Jay Rankin, news intern for CMAJ, reads the Humanities Encounters article "TB or not TB". The article is written by Adam Komorowski, a second-year medical student at the University of Limerick in Ireland. In the article, Mr. Komorowski describes the time he tested positive for tuberculosis. The story is true.

Full article (subscription required): www.cmaj.ca/lookup/doi/10.1503/cmaj.160828

Listen to the article reading:

...continue reading

Interview with Dr. Nathalie Auger, principal scientist at the University of Montreal Hospital Research Centre (CHUM) and associate clinical professor in the School of Public Health at the University of Montreal and with Dr. Brian Potter, clinical investigator and interventional cardiologist at the University of Montreal Hospital Research Centre, and assistant clinical professor with the department of medicine at the University of Montreal.

Dr. Auger, Dr. Potter and their co-authors investigated the association of quantity and duration of snowfall with hospital admission or death due to myocardial infarction.

Full research article (open access): www.cmaj.ca/lookup/doi/10.1503/cmaj.161064

Listen to the interview:

...continue reading

1 Comment

Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy

 

The Iroquois Confederacy’s Great Law is said to include the principle of making decisions taking into account impacts on the  seventh generation, which means thinking 140 – 175 years ahead. That is a far cry from our modern politicians, who can barely think past the next election, never mind our businesses and stock markets that are too often focused only on the next quarter’s bottom line.

As Canada celebrates its 150th anniversary, it seems a particularly good time to think about the next 150 years. Of course we can’t predict that far ahead; imagine how much of today’s world we could have predicted in 1867. But there is no doubt that what we do today will have impacts at least 150 years into the future, and probably much further. ...continue reading

7 Comments

Cory Peel is a GP-Anesthesiologist who locums throughout British Columbia, Alberta and the Yukon

 

A couple of months ago I read Mike Hager’s article in the Globe and Mail about Dr. Reggler’s tribulations at St. Joseph’s Hospital in Comox, BC, and I was overcome by a realization that, despite having been a practicing Family Physician for 7 years, I had culpably little understanding of the prejudicial impact of faith-based hospitals in determining patient access to care.

The article detailed the refusal of the “Catholic hospital” in Comox to provide medical aid in dying to its patients despite having a staff physician willing and able to do so, thereby forcing them to be transferred elsewhere. That such a policy could exist stunned me. It is the work of “the bishop [a.k.a. the Diocese of Victoria] and the hospital board,” with the board’s CEO maintaining that “minimizing patient discomfort and pain is always the highest priority,” which seems to me to fly in the face of logic.

It is not, however, an isolated example. Canada contains many hospitals whose delivery of healthcare to its patients is directed by Church doctrine. ...continue reading

1 Comment

Jesse Kancir is a resident in Public Health and Preventive Medicine at the University of British Columbia, and former Policy Adviser to Canadian federal Minister of Health, Jane Philpott

 

Donald Trump’s inauguration as president of the United States is a cause for worry for population and public health. An early policy victim appears to be Obama’s Affordable Care Act (ACA). The ACA’s founding policy debates influenced my own interest in public health and health systems as a young medical student so the early steps taken by US Congress to dismantle it have affected me deeply. But it’s not just nostalgia. Concerns are real that Trump’s administration may impact global welfare, yet I’ve been comforted by thinking that a Trump administration highlights several opportunities for progress in Canadian healthcare. In 2017, Canadian healthcare can strive to contrast with negative developments in the US and be the highest expression of our commitment to each other and to a better society. ...continue reading

6 Comments

David Falk is a palliative care physician working in Calgary, Alberta

 

Recently the president of one of the Quebec medical federations published a request to the public to give the medical profession some time to accept physician assisted death (or medical assistance in dying - MAiD) “because they do not like change.”  I agree and disagree with him about this.  Yes, physicians are slow to change without measured assurance that the change would be beneficial to their patients, but, when it comes to the matters of the heart, these changes may not be beneficial nor become mainstream.  Suppression of visceral responses does lessen with repeat exposure, just as shoplifting becomes less traumatic the more often you do it, but whether continued suppression of the heart language is good is questionable. ...continue reading

Interview with Dr. Ian Kitai, tuberculosis specialist with the Hospital for Sick Children and associate professor in the Department of Pediatrics at the University of Toronto School of Medicine. Dr. Kitai co-authored a review article (subscription required) on the diagnosis and management of tuberculosis in children. Tuberculosis is generally uncommon in children and adolescents in Canada, but among some populations we still find high rates of the disease. A high index of suspicion is required to ensure timely diagnosis.

Listen to the interview:

...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

The concept of the “Salon” is based on the tradition of European intellectual gatherings that led to the great literary, artistic and political movements of our time. At a recent meeting of primary care researchers in Colorado Springs, Frank deGruy gathered a group of colleagues in this way together to create discussion, debate and perhaps generate ideas. Such gatherings might take place with any group and in any context - in a department, region or nationally. On this occasion, Frank attracted a group of about twenty delegates of the NAPCRG meeting from various international and professional backgrounds and I was fortunate enough to be included. ...continue reading

1 Comment

Jacalyn Duffin is a hematologist and historian who holds the Hannah Chair in the History of Medicine at Queen’s University

 

The sixth full year of the global generic drug shortage has drawn to a close. We Canadians can look back and marvel at how little we still know about the problem. Generic drug shortages do not get anything like the attention paid to the fraught relationship between the federal government and the provinces over a renewed health accord. They are also obscured by concerns over brand-name, on-patent pharmaceuticals, such as the shocking price hikes that occurred overnight last February when Martin Shkreli raised the price of Daraprim from $13.50 to $750, or when Valeant upped the price for a month’s supply of two drugs for Wilson’s disease to more than $25,000. Yet, looking back over 2016, Canada has reported shortages of reliable generic drugs for epilepsy, bladder cancer, psychosis, syphilis, asthma, and kits for treating overdose.  ...continue reading

Iona Heath was a general practitioner in inner-city London for 35 years and is a Past President of the UK Royal College of General Practitioners.  She is a co-chair of the Scientific Committee for the 2017 Preventing Overdiagnosis conference

 

Over the past several decades, the economic interests of the pharmaceutical and medical technology industries have both pressured and tempted medicine to overextend itself.  The traditional moral commitment of the medical profession to relieve suffering and to care for the dying has been gradually displaced by a futile and misguided attempt to solve humanity’s most profound existential problems through biotechnical means.  Doctors now apply more and more powerful treatments towards the end of life and try to prevent diseases by seeking out and correcting more and more risk factors.  All this has led to an epidemic of overdiagnosis ...continue reading