Neil Chanchlani is a CMAJ Associate Editor and clinical research fellow at the University of Exeter, UK. He recently attended the 8thEBMLive conference in Oxford, England.
All healthcare practitioners are encouraged to make decisions that are based on strong evidence. But often we don’t – sometimes because the evidence is poor and conflicting, other times because we are ignorant and unaware and, rarely, because we aren’t comfortable with updating our practice. So we need to keep Evidence-Based Medicine (EBM) on the frontline and not on the (academic) shelves - we need to remind clinicians, researchers, and patients that decisions should be based on the best possible data. ...continue reading →
Charlie Tan is a medical student at McMaster University
Lawrence Loh is Associate Medical Officer of Health at Peel Public Health
Too often, physicians forget that they might be just one of many sources of health advice that patients access. Behind every physician-patient encounter is a difference in how health and wellness are perceived and pursued. For many physicians, their views and advice are shaped by formal education and training, the Hippocratic Oath, and the insights of colleagues, researchers, and experts. Their patients, by contrast, have a different and often wider range of influences, be it personal beliefs, social networks, or cultural traditions.
Over the last three decades, physician practice has been transformed by two important movements ...continue reading →
Cory Peel is a GP-Anesthesiologist who locums throughout British Columbia, Alberta and the Yukon
A couple of months ago I read Mike Hager’s article in the Globe and Mail about Dr. Reggler’s tribulations at St. Joseph’s Hospital in Comox, BC, and I was overcome by a realization that, despite having been a practicing Family Physician for 7 years, I had culpably little understanding of the prejudicial impact of faith-based hospitals in determining patient access to care.
The article detailed the refusal of the “Catholic hospital” in Comox to provide medical aid in dying to its patients despite having a staff physician willing and able to do so, thereby forcing them to be transferred elsewhere. That such a policy could exist stunned me. It is the work of “the bishop [a.k.a. the Diocese of Victoria] and the hospital board,” with the board’s CEO maintaining that “minimizing patient discomfort and pain is always the highest priority,” which seems to me to fly in the face of logic.
It is not, however, an isolated example. Canada contains many hospitals whose delivery of healthcare to its patients is directed by Church doctrine. ...continue reading →
The federal election seems to be focusing largely on issues such as the economy and security. If health is mentioned at all, it is in the context of health care.
But health care is a determinant of our health; it is not the main one. While our genetic inheritance also plays an important part, much of our health comes from the environmental, social, economic, cultural and political conditions we create as communities and as a society.
In our system, the federal government does not provide health care or manage a health-care system, aside from special situations such as for aboriginal people and the armed forces. But many other areas of policy for which the federal government does have full or at least partial jurisdiction do influence the health of Canadians. ...continue reading →