Author Archives: CMAJ

Nigel Rawson is President of Eastlake Research Group

 

Donna Lawrence is Director, HTA and Health Economics, with PDCI Market Access Inc.

 

You’ve been diagnosed with a rare disorder. It’s probably taken several referrals to many different medical specialists, countless tests and some misdiagnoses for you to get here because it frequently takes years to reach a correct diagnosis. Now what? Is there a medicine available to reduce your suffering or extend your life?

The odds are against you because fewer than one tenth of the estimated 7,000 rare disorders have an effective treatment. However, more and more drugs for these disorders are becoming available. You’re lucky – your physician tells you that a safe and effective drug has been approved by Health Canada. But, accessing it will likely mean travelling the Beatles’ long and winding road, surmounting obstacles along the way.

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Ernest Cutz is Professor Emeritus of the Department of Laboratory Medicine and Pathobiology at the University of Toronto, and a former senior pathologist in the Department of Paediatric Laboratory Medicine and Senior Research Associate at the Hospital for Sick Children's Research Institute.

 

This year’s Nobel prize for Physiology and Medicine, awarded to Drs. William Kaelin, Gregg Semenza and Sir Peter Ratcliffe for discovering details of how the body’s cells sense and react to low oxygen levels, is a remarkable feat for several reasons. The Nobel Committee cited the discoveries as ”one of life’s most essential adaptive processes”. The laureates' research answers profound questions about how the body works, helping to inform potential new therapeutic targets to treat cancer and other diseases. While I rejoiced in this remarkable accomplishment by these exceptional clinician-scientists, I was reminded of a colossal failure of the grant review process for medical research funding in Canada. ...continue reading

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Tara Riddell is a PGY4 resident in Psychiatry at McMaster University.

Ana Hategan is an Associate Clinical Professor and Geriatric Psychiatrist in the Department of Psychiatry and Behavioural Neurosciences, McMaster University.

Daniel L. Ambrosini is a Barrister and Solicitor in Ontario and an Assistant Professor in the Department of Psychiatry and Behavioural Neurosciences, McMaster University.

 

Although all healthcare professionals are at risk of experiencing burnout, physicians have especially high rates. A 2019 report on physician burnout conducted via Medscape found that more than 40% of U.S. physicians reported feeling burned out. The precipitants of burnout are manifold; however, increasing bureaucratic tasks, long work hours and disparaging comments from administrators, employers or colleagues have been cited among top contributors. Once present, burnout can lead to

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Martin Kaminski is a resident in internal medicine at Cambridge Health Alliance in Cambridge, Massachusetts and a clinical fellow in medicine at Harvard Medical School

Peter Kaminski is an advanced heart failure hospitalist and clinical instructor at UCSF Medical Center, San Francisco

 

Over the last decade, it has become widely accepted that chest compressions during Cardiopulmonary Resuscitation (CPR) should be done to the beat of the Bee Gees’ 1977 hit, “Stayin’ Alive”, to help save lives. The United Kingdom's Resuscitation Council advises that chest compressions during CPR should be between 100 to 120 beats per minute based on the consensus of the 2015 International Liaison Committee on Resuscitation. Meanwhile, “Stayin’ Alive” clocks in at 104 beats per minute. Case closed some would say. But the real question is, can we do better? The tools of medicine are constantly evolving. Furthermore, we question whether a song approaching its 41st year remains at the forefront of medical science. As both a senior millennial (MK, 35 years old) and a slightly less senior millennial (PK, 30 years old) we feel that “the times they are a changin’.” Therefore, we embarked on a serious, rigorous search for the best song to which to perform CPR.

You Ain’t Seen Nothing Yet  ...continue reading

Christopher Miller is an Investigator at the VA Boston Healthcare System Center for Healthcare Organization and Implementation Research (CHOIR), and an Assistant Professor of Psychology at the Harvard Medical School Department of Psychiatry

 

Abstract

Objectives:

(1) To empirically determine common grant-writing challenges; and (2) to compile the most common and frustrating challenges into a Christmas-themed song

Design:

Rapid qualitative analysis

Setting:

A health services research center in the northeastern United States

Participants:

Eight health services research staff with grant submission experience

Results:

Participants revealed common challenges in writing and submitting grants, including: the need for increased caffeine consumption; the rapid pace at which grant guidelines and requirements change; difficulties accommodating limited budgets; attempting to obtain responses from non-responsive co-investigators (Co-Is); developing and formatting seemingly endless appendices; fitting the grant text into page limits; formatting and finalizing letters of support; meeting obscure font size and line spacing requirements; formatting tables and figures; managing problems related to computer malfunctions or network disconnections; dealing with sleep deprivation; and responding to, or anticipating, reviews written by disgruntled grant reviewers.

Conclusions:

The resulting parody song, entitled The Twelve Days of Grants-mas, may provide some measure of comfort, good cheer, and humor to those research staff unfortunate enough to be writing or submitting grants during or near the holiday season.

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Maggie Keresteci is a caregiver to her sibling who lives with a life altering disease and is committed to advocating for solutions that will improve the lives of Canadian patients and their caregivers.

 

 

"Coming together is a beginning;

keeping together is progress;

working together is success."

These words of Henry Ford, that bastion of business innovation, have been taking up space in my mind for the last few weeks, as I have contemplated the emerging world of patient and caregiver partnership in Canada. ...continue reading

2 Comments

Dan Small is a medical anthropologist and lecturer at the University of British Columbia.

 

Since 2018, British Columbia has been pursuing legal action against pharmaceutical companies for their involvement in the opioid crisis. Within the wider context of North America, there have been over 2600 such lawsuits against the pharmaceutical companies including Purdue, Johnston and Johnson, Teva Pharmaceutical and Endo International. The Purdue pharmaceutical company, the maker of OxyContin, has recently filed for bankruptcy in response to the lawsuits. I believe a suitable strategy for examining the wider variables that have contributed to the opioid crisis: a Royal Commission. This is needed in order to widen public scrutiny beyond the role of pharmaceutical companies to include investigation of the overarching causes of Canada’s overdose epidemic.

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13 Comments

Maureen Topps is the Executive Director and CEO of the Medical Council of Canada.

 

Nothing matters more in my role than helping Canadian and international medical graduates succeed as they prepare to practice medicine in Canada. But what does success look like and how do we measure it?

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1 Comment

Marika Warren is an Assistant Professor in the Department of Bioethics, Dalhousie University.

 

In early July The College of Physicians and Surgeons of British Columbia dismissed a complaint against Dr. Ellen Wiebe made by the Louis Brier Home and Hospital, an Orthodox Jewish long term care facility. Dr. Wiebe had provided medical assistance in dying (MAiD) to a patient who resided in Louis Brier who had requested it. She thereby contravened the Home's policy. Cases such as these are increasingly likely as the policies of institutions exercising conscientious objection conflict with both patients’ interests in accessing MAiD (and other services) and providers’ interests in practicing with integrity. One way to resolve such conflicts would be to recognize a claim to conscientious provision of health care services that parallels the claims of individuals and organizations to conscientious objection. ...continue reading

CMAJ’s Holiday Reading is back! CMAJ Blogs will host the popular Holiday Reading series online in December 2019.

We’re seeking witty, offbeat, whimsical stories grounded in medicine. Have ideas? Email blogs@cmaj.ca 

Need inspiration? Check out some popular stories from previous years:

Pathology in the Hundred Acre Wood

Limitations

Diving into the ice bucket challenge