Author Archives: CMAJ

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Kirsten Patrick is Deputy Editor at CMAJ

 

Yesterday an open letter addressed to the leaders of Canada's federal political parties was published calling for a firm commitment to implementing a universal, comprehensive, public pharmacare plan for Canada in election manifestos. I signed this letter, along with my colleague, CMAJ Deputy Editor Matthew Stanbrook, the former federal Minister of Health Dr. Jane Philpott, 537 other physicians, and 700+ more academics and policy experts. Altogether, there are 1282 signatories.

I signed it because, in Dr Philpott's words, ...continue reading →

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

The declaration of Alma Ata, over forty years ago, was a key milestone in the development of general practice. Generations of physicians may remember how it defined their career. Dr Shannon Barkley, World Health Organisation Technical Officer for Primary Health Care Services and Family medicine, described the changes that have occurred since then, leading to the 2018 Declaration of Astana. Looking back, we can see why the Declaration of Alma Ata was so important and how the principles outlined are still as fresh and relevant as they then were. There has been progress although different countries move at different speeds. “Health for all by the year 2000” wasn’t achieved but the Millennium Development Goals” were quite successful and the focus has been, more recently, on universal health coverage. I asked Shannon to tell us a little more about the Declaration ...continue reading →

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

Resources for primary care in the United Kingdom are under increasing pressure, as Dr. Jennifer Dixon, Chief Executive of the Health Foundation, outlined in her keynote address to the  Society for Academic Primary Care meeting in Exeter last week. A healthy growth in spending from about 1990 until 2008 was followed by a rather dismal change in the funding landscape: the proportion of overall health spending allocated to primary care gradually declined and has now been flat for the last 6 years at roughly 9%. Overall, however, spending on health as a percentage of GDP is about average within the EU and despite austerity policies, spending on health has been relatively well preserved compared to education, for example. When it comes to public satisfaction with primary care, the main problem mirrors what we see in Canada - access. ...continue reading →

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

 

Research conferences should be an opportunity to gain insights from discussion and collegial debate about new research. At times, though, I have seen debate become adversarial and counterproductive; questions can be aggressive and speakers defensive. But one of the great attributes of the North American Primary Care Research Group annual meeting (NAPCRG) is the culture intellectual rigor yet respectful and collegial discussion, and the support for early career researchers. Researchers with impressive track records in publication in international journals are always keen to share their knowledge and help their colleagues. David Meyers, a long time NAPCRG supporter unable to attend the conference this year due to illness sent a video message in which he said, "May you find meaning in your work and friendship in your colleagues." ...continue reading →

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Matthew Yau and Krish Bilimoria are medical students in the Class of 2022 at the University of Toronto

 

Yosef Ellenbogen is a medical student in the Class of 2020 at McMaster University

 

 

Canada recently entered a trade agreement with the USA and Mexico: the USMCA. The new agreement has been pitched to Canadians as a progressive way forward that will grow our economy and strengthen the middle class. Eclipsed by discussions on preserving dairy supply chain management and automobile manufacturing was the subtle extension of patent protections for biologic drugs. Chapter 20, Article 20.F.14 of the USMCA allows for the extension of patents for registered biologics by 2 years, a total of 10 years of patent protection (2). The subject of patent exclusivity has historically been a sensitive topic in diplomacy, and was a contentious negotiating point between the US and Australia in the development of the original Trans-Pacific Partnership (TPP) in 2015. This seemingly benign change has serious implications for the future of Canada’s health system. ...continue reading →

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Nicolas Senn is professor and director of the Institute of family medicine at the University of Lausanne in Switzerland

 

In Lausanne, Switzerland, we are in the process of transforming our medical curriculum with new learning objectives (PROFILES), with the perspective of finally having a stronger focus on family medicine and primary care (PC). Before embarking in these important changes, we thought that it would be good to visit another University renowned for its strong PC teaching and research tradition.

So we, eight people, four from the Swiss Institute of family medicine and four from the medical pedagogy unit of the faculty of medicine, decided to go to Glasgow to learn about how academic PC developed over 40 years there. Academic primary care is only 10 years old in Lausanne! ...continue reading →

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Alastair McAlpine is a fellow in paediatric infectious diseases at BC Children's Hospital in Vancouver

 

People sometimes ask me, "What’s the difference between medicine in Vancouver and medicine in Cape Town?" The answer is, quite simply, Everything.

But let’s rewind a bit. In July of this year, I flew the 20 or so hours it takes to get from South Africa to Vancouver. I arrived in the city by myself with 2 suitcases, knowing hardly a soul, and feeling completely overwhelmed. A few months earlier, I had been accepted into a 2 year paediatric (even the spelling is different) infectious diseases program at BC Children’s Hospital. Before coming I had filled out endless paperwork, done a million online courses ...continue reading →

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Dr Margaret Rundle is a Family Physician practicing in Scarborough, Ontario

 

There is little dispute among care providers that a person’s dietary habits influence preventative and treatment outcomes. Every year, there is more research validating the role of food and therapeutic diets for chronic disease management and prevention. However, basic education around the role of nutrition and lifestyle for a long time has been a blind spot in the Canadian medical school system. ...continue reading →

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Katherine Atkinson is a PhD student at the Karolinska Institutet in the Department of Public Health Science.

Cameron Bell has a B. Eng from McGill and is the lead technical architect for the CANImmunize project.

Kumanan Wilson is a physician and senior scientist at the Ottawa Hospital, Professor of Medicine at the University of Ottawa, and lead at the Ottawa Hospital mHealth Lab

 

As they accumulate their “10,000 hours” of caring for patients or examining the health system, health care providers and researchers often come up with great ideas on how the system could be improved.  The advent of digital technologies and mobile apps has helped to tear down the barriers to introducing these newly devised solutions and created opportunities for a new breed of medical entrepreneurs.  You may want to build an app that will help you get critical information to your patients because you know this is why they are having trouble staying healthy.  Or perhaps you want to empower them to manage their own health care by tracking aspects of their health.  Or maybe you have an idea that could allow physicians to do simple diagnostic tests at the bedside using smartphones.

At the beginning of 2018, there were almost 100,000 health apps on the Apple iOS App Store and Google Play. Health and fitness apps are cited to have the highest user retention rates, engagement, and frequency of use ...continue reading →

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Kevin Lam is a third-year medical student at McMaster University

Lawrence Loh is Associate Medical Officer of Health at Peel Region, Ontario, and Adjunct Professor at the University of Toronto Dalla Lana School of Public Health

 

Suburbs, and later exurbs, became central to the Canadian lifestyle during the automobile boom in the 1960s and 1970s. Cars were sold as the future and urban planners created suburban neighbourhoods that quickly became the primary venue where people lived and learned. Suburbs were touted to be cleaner and safer spaces, far away from “derelict” urban cores, where people went only to go to work. From this idyllic image, suburban built environments have since developed various distinct characteristics, typically defined by "commercial strips, low density, separated land uses, automobile dominance, and a minimum of public open space."

Having reshaped many cities in North America, the suburban model has gone global. Around the world, the suburban forms of major cities such as Mississauga (Toronto), Surrey (Vancouver), Limert Park (Los Angeles), Footscray (Melbourne), and Prospect Park South (New York) share these similar characteristics. But it’s becoming clear that suburban living doesn’t necessarily promote wellbeing. In fact, urban sprawl is not healthy. ...continue reading →