Author Archives: CMAJ

Barbara Sibbald is editor of News and Humanities at CMAJ, and author of the recently published collection of short stories, "The Museum of Possibilities"

 

Health policy pundits should look to André Picard’s new book for a dose of common sense on some of Canada’s most urgent health issues. Picard, as most Canadians know, is the long-time health columnist for The Globe and Mail. The book, Matters of Life and Death: Public Health Issues in Canada (Douglas & McIntyre), is the best-of those columns over the past 15 years, updated and conveniently packaged under 14 topic headings like opioid use, medical assistance in dying, cancer, marijuana, indigenous health and infectious disease. Most importantly Picard delves into medicare itself.  Canadians spent $228-billion in 2016 on health care: Do we get value for our money? Is it sustainable? Picard not only asks the right questions, he provides some very credible answers. ...continue reading

Bill Jeffery is the Executive Director of the Centre for Health Science and Law (CHSL), and  publisher of Food for Life Report magazine

 

The new Director General (DG) of the World Health Organization (WHO) will soon be elected. If the upcoming election does not effectively hold to account all candidates, especially the successful one, the WHO risks losing its influence as the leading global public health authority.

On May 23, 2017, for the first time in WHO’s history, all 194 Member States of its governing body, the World Health Assembly, will cast a vote for the new WHO DG at its annual meeting in Geneva. (Previously, the DG was selected by the WHO's 34-member Executive Board.)

But, public health challenges are too great to allow the vote to descend into geo-political horse-trading and unchallenged controversy-dodging in an environment where opportunities for public vetting are few.

The WHO DG is head of a global staff of 7,000 and chief global ambassador to national health ministries world-wide. The WHO’s prominence and the need for its leadership in global public health have long been greatest in low- and middle-income countries where national health systems suffer a relative lack of financial resources and specialized technical expertise.  But high-income countries draw on the WHO’s work, ranging from graded distillations of nutrition and alcohol research to annual advice about the best flu vaccine to administer globally.

The three candidates shortlisted for the position of DG have been persistently ambiguous about their stances on important governance issues. ...continue reading

Matt Eagles is soon to graduate from Memorial University's medical school, and is headed to a Neurosurgery Residency program at the University of Calgary; he is a former Major Junior and University hockey player and a founding member of Concussion-U

 

On Monday May 1, 2017, the Pittsburgh Penguins entered their second-round playoff game against the Washington Capitals with a tight 2-0 grip on their best-of-7 playoff series. An important reason for this was the play of their star captain: Sidney Crosby.

Through 2 games in the series, Crosby had scored 2 goals and added 2 assists. He was, as he had been for much of the preceding year, playing at a level higher than anyone else in the sport of hockey. However, in the first period of game three, the fortunes of the Pengiuns and their superstar appeared to change when he was cross-checked in the face by the Washington Capitals’ Matt Niskanen.

Crosby lay on the ice for several minutes, and was eventually helped up by his teammates before skating off the ice under his own power. ...continue reading

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Ijaz Rauf is President at Eminent Tech Corporation and an Adjunct Professor of Physics, School of Graduate Studies at York University

 

Growing evidence of problems in the level of quality and safety of care across healthcare organizations, along with public awareness, has made the quality of health care the talk of town. This has drawn significant government and regulatory attention to healthcare systems across the country. Health Quality Ontario (HQO) was established with the mandate to monitor and report on healthcare performance in Ontario and the mission to bring about meaningful improvement in health care. Besides reporting on the key performance indicators, HQO holds quality rounds to share knowledge and best practices. Recently, I attended one of HQO’s quality rounds,  and I left with the impression that quality in health care is not considering the right measures, using the right experts or measuring the right data. ...continue reading

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Praveen Ganty is a Consultant in Pain Medicine & Anesthesia in Toronto

 

There is a new fashion in the world of Medicine, and in the world of primary care in particular. It is the reluctance to continue prescribing, or to prescribe, opioids. There are two sides to the situation. As medical professionals, we have realized the potential harm that opioids can cause to potentially any patient, especially if prescribed for chronic non-cancer pain. However, many of us have also decided to stop prescribing opioids to patients who have been on them for many years, which raises some concerns.  The first principle in the practice of Medicine is Primum non nocere-first do no harm - (modified to ‘first do no further harm’ by some authors).

Managing chronic pain is not easy and - let’s face it - most of us don’t have enough training in this area. A 2011 survey revealed that only an average of 19.5 hours are devoted to the management of pain in an average medical school curriculum. ...continue reading

Charlie Tan is a medical student at McMaster University

Lawrence Loh is Associate Medical Officer of Health at Peel Public Health

 

Too often, physicians forget that they might be just one of many sources of health advice that patients access. Behind every physician-patient encounter is a difference in how health and wellness are perceived and pursued. For many physicians, their views and advice are shaped by formal education and training, the Hippocratic Oath, and the insights of colleagues, researchers, and experts. Their patients, by contrast, have a different and often wider range of influences, be it personal beliefs, social networks, or cultural traditions.

Over the last three decades, physician practice has been transformed by two important movements ...continue reading

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Kim Perrotta is Executive Director of the Canadian Association of Physicians for the Environment (CAPE)

 

A month ago the Financial Post published a commentary entitled “They keep saying shutting down coal will make us healthier, so how come there’s no evidence of it?” written by Warren Kindzierski of the School of Public Health at the University of Alberta. It seems a sad statement of our times that this article, which muddies the waters with incomplete facts and misleading information about coal plants, air pollution and human health, was published in the middle of  an important debate about policies aimed at supporting the phase-out coal plants Canada-wide by 2030. The Canadian Association of Physicians for the Environment feels strongly that publication of the article was irresponsible. ...continue reading

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Sarah Currie lives in Ottawa, Ontario

 

I changed jobs this week. On Monday, my first day, when I should have been primarily concerned with learning the office microwave-cleaning rota and orienting myself to a new Xerox print centre, I was a little preoccupied. At 8 pm on Sunday, I found out that my father had fallen, broken his hip, undergone emergency surgery, and was in isolation in a hospital in southwestern Ontario. Details were fuzzy. Hospital staff would not share much with my aunt, my father’s sister. He had managed to call her on Sunday morning, 24 hours after his fall, once he had come round after anaesthesia. He needed her to go to his house to make sure my mom was okay. My mom wasn’t answering the phone.

Unanswered phone calls are not uncommon at my parents’ house. My father is quite hard of hearing, after spending 37 years as an infantry officer. My mother tends not to answer the phone because she is self-conscious. She has a severe cognitive disability ...continue reading

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Doctor Mom is a physician who lives in Ontario*

 

It’s March Break, which means last chance to do winter activities for some families in Canada. Unfortunately, I’m not Winter Fun Mom so I booked Son #2 - the only person in our family who is interested in winter sports - on a bus-in snowboarding camp. On day 1 I warned him to be careful and to try not to injure himself. On day 2 I forgot to warn him. So at 2pm on day 2 I got a call from the snowboard instructor to tell me that my son had fallen and would soon be on his way to hospital in an ambulance.

I know I should be more encouraging of adventure and more accepting of risk-taking in my boys. ...continue reading

Did you hear about Chris’s mint condition 1963 Shelby Cobra? Mechanics say he didn’t check the oil for decades, and the engine just seized one day on the way to work. When they opened it up, they say there wasn’t much left. Such a shame really.

Said Nobody. EVER.

Jazlin Mayhue is a researcher in Victoria, BC

Peter Hobza is a family physician in Victoria, BC

Robert O'Connor is a family physician in Victoria, BC

 

Introducing a new concept...

We all know folks who are not vigilant with preventive health for their body. However, a subset of them wouldn’t drive an irreplaceable million-dollar car until it was destroyed from lack of maintenance. A human’s life and body are irreplaceable, and worth at least a million dollars, when considering the price of an injury causing death. Therefore, it’s logical to help some people think of treating their body as well as a valuable car. ...continue reading