Reflections

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Maggie Keresteci is a caregiver to her sibling who lives with a life altering disease and is committed to advocating for solutions that will improve the lives of Canadian patients and their caregivers.

 

 

"Coming together is a beginning;

keeping together is progress;

working together is success."

These words of Henry Ford, that bastion of business innovation, have been taking up space in my mind for the last few weeks, as I have contemplated the emerging world of patient and caregiver partnership in Canada. ...continue reading →

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Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor. Follow his writing instagram: @_kenkan.

 

 

arachnoid aneurysm

there used to be tall trees here
that stood alone
where these cluttered papers are now
with my pencil touching a thought you had fifteen years ago
you stroking the first stitch that is meant to keep the rest together
both of us dreaming of long hair that you used
to use to comb the night
though morning bleeds in like scratching wounds
and the webs must be cleaned away
by things worse than bugs
...continue reading →

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Imaan Javeed is a medical student at the University of Toronto.

Warming up my dinner in the microwave, I habitually open the YouTube app to see what's going on in the world. Before the microwave can finish whirring, though, it suddenly occurs to me: do I even like this stuff?

I’m talking, of course, about politics.

I must, right? For a pill I take religiously every day, multiple times a day, which occupies an embarrassingly large chunk of my attention, you'd think it would be something I at least enjoy. The thing is, though, for me, it doesn't feel like a choice. It's not voluntary, nor is it just a hobby or a game. It's an obligation.

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Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor. Follow his writing instagram: @_kenkan.

 

 

a voice
from mine,
to yours 

a nose
poor plumbing
when frozen

freckles
little her
left holding
onto summer  ...continue reading →

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Due to the sensitivity of the post, the author wished to publish the following piece anonymously. 

Dear potential Referee,

My name is Jane Doe, medical student and residency applicant. So nice to meet you. You are the 30th new staff that I have worked with in the past 15 months and among the over 100 physicians and residents who I’ve met and had to prove myself to across many disciplines and hospitals in our fair country.

So excited to be working with you, to learn from you and to incorporate some of the approaches and expertise that you have into my slowly forming future practice. Look at all that I know how to do! Please appreciate all the additional readings I have done. Did you notice that I’m wearing a perfectly professional outfit with properly groomed hair? I’m actually living out of a suitcase and couch surfing in a city I have never been to that I paid hundreds of dollars to come to just so that I could have the opportunity to spend the day with you today. ...continue reading →

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Dan Small is a medical anthropologist and lecturer at the University of British Columbia.

 

Since 2018, British Columbia has been pursuing legal action against pharmaceutical companies for their involvement in the opioid crisis. Within the wider context of North America, there have been over 2600 such lawsuits against the pharmaceutical companies including Purdue, Johnston and Johnson, Teva Pharmaceutical and Endo International. The Purdue pharmaceutical company, the maker of OxyContin, has recently filed for bankruptcy in response to the lawsuits. I believe a suitable strategy for examining the wider variables that have contributed to the opioid crisis: a Royal Commission. This is needed in order to widen public scrutiny beyond the role of pharmaceutical companies to include investigation of the overarching causes of Canada’s overdose epidemic.

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Maureen Topps is the Executive Director and CEO of the Medical Council of Canada.

 

Nothing matters more in my role than helping Canadian and international medical graduates succeed as they prepare to practice medicine in Canada. But what does success look like and how do we measure it?

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Marika Warren is an Assistant Professor in the Department of Bioethics, Dalhousie University.

 

In early July The College of Physicians and Surgeons of British Columbia dismissed a complaint against Dr. Ellen Wiebe made by the Louis Brier Home and Hospital, an Orthodox Jewish long term care facility. Dr. Wiebe had provided medical assistance in dying (MAiD) to a patient who resided in Louis Brier who had requested it. She thereby contravened the Home's policy. Cases such as these are increasingly likely as the policies of institutions exercising conscientious objection conflict with both patients’ interests in accessing MAiD (and other services) and providers’ interests in practicing with integrity. One way to resolve such conflicts would be to recognize a claim to conscientious provision of health care services that parallels the claims of individuals and organizations to conscientious objection. ...continue reading →

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Iris Gorfinkel is a General Practitioner, and Founder and Principal Investigator at PrimeHealth Clinical Research in Toronto, Ontario.

 

Medical documentation in primary care is a balancing act between promoting timely connection with patients and reducing clerical demands placed on physicians. Clinical notes contain increasingly less by way of narrative. They are often made up of time-saving digitized checklists of symptoms, physical findings, and treatments. Or the progress note may be a copy-and-pasted template. Both checklists and templates lessen the need for clinician typing and offer detailed notes within a few clicks.

Prior to the electronic medical record (EMR), hand-written or dictated notes would often relate a patient’s experience by quoting patients' descriptions of their symptoms. With the arrival of the EMR, doctors, most of whom had little typing experience, were abruptly confronted with having to type detailed patient encounters. The degree to which a clinician must type has since been correlated with physician burnout, which has risen sharply in conjunction with EMR utilization. ...continue reading →

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Sarina Lalla is a medical student in class of 2020 at McMaster University.

 

 

 

When I was on an emergency medicine rotation, I asked for a room to tell a patient news about an X-ray. I was told that this was not a common practice given the scarcity of private rooms. It was advised that I inform them in the waiting room where other strangers sat nearby. I was also told to present cases to staff in small spaces in earshot of patients. This was unsettling to me, and pushed me to reflect on confidentiality and privacy breaches in the ED.

Canadian EDs are well-known to be overcrowded. With limited resources and a high patient volume, the space of a department is used to house a maximum of patients. Sometimes thin curtains are separating patients, or nothing is separating them at all. Often, they are placed in hallways and close to workstations where healthcare staff outside of their circle of care are working. ...continue reading →