Editors’ Blog

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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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Kirsten Patrick is Deputy Editor at CMAJ

 

Yesterday an open letter addressed to the leaders of Canada's federal political parties was published calling for a firm commitment to implementing a universal, comprehensive, public pharmacare plan for Canada in election manifestos. I signed this letter, along with my colleague, CMAJ Deputy Editor Matthew Stanbrook, the former federal Minister of Health Dr. Jane Philpott, 537 other physicians, and 700+ more academics and policy experts. Altogether, there are 1282 signatories.

I signed it because, in Dr Philpott's words, ...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

The declaration of Alma Ata, over forty years ago, was a key milestone in the development of general practice. Generations of physicians may remember how it defined their career. Dr Shannon Barkley, World Health Organisation Technical Officer for Primary Health Care Services and Family medicine, described the changes that have occurred since then, leading to the 2018 Declaration of Astana. Looking back, we can see why the Declaration of Alma Ata was so important and how the principles outlined are still as fresh and relevant as they then were. There has been progress although different countries move at different speeds. “Health for all by the year 2000” wasn’t achieved but the Millennium Development Goals” were quite successful and the focus has been, more recently, on universal health coverage. I asked Shannon to tell us a little more about the Declaration ...continue reading

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

Resources for primary care in the United Kingdom are under increasing pressure, as Dr. Jennifer Dixon, Chief Executive of the Health Foundation, outlined in her keynote address to the  Society for Academic Primary Care meeting in Exeter last week. A healthy growth in spending from about 1990 until 2008 was followed by a rather dismal change in the funding landscape: the proportion of overall health spending allocated to primary care gradually declined and has now been flat for the last 6 years at roughly 9%. Overall, however, spending on health as a percentage of GDP is about average within the EU and despite austerity policies, spending on health has been relatively well preserved compared to education, for example. When it comes to public satisfaction with primary care, the main problem mirrors what we see in Canada - access. ...continue reading

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 

 

meta static
food undigested on the chest
breasts already pancakes
they will laugh when reaching under
the napkin of my body

they the strong
they the knowledgeable

will the question caught on my throat
survive the morning ...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.

 

Research conferences should be an opportunity to gain insights from discussion and collegial debate about new research. At times, though, I have seen debate become adversarial and counterproductive; questions can be aggressive and speakers defensive. But one of the great attributes of the North American Primary Care Research Group annual meeting (NAPCRG) is the culture intellectual rigor yet respectful and collegial discussion, and the support for early career researchers. Researchers with impressive track records in publication in international journals are always keen to share their knowledge and help their colleagues. David Meyers, a long time NAPCRG supporter unable to attend the conference this year due to illness sent a video message in which he said, "May you find meaning in your work and friendship in your colleagues." ...continue reading

Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.

 

Liveability. What a cool, trendy word that immediately paints a vibrant picture in your mind. We know instinctively what it means as it conjures up an image of a healthy environment, an active lifestyle and personal wellbeing. No surprise, therefore that its used in advertising  to sell everything from domestic products to real estate.  If, on the other hand, we talk about the social determinants of health, most people don’t really know what we mean and they switch off. But, liveability gives us a common language to explain how there is so much more to health than just medicine.

This was a recurring theme at the conference on Creating Active and Liveable Societies hosted by the Centre of Excellence for Public Health in Belfast with a host of international experts. ...continue reading

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Kirsten Patrick is Deputy Editor at CMAJ

 

A week ago, André Picard published a column in the Globe and Mail entitled “How many people actually suffer from mental illness?” and later he tweeted his thanks to readers for making that column the publication’s most-read story of the day. The column may have been well-read - it certainly sparked controversy on social media - but it wasn't because Picard had anything very profound to say. In fact the piece was based on an epidemiological faux pas, which is why I called it a nothingburger.

Commenting on the findings of a poll commissioned by Sun Life Financial Canada, which found that 49% of Canadians have “experienced a mental health issue” at some point in their lives, ...continue reading

Barbara Sibbald is associate editor, Humanities, at CMAJ

 

After ten years, eight annual meetings and countless, long discussions the new Canadian Association of Health Humanities (CAHH) is up and running. According to its constitution, the CAHH aims to “add significant value to the interdisciplinary cultures of medicine, health care and the field of health humanities locally, nationally and internationally.”

On April 27, some 120 registrants at Creating Space VIII, the annual health humanities conference ...continue reading

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Kirsten Patrick is Deputy Editor at CMAJ

 

Rising awareness of the toll that physician burnout is taking on our profession and our healthcare services has inspired numerous organizational physician wellness initiatives and resilience courses aimed at individual physicians. Yet, as experts discuss the relative merits of the system-level approach vs. the individual-wellness-training approach to addressing burnout, one key element seems to be all-but ignored: the healing power of the relationship between physicians and the patients they serve.

Dr. Tom Hutchinson, in his book, Whole Person Care: Transforming Healthcare (Springer International Publishing AG, 2017), suggests that we have lost touch with “the interior processes of healing and growth in the individual patient and the practitioner that give meaning to illness and to healthcare,” ...continue reading