Tag Archives: meded

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CMAJ Photograph OgunyemiBoluwaji Ogunyemi is a Dermatology Resident Physician in Vancouver, BC, and a freelance writer for the Huffington Post, Ubyssey Newspaper, and the Online Journal for Community and Person-centered Dermatology

 

Few topics evoke as much controversy and emotion as that of race.

Though much has been said about differences in the physiology of minority groups seen as “other”, there exists no clear consensus of the meaning and utility of these findings.

Through much of the 19th and early 20th centuries, medical experiments were performed on vulnerable populations including the infamous Tuskegee University-affiliated investigation concerning “Untreated Syphilis in the Negro Male” and those carried out by the Third Reich.

     It is, in fact, a physician whom we can credit - or blame - with being the first to use the term “race.” In his 1684 novel ...continue reading

 

Kira Payne photoKira Payne MD, FRCPC, is a recently retired psychiatrist and jazz musician living in Toronto, Ontario

 

You would think it would be easy to be an expert in the information age: all those books and journal articles, indexed in libraries, ready and waiting to be perused; all those digital bits and bytes coursing through the internet, searchable on academic databases or Google; all those archived videos on You Tube providing information on everything from how to calculate Pi to how to fold a t-shirt in only 2 seconds. Wikis abound, democratizing information, enabling it to exist in a continuously amendable form. Information is everywhere and growing exponentially. It is “kid in a candy store” stuff, right? But there is something sinister about the overabundance of information. Reminiscent of a Grimm fairy tale, there is the very real possibility of paradoxical starvation despite the bounty. ...continue reading

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Greiver_photoMichelle Greiver is a family physician with the North York Family Health Team in Toronto

 

As a family doctor, I sometimes wonder if I provide too much care for some patients in my practice. Do my elderly patients with diabetes need very low A1Cs? What about the risk of falls and fractured hips due to hypoglycemia associated with enthusiastic use of diabetic medications? Should patients over the age of 90 really be on a statin? Should they be on anything that does not improve their quality of life? Perhaps I should be asking them what they would like? ...continue reading

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Patrick_ODonnellDr Patrick O’Donnell is a Clinical Fellow at the University of Limerick and works on the Partnership for Health Equity project. Last week he attended WONCA Europe 2015 Congress as the recipient of the 2015 WONCA Europe Montegut Scholarship

 

Nobody could have predicted the desperate state in Syria when the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Europe Conference for 2015 was awarded to the Turkish Family Medicine Organisation  (TAHUD) a few years ago. Few could also have predicted that Turkey would be at the very centre of a mass exodus of people not seen in Europe since the Second World War. According to the UNHCR as of September 2015 the country now finds itself providing refuge to an estimated 2 million Syrians fleeing conflict and destitution. I have heard the current situation being described as a ‘stress test’ of the European values of solidarity and collegiality, ...continue reading

JTepperDr. Joshua Tepper is a family physician and the President and Chief Executive Officer of Health Quality Ontario, the provincial adviser on health care quality

AGlassman

Written with Alanna Glassman, writer and editor at Health Quality Ontario

Recently, members of the health care community and the public at large mourned the loss of neurologist Dr. Oliver Sacks. My grandfather, also a neurologist, sent me one of Dr. Sacks’s books when I first expressed an interest in applying to medical school. I have since enjoyed many of his other written works.

Earlier this summer, the health care community also lost another tremendous leader, Dr. David Sackett, the father of evidence-based medicine. On my first day of medical school, I remember receiving one of his books too, and to this day it remains a fixture on my bookshelf as a resource.

It may seem odd to bring these two doctors together, because they held such divergent views of the clinical world. ...continue reading

RThom photoRobyn Thom is a PGY 1 psychiatry resident at Harvard Longwood

 

It was a winter afternoon when I came to the shocking realization that although I was only months away from becoming a doctor, there was a significant subset of the Canadian population that I lacked the medical knowledge to care for. I was working at the Gender Identity Clinic at the Centre for Addiction and Mental Health (CAMH), where patients undergo psychiatric assessment to qualify for provincially-funded gender reassignment surgery. There, not only did I find myself listening to my patients rattle off multiple behavioural, hormonal, and surgical options for gender transition that I had never heard of before, but I also gained an appreciation for the degree to which skilled healthcare for transpeople in Ontario is lacking. ...continue reading

Bruce Guthrie05_resizeBruce Guthrie is Professor of Primary Care Medicine at the University of Dundee in Scotland. He is a keynote speaker at this week's Society for Academic Primary Care annual conference in Oxford.

 

Multimorbidity is usually defined as present when people have two or more chronic conditions. It’s an idea that appeals to medical generalists because it makes clear that specialist care that only focuses on one of those conditions may sometimes be too narrow, particularly when someone has very many conditions or when the conditions they have are very different. Physical and mental health conditions are the exemplar of the latter, with many countries having separate services ...continue reading

MichaelGarfinkleMichael Garfinkle is a Nephrology Fellow at the University of Calgary

 

The practice of evidence based diagnosis is what we are taught we should all do, but, in practice, this is quite difficult. EBM diagnosis relies on likelihood ratios, but it’s impossible to remember the diagnostic accuracies of the thousands of tests that exist.

 This is why I made a simple tool to help with the scientific diagnosis of diseases spanning most specialties. It is a database of over 700 likelihood ratios of tests (history, radiology, physical exam etc.). The likelihood ratios are completely free for all to access ...continue reading

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declanfoxDeclan Fox is a Family Physician in Tignish, PEI

 

Dubrovnik, Croatia, was the setting for this year's WONCA rural practice conference. This is an amazing small city, the so-called 'Pearl of the Adriatic' and a tourist attraction since the late 1800s.

We are two nurses and a physician from rural PEI who took on the job of resurrecting an old medical practice, starting on a very part-time basis in the fall of 2013 and going full-time a year later. The “why” of it is far too long a story for this blog but I have blogged about it before.

We were trying to find some good multi-disciplinary CME in Canada for us three to attend last year. We failed, of course. And then one of us suggested the 13th WONCA world rural health conference as a place where we would likely meet like-minded professionals who were concerned about the systems aspect of rural health care as well as the individual encounters. ...continue reading

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Kirsten_headshot

Kirsten Patrick is Deputy Editor at CMAJ

 

Yesterday, after a long public consultation by the Human Fertility and Embryology Authority and a heated debate and vote in the English House of Commons, it began to seem likely that the UK will be the first country to allow the practice of mitochondrial transfer (albeit with safeguards). If the House of Lords approves it, this will result in an amendment to the UK’s 2008 law regulating IVF, embryological manipulation and pre-implantation genetic therapies. We’re effectively seeing glimmerings of a green light for the creation of ‘three-parent babies’ in the UK.

I've been following this process closely. Once I understood the reason WHY mitochondrial transfer is important in the prevention of certain serious diseases of mitochondrial DNA, I felt convinced that legalising it was the right thing to do. ...continue reading