Puneet Sethis a practicing family physician in Toronto, part-time Assistant Clinical Professor (Adjunct) in the Department of Family Medicine at McMaster University and Chief Medical Officer of InputHealth Systems
As someone whose life is deeply entrenched in health care technology, both as a physician tinkering with a variety of digital health tools in my own practice and as an entrepreneur helping to build these tools, I've become acutely aware of the growing trend among health professionals in viewing "virtual care" as some kind of magical endpoint that will solve all of the woes of health care. ...continue reading →
Caitlin Dunne is a Co-Director at the Pacific Centre for Reproductive Medicine (PCRM) in Vancouver and a Clinical Assistant Professor at the University of British Columbia.
A new study published in the Journal of the American Medical Association (JAMA) Pediatrics has linked fertility treatment with a risk of childhood cancer. The researchers linked data on babies from an American fertility database with birth and cancer registry data from 14 states. Their study spanned an eight-year time period, including 275 686 children conceived by in vitro fertilization (IVF) and 2 266 847 children who were conceived naturally. The focus was on young children, up to four and a half years old. ...continue reading →
Imagine yourself as a family physician seeing a 68-year-old woman with type 2 diabetes, chronic obstructive pulmonary disease, hypertension, and chronic knee pain. While these medical concerns are well-managed, things for your patient are tough socially. She has become increasingly isolated since her husband passed. Her apartment is in an older building with good heating but no air-conditioning and near to no sidewalks, green spaces, or public transit routes in the area. She often requires friends or a cab to drive her around.
How can you assess and mitigate the acute and chronic environment-related health risks faced by this woman, and other patients like her? ...continue reading →
Raafia Siddiqui is second year medical student at McMaster University.
The surgeon asked me for the second time, “So are you here alone?” “Yes”, I answered, this time a bit impatiently. I was a 20-year-old with other things than this appointment but my family doctor had noticed a lump on my throat and insisted I see a specialist. We were supposed to discuss the results of the biopsy today.
After my response, the surgeon placed his hand on my shoulder and let out a long sigh. I asked him, “What is it?” His reply was very short and urgent, “There’s a lump - and we have to take it out”.
Immediately, I understood what he meant and began pressing him with questions, “Is it malignant? Has it metastasized? What type of cancer is it?” Although I felt I had to pry answers out of him, the specialist finally told me I had a thyroid tumour, which he believed had begun to spread.
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 →
Iris Gorfinkel is a General Practitioner, and Founder and Principal Investigator at PrimeHealth Clinical Research in Toronto, Ontario.
On July 10, 2018 Health Canada issued a recall of several products containing the blood pressure lowering drug, valsartan. This came in response to a disclosure from its Chinese manufacturer that the drug had been contaminated with a known carcinogen. A massive effort to contact patients to stop the affected drug lots, and to replace it with an alternative, ensued. Few clinicians had been even remotely aware that ...continue reading →
Emily Harris is the Business Manager for the Heart and Vascular Program at Unity Health Toronto – St. Michael's Hospital
Healthcare is a varied and multidisciplinary world. From clinical medicine to social work to data collection, expertise from many diverse specialties is required to ensure that hospitals run successfully and that patients receive the very best care.
Courtney Bercan is community health nurse at a clinic in the Downtown Eastside of Vancouver
Years later, I still don’t want to think about it, let alone type it out. Three children, babies practically, dead before me. Their parents, dead beside them.
It has now been two years since I was on a Doctors Without Borders search and rescue vessel in the Mediterranean and it’s been a slow path, at times, to finding healing and peace for the things I saw and experienced there. As my life settled into a predictable rhythm, the memories started coming out of the blue and with intensity. They demanded attention. Normally, in Canada, the process of finding closure for a patient’s death, while not always easy, is not usually this difficult. There are mitigating thoughts and phrases to help you along the way:
Sarah Tulk is a family physician in Hamilton, Ontario
Despite earnestly advocating for physician mental health, my own story has remained cloaked in secrecy. As a medical student, I felt far too junior to risk such a revelation. I watched as stigma, perpetuated by the hidden curriculum, kept my peers from seeking mental health care. Still, I kept my head tucked safely in the sand, and swore to break my silence in residency. However, as a resident the fear of jeopardizing job prospects maintained my mutism. I vowed to speak up when I was staff. Unfortunately, early in my staff career my advocacy efforts were smothered by fierce judgment and harsh consequences. I wholeheartedly renewed my vows with the ostrich approach and reconciled to start talking about mental health when I was protected by more seniority. I hated the secrecy and hypocrisy, but at least I was safe. Then I heard of another resident suicide. Then a medical student. Another resident. A staff physician. ...continue reading →
Sarina Lalla is a medical student in the Class of 2020 at McMaster University
When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.
However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading →