most contentious questions in Canadian health care. Goldman argues that it’s time for a calm, respectful, and evidence-based discussion about whether private options should play a larger role within Canada’s publicly funded system. Rather than treating the issue as ideological warfare, he makes the case for focusing on what actually improves patient care, and how other jurisdictions are approaching this problem.

It’s a frank discussion about the realities facing Canada’s healthcare system, the people trying to hold it together, and the difficult choices that may lie ahead.

This episode is also brought to you by Cameco. In nuclear energy, timelines and costs matter. Incomplete designs carry real risk of delays and cost overruns. That’s why the AP1000 reactor is the right choice for Canada: it is already operating today and ready now to deliver the power we need, with 100 percent Canadian ownership and strong participation from Canadian suppliers. If we are serious about building Canada and powering it on time and on budget, the choice is clear. The AP1000 reactor is the only option that delivers.

To learn more, visit ap1000.cameco.com.

If you enjoyed the episode, be sure to share it, and as always, like and subscribe to us on your podcast or video app of choice, and check out our main page at ReadTheLine.ca.

#OnTheLine #BrianGoldman #Healthcare #EmergencyMedicine #CanadianHealthcare #MountSinai #TheCasinoShift #PublicHealth #CanadaPolitics #MattGurney

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By Matt Gurney and Jen Gerson

3.3

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