Medical Dispatches

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Matthew Yau and Krish Bilimoria are medical students in the Class of 2022 at the University of Toronto

 

Yosef Ellenbogen is a medical student in the Class of 2020 at McMaster University

 

 

Canada recently entered a trade agreement with the USA and Mexico: the USMCA. The new agreement has been pitched to Canadians as a progressive way forward that will grow our economy and strengthen the middle class. Eclipsed by discussions on preserving dairy supply chain management and automobile manufacturing was the subtle extension of patent protections for biologic drugs. Chapter 20, Article 20.F.14 of the USMCA allows for the extension of patents for registered biologics by 2 years, a total of 10 years of patent protection (2). The subject of patent exclusivity has historically been a sensitive topic in diplomacy, and was a contentious negotiating point between the US and Australia in the development of the original Trans-Pacific Partnership (TPP) in 2015. This seemingly benign change has serious implications for the future of Canada’s health system. ...continue reading

Alastair McAlpine is a fellow in paediatric infectious diseases at BC Children's Hospital in Vancouver

 

People sometimes ask me, "What’s the difference between medicine in Vancouver and medicine in Cape Town?" The answer is, quite simply, Everything.

But let’s rewind a bit. In July of this year, I flew the 20 or so hours it takes to get from South Africa to Vancouver. I arrived in the city by myself with 2 suitcases, knowing hardly a soul, and feeling completely overwhelmed. A few months earlier, I had been accepted into a 2 year paediatric (even the spelling is different) infectious diseases program at BC Children’s Hospital. Before coming I had filled out endless paperwork, done a million online courses ...continue reading

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Katherine Atkinson is a PhD student at the Karolinska Institutet in the Department of Public Health Science.

Cameron Bell has a B. Eng from McGill and is the lead technical architect for the CANImmunize project.

Kumanan Wilson is a physician and senior scientist at the Ottawa Hospital, Professor of Medicine at the University of Ottawa, and lead at the Ottawa Hospital mHealth Lab

 

As they accumulate their “10,000 hours” of caring for patients or examining the health system, health care providers and researchers often come up with great ideas on how the system could be improved.  The advent of digital technologies and mobile apps has helped to tear down the barriers to introducing these newly devised solutions and created opportunities for a new breed of medical entrepreneurs.  You may want to build an app that will help you get critical information to your patients because you know this is why they are having trouble staying healthy.  Or perhaps you want to empower them to manage their own health care by tracking aspects of their health.  Or maybe you have an idea that could allow physicians to do simple diagnostic tests at the bedside using smartphones.

At the beginning of 2018, there were almost 100,000 health apps on the Apple iOS App Store and Google Play. Health and fitness apps are cited to have the highest user retention rates, engagement, and frequency of use ...continue reading

Dr. Susan Sutherland is Chief of Dentistry at Sunnybrook Health Sciences Centre and President of the Canadian Association of Hospital Dentists

 

 

Dentists in community practices usually work in isolation from our physician colleagues. Often, dentists  prescribe an antibiotic to patients in advance of minor dental procedures like root canal therapy. Evidence shows us that the prophylactic antibiotic use for most patients is not necessary in these cases. And, if the patient develops a C. difficile infection several weeks after the unnecessary antibiotic, the dentist is usually not informed of this until the patient is seen at their next checkup – if at all. Not only do dentists not usually get feedback about the adverse event caused by inappropriate antibiotic use, they are also unaware of their role in the emergence of antimicrobial resistance.

For reasons such as this, the Canadian Association of Hospital Dentists has recently joined the Choosing Wisely Canada campaign. ...continue reading

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This article is co-authored** by (top row) Christina M. Nowik , Pamela Lai, Thomas McLaughlin, Simon Moore, (bottom row) Gillian Shiau, Natasha Snelgrove, Nureen Sumar, and Jasmin Yee, all of whom previously served on the Resident Doctors of Canada (RDoC) Resiliency Working Group

 

For Canadian resident doctors, July 1st is more than a national holiday; it represents the day when newly-minted doctors become responsible for decisions in patient care.  While this is an exciting day, it can also be fraught with anxiety and stress. Over the course of residency, acute work-related stressors, including traumas and patient deaths, can negatively impact residents’ wellbeing.  Additionally, residents endure chronic stressors such as large debts, extended work  hours, and isolation from family.  These factors predispose residents to burnout. The prevalence of burnout among resident doctors is up to a staggering 75%. Resiliency interventions have been shown to work, and the time to begin implementing them nationwide is now. ...continue reading

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Reza Mirza is a second year Internal Medicine resident at McMaster University

Justin Hall is a third year Emergency Medicine Resident at the University of Toronto.

Odion Kalaci is a PGY-3 in Pediatrics at the University of British Columbia

(All authors are members of the Practice Committee of the Resident Doctors of Canada - RDoC)

 

In Canada, 38 percent of recently graduated specialists are unemployed or underemployed with a further 31 percent having delayed entering the job market altogether according to a Royal College report. Thus, many of us will struggle. As residents and members of Resident Doctors of Canada (RDoC), this report is alarming as it reinforces existing job-security anxieties. And yet Canadian patients face the longest wait times among high income countries. Consider: 29 percent of patients had to wait four or more hours for an emergency room visit, compared to one to four percent in Germany and France according to a Commonwealth Fund report.

Specifically, the report reveals that 16 percent of specialist physicians were unable to secure employment three months from certification. This excludes 22 percent of new physician graduates who piece together an income by combining locum and part-time positions (they wryly self-identify as “locum-ologists”) ...continue reading

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Tanishq Suryavanshi is a medical student at McMaster University

Blair Bigham is an emergency medicine resident at McMaster University and a freelance journalist

 

Bandar Baw is an assistant professor, emergency physician and toxicologist at McMaster University

 

 

The early part of 2018 has seen the rise of the “Tide Pod Challenge”, in which people have posted viral videos of themselves attempting to eat laundry detergent pods from a variety of brands. The number of poison control calls for laundry detergent pod poisoning in the first 15 days of 2018 already equalled all calls in 2017, thanks to internet viral videos. These ingestions pose a significant concern for the healthcare system, as care spans a variety of disciplines and is a presentation that many may not be familiar with. ...continue reading

Dr. Carol Ann Courneya is an Associate Dean of Student Affairs at the University of British Columbia

SHATTERED by Sonam Maghera, Student, U of Ottawa Medicine

For the past eight years, the Canadian Conference in Medical Education (CCME) has acted as host to a fabulous medical trainee and practitioner art exhibit.  Called White Coat Warm heArt, it celebrates coast to coast Canadian medical creativity.

CCME participants routinely visit the exhibit, seen by many as a sanctuary for reflection in an otherwise busy conference setting. There are benefits for the trainees and practitioners in making the art ...continue reading

Nicole Le Saux is Associate Professor in the Division of Infectious Diseases at the University of Ottawa *

 

As physicians we should be concerned about the inappropriate use of antibiotics. Have you ever had a patient with an extended spectrum beta-lactamase (ESBL), E. coli or Klebsiella urinary tract infection, a Clostridium difficile infection (CDI) or a drug-resistant N. gonorrhoeae?

Whereas resistant bacteria and CDI were rare a decade ago, these clinical situations are now commonplace in hospitals, long term care facilities and emergency departments. According to the Canadian Antimicrobial Resistance Surveillance System Report 2016 the rate of CDI in hospitalized patients is 3.4 cases per 1000 patient admissions (approximately one in every 300 patients admitted). As of 2014, 18.2% of isolates of Neisseria gonorrhoeae were resistant to penicillin with worrisome decreased susceptibility to cefixime, ceftriaxone and azithromycin. ...continue reading

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Barbara Zelek is Associate Professor and Co-Chair for the Section of Family Medicine at the Northern Ontario School of Medicine

 

Marathon, a rural community on the North shore of Lake Superior, made CMAJ headlines in 1997 because it boasted a stable workforce of seven physicians for the first time in over a decade. 2017 marks the 20th anniversary of that CMAJ article and of the arrival of Dr. Sarah Newbery and Dr. Eliseo Orrantia in Marathon.

The article described “a medical renaissance” taking place in Marathon and an end to “the revolving door that has affected rural medicine across the country”. That door has stopped revolving in Marathon since 1997 thanks, in many ways, to the leadership of Eli and Sarah.

Let me put this important milestone in context. ...continue reading