Opinions
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May 2013
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Who is “the patient” in patient-centred care?
I breathe a sigh of relief as the announcement system comes on after an 8-minute clinical encounter: “please begin patient feedback.” I especially enjoy this part of our weekly clinical skills session, and not only because it heralds the end of an encounter wherein I,…
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For some patients the harm is not in dying, but in being kept alive
It’s been five years since my grandmother died, and I still remember how sterile, cold, and distant her hospital room felt, no matter my family’s loving efforts to make it look more like home. I still remember the guilt-feeling too, of having to work up…
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Health Canada and the FDA: two peas from different pods
Health Canada’s Health Products and Food Branch has a mandate of “minimizing health risk factors to Canadians while maximizing the safety provided by the regulatory system for health products”. The FDA’s mandate is “protecting the public health by assuring that… human and veterinary drugs, and…
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Generic drug prices in Alberta: a step in the right direction
Want to buy a $100 coffee? Sounds absurd, doesn’t it? However, it’s equally absurd that this is how much more Albertans pay for some generic drugs than people in other countries. Take, for instance, 20mg of the cholesterol-lowering drug simvastatin. Albertans pay 90 cents for…
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Healthy, wealthy and wise: we need to recognize that health drives wealth
Is the formula for Canada’s success to be wealthy, healthy and wise or to be healthy, wealthy and wise? The difference may appear subtle, but it gets to the heart of a question that has serious implications for the future of publicly funded health care:…
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April 2013
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Tethered to a pole: the challenge of end of life decisions
When I attended the Association of Health Care Journalists (AHCJ) conference in Boston recently, discussion swirled on the topics of unsustainable costs of care, doctors’ incentives under traditional payment models to order more tests and treatments, and the struggles of patients’ family members to avoid unwanted care at the…
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Values in health care
The language of health care has had dramatic change – we now commonly use terms like patient centred care, quality outcomes, accountability, and so on in our description of a current or desired state for health care systems and the delivery of care. One discussion…
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Should Ontario be more proactive in pressure ulcer prevention?
Pressure ulcers (bed sores) can cause severe pain and decrease quality of life. They are common among the very ill, the elderly, and immobile or neurologically compromised patients. In Canada, approximately 1 in 8 patients in acute care hospitals, 1 in 11 nursing home residents,…
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Addiction is not a disease of society’s margins
The Canadian Centre on Substance Abuse (CCSA) and its National Advisory Council on Drug Misuse recently released a national strategy: “First Do No Harm: Responding to Canada’s Prescription Drug Crisis.” The plan, which focuses on education, treatment, and multiple levels of prevention, could not have…
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A hospital CEO’s take on CBC’s “Rate My Hospital”
Following the public release of Rate My Hospital report last week, I received the following question on twitter: “CBC 5thEstate is being pretty provocative, are hospital CEO’s cringing across the country? Reaction?” Personally, I welcome the public scrutiny, and support actions that increase the transparency and…
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When dealing with cancer, “lost battle” language is inappropriate
I was very saddened to learn of the recent death of Roger Ebert. I, like so many around the world, was impressed and inspired at how he handled himself in the aftermath of his cancer surgery years ago that left him disabled and disfigured and…
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Should the public have a greater say in health care decision making?
I am a born and raised Canadian now living and working in the UK. Having been in the UK for over two years, I tend to draw comparisons between the UK’s National Health Service (NHS) and the Canadian health system. Before I start here with…
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Why do doctors still think pharma doesn’t influence them?
Why do so many doctors still think they are invincible to the influence of the pharmaceutical industry? Attractive, well-dressed, charismatic drug reps with pearly smiles and shiny flow charts still wait in waiting rooms. Lectures and conferences still occur where lunch is paid for by the…
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The gap between rich and poor is bad for our health
The gap between rich and poor in Canada is growing. Organizations across the country, from the Conference Board of Canada to the Canadian Centre for Policy Alternatives have recognized the rise of income inequality in Canada. For some, this concentration of wealth is an unremarkable…
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Do medical schools teach future doctors about weight management?
In my day to day I often will supervise residents or medical students who have taken it upon themselves to learn more about obesity medicine. I say taken it upon themselves because despite diet and weight related/responsive conditions being huge contributors to a physician's caseload,…
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March 2013
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It’s compassion – not amenities – that makes health care work
Transitioning my father from our home, to the hospital, and ultimately to long-term care hit us by surprise and we faced many challenges along the way. This is not a post about how to improve the system or a post about the challenges we faced….
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Quality in health care: the road ahead
Achieving high quality in a health care system, as in any other enterprise, requires that the factors necessary for success be defined, measured, continually monitored and openly reported. The good news is that almost all jurisdictions and professional bodies in Canada are beginning to take…
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Why Canadian health care needs a new kind of patient input
Modern health care systems emerged in the late 19th Century from the ascendance of scientific medicine. The major killers at the time of Robert Koch and Louis Pasteur were infectious diseases such as anthrax, tuberculosis and typhoid fever. These scientists were among the first to…
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The jury is in: time to fill Medicare’s prescription
Canada is the only country in the world that provides universal public insurance for medical and hospital care but not for prescription drugs. Is this a desirable divide in health policy or a failing of our health care system? If the latter, what would our…
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Childhood obesity: it’s about more than banning marketing of junk food
The media had a field day recently with the proposal from Ontario’s Healthy Kids Panel to ban marketing of junk food to kids under 12. Sadly, this covereage missed a number of the panel’s crucial recommendations that would address the biggest contributors to childhood obesity. Childhood obesity rates…
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