Tag Archives: primary care

NormanWendyVWendy Norman is the CIHR and PHAC Chair in Family Planning Public Health Research, and Associate Professor in the Department of Family Practice at the University of British Columbia

 

As a career offering diverse experiences, challenge and intense satisfaction, academic family practice surely cannot be beat. Many of us may have begun our academic practice early in our career, particularly those of us who were biomedical clinicians-scientists. However, for me the journey to a full academic career, as maybe more typical for family practice clinician scientists, developed over several decades.

Although my early practice-only years in a BC coastal fishing village, accessible only by ferry or float plane, came with long hours and difficult decisions ...continue reading

Fahey_150x240Tom Fahey is Professor of General Practice in The Royal College of Surgeons in Ireland and a general practitioner in Dublin, Ireland

 

In late 2015 I was fortunate to be awarded a James M. Flaherty visiting professorship  from the Ireland Canada University Foundation (ICUF). The purpose of this award is to enable academic exchange between Canada and Ireland. Earlier this year I visited the Universities of Ottawa, Toronto and British Columbia and also met with the editorial team of the CMAJ. In the latter part of my visit I met with Dr. Wendy Norman, Canadian Institutes of Health Research (CIHR) and Public Health Agency of Canada (PHAC) Chair ...continue reading

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the 2016 Primary Health Care Research Conference (PHCRIS) in Canberra, Australia
 

Grant Russell, newly elected for a second term as President of the Australasia Association of Academic Primary Care (AAAPC) was upbeat in his introduction to the second day of the meeting. He reminded us how the Canadian academic, Martin Bass, had warned against learned helplessness and he pointed out that primary care has much more influence than we give ourselves credit for.

Claire Jackson, one of Australia’s leading primary care researchers was introduced at her plenary lecture as “an eternal optimist”. True to form, she told us that there has never been a more exciting time to be in primary care research. She listed the national primary health care strategy, the primary care framework, and the 31 primary health networks. While there have been numerous health care reforms, each one has primary care at its centre and there is growing government awareness of the need to address complex chronic illness in community. ...continue reading

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DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

My programmed response is always to jump to the defence of primary care, but a report entitled “Chronic Failure in Primary Care” that was recently published by the Grattan Institute, a public policy think tank in Melbourne, Australia, raises interesting challenges.

It was written by Jo Wright, Hal Swerissen, a health policy expert from LaTrobe University in Australia, and Stephen Duckett, an economist who will be known to many Canadians from his time in Alberta. It is critical and challenging but behind the headlines there are some constructive ideas. ...continue reading

JR_2016Joanne Reeve is an Associate Clinical Professor in Primary Care at Warwick Medical School in the UK, and the Chair of the Society for Academic Primary Care


A recent editors' blog by Domhnall MacAuley suggested that it is “difficult to see a future for academic general practice.” I propose that the solution lies in the broader discipline of Academic Primary Care (APC).

Academic Primary Care matters. APC is a distinct discipline driving improvement in primary care through education and research. Academic general practice lies at the heart of this wider multidisciplinary community committed to improving whole-person centred primary health care. The APC community lead health service research driving improvements in policy and practice in key priority areas such as antibiotic stewardship and cardiovascular risk management. But APC also tackles the distinct challenges facing the Primary Care community: for example, the need for new person-centred models of acute and chronic care to address problems of treatment burden and ‘too much medicine’. APC supports the redesign of Primary Care through re-engaging with the core principles of continuous, comprehensive, accessible, whole person-centred care. ...continue reading

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DenisSir Denis Pereira Gray, OBE, is a consultant at St Leonard’s Research Practice, Exeter, and Emeritus Professor at the University of Exeter in the United Kingdom

 

A few weeks ago a blog by Domhnall MacAuley picked up on an article that I had written in the British Journal of General Practice, entitled “Academic general practice: a viewpoint on achievements and challenges.” The article was written to ask some big questions and to stimulate debate about academic general practice and Domhnall's blog followed it up interestingly and extended the issues.

I am still optimistic about academic general practice. General practice is the key branch of the medical profession and there are still many aspects of it to be discovered. Yes of course “big data” are a new resource and need new techniques, but a place remains for clinical research in general practice and in single research active general practices too. However, the relationships and the support for research in clinical settings need clarification and funding. The prime role of single practice research is to study new clinical developments, to scope their potential, and pave the way for bigger definitive studies.   Single practices do have the numbers for statistical significance if they choose their subject ...continue reading

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DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Reading a recent robust critique of the achievements and challenges to academic general practice in the UK, and a plea by senior academics for increased capacity in clinical academic general practice, I began to wonder.... How might we design general practice research for the future, what direction should a department of general practice take, and where does general practice fit into the future of clinical research? As an intellectual exercise, I allowed myself to think the unthinkable. And, for a general practice academic, brought up in family medicine and immersed in the traditions of personal primary and continuing care, this felt like heresy. At the very least, however, perhaps we should begin to think creatively about the future. What do you think?

It is difficult to see a future for academic general practice. ...continue reading

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Pollanen Michael-001Dr. Michael Pollanen is the Chief Forensic Pathologist at the Ontario Forensic Pathology Service

 

I have recently returned from a humanitarian forensic medicine mission in Iraq. The autopsies I performed gave me some insight into how people die in Baghdad die. My observations in the autopsy room are witness to the major cost of war and terrorism on a civilian population. I concentrate on the 6 most frequent types of preventable deaths that I encountered, many of which would not occur - or would not occur to the same extent-  in Canada or other parts of the Western world.

Although my mission to Iraq was focused on the application of forensic pathology to the protection of Human Rights, during my time in Iraq I was struck by the observation that Iraq is a society embedded in conflict. It was once the major cultural and intellectual centre of the Middle East. Yet due to recent wars and internal armed conflict with terrorists, Iraq now faces problems with the safety and security of the population and a widening gap between people who have and do not have access to the essentials of daily life, justice and health care ...continue reading

DMacA_3Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

The James Mackenzie Lecture is one of the most prestigious eponymous lectures of the Royal College of General Practitioners. The title of the lecture recently delivered by Toronto Professor, Frank Sullivan, certainly grabbed attention. The title, "Atomic Data", actually comes from cardiologist James Mackenzie’s own ambition in setting up the Institute for Clinical Research in St. Andrews on his return to Scotland in 1918: 'to do for medicine what the Atomic Theory had done for chemistry'. And, as we may have expected from Frank, whose research interests lie in health informatics, electronic medical records, decision support systems and, of course, community based trials, he explored how “big data” could be used to transform medical 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