Monthly Archives: February 2017

Arlene Bierman is the Director of Center for Evidence and Practice Improvement (CEPI) at the United States Agency for Healthcare Research and Quality (AHRQ)

Rick Glazier is a Family Physician and Senior Scientist and Program Lead of Primary Care and Population Health at the Institute for Clinical Evaluative Sciences (ICES) in Toronto, Canada

 

Primary care is foundational to optimizing individual and population health. Health systems based upon primary care provide better access to care while improving health equity and outcomes and reducing costs. Effective models of primary care can greatly enhance the value of increasingly constrained health care spending. Despite large investments on primary care transformation in the US and Canada, primary care has yet to achieve its full promise in either country. Sharing successes and failures from attempts at innovation on both sides of the border can help each country accelerate improvement.

Despite very different health systems, primary care practices in both countries encounter remarkably similar challenges in delivering care. At the point of care, patients’ needs are similar and their experiences too often suboptimal. ...continue reading

Interview with Dr. Steve Morgan, professor of health policy at the University of British Columbia School of Population and Public Health and Dr. Nav Persaud, physician at St. Michael’s Hospital in Toronto and assistant professor in the Department of Family and Community Medicine at the University of Toronto.

Dr. Morgan, Dr. Persaud and their co-authors published a research article in CMAJ in which they estimated the likely savings from public coverage of a list of essential medicines across Canada. They explain their findings in this podcast.

Listen to the author interview:

...continue reading

Robyn Tamblyn is the Scientific Director of the Canadian Institutes of Health Research Institute of Health Services and Policy Research, and a Professor in the Departments of Medicine and  Epidemiology & Biostatistics in the Faculty of Medicine at McGill University, Canada

Andrew Bazemore is a practicing physician and the Director of the Robert Graham Center – Policy Studies in Family Medicine & Primary Care -  in Washington, DC

 

Yehuda Berg, an American author and spiritual leader, was probably talking about individual level transformation when he said “We need to realize that our path to transformation is through our mistakes. We're meant to make mistakes, recognize them, and move on to become unlimited.” But the statement has a lot of validity even applied to system level transformation.

Canada and the United States share the dubious honor of ranking near the top of OECD nations for total healthcare costs and near the bottom for health outcomes, whether measured in terms of individual health or health system performance. But it is through the recognition of these mistakes that both countries have embarked on a path toward transformation.

While differences between the two systems of health care delivery are frequently emphasized, we actually face some common challenges to primary care transformation ...continue reading

How do lifestyle factors influence breast cancer prognosis? In a review article published in the CMAJ, Dr. Ellen Warner and Ms. Julia Hamer identify which lifestyle changes can be recommended to patients as an adjunct to standard breast cancer treatments, to reduce their risk of distant recurrence and death.

Dr. Warner is a medical oncologist at the Odette Cancer Centre at Sunnybrook Health Sciences Centre and professor of medicine at the University of Toronto. Ms. Hamer is a Master of Medical Science student and lecturer at the University of Toronto.

Full review article (open access): www.cmaj.ca/lookup/doi/10.1503/cmaj.160464

Listen to the author interview:

...continue reading

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

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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