Frustration builds up among Canadian family doctors

Faced with an aging population requiring increasingly complex care, overwhelmed Canadian doctors are feeling more and more frustrated by their inability to properly serve their patients' health needs, a national survey of physicians reports.

In the survey of more than 20,000 doctors and doctors-in-training from across the country, 75 per cent reported that inadequate funding of the health care system and an under-supply of physicians and other health professionals, along with paperwork and bureaucracy, are curtailing the amount and level of care they want to provide patients.

While that attitude was expressed by all the specialties, it is perhaps most pronounced among family physicians, simply because of their number and the nature of their practice, said Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada.

Almost half of Canada's roughly 60,000 doctors are family practitioners, and it's usually the specialty seen most often by patients, he said.

"I think the frustration remains related to just the capacity within the family medicine community to address all of the needs of the population," said Dr. Gutkin, whose organization conducts the triennial survey jointly with the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada.

"Physicians in most communities across the country are doing their best to try to see as many patients as they can," he said.

"But still many of them have had to ... limit the number of new patients they can take. And we have community after community with patients who are unable to access a family physician for themselves or for their families. "

Read the rest of the story here

A related story about Calgary doctors can be read in here

Insufficient warning dangerous drugs by Health Canada

Despite evidence indicating seniors are being prescribed potentially dangerous drugs, Health Canada says it can't do anything more to make its warnings about these medications more effective.

The department is responding to an investigation in December revealing that doctors continue to prescribe anti-psychotic drugs to seniors, despite Health Canada warnings in 2005 that the drugs increased the risk of heart attack, stroke and death.

The analyzed sales data for the drugs indicated that prescriptions increased from seven to 40 percent for a 24-month period after the warnings.

Dr. Marc Berthiaume, director of the Marketed Pharmaceuticals Division at Health Canada, said the department warns doctors and their patients about dangerous drugs through an increasing number of safety alerts such as letters, e-mails and its website.

"We have developed over the years different ways to increase our outreach of that safety information," he said.

But he acknowledges it is up to physicians to read the mailed material. "We cannot open the letter for them. We cannot make them read them."

He said that's because the department doesn't have the legal power to do anything more than publish warnings.

Terence Young, whose 15-year-old daughter Vanessa died seven years ago after taking the drug Prepulsid, said that is nonsense. "Health Canada claims their responsibility stops when the information gets into doctors' hands. I find that disingenuous on several levels.

"The safety warnings sent out to doctors simply don't work, and this was well established at the inquest into Vanessa's death."

Young said Health Canada is wrong to claim it has no legal authority to beef up health warnings, because the law makes it clear the minister's ultimate duty is to protect the safety of Canadians.

Michèle Brill-Edwards, a pediatrician and clinical pharmacologist and one of Health Canada's fiercest critics, agrees. "The minister has in the enabling legislation called the National Department of Health Act very broad powers for the protection of the public."

"I think Dr. Berthiaume is voicing the standard views of the department that seek to limit the department's responsibility for safety."

Although Health Canada refers to its drug alerts as risk communication, Brill-Edwards said that it's hard to call it communication when no one seems to be paying attention.

Source: CBC News

Related article:

Dangerous drugs still prescribed to seniors

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

Growing trend Multiple Births in Canada

There is a growing trend of multiple births in the western world.

According to Multiple Births Canada, between 1974 and 1990 the incidence of twins rose 35 percent, triplets climbed 300 percent and quadruplets skyrocketed 400 percent.

In the last five years alone, according to Statistics Canada, the incidence of triplets has increased 14 percent across the country.

"Primarily it's because of reproductive technology," said Dr. Bill Mundle, medical director of the Windsor Regional Hospital maternal fetal medicine department.

"People who are having trouble getting pregnant will often go through treatment, though sometimes they get more than what they bargained for."

This year, on January 7th in Vancouver, Canada's first set of sextuplets were born, eclipsing the country's famed Dionne quintuplets, born May 28th, 1934.
Not all the sextuplets survived, however.

Multiple-birth children are often born prematurely, which is why the Human Fertilization and Embryology Authority will soon limit the number of multiple births which reproductive-technology doctors in the United Kingdom can produce.

Heather McAuley, president of the Parents of Multiple Births Association Windsor Essex County, said another reason more twins and triplets are being born is because the average age of women having their first children is rising.
Older women produce multiple-birth children more often than younger women.

Source: Times Colonist

Nova Scotian doesn't get his wife back from British hospital

Sandy Munroe from Tennycape, Nova Scotia, was not surprised to hear Thursday that a British hospital will not send his wife back to Canada. But he was undeniably devastated.

"They said it was not in her best interest to send her back," he said.

"They don’t think she should be sent over to be close to her husband of almost 45 years."

Mr. Munroe was notified of the decision in an e-mail from Billingham Grange, the North Yorkshire hospital where 65-year-old Alzheimer’s patient Helena (Heli) Munroe has lived since last spring.

Many people close to Mr. Munroe believe members of the hospital panel changed their minds after the CBC aired a television report on the couple last month in which their son accused Mr. Munroe of physically abusing his wife.

"I can’t even begin to talk about The Fifth Estate," Mr. Munroe said. "It was a wicked misrepresentation of a loving marriage."

"It broke my heart to hear the things they accused me of. . . . I love my wife and I treated her well. . . . I always did."

"This has been devastating, and Billingham Grange is a good, good hospital, but they did the wrong thing."

Mr. Munroe’s voice quavered as he talked about his two-year battle to get his wife returned to Nova Scotia from her native England, where her brother took her in November 2005.

Mrs. Munroe who herself, held a doctorate in cognitive therapy and was an expert in Alzheimer’s disease, was declared mentally incompetent by her Canadian geriatricians in early 2005.

Read the full story here

Lobby to reverse directive on $500 administration fee out-of-country patients

Whistler Mayor Ken Melamed has thrown his support behind an initiative by Whistler Health Care Centre (WHCC) staff to lobby B.C. Ministry of Health officials to reverse a recent directive on administration fees charged to out-of-country patients.

Local health care providers say that in the past three weeks they’ve counted at least 64 people who have left the centre after learning of the $500 administration fee for anyone who needs to see a doctor.
In an article in The Question last week, Dr. Bruce Mohr and others said they worry that some patients whose conditions should be assessed and treated by a doctor will go untreated, potentially leading to “adverse outcomes.”

Before Nov. 22, non-Canadian residents coming to the WHCC emergency room were charged a $400 administration fee for significant problems such as broken limbs, but only a $90 “minor” fee for issues that required only a brief doctor’s assessment and perhaps a prescription. Since then, all out-of-country WCSS patients have been required to pay $500 to see a doctor for either an initial or follow-up visit, no matter what their medical condition.

Mayor Melamed said he supports Dr. Mohr’s call for community leaders to send a letter to B.C. Health Minister George Abbott seeking to reverse the directive because of the number of out-of-country patients who visit the WHCC.

“We think there are provincial and national interests at stake here,” Melamed said. “In many cases, Whistler is people’s first and only visit to Canada and it reflects on Canada and British Columbia if people’s first experience here has that negative aspect.”

Melamed said he agrees that fees are necessary and added that local officials aren’t seeking a free ride for anyone.

“What we’re potentially asking, and we’re not there yet, is for some kind of a sliding scale,” he said, adding that health professionals in other B.C. resort towns probably have similar experiences, but perhaps not with the same frequency as those in Whistler.

“It’s not special treatment for Whistler,” Melamed said. “We’re just looking for recognition that it’s not one size fits all. Don’t try and shoehorn all situations into one model.”

Dr. Mohr said that in the short term, the doctors working in emergency at the WHCC are looking at using the offices of Whistler Medical Clinic doctors, upstairs, after hours as an alternative for patients who are non-residents of Canada.

“If patients feel it’s too expensive, we would just take them upstairs,” he said, adding that that doesn’t cover the larger issue.

Question

Goverment criticized about care refugee claimant Singh

Volunteers are caring for quadriplegic refugee claimant Laibar Singh 24 hours a day, but it is unclear how many of them have formal medical training, despite his supporters' assertions that he needs access to Canada's top-notch medical care.

Harjap Grewal, a spokesman for Mr. Singh and refugee advocate with No One is Illegal, said in an interview that hundreds have volunteered to care for Mr. Singh since an aneurysm left him paralyzed, but he did not provide specific numbers of formally trained people who have been tending to him.

He said that a maximum of 10 people with training as nurses or doctors have volunteered to care for Mr. Singh, but that most volunteers are not health-care professionals. They have been helping him with needs such as hygiene and going to the bathroom that he cannot handle himself.

Mr. Grewal added that Mr. Singh would not receive the treatment he needs in India because neither he nor his children can afford to pay for it.

"A lot of people have the means to make sure that he gets that care here," he said.

Harsha Walia, also with No One is Illegal, said that money for Mr. Singh's care has come through community donations. For example, Maninder Gill, owner of Radio India, has donated $5,000 toward his care.

When asked why such donations could not be used to pay for private health care in India, Mr. Singh's home country, Ms. Walia said his case is a "simple issue of justice and humanity."

"If that argument were to be made that everyone here that's in need of care just raised money and went somewhere else, it defies a basic value of human dignity," she said. "His wish is that he feels safe here. He chooses to be with his community here."

Read the rest of the story here

"His condition just deteriorates rapidly every time he's put through this game that the government's playing...................................."

GlobeAndMail

Drug industry used too much as source for Doctors' prescription

Following my earlier article of today about drug use among seniors:

Dr. John Haggie, a Canadian Medical Association board member who chairs its ad hoc working group on pharmaceutical issues, said government warnings often get lost in the stack of documents physicians routinely receive.

Haggie warns that there is a lack of impartial information available to doctors.

"Most of the information the physician would receive in the general course of a week on medication by and large tends to come from material from drug companies," he said.

Drug companies have a very active sales and marketing team, he said, and they follow Health Canada warnings by issuing their own.

Health Canada warnings are sent out to physicians by fax, e-mail and mail, but are often one among many documents received.

Haggie said the CMA is trying to work with the academic community to provide doctors with unbiased education material to replace documents received from drug companies.

The association is also trying to get tools on its website so doctors can quickly access the latest peer-reviewed information on what drugs are safe and which need to be used with caution.

Source: CBC

Related article:

Dangerous drugs still prescribed to seniors

editor's opinion:

"Just as I thought...............the power of marketing"

New program to help seniors taking medication in a safer way

In Newfoundland and Labrador, a new program designed to ensure senior citizens are safely taking their medications will be introduced to the Corner Brook area early in the new year.

The program will be led by Elaine Fost and Bernice Buckle, who both recently participated in a facilitators' course called Safe Medicine for Seniors.

The course, designed by Health Canada, was offered at the Victorian Order of Nurses national headquarters in Halifax.

Fost and Buckle plan to deliver presentations to seniors and caregivers, teaching them tips on mixing combinations of prescribed and over-the-counter medications, safely storing and discarding medications and preparing for visits with doctors and pharmacies.

The Western Star