Dr. Susan Sutherland is Chief of Dentistry at Sunnybrook Health Sciences Centre and President of the Canadian Association of Hospital Dentists
Dentists in community practices usually work in isolation from our physician colleagues. Often, dentists prescribe an antibiotic to patients in advance of minor dental procedures like root canal therapy. Evidence shows us that the prophylactic antibiotic use for most patients is not necessary in these cases. And, if the patient develops a C. difficile infection several weeks after the unnecessary antibiotic, the dentist is usually not informed of this until the patient is seen at their next checkup – if at all. Not only do dentists not usually get feedback about the adverse event caused by inappropriate antibiotic use, they are also unaware of their role in the emergence of antimicrobial resistance.
For Canadian resident doctors, July 1st is more than a national holiday; it represents the day when newly-minted doctors become responsible for decisions in patient care. While this is an exciting day, it can also be fraught with anxiety and stress. Over the course of residency, acute work-related stressors, including traumas and patient deaths, can negatively impact residents’ wellbeing. Additionally, residents endure chronic stressors such as large debts, extended work hours, and isolation from family. These factors predispose residents to burnout. The prevalence of burnout among resident doctors is up to a staggering 75%. Resiliency interventions have been shown to work, and the time to begin implementing them nationwide is now. ...continue reading →
Reza Mirza is a second year Internal Medicine resident at McMaster University
Justin Hall is a third year Emergency Medicine Resident at the University of Toronto.
Odion Kalaci is a PGY-3 in Pediatrics at the University of British Columbia
(All authors are members of the Practice Committee of the Resident Doctors of Canada - RDoC)
In Canada, 38 percent of recently graduated specialists are unemployed or underemployed with a further 31 percent having delayed entering the job market altogether according to a Royal College report. Thus, many of us will struggle. As residents and members of Resident Doctors of Canada (RDoC), this report is alarming as it reinforces existing job-security anxieties. And yet Canadian patients face the longest wait times among high income countries. Consider: 29 percent of patients had to wait four or more hours for an emergency room visit, compared to one to four percent in Germany and France according to a Commonwealth Fund report.
Specifically, the report reveals that 16 percent of specialist physicians were unable to secure employment three months from certification. This excludes 22 percent of new physician graduates who piece together an income by combining locum and part-time positions (they wryly self-identify as “locum-ologists”) ...continue reading →
Blair Bigham is an emergency medicine resident at McMaster University and a freelance journalist
Bandar Baw is an assistant professor, emergency physician and toxicologist at McMaster University
The early part of 2018 has seen the rise of the “Tide Pod Challenge”, in which people have posted viral videos of themselves attempting to eat laundry detergent pods from a variety of brands. The number of poison control calls for laundry detergent pod poisoning in the first 15 days of 2018 already equalled all calls in 2017, thanks to internet viral videos. These ingestions pose a significant concern for the healthcare system, as care spans a variety of disciplines and is a presentation that many may not be familiar with. ...continue reading →
SHATTERED by Sonam Maghera, Student, U of Ottawa Medicine
For the past eight years, the Canadian Conference in Medical Education (CCME) has acted as host to a fabulous medical trainee and practitioner art exhibit. Called White Coat Warm heArt, it celebrates coast to coast Canadian medical creativity.
CCME participants routinely visit the exhibit, seen by many as a sanctuary for reflection in an otherwise busy conference setting. There are benefits for the trainees and practitioners in making the art ...continue reading →
Nicole Le Saux is Associate Professor in the Division of Infectious Diseases at the University of Ottawa *
As physicians we should be concerned about the inappropriate use of antibiotics. Have you ever had a patient with an extended spectrum beta-lactamase (ESBL), E. coli or Klebsiella urinary tract infection, a Clostridium difficile infection (CDI) or a drug-resistant N. gonorrhoeae?
Whereas resistant bacteria and CDI were rare a decade ago, these clinical situations are now commonplace in hospitals, long term care facilities and emergency departments. According to the Canadian Antimicrobial Resistance Surveillance System Report 2016 the rate of CDI in hospitalized patients is 3.4 cases per 1000 patient admissions (approximately one in every 300 patients admitted). As of 2014, 18.2% of isolates of Neisseria gonorrhoeae were resistant to penicillin with worrisome decreased susceptibility to cefixime, ceftriaxone and azithromycin. ...continue reading →
Barbara Zelek is Associate Professor and Co-Chair for the Section of Family Medicine at the Northern Ontario School of Medicine
Marathon, a rural community on the North shore of Lake Superior, made CMAJ headlines in 1997 because it boasted a stable workforce of seven physicians for the first time in over a decade. 2017 marks the 20th anniversary of that CMAJ article and of the arrival of Dr. Sarah Newbery and Dr. Eliseo Orrantia in Marathon.
The article described “a medical renaissance” taking place in Marathon and an end to “the revolving door that has affected rural medicine across the country”. That door has stopped revolving in Marathon since 1997 thanks, in many ways, to the leadership of Eli and Sarah.
Did you hear about Chris’s mint condition 1963 Shelby Cobra? Mechanics say he didn’t check the oil for decades, and the engine just seized one day on the way to work. When they opened it up, they say there wasn’t much left. Such a shame really.
Said Nobody. EVER.
Jazlin Mayhue is a researcher in Victoria, BC
Peter Hobza is a family physician in Victoria, BC
Robert O'Connor is a family physician in Victoria, BC
Introducing a new concept...
We all know folks who are not vigilant with preventive health for their body. However, a subset of them wouldn’t drive an irreplaceable million-dollar car until it was destroyed from lack of maintenance. A human’s life and body are irreplaceable, and worth at least a million dollars, when considering the price of an injury causing death. Therefore, it’s logical to help some people think of treating their body as well as a valuable car. ...continue reading →
The ASHG annual meeting takes place every fall towards the end of October or in early November, as the leaves are changing from green to reds and golds. Every four years the meeting also takes place against the backdrop of the US presidential elections. In 2012, in San Francisco, when the meeting ran from the 6th to the 10th of November, I recall standing in the main hall as part of the opening ‘mixer’ event, where several thousand scientists watched a big screen projection as President Obama was re-elected to office.
This year's meeting, which ran from the 18th to the 22nd of October, took place against the backdrop of a very different election ...continue reading →
Bonnie Larson is Family Physician at Calgary Urban Project Society (CUPS) Health Centre
Recently I called the emergency department from my outreach clinic in an urban shelter. Near the end of the day, the nurse mentioned that one of the clients staying there, a young aboriginal woman I will call Ms. Rain, was supposed to follow up on an abnormal lab result from a few days earlier. As I looked the patient up on the ancient clinic laptop, I thought about the promise I had made to my daughter that morning to try to be home by suppertime. I willed the computer to load the results a little faster so I could get home to my family.