Does Halifax get its own Mayo Clinic?

Liberal Leader Stephen McNeil's remonstrations in the legislature this month condemning a year-old memo from some Capital District Health Authority physicians proposing a new, doctor-driven, private-public, "Mayo Clinic-like" hospital facility in metro were an emblematic example of the sort of backward, stick-in-the-mud attitudes and reactionary, tunnel-vision thinking that keep Nova Scotia an underachieving backwater.

McNeil trotted out the customary boilerplate about defending the sacrosanct public health care system from the evils of profit motive or market accountability, trotting out the old FUD (Fear, Uncertainty and Doubt) about privatization of health care delivery leading to (horrors!) - two-tiered health care, with NDP leader Darrell Dexter chiming in with his labour-union constituency's pet trope about private hospitals and clinics supposedly luring doctors and nurses away from the public system.

The 2006 memo, reportedly authored and signed by Capital Health surgeon Robert Stone, lays out a concept for clinics or centres that "should not be staffed by 'unionized' personnel

It would focus on providing endoscopy; breast health services; prostate therapy; various other diagnostics; orthopedic surgery, other same-day surgeries, and executive preventive health - all procedures that do not require the facilities of a fully-equipped and staffed, acute-care surgical hospital.
For which there is a strong demand that isn't being met in a timely fashion by the current public system, and which helps keep waiting lists long for other, more complex surgeries and treatments.

It's just, plain inefficient and a misuse of scarce resources.

Read the full story here

York University needs to improve Medical Education

Originally designed as a feeder school for the University of Toronto, York University has managed to break away, except when it comes to medical students who are still forced to leave after completing their undergraduate degrees.

According to York University’s mission statement: “We promise excellence in research and teaching in pure, applied and professional fields.”

Since York’s founding in 1959, however, a strong emphasis has been placed on the arts and fine arts, while future doctors have moved on to other schools for further education.

Canadian universities do not have enough medical schools to keep up with the growing need for professional doctors.
Only four medical schools have been created in Canada since 1959, and only one since 1968. During this same time, the population of Canada grew 178 percent from 18 million to 32 million.

According to the Canadian Medical Association Journal, the average general practitioner in Canada works 51.4 hours per week.
From 1979 to 2003, the average Canadian workweek dropped from over 34 hours per week to around 33 hours per week.

Despite doctors working over 50 hours per week, many Canadians still have a hard time trying to find family doctors and wait times at hospitals have increased dramatically.

Meanwhile, Canada has seen a reversal of the brain drain of the mid 1990s, which saw its peak with around 1.5 percent of Canadian doctors leaving Canada to work in the United States, according to the Canadian Institute for Health Information.

Fortunately, 2006 was the third year in a row that saw a brain gain, with 238 doctors returning from abroad and only 207 leaving.
This only represents 0.05 percent of Canada’s 62,307 practicing physicians, which is not nearly enough of an increase to significantly affect hospital wait times, overworked doctors or the lack of family physicians.

The average age of doctors in Canada continues to increase, reaching 49 in 2006, with only 23 percent of doctors in Canada being under 40 and 19 percent being over 60.
The need for young doctors has never been greater, and in order to fill this need Canada needs more medical schools.

Most of the schools York competes against, including the University of Toronto, McMaster University, the University of Western Ontario and the University of Ottawa, all have quality medical schools.

York has managed to compete with and often surpass the big established programs with its business and law faculties, now it needs to do the same with a medical school.

After all, shouldn’t an interdisciplinary university strive to give their students everything that is possible, instead of simply taking the easy route and sticking to what they know best?

Source: Excalibur

Two great stories about Canadian health care professionals

Here are two interesting stories I came across, about two Canadian health care professionals who have been active elsewhere in the world to share knowledge with their local health care professional counterparts.

Both are on their own, unique mission:

The first is Dr. Laura Louie, a naturopathic doctor from Vancouver, who set up an acupuncture clinic for HIV infected people in Thailand.

"It's Tuesday morning and Louie is only a few days off the plane from Canada when she arrives at the Mae On Clinic, bright and early so she can consult with head nurse Unchalee Pultajuk before the patients start arriving for the weekly HIV-acupuncture clinic."

"........Patients move from the acupuncture beds to a chair where a Tui Na massage completes their treatment. The traditional Chinese massage is done with bare hands -- "with healing, touch is so important"

The second is Dr. David Chaulk, a pediatrician from Alberta, who teaches Yemeni health care professionals the advanced knowledge from Canada and to help them catch-up.

“When I first arrived in Yemen and began teaching it was easy to have a feeling of superiority — for lack of a better word,” Chaulk said. “As Canadian physicians we have far better education, far superior training and more experience."

"..........You see two children to a bed, two patients with one intravenous infusion going to both patients and extremely malnourished, dehydrated and dying children that would be in intensive care units in Canada lying on a bed, being cared for primarily by the parents and with no monitoring equipment or any type of modern medical devices..........."

Enjoy reading the full stories (just click on their names)

Doctors of Ontario urge smokers to quit smoking in 2008

Ontario's doctors are encouraging those who smoke to make 2008 the year they quit.

Doctors and other primary care providers have been working with patients to help them develop a plan to quit smoking and can help increase the chances of success.

"Doctors understand that smoking is a serious addiction and we want to provide patients with the support they need to become smoke-free," said Dr. Ken Arnold, President-elect of the Ontario Medical Association (OMA).
"The beginning of a new year is always a good time to renew your commitment to improving your health and to make the decision to quit smoking for good."

The OMA is offering the following tips for individuals who are looking to quit smoking:

• If you smoke, avoid exposing others (especially children) to second hand smoke
• Never smoke in a car with children present
• Nicotine Replacement Therapies, like nicotine gum and the patch, will help you deal with the cravings. Keep nicotine gum with you at all times. It's available over the counter at pharmacies
• Remove ALL cigarettes and ashtrays in your home and car
• Regular exercise can help calm you down and relieve tension
• Make an appointment to see your doctor to discuss how they can help
• Make a resolution that you're going to have a healthy and smoke-free 2008

Tobacco use is the number one preventable cause of death and disease in Canada.
One in every four deaths from heart attacks and strokes in Canada is caused by smoking, and tobacco use causes about 30 percent of all cancers in Canada and more than 85 percent of lung cancers.
In Ontario and each year 16,000 patients die prematurely because of smoking.

"Make a commitment to be smoke-free in the New Year to keep you, and those around you, healthier in 2008," said Dr. Arnold.

"Everyday doctors treat patients whose health is compromised from smoking, which is why we have been advocating so strongly to protect Ontarians from tobacco use and second-hand smoke."

Editor's opinion:

"Does anyone know anyone who quit smoking with the 'help' of nicotine patches or gum?
You could get addicted to those instead and they don't solve the problem anyways.

Nicotine, the main addictive substance in tobacco products, is processed by the human body in a few hours, hence the need to light up a new one after approximately and averagely an hour.

If a smoker quits smoking cigarettes their body is in complete control.
Many smokers quit smoking cigarettes daily but they never experience any physical problems.

Even chain smokers hardly ever wake up in the middle of the night to 're-fuel', unlike a Heroin or Cocaine addict who often wake up at night to feed the addiction.

A smoker can simply spend a couple of hours watching a movie in a theater or being on an airplane, without having a cigarette and without shaking, screaming and sweating.
This shows clearly that smoking cigarettes is not at all a physical addiction!

There are always smokers who claim that they cannot sit for such long hours without cigarette while I'm sure they never even tried it or are simply lying about it, it's called addictive behavior.
This, in my opinion, only tells us that smoking is a mental addiction.

Therefore quitting smoking doesn't require products that only prevent your body to be in a state of total nicotine neutralness as a starting point to deal with the more important job: the bending of the lies your telling yourself in your mind why you shouldn't quit or just not yet.

Take it from an extreme, 2-packets-a-day, EX-smoker since 7 or 8 years (don't really remember!).
There is another painless, effortless, inexpensive and effective way to quit, since it deals with the mental and not the physical part of the addiction.

Believe it or not, it only requires to read a very amusing book, written by Allen Carr, called "The Easy Way to Stop Smoking"

It was the most valuable, yet in-expensive present I ever gave myself."

Source: CNW Group

Quebecer complians about "English treatment" in hospital

The reaction of many people to being kept waiting for 20 hours in a hospital emergency ward in Quebec might be to worry, or complain, about what seems like a chronic shortage of medical personnel.

Sitting for hours on a hard chair in a room with other injured or ill people, watching for the faintest hint that the one overworked doctor might see you now, could lead a sensible person to think that whatever Quebec is doing to find more health care workers, it isn't enough.

Jean Dorion, the head of the Société St. Jean Baptiste de Montréal, takes a different approach. His reaction to waiting nearly a day for care was to call for French to be made the working language in all Quebec hospitals, including the few remaining bilingual hospitals.

Why? Because when he was finally seen by a doctor, the doctor asked if he spoke English.
Dorion said he replied that he did speak English. "I was treated in English," he said. "I found it humiliating."
He further suggested that if he had asked for treatment in French the doctor might not have looked at his case "with a very favourable prejudice."

This is ridiculous, to say nothing of offensive. Dorion has the nerve to suggest that a medical practitioner would take less care with his health if he asked to be treated in one of Canada's two official languages.

Dorion provides nothing in the line of proof for this odious suggestion. So pressed is he for ammunition for his make-everything-French cause that he has to go back seven years to unearth a study by the Office Québécois de la langue française.

This dusty study shows, Dorion said, that 18 percent of francophone patients treated in bilingual hospitals said they had been "in contact" with medical workers or other personnel who lacked a "sufficient" knowledge of French. Is he kidding? What does "in contact" mean? Who defines "sufficient"?

More recently, according to information compiled by the Office québécois de la langue française, it received a grand total of five complaints on the subject of language use in hospitals. Four of the complaints concerned language on signs; only one had to do with language of service. Exactly one complaint in the course of a year. In a normal world, that would be considered a triumph. It is a triumph.

Some hospitals in Quebec are allowed to be bilingual but must make French service available - and by the evidence, they do just that. This requirement does not mean that every single person working in a bilingual hospital has to be perfectly bilingual. Dorion, for instance, doesn't even know if the doctor who asked if he spoke English was bilingual. It appears that Dorion preferred getting a chance to complain to the simple expedient of asserting his right to be helped in French. What nonsense.

If any group is having trouble communicating in hospitals, it is rural anglophones. The regions are becoming more unilingually French even as unilingual anglophones grow older and require more medical care. Now there is a real problem.

Source: The Gazette

Editor's opinion:

"How does that work, open heart surgery in French? Or getting a French flu shot? Complaining about something like that, after having waited for 20 hours? To magnify a futility like that can only come from a French speaking nitpicker. Humiliated? What's so humiliating about the English language? How many people, on a world-scale, actually speak French and why is that do you think? Of course there are many nice francophone people, but in general as a people, is there anyone that likes the French? I know in Europe nobody really does. They don't even like each other, hence the cold relationship between the French from France and the ones from Quebec!"

Two children's heart doctors for Winnipeg Regional

The Winnipeg Regional Health Authority has successfully recruited two children's heart doctors from London, Ont.

WRHA spokeswoman Heidi Graham confirmed doctors Dion Pepelassis and Ilan Buffo of the Children's Hospital of Western Ontario were "aggressively recruited" to come work at Winnipeg's Children's Hospital, which has only one pediatric cardiologist for a population of 1.2 million.

The London doctors will leave their positions in Ontario at the end of June. The two are then expected to start in Winnipeg next summer, said Graham.

The move has left the Southwestern Ontario region with no such specialists for 450,000 kids.

"As every other jurisdiction does when there's a shortage, we recruit," said Graham.

"Manitoba has been short two cardiac specialists since this past summer," she said. The WRHA has been searching for specialists across Canada and the U.S. for months.

The two heart doctors weren't talking yesterday, but the London Health Sciences Centre's senior medical director for women and children said he believes they were offered "a very attractive overall package" in Winnipeg.

Winnipeg Sun

Canada most dangerous to the United States?

Which country is most dangerous to the United States?
This question was posed to the presidential candidates in the United States by CBS' Katie Couric last week.
Most of the candidates named Iran as the most worrisome country with Pakistan coming in a somewhat distant second place.
There was one vote for China which is not an unreasonable choice considering the quality of their exports.

"In pondering my choice, I must admit that I was heavily influenced by the recent Michael Moore movie, "Sicko." There is no question that Canada must be considered the more immediate danger to the United States...................................................."

Read what a Massachusetts' Doctor has to say about Canada and the Canadian health care system here

Ontario physicians best paid

Ontario is even more competitive in physician compensation than figures reported today by the Canadian Institute for Health Information (CIHI) said Deputy Premier and Minister of Health and Long-Term Care George Smitherman.

Today, CIHI released Physicians in Canada: Average Gross Fee-for-Service Payments which covers the 2005/06 year. (download the report here)

"We are headed in the right direction in making Ontario an employer of choice in health care," said Smitherman.
"I look forward to building on this success with our doctors so that an additional 500,000 Ontarians can benefit from family health care."

Since the year that the report captures, the ministry has invested a further $652 million for physicians that includes incentives to enroll more patients and to treat people with chronic diseases.
Beginning in 2008, an additional $364 million will flow to doctors in recognition of the important care they provide to patients. Total investments in this deal will total $1.3 billion annually in physician services.
By working together, the McGuinty government and Ontario's doctors have been able to increase the number of Ontarians with access to a family doctor. Based on independent survey data and data from Statistics Canada, the number of Ontarians with regular access to a family doctor has increased by 500,000.

The additional $652 million of funds dedicated to doctors is being used as follows:

• $285 million to provide Ontarians access to family health care;
• $290 million for better hospital care in areas such as emergency rooms and palliative care;
• $77 million for other areas such as chronic disease management, psychiatry and surgical services.

More info: http://www.health.gov.on.ca

source: CNW Group

Dr. Colleen Flood about "Wait Times in Canada"

On November 26th and 27th, 2007, health care and policy experts from across the country were invited to help write the prescription for managing wait times for health care at the Wait Times in Canada conference, co-hosted by Kingston General Hospital and Queen's University.

At the conference, someone from InsiderMedicine had a chance to speak to Dr. Colleen Flood. Dr. Flood is Scientific Director of CIHR's Institute of Health Services and Policy Research (CIHR-IHSPR).

She is also a former Associate Professor in the Faculty of Law at the University of Toronto and a Canada Research Chair in Health Law and Policy. She completed her Master of Laws (LL.M.) in 1994 and her Doctor of Juridical Science (S.J.D.) in 1998 at the University of Toronto.

Her areas of research interest include comparative health care policy, public/private financing of health care systems, health care reform, and accountability and governance issues. She was the 1999 Labelle Lecturer in Health Services Research and was appointed a Senior Fellow of Massey College in 2004 and in 2006 on to the Corporation of Massey College.

"Find out what Dr. Flood has to say about the health care system in Canada compared to the rest of the world and wait times in particular in this Flash video:"

In Depth - "Wait Times in Canada" - Dr. Colleen Flood

Toronto physician under fire for spying on colleague

Three of the largest professional organizations representing plastic surgeons in Canada are filing formal complaints against a Toronto physician who hired a private investigator to spy on a colleague whom she suspected was causing a drop in her business.

The Ontario Society of Plastic Surgery, the Canadian Society of Plastic Surgery and the Canadian Society of Aesthetic Plastic Surgery plan to ask Ontario's medical watchdog to investigate Dr. Behnaz Yazdanfar's decision to send an undercover female investigator to consult with plastic surgeon Dr. Sean Rice and secretly record the conversation.

As the Toronto Star reported last week, Yazdanfar used the recording as the basis of a $300,000 lawsuit against Rice, alleging the plastic surgeon slandered her reputation.

"Nobody has ever seen anything like this," says Dr. Michael Weinberg, a Toronto-area plastic surgeon and member of the three organizations filing complaints with the College of Physicians and Surgeons of Ontario.

"We would like them to investigate the ethics of wiring an investigator to come in, ask questions, to pretend to be a patient and pose naked."

Weinberg says members of the three organizations decided to file the complaints Monday.

"The medical community is very upset by this," he said. "I can't imagine that asking a woman to expressly lie to a doctor and then to have their breast examined by a doctor and that person being sent by another doctor for the sole purpose of trapping them could be considered in any way ethical."

College officials would not comment.

"I can confirm we are investigating Dr. Yazdanfar, but I can't provide you with details of the investigation or how the matter came to our attention," said Kathryn Clarke, college spokesperson.

Yazdanfar has been at the centre of controversy since Krista Stryland, a 32-year-old real estate agent and mother, was pronounced dead in hospital Sept. 20 following a liposuction procedure at Yazdanfar's Toronto Cosmetic Clinic.

Read the full story in the Star (click here)

GlaxoSmithKline Inc. prescribes restricted use of diabetes drug Avandia

GlaxoSmithKline Inc., the manufacturer of a drug for treating Type 2 diabetes has placed new restrictions on use of the medication based on a Health Canada review of clinical data pointing to an increased risk of heart-related problems in some patients.

In consultation with Health Canada, Glaxo is updating prescribing information on products made from or containing the drug rosiglitazone: Avandia, Avandamet and AvandarylTM.

Once touted as the gold standard for preventing Type 2 diabetes in high-risk patients, rosiglitazone lost its glitter after a study published in the New England Journal of Medicine in May showed Avandia significantly raised the risk of heart attack and possible death.

The NEJM analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking rosiglitazone compared to people taking other diabetes drugs or no diabetes medication at all.

Glaxo said patients taking rosiglitazone and especially those with underlying heart disease or with a high risk of heart attack or heart failure should talk to their doctor about the benefits and risks of continuing the drug.

Important restrictions for patients are:

• Rosiglitazone should not be used in patients with any stage of heart failure
  
• Rosiglitazone should not be taken if insulin is also being used.
• Rosiglitazone should not be used as part of a "triple therapy" in combination with metformin and a sulfonylurea drug.

Rosiglitazone can cause the body to retain fluid, which can worsen some heart problems and lead to heart failure, swelling and weight gain.

Several lawsuits have been launched in Canada and the United States over the medication's adverse effects, and drug safety regulators in both countries have been investigating its safety.

CBC

Walk-in clinic closes doors due to doctor shortage

In western Prince Edward Island, a weekly walk-in clinic has been forced to shut down until at least the the end of this year.

The Beechwood Community Health Centre in O'Leary has been open on Wednesday nights for about the past six months, attracting about 20 patients a week.

According to acting manager Cheryl Doran there simply aren't enough doctors in the area to staff the evening clinic and emergency rooms.

The clinic had to suspend its services a couple of times earlier, just because the physicians have already been working long hours.

"We just don't have the manpower to keep the emergency rooms running as the physicians are trying to cover a call there and do the evening clinic as well," said Doran.

Doran further said that the staff will reassess the situation in January, but another doctor will be required in the area for the clinic to reopen.

CBC

"I think it's time to relocate one or two healthcare professionals"

Doctors can be dick-heads too!

Pathologist made threat over ticket

"Constable testifies that Charles Smith said he would withhold services from Cobourg area"

TORONTO — A furious Charles Smith threatened to cut off forensic services for an entire region of Ontario out of spite after a local police officer gave him a speeding ticket, the Goudge Commission heard yesterday.

The bizarre incident occurred on Nov. 9, 2002, when Dr. Smith - driving his Ford Explorer with personalized licence plates that read "Coronr" - was stopped on Highway 401 near Cobourg for driving 136 kilometres an hour in a 100-kilometre-an-hour zone.

"Did you not see my licence plate? Do you know who I am?" Ontario Provincial Police Constable Nancy Wagner quoted Dr. Smith as saying. "I am the head of pediatric forensic pathology for this province."

"Next time Cobourg needs forensics on a child, they won't get it from our office," she quoted the pathologist, now 57, as saying.

The incident - detailed immediately afterward in a letter of complaint from OPP Superintendent Jim Szarka to former chief coroner James Young - was revealed at the inquiry yesterday by Peter Wardle, a lawyer for several families that are suing Dr. Smith over autopsy mistakes that led to their being charged in the deaths of their children.

According to Supt. Szarka, Constable Wagner reported that she challenged Dr. Smith: "So, you are denying Cobourg your services because you got a speeding ticket? You are going to risk an investigation for a family and child because you got a speeding ticket?"

Dr. Smith allegedly nodded his head and said yes. "I do not think I need to comment further about the seriousness of the matter," Supt. Szarka concluded in his letter.

Asked yesterday how he reacted to the letter, Dr. Young testified that he told Dr. Smith he had been wrong, and then sent a letter to Supt. Szarka apologizing on behalf of his star pathologist.

At the time of the incident, Dr. Smith had been suspended from conducting autopsies in suspicious deaths because of the growing controversy about his competency. However, he was still the head of two important committees that oversaw pediatric deaths.

Mr. Wardle attacked Dr. Young yesterday for permitting Dr. Smith to carry on in this senior capacity after he had issued such an irresponsible threat.

Dr. Smith's titles and committee responsibilities were "meaningless" in the grand scheme of things, Dr. Young replied. He also said that Dr. Smith was no longer in a position to do anyone any harm.

globeandmail

"Aren't we just glad that this Doctor won't be dealing with "live" patients?!
He must have thought he was an untouchable.
If this isn't a cry for better screening......................................."