Tag Archives: family physician

NK 2016Nicole Kain is a PhD Candidate in Public Health Sciences at the University of Alberta

Jardine_200x267

Cindy Jardine is a professor in the School of Public Health at the University of Alberta

 

Autumn 2003: Hurricane Juan claims eight lives, destroys countless buildings and residences causing power outages across the Maritimes, and is recorded as the most damaging storm in Halifax’s modern history.

June 2013: Southern Alberta is pummeled by torrential rains, combined with melting ice that causes rivers to overflow their banks; paralyzing communities and resulting in the loss of four lives and an estimated $6 billion in damages. Hospitals are forced to close, physicians can’t get into their offices due washed out roads - including portions of the Trans-Canada Highway.

Summer 2014: the “worst fire season in decades” sees more than 130 wildfires burning in the Northwest Territories ...continue reading

Magbule Doko Magbule Doko is a family physician in Windsor, Ontario, and an adjunct professor at The University of Western Ontario

 

School. Career. Children. Partner. Parents. Siblings. Being a Doctor. Getting Older. Turning 30. Teaching the next generation of doctors. Next step in my career. In-laws. Body. Health. Meditation. Having another baby. Trying to make the world a better place. Trying to understand who I am. Vacation time. Couple time. Debt. Income. Work. People living. People dying. Crying. New life. ...continue reading

Interview with Anna Taddio, Professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto. This guideline, co-authored by Dr. Taddio, provides practical recommendations for reducing pain during vaccine injections in all age groups. Pain from vaccine injections is common, and concerns about pain contribute to vaccine hesitancy across the lifespan.

Also, interview with Dr. Kris Aubrey-Bassler, family physician and associate professor in the Primary Healthcare Research Unit at Memorial University. In their observational study (open access), Dr. Aubrey-Bassler and colleagues analyzed administrative data for all hospital births in Canada (except Quebec) between April 2006 and March 2009, comprising nearly 800 000 babies and 800 000 mothers. Instrumental variable analysis was used to adjust for unmeasured potential confounders. Whether babies were delivered by a family physician or an obstetrician made no difference to perinatal mortality or to maternal mortality and morbidity.

-----------------------------------

Subscribe to CMAJ Podcasts on iTunesStitcher, Overcast, Instacast, or your favourite aggregator. You can also follow us directly on our SoundCloud page. Our podcasts are also released on cmaj.ca and here on the blogs.

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's giving the opening keynote address at the upcoming Swiss Family Doctors Conference 2015 in Bern, which focuses on core competencies in family medicine.

 

What is a family physician?

Many colleges and organisations have tried to define the core competencies of general practice. These include the College of Family Physicians of Canada, the Royal College of General Practitioners in the UK, and WONCA Europe with their definition of general practice /family medicine and the revised WONCA tree illustrating the core competencies and characteristics. Defining the role of the family doctor is difficult ...continue reading

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

 

French general practitioners went on strike today. It’s part of an extended period of industrial action that includes refusing to process paperwork and a number of planned medical centre closures. Not every GP could participate today, however, due to a flu epidemic sweeping across France. Doctors had already closed their offices during December but there was little response from Marisol Touraine, the Minister for Health, and this was part of their planned efforts to maintain pressure.

Money is one problem. The agreed fees paid by l'Assurance Maladie seem modest. Doctors are paid €23 euro per consultation with reported average earnings for 2013 of just over ...continue reading

Rich-Roberts preferredRichard Roberts is Professor and past Head of the Department of Family Medicine at the University of Wisconsin School of Medicine and Public Health. He is immediate past president of the World Organization of Family Doctors (WONCA) 2013-2016. He is a family physician and an attorney.

During my term as President of WONCA, I toured hundreds of hospitals and clinics in more than 70 countries. I never expected to be a patient in one.

In June 2012, I was excited to be attending another national conference of the Spanish Society of Family and Community Doctors (semFYC). I looked forward to reconnecting with good friends and mingling with the several thousand family doctors in attendance . My three flights from Wisconsin, USA to Bilbao, Spain were uneventful. The real excitement began as I was settling in to my hotel room.

About 7 pm, I had the sudden onset of several fleeting episodes of lightheadedness. There were no other symptoms and I felt well between episodes. With a regular rhythm and heart rate in the 60s, I concluded that I had jet lag and dehydration. I pushed fluids and rested the remainder of the first evening.

Although I felt well the next day, I was determined not to be the stereotypical physician trying to be his own doctor. I sought the advice of the semFYC President. Within moments, I was ushered to a nearby health center where my exam and electrocardiogram were normal.

The following day, I had several more episodes while touring another health center. A quick electrocardiogram revealed atrial fibrillation with a controlled ventricular response of 92 beats per minute. My rhythm converted spontaneously to sinus in a few minutes. Even so, my hosts insisted on driving me to a major teaching hospital. Their faces betrayed a mix of sincere concern and worry that an esteemed guest would die on their watch.

My memories of my experience in the Bilbao hospital remain vivid. The 4 hours I spent there seemed an eternity, and yet passed by in a flash. I remember the 40 minute registration process, for someone with an acute cardiac condition! Bureaucracies are the same everywhere. The bright ceiling lights all seemed positioned strategically to make it impossible to keep one’s eyes open while supine. These minor annoyances were much less memorable than the people who looked after me.

Mostly I remember the nurses. The emergency physician breezed by me several times, but it was the nurses who made certain that I knew that someone cared, that I was in good hands. Perhaps that is why I found myself humming the Leonard Cohen song “Sisters of Mercy.” I did so quietly, not wanting to add to the suffering of those around me.

My exam, blood tests, chest x-ray, and electrocardiogram were all normal. The hours of waiting enabled me to call my wife, my family doctor, and a cardiologist back home to inform and to seek advice. Even before I left the hospital, they made arrangements for a more extensive evaluation on my return home.

I later reflected on the miracle of modern telecommunications and on the privilege of being a physician. Mobile telephony instantly connected me across the world to those at home, where I really wanted to be. My colleagues at home made certain that my eventual treatment was swift and skillful. The paroxysmal atrial fibrillation resolved after catheter ablation. Yet, it did not feel right that the system moved faster for me than I was able to make it move for my own patients.

Writing this blog prompted me to look back on the lessons learned and on the priorities I reset for myself as I went through the first major health episode of my life. As a physician, I understood well my condition and the murky state of the science that guided therapy. I was annoyed at the interruption in my busy life and anxious about the risks and possible failure of treatment. As a patient, I assumed and received clinical competence and technical prowess. Better communication and empathy were the two qualities that were sometimes lacking.

As a result of this experience, I resolved to work harder to spend more time with my family and to listen longer, and better, to my patients. A candid self-assessment confirms that I remain a work in progress.

 

* This blog is part of a series that CMAJBlogs is publishing in the lead up to the International Conference on Physician Health #ICPH2014 to be hosted by the British Medical Association September 15-17 in London, UK

3 Comments

MidMainCHC_image

Dr. Ryan Herriot, Dr. Steven Persaud, Dr. Rannie Tao, and Dr. Stephanie Stacey are Resident Physicians in Family Medicine at St. Paul’s Hospital, UBC Faculty of Medicine

 

As family physicians in the first stage of our careers, we look forward to practicing medicine in a world that would be unrecognizable to our predecessors: a world where all patients have access to dedicated "primary care homes,” where multidisciplinary care is the norm, and where siloed, fee-for-service practice no longer predominates.

Therefore, we are very happy that Vancouver’s City Council has voted unanimously to support the continued and expanded provision of multidisciplinary primary care at Vancouver’s Community Health Centres (CHCs), which are vital to the future of frontline health care in this province. However, several of these Centres are facing funding cuts under a plan put forward by Vancouver Coastal Health (VCH). VHC is adamant that their plan is a rational one that will shift resources away from low-needs patients towards high-needs ones. We feel, however, that this a classic example of “robbing Peter to pay Paul.” Many patients will be forced into inferior care models and many “high needs” patients will be forced to travel great distances to a single “super clinic” being created at one CHC, Raven Song. ...continue reading