Articles

  • December 2014

    • Healthy Debate e-book

      Free e-book: A patient’s guide to navigating Ontario’s health care system

      Ontario’s health care system can feel like a maze. The system has become so complex that even people who work in it every day often struggle to navigate it. So for members of the public – who often encounter the system at a time of […]

    • Medication safety at home

      Improving medication safety for the elderly

      Mimi Roots is worried about her ninety year old mother, Maria. Maria lives alone and has multiple health issues: congestive heart failure, asthma, arthritis, gastrointestinal issues, and a thyroid that was surgically removed. She receives care from five specialists and her family doctor – and […]

    • C

      Complacency about road safety hiding a public health crisis

      “96 vehicles involved in collision after ‘wall of snow’ hits Highway 400” “Highway 17 Crash Leaves Five Men Dead” “Huge multi-vehicle pile-up injures 100 people near Edmonton.” Every winter, we’re snowed under by headlines like these, on stories of car crashes that seem as inevitable […]

  • November 2014

    • Health care spending

      Slowing growth in health care spending: temporary blip or permanent gain?

      For years, health care spending in Canada (both public and private) grew much faster than the economy. Until very recently, this trend was expected to continue, casting doubt on the sustainability of Canada’s health care system. However, recent data from the Canadian Institute for Health […]

    • TRT HD Banner

      Please help us evaluate The Rounds Table

      It has been just over six months since we launched The Rounds Table on Healthy Debate. This week we are posting a user survey to get your feedback. Hareem, our Associate Producer is conducting this evaluation as part of an Independent Study project she is […]

    • Judges Gavel

      Is Canada’s medical malpractice system working?

      Starting next year, doctors’ malpractice insurance in most parts of the country will cost a lot more – more than doubling in many places. Fortunately for physicians, however, that will affect provincial health budgets more than their own practices. Most doctors are covered by the […]

    • drugs

      Drug treatment courts offer an alternative to jail for people with addictions

      It’s not a flashy place. The Toronto Drug Treatment Court, tucked away in a corner of Old City Hall, has plywood sheets on the walls, wires dangling where ceiling tiles should be, and a microphone that only works sporadically. Today is one of the days […]

    • Pharmacy chemist woman in drugstore

      Should pharmacies sell natural health products?

      Suffering from migraines, back pain, acne, diarrhea or constipation? Rexall pharmacies have a product that might help, but it’s not medication or an over-the-counter fix. Rather, it’s an IgG test called Hemocode that looks for 250 food intolerances – and costs $450. The test, which […]

  • October 2014

    • Pan-Canadian Pharmaceutical Alliance

      Canadian provinces take first steps towards lower drug prices

      Prescription drugs provide important benefits to patients, and are an essential component of the health care system. They also have significant costs: Canadians spent roughly $35 billion on drugs in 2013, or about 16% of total health care spending. Drug costs have put significant strain […]

    • cherry picking

      Are family doctors cherry picking patients?

      When Anne Lyddiatt’s family doctor retired, she went looking for a new one.  The Ingersoll, Ontario resident thought she’d found one for herself, her two daughters, and her granddaughter, and they filled out application forms with their health information. But only one of the four […]

    • Temporary Foreign Workers

      Changes to temporary foreign worker program have unintended impacts on doctors

      Reports of low-skilled Canadian workers being replaced with those from other countries spurred changes earlier this year to the Temporary Foreign Worker Program. But they’ve made it harder for areas in need of physicians as well. The system was overhauled this summer after reports that […]

    • hospital

      Controversy over closing rural hospitals

      Hymns, protests, and arrests – that’s what happened when the Fort Erie, Ont. community rallied against a planned conversion of their local hospital’s emergency room to an urgent-care centre. It didn’t work, and in 2009, it seemed their fears were realized when a teenager died after […]

    • Medical legal partnerships

      Widening the circle of care: adding legal and financial expertise to the health care team

      Grace (name and some details changed to protect her identity) is a nine year old girl who lives in the northern suburbs of Toronto. Her doctor diagnosed her with asthma last year, and developed a care plan and prescribed her medication. Grace’s family understands and […]

  • September 2014

    • Home Care

      How should we measure quality in home care?

      Trevor Cranney gets 60 hours of home care a month. Though he’s happy with the quality of care he’s getting, he doesn’t think it’s enough. “I suffer from ALS, and I’m unable to feed myself, brush my hair or do anything,” says the 42-year-old, who was recently […]

    • registries

      What Canada can learn from Sweden’s health registry system

      In 2007, a group of Canadian cardiologists found themselves in a unique position. New – and expensive – implantable cardiac defibrillators were being used by fewer than a dozen doctors. And the Institute for Clinical Evaluative Sciences was offering to help them create a registry that would track […]

    • Lean healthcare whiteboard

      From the factory floor to the emergency department: Hospitals explore Lean method

      Can health care learn from assembly lines? Manitoba’s St. Boniface General Hospital thinks so. It’s been using Lean, a system inspired by Toyota, on processes around the institution. Last year, one of its projects was to reduce wait times for CT scans. Staff ran a Rapid […]

    • doctorcomputer

      How Norway’s innovative library made high-quality health information free for everyone

      If you’re looking for evidence-based health information in Canada, a lot depends on who – and where – you are. A physician in a teaching hospital? No problem. But family doctors in rural areas, nurses or physiotherapists have a much harder time accessing up to date […]

  • August 2014

    • hospital direction sign

      Hospital parking: health care’s controversial cost

      Shalimar Novak is sick of paying for parking. The social worker has been to Toronto’s Mount Sinai once or twice a week recently for appointments related to her pregnancy, and paid about $15 every time. “It definitely adds up,” she says. “And when you have a kid […]

    • Euthanasia

      Physician-assisted death and euthanasia in Canada: should it be legal or banned?

      When Canadians saw the video from Donald Low pleading for physician-assisted death, it sparked a nationwide conversation on the issue. The public had grown used to seeing Mount Sinai Hospital’s microbiologist-in-chief at press conferences, poised and  explaining how Toronto was battling the SARS outbreak. But […]

  • July 2014

    • Gluten sensitivity: bread

      Does non-celiac gluten sensitivity really exist?

      When Linda Kerr’s son’s growth flatlined, a doctor suggested the teen might benefit from a gluten-free diet. In support, she tried the diet with him. Her son eventually decided he wasn’t going to follow it, but it did have an unexpected effect: after about a month, […]

    • Bridgepoint

      The surprising science behind evidence-based hospital design

      Rahel Yetbarek sits with her feet up, looking out onto the city and the large swath of treed land that surrounds the freeway below her. The nurse is taking in the view over her lunch break, from the 10th floor rooftop garden at Bridgepoint, a […]

    • Northern Travel Grant

      Despite Ontario’s Northern Health Travel Grant, some still pay out of pocket

      When Nan Normand’s husband had quintuple bypass surgery, it cost them $1,500. It wasn’t the operation that was pricey, but the travel. The couple went from Kenora, a small city near the Ontario-Manitoba border, to Hamilton for the surgery. The trek included flights and a multiple-night stay. Normand was […]

    • Genetic testing

      Should patients be told about incidental findings from genetic testing?

      Genomics is moving at a lightning pace. Whole genome sequencing, a special type of genetic test, can produce much more information about a person’s genes than ever before. However, this rapid advance in technology has outpaced our ability to understand what to do with all […]

    • Front-of-package labels

      Are food labels more sell than science?

      Probiotic ice cream. Antioxidant 7Up. Cupcakes that are “a good source of iron.” Grocery store shelves are lined with products that claim they’re good for you. Some food labels say they’ll help you dodge health conditions – like oatmeal boxes that say “oat fibre helps reduce cholesterol.” […]

  • June 2014

    • OLYMPUS DIGITAL CAMERA

      Should the public know how much doctors are paid?

      The United States began releasing the Medicare payments it made to individual doctors on April 9, a move that sparked sensational headlines and debates about privacy. The data offer insights into the $77 billion paid by Medicare’s fee-for-service program to more than 880,000 health care professionals […]

    • Family doctor

      Family medicine attracts record number of graduates

      Family medicine was a popular choice among medical graduates in the 1980s, when Roger Strasser was training at The University of Western Ontario. “The residents had almost a missionary zeal that they were going to be family doctors,” he says. He shared their passion, becoming […]

    • Boy with childhood obesity

      Treating childhood obesity with family-focused interventions

      Many Canadian children struggle with their weight. The number of kids with childhood obesity has been growing since the 1970s, with measured rates rising from 6% in 1978 to 13% in 2004. In addition, 18% of children are overweight. It’s part of a larger global trend: 23% of children […]

    • Many internationally educated doctors need to do a Canadian residency before being able to practise.

      Changes ahead for international medical graduates hoping to practise in Canada

      About halfway through Anmar Salman’s attempts to become a doctor in Canada, he almost gave up. After studying medicine in his native Iraq and doing a master’s in public health in the U.K., he immigrated to Canada, found a job at the Ontario Ministry of […]

  • May 2014

    • caesarian section

      Pulling back the curtain on Canada’s rising C-section rate

      Caesarian sections (C-sections) are among the most common surgical procedures performed on women of child-bearing age. Canada’s C-section rate has increased dramatically in the past two decades. The national C-section rate  has increased from 17% of all births in 1995 to nearly 27% in  2010. In Ontario, nearly 29% of births […]

    • mandatory school entry vaccine

      Provinces divided over mandatory vaccination for school children

      The past year has seen confirmed outbreaks of measles across in British Columbia, Alberta, Saskatchewan and Ontario. Measles is highly contagious, and can lead to serious complications and death for children under the age of five. It is strongly recommended by the Public Health Agency […]

    • IntegrativeCancerCare

      Integrative cancer care in Canada: curiosity and cautions

      Joanne MacPhail was diagnosed with breast cancer  in 1993 at the age of forty three. At that time, her treatment included two surgeries, as well as a lengthy course of chemotherapy that had profound physical and emotional side effects. MacPhail details how she sought out reflexology, therapeutic […]

    • Earth Checkup

      Tensions around physicians and environmental advocacy

      A poll of Canadians from earlier this year found that the environment ranks as the third most important issue to us, behind the economy and health care. In fact, Canadians are quite divided in their opinions about the environment and what we ought to be doing […]

    • pregnancy

      Non-invasive prenatal testing and chromosomal microarray: changing the landscape of prenatal genetic testing

      Prenatal testing is a routine part of pregnancy care in much of the world. Every pregnant woman in Canada is offered blood tests and ultrasounds to evaluate the health of her pregnancy. When testing suggests potential genetic abnormalities, doctors offer a further test such as […]

  • April 2014

    • Plasma

      Paying for plasma – Canada’s double standard?

      Sandra Duvlock was 58 when she was diagnosed with dermatomyositis. The gradual inflammation of her muscles had gotten to the point where she was unable to walk, clean or feed herself. When this relatively rare disease was diagnosed, Duvlock was prescribed intravenous immunoglobulin (IVIG) treatment and long-term physical […]

    • senior friendly hospitals

      How far along are we in making hospitals more ‘senior friendly’?

      Being hospitalized can have dramatic impacts on seniors’ wellness, and time spent in hospital contributes to loss of important functions such as strength and mobility – critical to their independence and wellbeing. Camilla Wong, a geriatrician at St. Michael’s Hospital in Toronto says “hospitalization robs […]

    • HCW_Injury

      Stubbornly high rates of health care worker injury

      Ann Smith starting working as a bedside nurse on an Edmonton general medical unit  in 2012, three years after graduating with her nursing degree. She was working a night shift when she entered the room of an elderly patient who had called for help to […]

  • March 2014

    • Physician wellness

      Physician health: reducing stigma and improving care

      John Bradford always prided himself on being psychologically tough. After all, he needed to be. As one of Canada’s top forensic psychiatrists, he analyzed some of the country’s most high-profile murderers including Paul Bernardo, Karla Homolka and Robert Pickton. In order to keep healthy and […]

    • eCigarette

      Regulating the ‘wild west’ of e-cigarettes

      E-cigarettes have exploded onto the market in recent years and there are multi-billion dollar questions swirling around them. Advocates say that they offer a safe and effective smoking cessation aid while opponents are concerned that they may erode the success of decades of tobacco reduction […]

    • GregPrice

      Improvements suggested to the health system that failed Greg Price

      Greg Price died at the age of 31. His death may have been preventable had he been diagnosed and treated earlier for testicular cancer. He was left alone to navigate the health system and follow up on referrals, while experiencing major delays and the absence […]

    • Andreas Laupacis healthy debate editor in chief

      Introducing “The Rounds Table”, a weekly podcast about major new studies in medicine

      Dear Healthy Debate community, I’m pleased to announce that Healthy Debate is launching a new feature today – a podcast we’re calling The Rounds Table. Healthy Debate’s articles and opinion pieces are aimed at a general audience, but we also produce more specialized content in […]

    • G

      Should HPV vaccination programs be expanded to boys?

      Vaccination programs are based on the old adage that an ounce of prevention is worth a pound of cure.  Since 2007 Canada has had a vaccination program for the Human Papillomavirus (HPV) administered to girls, although the age of vaccination varies by province:  Grade 5 […]

  • February 2014

    • PoliceiStock_000001926087Small

      Improving hand offs between police and emergency departments

      Police have been described as “street corner psychiatrists.” They are often the community resource that responds at all hours when emergency calls come in for someone in mental health crisis. Police also serve a gatekeeper function in determining what services are required for an individual […]

    • Medical marijuana

      Medical marijuana: what doctors need to know about Canada’s new rules

      Herbal marijuana is not an approved drug in Canada, but court rulings have required reasonable access to a legal source of marijuana when authorized by a physician. On April 1st, Canada’s current regulatory system for medical marijuana will be replaced entirely by a new set […]

    • HockeyConcussionl

      Buyer beware – no quick fix for concussion symptoms

      The world is watching athletes in Sochi compete in sports such as hockey and downhill skiing. Concussion poses a risk, not only to the highly trained individuals competing in the Olympics, but also to ordinary Canadians who play sports occasionally. Concussions are the result of […]

    • Mandatory vaccine health care workers

      The evidence and politics of mandatory health care worker vaccination

      The United States Center for Disease Control reports that while only 44% of employees get the influenza or “flu” shot on a voluntary basis, that number rises to 89% when it is required or mandated by the employer. With vaccination rates of 45% among health care workers in some […]

  • January 2014

    • Homeless

      Sheltering Canada’s homeless

      “I’d do whatever I had to do to stay warm” recalls David, who was homeless on Toronto’s streets from 2000 to 2003. David said he spent the winter nights in emergency shelters, and bitter cold days in bank ATM lobbies or riding around on public […]

    • Andreas Laupacis healthy debate editor in chief

      A primer on Ontario’s health care system for primary health care boards of directors

      Last year, Healthy Debate published a primer on Ontario health care system for the boards of directors of hospitals. We’re very happy to now release a primer on the health care system specifically designed for the boards of directors of community governed primary health care […]

    • TargetsiStock_000004380091Small

      Missing the target on health care performance?

      Setting targets has long been a mechanism in industrial psychology to motivate managers and workers to achieve specific organizational objectives. In the last decade, targets have become important methods of driving performance improvement in health care. However, deciding where and when to set targets is […]

    • Prescription opioid abuse

      Canada’s prescription opioid crisis

      There is a prescription opioid crisis in Canada. While these drugs are effective in treating acute pain, and pain near the end of life, the evidence to support long-term use in patients with chronic pain is weak, and for many people the harms exceed the […]

  • December 2013