Editors’ Blog

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

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 

 

meta static
food undigested on the chest
breasts already pancakes
they will laugh when reaching under
the napkin of my body

they the strong
they the knowledgeable

will the question caught on my throat
survive the morning ...continue reading

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

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

 

Liveability. What a cool, trendy word that immediately paints a vibrant picture in your mind. We know instinctively what it means as it conjures up an image of a healthy environment, an active lifestyle and personal wellbeing. No surprise, therefore that its used in advertising  to sell everything from domestic products to real estate.  If, on the other hand, we talk about the social determinants of health, most people don’t really know what we mean and they switch off. But, liveability gives us a common language to explain how there is so much more to health than just medicine.

This was a recurring theme at the conference on Creating Active and Liveable Societies hosted by the Centre of Excellence for Public Health in Belfast with a host of international experts. ...continue reading

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Kirsten Patrick is Deputy Editor at CMAJ

 

A week ago, André Picard published a column in the Globe and Mail entitled “How many people actually suffer from mental illness?” and later he tweeted his thanks to readers for making that column the publication’s most-read story of the day. The column may have been well-read - it certainly sparked controversy on social media - but it wasn't because Picard had anything very profound to say. In fact the piece was based on an epidemiological faux pas, which is why I called it a nothingburger.

Commenting on the findings of a poll commissioned by Sun Life Financial Canada, which found that 49% of Canadians have “experienced a mental health issue” at some point in their lives, ...continue reading

Barbara Sibbald is associate editor, Humanities, at CMAJ

 

After ten years, eight annual meetings and countless, long discussions the new Canadian Association of Health Humanities (CAHH) is up and running. According to its constitution, the CAHH aims to “add significant value to the interdisciplinary cultures of medicine, health care and the field of health humanities locally, nationally and internationally.”

On April 27, some 120 registrants at Creating Space VIII, the annual health humanities conference ...continue reading

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Kirsten Patrick is Deputy Editor at CMAJ

 

Rising awareness of the toll that physician burnout is taking on our profession and our healthcare services has inspired numerous organizational physician wellness initiatives and resilience courses aimed at individual physicians. Yet, as experts discuss the relative merits of the system-level approach vs. the individual-wellness-training approach to addressing burnout, one key element seems to be all-but ignored: the healing power of the relationship between physicians and the patients they serve.

Dr. Tom Hutchinson, in his book, Whole Person Care: Transforming Healthcare (Springer International Publishing AG, 2017), suggests that we have lost touch with “the interior processes of healing and growth in the individual patient and the practitioner that give meaning to illness and to healthcare,” ...continue reading

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

 

A normal day for Dr. Pierre Pili may involve being helicoptered up to a glacier in the Alps, and then lowered by cable 30m down into a crevasse to assess and treat casualties. Few of us see patients in such a difficult and unforgiving environment but this is Pili’s consulting room. A mountain rescue doctor based in Chamonix, he is involved in about 1500 rescues per year, and when not on the mountain, he works as an emergency medicine doctor.

On his first rescue he was called to help two skiers who had fallen deep into an Alpine crevasse. One was dead and one was seriously injured. Pili talks about the mixed fear and excitement of doing this work ...continue reading

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Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He's currently also Chair of the Jury for the National Research Award of the Swiss College of Primary Care Medicine

 

Swiss primary care research has a very bright future, from what I could see at the early career researchers meeting (TAN HAM) that I attended recently in Bern. Oliver Senn put together a superb programme but the key to its success was the commitment and contribution of the researchers. It was their programme and, not only did they present their work with skill and style, and almost exclusively in English, but each research presentation was chaired by one of their peers as the senior academics looked on from the side lines. The presentations were fantastic, covering a range of topics, as described below. But I thought the peer chaired sessions were an innovation worth replicating at other national and international meetings.

Many countries are struggling to recruit and retain a family medicine workforce and Switzerland is little different. ...continue reading