Healthydebate.ca has run a series of stories on breast cancer screening mammography, stimulated by the recent guidelines from the Canadian Task Force on Preventive Health Care. This last story focuses on how women and policy makers must balance the benefits and harms of screening mammography. The issues raised in this series are relevant to screening …
Some breast cancers detected by screening mammography are cured and would have led to death had they not been detected early. Other breast cancers detected by screening can be treated just as effectively if diagnosed later, may not have needed treatment at all, or may be so advanced that treatment does not prevent death from …
As a rural family doctor I have to factor in travel costs when referring my patients for specialized services. Costs of travel include not only transportation expenses but time from work and home. Increasingly patients are being forced to travel again and again after having tests. A good example is breast screening which causes many …
The Canadian Task Force on Preventive Health Care recently released recommendations about screening for breast cancer. These recommendations have been criticized by some because they emphasize the results of randomized trials. This article explores the advantages and limitations of randomized trial evidence regarding screening mammography. The recent recommendations by the Canadian Task Force on Preventive …
The acting editor of the CMAJ has sparked a controversy weighing in to a debate about parking, suggesting that parking near health facilities should be subsidized. Assuming such a policy can be operationalized (how near? For whom?), the underlying issue is an interesting and global one. When I was first appointed as a Board chair in …
The results of research on screening for breast cancer with mammography can be presented in ways that make the benefits seem larger or smaller Similarly, the benefits can be described as avoiding deaths from breast cancer or avoiding deaths from any cause Part of the debate about the benefits of screening mammography may be related …
A recent report by the Canadian Institute for Health Information provides information about the major drivers of health care costs in the past decade, which include growing salaries for health care workers and greater intensity of treatment. The report suggests that the aging population is not a major contributor to rising health care costs. These findings clash …
In medical journals, doctors and scientists continue to debate the relative benefits and harms of breast cancer screening for women who are at average risk of developing breast cancer. This debate is not always reflected in screening programs, most of which strongly recommend mammography to average risk women within a certain age bracket. Some experts …
Each year several thousand Canadians die from influenza. Vaccinating health care workers against flu reduces transmission and would protect patients who are most vulnerable. However, only about 40% of hospital staff in Ontario were vaccinated last winter. Is it time for Ontario to make the flu vaccine mandatory for health care workers? Explaining the influenza …
The past ten years have seen a surge of bedbug infestations across North America, with many cities across Canada affected. Although they do not cause or transmit disease, bedbug infestations are often perceived to be a health problem. An effective and efficient bedbug strategy requires coordination among various sectors, including public health, housing, community and …
The Ontario Health Insurance Plan (OHIP) does not cover all health services that can be provided by a doctor. These “uninsured” services include telephone renewal of prescriptions, writing sick notes for work or school and transferring medical records. Doctors can offer patients the option of paying for a set of uninsured services with a single …
With the expiry of the Health Accord in 2014 looming, the debate about the role of the federal government in paying for health care is once again taking centre stage. The School of Public Policy and Governance at the University of Toronto hosted a roundtable on the future of how the federal government transfers …
Hospital accreditation is a process that assesses a hospital’s performance against a set of standards. This process is done differently across provinces and countries. In Canada, most hospitals go through an accreditation process conducted by Accreditation Canada. The accreditation process could be more transparent and provide more information to the public about the quality of …
The recent controversy about a new treatment for multiple sclerosis (MS) has raised questions about the role of patients and politicians in determining health research priorities. In the past, the scientific community has generally determined what research is conducted. However the public is increasingly demanding that they be involved in setting research priorities – the …
Increasing access to primary care providers, such as family doctors or nurse practitioners, has been a government priority. Better access to primary care is also associated with improved population health. Although the percentage of Ontarians with a regular primary care provider has increased in recent years, fewer than half can see their primary care provider …
In the run up to the Ontario election, the Liberal party has promised $60 million to support physician house calls. The number of doctors who make house calls has declined markedly over the past fifty years, and only a small proportion of Ontario family doctors currently provide ongoing care to patients in their homes. What …
In August 2011, a supervisor was appointed at the Niagara Health System to “restore public confidence” in the hospital. The Ontario Public Hospitals Act allows the government to appoint a supervisor to take over the administration of a hospital if it is considered in the public interest to do so. While appointing a supervisor happens …
Smoking is the leading cause of preventable death and disease in Ontario, and is costly to the health care system. From the 1990s into the past decade, Ontario made significant progress in reducing smoking rates. However, smoking rates are no longer declining as steeply. More aggressive action needs to be taken if Ontario wants to …
Most of Ontario’s doctors bill the Ontario Health Insurance Plan for their services on a “fee for service” basis. The amount doctors are paid for each service is established through negotiations between the Ontario Ministry of Health and Long-Term Care and the Ontario Medical Association. Although fees are reviewed every few years, there is disagreement about …
The frequency of obesity has skyrocketed across Canada, and its treatment is a major challenge to the health care system. Bariatric surgery is an effective treatment for obesity that appears to be good value for money. Although Ontario is expanding bariatric surgery capacity, some are concerned that capacity remains below current needs. What is bariatric …