Author Archives: CMAJ

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Neil Chanchlani is a CMAJ Associate Editor and clinical research fellow at the University of Exeter, UK. He recently attended the 8th EBMLive conference in Oxford, England.

 

All healthcare practitioners are encouraged to make decisions that are based on strong evidence. But often we don’t – sometimes because the evidence is poor and conflicting, other times because we are ignorant and unaware and, rarely, because we aren’t comfortable with updating our practice. So we need to keep Evidence-Based Medicine (EBM) on the frontline and not on the (academic) shelves  - we need to remind clinicians, researchers, and patients that decisions should be based on the best possible data. ...continue reading

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Eleftherios Diamandis is Professor and Head, Division of Clinical Biochemistry, Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto

 

In the 1970s, my mentor and Professor at the University of Athens, Greece, Dr. Themistokles Hadjiioannou, asked me periodically to go to the library and check his citation record. I remember grabbing from library shelves printed volumes of the “Science Citation Index”, which were as heavy as 5 kg each, going through the pages and then recording manually as to who cited his work. This task required many days of intellectual and physical work ...continue reading

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Arundhati Dhara is an Assistant Professor at Dalhousie University in the Department of Family Medicine

Saroo Sharda is an Anesthesiologist in Oakville and an Assistant Clinical Professor at McMaster University

 

There are few data available on the racial make-up of Canadian female physicians. What data exist suggests that South Asian and East Asian groups are over-represented relative to their proportion of the general population and Black and Indigenous people remain underrepresented.

There is also evidence that non-white physicians experience discrimination from colleagues and patients ranging from daily microaggressions to more overt acts. While organizational anti-discrimination policies often exist, we are generally ill-prepared to deal with incidents when they occur and in their immediate aftermath. The clinicians experiencing bias are often left to act, and must weigh power dynamics against speaking up. The damaging effects of physician discrimination based on race or gender are clear, and yet we know little about the ways in which gender and race intersect to further marginalize women physicians of colour. ...continue reading

Puneet Seth is a practicing family physician in Toronto, part-time Assistant Clinical Professor (Adjunct) in the Department of Family Medicine at McMaster University and Chief Medical Officer of InputHealth Systems

 

As someone whose life is deeply entrenched in health care technology, both as a physician tinkering with a variety of digital health tools in my own practice and as an entrepreneur helping to build these tools, I've become acutely aware of the growing trend among health professionals in viewing "virtual care" as some kind of magical endpoint that will solve all of the woes of health care. ...continue reading

Anser Daud is a medical student at the University of Toronto. He enjoys writing about health advocacy and human rights issues.

 

“We’re dealing with a situation that’s not far from here, this is serious,” said Toronto Raptors sportscaster Matt Devlin as he interrupted the proceedings of the championship ceremony at Toronto’s Nathan Phillips Square on June 17. Those present—perhaps 2 million people by some estimates—began to wonder if their worst fears were beginning to materialize. Videos on social media show ...continue reading

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Caitlin Dunne is a Co-Director at the Pacific Centre for Reproductive Medicine (PCRM) in Vancouver and a Clinical Assistant Professor at the University of British Columbia.

 

A new study published in the Journal of the American Medical Association (JAMA) Pediatrics has linked fertility treatment with a risk of childhood cancer. The researchers linked data on babies from an American fertility database with birth and cancer registry data from 14 states. Their study spanned an eight-year time period, including 275 686 children conceived by in vitro fertilization (IVF) and 2 266 847 children who were conceived naturally. The focus was on young children, up to four and a half years old. ...continue reading

Nigel Rawson is President at Eastlake Research Group

 

The 2019 federal budget announced that the federal government will take initial steps towards implementing national pharmacare to improve the affordability and accessibility of prescription drugs across Canada. The government's plan includes the development of "three foundational" elements - a national Canadian Drug Agency (CDA), a comprehensive national drug formulary, and a national strategy for high-cost rare-disorder medicines. ...continue reading

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Noni MacDonald is a Professor at Dalhousie University

Shawn Harmon is a Policy Analyst at Dalhousie University

 

A recent family arbitration case that saw the arbitrator side with a mother who did not wish to vaccinate her two children is concerning. Their father, who shares custody of the children, wanted the children to be vaccinated. Arbitrator Herschel Fogelman appears to have given insufficient weight to the compelling evidence presented by the father and too much weight to questionable evidence presented by the mother and an expert witness whose expertise has been called into question. ...continue reading

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Mark Speechley is a Professor of Epidemiology at Western University

 

The age-old debate over who should be addressed as ‘doctor’ lives again in recent letters to CMAJ. Of course, it is important not to confuse the public. Since more people get sick than get university educated, members of the public are more likely to have met a physician-doctor than a professor-doctor. As a PhD epidemiologist, ‘the population is my patient’. Consequently, when I meet my medical colleagues in the hospital, I do not expect to be addressed as ‘Doctor’, but should the whole population be in the hospital, and the crowding in the corridors be so acute that I would have the statistical power to practice my profession by expertly assembling the massed throngs of gurneys into long rows of cases and controls, or exposed and unexposed, as appropriate, I would most certainly expect to be addressed as such.  ...continue reading

Philippe Barrette is a psychotherapist, workplace facilitator and former Assistant Clinical Professor at McMaster University, Department of Psychiatry.

David Streiner is Professor Emeritus in the Department of Psychiatry and Behavioural Neurosciences, and the Department of Clinical Epidemiology and Biostatistics at McMaster University; and Professor of Psychiatry at the University of Toronto.

 

 

Halfway through, Roma, the 2018 award-winning film set in the early 1970’s, the audience is suddenly confronted with witnessing a stillbirth. The scene elicited audible gasps from some viewers in a screening we attended, when the perfectly formed, dead baby was removed from its mother’s womb.

In the film, Cleo, the nanny and domestic worker for a middle-class family living in Mexico is rushed to hospital following an emotionally draining 9 months. Cleo’s boyfriend abandoned her shortly after learning of her pregnancy, and the family have endured marital tensions and a separation.

After an initial examination the assisting physician at the birth says, “I can’t hear a heartbeat," ...continue reading