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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

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

Iona Heath was a general practitioner in inner-city London for 35 years and is a Past President of the UK Royal College of General Practitioners.  She is a co-chair of the Scientific Committee for the 2017 Preventing Overdiagnosis conference

 

Over the past several decades, the economic interests of the pharmaceutical and medical technology industries have both pressured and tempted medicine to overextend itself.  The traditional moral commitment of the medical profession to relieve suffering and to care for the dying has been gradually displaced by a futile and misguided attempt to solve humanity’s most profound existential problems through biotechnical means.  Doctors now apply more and more powerful treatments towards the end of life and try to prevent diseases by seeking out and correcting more and more risk factors.  All this has led to an epidemic of overdiagnosis ...continue reading

AedanCoffeyAedan Coffey is a consultant electronic design engineer working in Ireland

 

We got hacked. Some nice person somewhere in the world managed to get into the little black box that connects our house to the internet and modify it. The result was that every time anyone in the house clicked on a link on a web page they were misdirected to some rather unsavoury ones instead.

To us this was merely an unpleasant inconvenience; no permanent damage was done and a few days later we had a new router and it was all fixed. But what happens when a medical device gets hacked? It’s probably not too serious if somebody manages to download all the data from the activity tracker on your wrist, but imagine the consequences of a pacemaker that is suddenly set to defibrillate continuously at its maximum power, an insulin pump that delivers its complete reservoir of insulin in a few moments or a ventilator that just stops working without any alarms going off.

You may think these things can’t happen. ...continue reading

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VKoskenojaphoto

Viktoria Koskenoja is an emergency medicine resident in her fourth year of the Harvard-Affiliated Emergency Medicine ResidehaleyKcochranency

 

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

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Ryhana DawoodRyhana Dawood
Western University
Class of 2016

“I have stage 4 lung cancer. I’m dying and this is where I will spend my last days.”

I listened as a vulnerable, palliative, homeless man told our team about his life in a homeless shelter in Toronto. I watched him and thought of my great aunt who passed away from cancer, surrounded by her loved ones, housed, safe and comfortable. I was left feeling ashamed - how could we allow people to pass in such circumstances? ...continue reading

Interview with Dr. Elissa Abrams, Pediatric Allergist Immunologist with the Faculty of Health Sciences at the University of Manitoba. Guidelines used to recommend that parents avoid feeding their infants common allergenic foods in their first year, but expert advice has recently changed. Emerging evidence from randomized controlled trials suggests that early introduction of allergenic foods, particularly peanut, is protective against the development of food allergy. Dr. Abrams and her co-author Dr. Allan Becker discuss the updated recommendations in their analysis article in the CMAJ (subscription required) that examines food introduction and allergy prevention in infants.

...continue reading

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Dr. Harpreet Sood Dr. Mahiben Maruthappu

Dr. Harpreet Sood and Dr. Mahiben Maruthappu

Harpreet Sood and Mahiben Maruthappu are Senior Fellows in the office of the Chief Executive for NHS England.

Over the last decade, the NHS has achieved a lot. It has been ranked the number 1 healthcare system in the world, public satisfaction has almost doubled, cancer survival is at its highest, and early deaths from heart disease down by 40%. Central to this achievement has been general practice as it continues to be the cornerstone of the health system, with 99% of the population registered with a general practice today.

There are an estimated 340 million consultations that occur in general practice today but the demand across the health system is rising. An estimated 70% of the NHS budget is spent on long term conditions but the number of people of choosing to become a GP is not keeping pace with the growth in funded training posts.

Therefore as a health system we need to look for innovative ways to keep up with the demand and ensure primary care remains a key component of the NHS.

Models of care

Primary care of the future will build on the traditional strengths of ‘expert generalists’, proactively targeting services at registered patients with complex ongoing needs such as the frail elderly or those with chronic conditions, and working much more intensively with these patients. Future models will expand the leadership of primary care to include ...continue reading

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Mona 2015 Mona Al-Taha
Dalhousie University
Class of 2017

 

 

 

 

 

Patient M. presents to clinic,
Melanoma of the Heel.
Surgically excised,
Radial forearm free flap,
Doing well post-op.

Day 1 - How is the flap?
It's looking well-perfused, Dr.

Day 2 - Is it congested? Should we revise?
Let's operate.

...continue reading

NotSureGraeme Rocker is a professor at Dalhousie University in Halifax

 

 

Editor’s note: Part I of this series appeared as a Humanities article in CMAJ; part II appeared on CMAJ Blogs.

Days 1–4

Early days at home, with no major events until day 3. I simply could not get warm. It was the same on day 4. My extremities felt like blocks of ice coupled with which I had persistent cramps in hands and feet that wouldn’t shift. It finally dawned on me that this might be carpo-pedal spasm in a setting of some subconscious hyperventilation caused by overall discomfort. Whatever the cause, it was a lousy way to spend a day.

Day 5 Intense bladder spasms coupled with colonic gas distension pain made for, if not the worst pain, certainly the most discomfort yet. I don’t know if there’s such a thing as a horrible orgasm, but a bladder spasm in the early stages must come close to it. It’s a foul experience and for 5, 10, 15 seconds you pray for relief from an internal surge of gargantuan proportions and thank some deity when it passes. ...continue reading