Tag Archives: patients

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Interview with Dr. Camilla Zimmermann, head of the palliative care program at UHN in Toronto, associate professor and Rose family Chair in the Department of Medicine at the University of Toronto, as well as senior scientist at Princess Margaret Cancer Centre.

In a research article (open access) she co-authored, Dr. Zimmermann conducted interviews with patients and their caregivers in an effort to understand attitude and perceptions about palliative care. Early palliative care improves quality of life, symptom management and satisfaction with care in patients with advanced cancer. However, stigma associated with the term palliative care may be a barrier to timely referral.

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QFufXYgd_400x400Medical Students, Henry Annan (Dalhousie University), Jackie Vanek (University of Ottawa), Jacquie Lu (Queen’s University) and Dorothy Yu (University of Manitoba), are the CFMS team responsible for Humans of Pharmacare

 

 

TEN. This is the percentage of Canadians who are unable to afford their prescribed medications.

NINETY-ONE. This is the percentage of Canadians  in favour of a Universal Pharmacare strategy for Canada.

SEVEN BILLION. This is the amount of Canadian dollars that could be saved on prescription drug expenditures every year.

The statistics speak for themselves. The evidence, published in countless editorials and reports across the country, is difficult to deny.

On average, our country spends 30% more than our OECD peers on prescription drug coverage. Of these nations, Canada has the fastest rising drug costs. These costs are often shouldered by our patients due to the low proportion of public funding for pharmaceutical products. Our current system is fragmented and inefficient, leading to profound inequities with regards to who gets to fill their medication prescriptions and thus, who gets to access our health care system. ...continue reading

dprDawn Richards provides project management consultant services to the Canadian organization Network of Networks (N2). She also works as a patient consultant for other organizations.

 

Have you ever wondered what clinical trials are? How they work? What the potential benefits and risks are? If a clinical trial is an option for you or someone you know we hope that a new website called Itstartswithme.ca (Cacommenceavecmoi.ca) will answer a number of these questions for you, and help you make an informed decision about clinical trials. The website also includes some questions to ask if you’re interested in becoming a participant as well as what to expect, and a large glossary of terms.

ItStartsWithMe.ca was created by the Network of Networks (N2), a Canadian organization that represents organizations that carry out clinical research ...continue reading

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

 

Some sessions just stand out. Dee Mangin's stunning distinguished presentation of her research into whether iron deficiency without anaemia in infants affected their long term developmental outcomes. They had, incredibly, 100% recruitment with blood tests in infants, and they followed the kids meticulously for 6 years with validated outcomes for intellectual and psychomotor ability. There was no loss to follow up with only minimal data loss e.g. 5% missing blood data blood at age 6 years. Dee’s presentation kicked off a superb afternoon on Tuesday at NAPCRG 2015 of ground-breaking trials asking important clinical questions... Do steroids help in chronic cough? What's the effectiveness of maintenance SSRI (and what happens with antidepressant withdrawal)? It would be unfair to release any of these findings in a blog and we all look forward to publication of the papers. Suffices to say, they will be practice-changing. ...continue reading

ATS 2015 press conference_MSMatthew Stanbrook is Deputy Editor at CMAJ; he recently returned from the American Thoracic Society 2015 annual meeting in Denver, Colorado

 

Denver has always presented a striking contrast of natural beauty with urban realism. The two most prominent expressions I saw of the latter are an increased presence of homeless persons and the pungent and almost inescapable aroma of marijuana, both regularly encountered when walking down the pedestrian mall at the heart of the city’s downtown. The two are not unrelated and illustrate one of perhaps many unanticipated consequences of the recent legalization of marijuana in the state of Colorado.

I can’t decide if this made the choice of Denver as host city for the world’s largest lung diseases conference, the 110th annual meeting of the American Thoracic Society, particularly appropriate or particularly ironic. ...continue reading

Kirsten_headshotKirsten Patrick is a deputy editor at CMAJ

 

Health care professionals need to learn to do more to encourage self-expression in healing.

Watching Friday’s TEDMED session entitled ‘Weird and Wonderful’ I was humbled by talks by two non-medics who have done wonderful creative things that have vastly improved the lives of patients.

First up was Bob Carey. I had never heard of Bob Carey before – WHY had I never heard of Bob Carey before? – so I was surprised to see a middle-aged man standing on the TEDMED stage in a pink tutu and nothing else. He said, “I’m a commercial photographer …and I have been photographing myself for over 20 years as a form of self-therapy because that’s what I do; when things get hard I go take pictures of myself…and it’s a lot cheaper than real therapy...” He transforms himself through photography into something that he is ‘not’ and that helps him to get out of himself, he says. In 2003 his wife, Linda, was diagnosed with an aggressive form of breast cancer and Bob started to take pictures of himself wearing a pink tutu in beautiful landscapes. What started out as a way of expressing his inner discomfort and difficult feelings and sharing his wife’s experience, grew, through self-publication of a book, into the Tutu Project. ...continue reading

Diane_photoDiane Kelsall is Deputy Editor, clinical, at CMAJ, and Editor of CMAJ Open

 

As clinicians, we are taught about patient-centred care, where the needs and desires of the patient are foremost. For those of us who work as medical teachers, we are told to focus on the goals of our students in a learner-centred curriculum. We work in multi-disciplinary teams in hospitals and clinics, where it seems, at the very least, paternalistic for the leader to be a physician.

Some of our traditional roles have been taken over by other health professionals—and we are often told that they provide the same or better service at a lower cost. Administrators and other health professionals run the hospitals and clinics we work in. Few doctors are in leadership at the government level, even for decision-making related to health care.

We are frequently blamed for rising health costs, and some of us are not welcome at the bargaining table where our own remuneration is discussed. People may view us as greedy or, increasingly, as lazy and not willing to sacrifice for the greater good.

Somehow over the years, things changed from the physician as “god” to the physician as No Good.

Why did this change happen? Could it have been a reaction to our casual assumption of money, control and entitlement? Or maybe our failure to play well with others? Did we destroy the mystique around our profession when we abandoned our white coats in favour of casual clothes? Perhaps it was when women entered the profession in large numbers? Or was it simply that health costs began to spiral out of control and a scapegoat was needed?

Few of us would wish to go back to the times when a patient may have been kept ignorant of a cancer diagnosis for “his good”, a nurse had to step back to allow a doctor to go ahead through a door, or throwing surgical instruments across the operating room was condoned.

But surely there must be room for us—a physician-centred place—in the health care system.

There is such a place. That place is Medicine. And we are the experts, the only experts, in this millennia-old discipline. From its early days in ancient Egypt to the heady promise of gene and molecular therapy, the medical profession has advanced—and society has benefited.

Because of the life’s work of physicians over the centuries, we have a greater understanding of the human body and mind; what can go wrong and how to fix it. We now know that that cancer or diabetes or an infection does not have to be a death sentence. Indeed, the blind may see and the lame walk; some may even be raised from the dead.

To be able to do this work, we study for years (in some specialties for more than a decade)—and then we keep on studying to maintain our skills in the discipline where we are the experts, the only experts. There is no one else.

Because when patients are sick - really sick - they need a doctor. Yes, the doctor needs to be part of a health care team that works together. And yes, the doctor needs to respect the contributions of others and recognize the importance of involving the patient in his or her own health care. But a health care team without a doctor is missing expertise, expertise that can literally mean the difference between life and death, between illness and health.

But even when patients are not at death’s door, we bring our expertise to bear in addressing their current health concerns—major and minor—and work with them, in conjunction with our colleagues, towards a healthier future. We can listen, we can examine, we can diagnose, we can treat—and perhaps even heal.

Sure, we have made mistakes (big ones, on occasion) but, for the most part, we have tried to make the lives of our many, many patients better. People live better for longer, and are healthier.

And as such, we have earned the right to be key players in our health care system. At all levels.

We need to be included at decision-making tables—to participate as essential contributors. From the individual clinic to the hospital to government. Locally, provincially and nationally.

If health is the issue, we have the right to be there. To speak, to share our expertise—and to have our contribution respected. We need to be heard, along with the voices of our patients, our fellow health professionals and others.

To improve the health care of all Canadians, we, as doctors, need to be in our rightful place.

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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