“I want to quit my chemo. I can’t take the nausea. My drug is not available and the other things just don’t work.” It was November 2010 and in front of me sat a 50 year-old widowed mother of two with uncanny, pale green eyes and stage IV cancer; she shook with nerves and defiance. Her support drug was prochlorperazine, which has been around as long as I have. “That’s impossible!” I said and picked up the phone to call her pharmacist. He sounded weary, but politely explained that there was none left in the entire city. “But,” he added, “you can prescribe XXX.” Well, although XXX is fancy, new, and expensive, it did not work for my patient. I smelled a rat.
We quickly discovered that this “shortage” was just one of many that had been increasing ...continue reading →
Alumni of The Graduate Institute Geneva include former Secretary-General of the United Nations Kofi Annan. It seemed to me to be the obvious choice for a course on Global Health Diplomacy. Geneva hosts many of the well known international organizations in the world, including the headquarters of many of the agencies of the United Nations and the Red Cross. I joined a group of 30 executives from all over the world who got together to learn and share on the topic of Global Health Diplomacy. There were participants from government sector as well as the private sector, Ministers of Health and of Finance, diplomats and doctors, academics, clinicians, policy developers, philanthropists and activists. In a relatively short period of time we got to know each other, learn from each other’s diverse backgrounds, and build relationships. ...continue reading →
Bill Cuddihy is a former Chief Medical Officer of Athletics Ireland and has been a member of the Anti-Doping Committee of Irish Sports Council since 2007
The doping problem is slowly killing many sports, especially Olympic sports like Track and Field Athletics. Major changes are required in how we tackle these problems. But how far away are we from Standardisation and Harmonisation in the world of anti-doping? The answer is, a long way. ...continue reading →
Mike Loosemore is Lead Consultant Sports Physician at the English Institute of Sport, Exercise and Health; he is currently at the Rio 2016 Olympics
Have you noticed that the male competitors in Boxing don’t have to wear head guards at the Rio 2016 Olympics? This may seem odd, perhaps. However, the requirement to wear head protection has been removed for the first time since it was introduced in 1984 at the Los Angeles games. In the lead up to the 1984 Olympics, concerns about brain damage as result of boxing led to a strong anti-boxing feeling within the medical profession. It was under pressure from the medical profession to make boxing safer that head guards were introduced. ...continue reading →
Paul Dhillon is a Clinical Assistant Professor in Academic Family Medicine at the University of Saskatchewan
Twenty-two physicians from across Canada recently left their examination rooms and operating theaters behind for a unique opportunity to represent Canada internationally at the World Medical Football Championships in Barcelona, Spain.
The championships have been occurring annually for 22 years with an associated medical sports and health symposium offered concurrently. This was Canada’s first ever team to participate. Canada was represented from coast to coast with physicians from Halifax to Vancouver selected for the team (see a full list of players below).
We began the tournament in a difficult group that contained the eventual runners-up, Sweden, and the 4th place finishers Australia ...continue reading →
The Complex Care Initiative at Sick Kids began in 2006, in memory of the late pediatrician Dr. Norman Saunders. For ten years it has opened its doors to children with multiple and complex health challenges, often to those who could not find adequate care anywhere else.
For Ian Brown’s 19-year-old son, Walker, who was diagnosed with a rare genetic disorder at birth, the care provided more than just resources to manage his health. It was the first time his son was not just treated as a patient, or problem to be fixed, but a human being. ...continue reading →
Often when we talk about improving health care, we turn to the Triple Aim. Developed in 2007 by the Institute for Healthcare Improvement (IHI) in the United States, the Triple Aim captures three objectives for a better quality health system: Improving a patient’s experience of care, improving population health and doing this at a reasonable cost. It has become a way of thinking embraced by many health care systems around the world.
The Triple Aim takes a big-picture, system-wide approach that can be applied to any part of the health care system, as well as across all levels of an organization. The ultimate endgame is a sustainable health care system that patients trust and that contributes to healthier populations.
Viktoria Koskenoja is an emergency medicine resident in her fourth year of the Harvard-Affiliated Emergency Medicine Residency
Haley K. Cochrane is an emergency medicine resident in her second year of the Harvard-Affiliated Emergency Medicine Residency
We are Canadian women, born and raised in northern Canadian communities. We are both training to be emergency physicians at the Harvard-Affiliated Emergency Medicine Residency in Boston. While we would like to come home, there are only massive barriers before us.
There is a known scarcity of emergency physicians (EPs) in Canada. The combination of physician shortages, as well as a concentration of specialists in urban centers, has led to regions where up to 70 percent of ED providers have no formal emergency medicine (EM) training. “With a national shortage of trained emergency physicians, most Canadians will continue to have their emergency care delivered by family physicians,” states the Canadian Association of Emergency Physicians, “[with] no guarantee that the family physician staffing a community ED will have adequate training in the management of actual emergencies or in resuscitation.” In recognizing these workforce issues, the CAEP recommended increasing residency spots for CCFP (EM) and FRCP-EM programs as well as increasing the use of mid-level providers. But what about a simpler, more cost-effective option—allow U.S. trained EPs to return to Canada? ...continue reading →
Peter Uhlmann is a semi-retired psychiatrist from Powell River, BC. He works as a locum consultant psychiatrist to several Northern communities.
In 2004 I started providing psychiatric locum service to Yellowknife, in the Northwest Territories. I worked in the local mental health centre and also on the psychiatric ward at Stanton Territorial Hospital. Later I travelled to three other communities; Hay River, Ft Smith, and Ft Simpson. For a few years I served those three communities on a regular basis every three to four months. As well as seeing patients, I would provide in service to health providers and education to community agencies. In 2006, I began working in four Inuit communities in Nunavut, specifically in the Kitikmeot region. I would service Taloyoak, Kugaaruk, Gjoa Haven, and Cambridge Bay. I still travel to these communities twice a year, and provide back up consultation via telehealth, telephone, or email. ...continue reading →
Canada’s health ministers will meet in Vancouver on January 20, 2016. It is good to know we have a federal government that will engage with the provinces on health care. Let’s hope they will engage on health, not just health care.
Forty years ago, the Trudeau government of the day produced the fabled Lalonde report. It became the first government in modern times to acknowledge that further improvements in the health of the population would not come primarily from more health care. ...continue reading →