Sujin Im is a family medicine resident R1 at University of Toronto.
The morning after another 24-hour call shift at labor and delivery, I went for my routine rounding of families who delivered during my shift. Some days, patients all blur together and I am also a blur. Especially when I just feel inadequate and exhausted. But this one morning, the father offered his newborn son to my arms. "Hold him. You helped bring him out to life. You should get to see what you work so hard for." ...continue reading →
Maureen Topps is the Executive Director and CEO of the Medical Council of Canada.
Nothing matters more in my role than helping Canadian and international medical graduates succeed as they prepare to practice medicine in Canada. But what does success look like and how do we measure it?
Grace Zhao is a third year MD/MSc student in the Systems Leadership and Innovation program at the Institute of Health Policy, Management and Evaluation.
Ontario is undergoing its biggest health system reform in 50 years. Under Premier Doug Ford, 20 health agencies will be merged into a superagency – Ontario Health. The rationale behind this is to eliminate duplicative back office infrastructure and administration in order to streamline work to achieve integrated and coordinated care. The functional unit would be the Ontario Health Teams, which are made up of local health care providers who work together to provide coordinated care through technology.
With much attention being placed on health systems innovation and transformation, I asked two health system leaders on their thoughts about leading system innovation and transformation and the current climate of Ontario’s health care system. ...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 →
Mark Speechley is a Professor of Epidemiology at Western University
The age-old debate over who should be addressed as ‘doctor’ lives again in recent letters to CMAJ. Of course, it is important not to confuse the public. Since more people get sick than get university educated, members of the public are more likely to have met a physician-doctor than a professor-doctor. As a PhD epidemiologist, ‘the population is my patient’. Consequently, when I meet my medical colleagues in the hospital, I do not expect to be addressed as ‘Doctor’, but should the whole population be in the hospital, and the crowding in the corridors be so acute that I would have the statistical power to practice my profession by expertly assembling the massed throngs of gurneys into long rows of cases and controls, or exposed and unexposed, as appropriate, I would most certainly expect to be addressed as such. ...continue reading →
Philippe Barrette is a psychotherapist, workplace facilitator and former Assistant Clinical Professor at McMaster University, Department of Psychiatry.
David Streiner is Professor Emeritus in the Department of Psychiatry and Behavioural Neurosciences, and the Department of Clinical Epidemiology and Biostatistics at McMaster University; and Professor of Psychiatry at the University of Toronto.
Halfway through, Roma, the 2018 award-winning film set in the early 1970’s, the audience is suddenly confronted with witnessing a stillbirth. The scene elicited audible gasps from some viewers in a screening we attended, when the perfectly formed, dead baby was removed from its mother’s womb.
In the film, Cleo, the nanny and domestic worker for a middle-class family living in Mexico is rushed to hospital following an emotionally draining 9 months. Cleo’s boyfriend abandoned her shortly after learning of her pregnancy, and the family have endured marital tensions and a separation.
After an initial examination the assisting physician at the birth says, “I can’t hear a heartbeat," ...continue reading →
Pat Rich is an Ottawa based medical writer and editor.
Cometh the hour, cometh the man.
It would be the very height of pretentiousness to apply this phrase to Dr. Liam Farrell, an author and former family physician from Rostrevor, Co. Down, Ireland and I am sure he would be the last person to do so.
But at a time when family medicine seems to be at its lowest ebb, if not globally then very much here in Canada, there is much to be said for having a physician who can so eloquently write about both the rigors and the ...continue reading →
Hillel M. Finestoneis a Physiatrist at the Elisabeth Bruyere Hospital and Professor, Division of Physical Medicine and Rehabilitation, University of Ottawa.
My 52-year-old patient took his BP at a pharmacy on 6 separate occasions. Systolic BP values were high, ranging from 150-177. When I take his BP in the office it’s 168/98. Yup, he has high BP. He’s 10 pounds overweight, doesn’t have diabetes, doesn’t smoke and thinks that he was told that his BP was “probably high” 5 years ago, but he didn’t feel that medications would make a difference.
We talk about weight loss, healthy eating and reducing high sodium foods, that we don’t know why BP elevates but that medications really work and help stop strokes and heart attacks from occurring. He agrees to my prescription of one medication and we discuss its side effects. A drug information sheet is provided. ...continue reading →