My parents (86 years old, married 61 years) have only rarely been separated in the last 20 years. They have dementia and osteoporosis and additional health concerns. Three years ago their problems became acute, Dad was on the verge of burn-out as caregiver and it became clear they couldn’t manage at home any longer. I …
In recent weeks, I have read several reports on the health of immigrants in Canada. All these reports are unanimous in their conclusion that immigrants are healthier than Canadians when they arrive in Canada. However, over a 10 year period, their health deteriorates, with increasing rates of heart disease, hypertension, blood pressure, autism, diabetes and …
I’ve had a couple of sour experiences with teamwork since entering medical school. These experiences are bad teamwork of the usual sort: a miscommunication, a slighted ego, and pretty soon we’re starting arguments with no other reason than to prevent the other person from having his way. And though I know experiences of bad teamwork …
The governments of Canada and the United States have patient-oriented research initiatives underway, which share the goals of supporting research that will improve health care systems and directly benefit patients. However, the mandate, structure and funding of these initiatives differ significantly, with the United States accomplishing a great deal in a relatively short period of …
At the recent Council of the Federation meeting, Canadian provinces (except Quebec) announced that they will begin bulk-buying different generic drugs to reduce health care costs. They also flagged the need to both expand and accelerate group pricing on brand name pharmaceuticals. This is a long time coming and a step in the right direction. …
The staff at the Community Health Centre (CHC) where I work often discuss behavior change and the fact that many of our clients struggle to make changes that could affect the quality of their life. “If this client would only make some of the dietary changes as I’ve suggested…” “Despite all that we know about …
As medical students, we fall under the scope of ‘future physicians’ and the public expects us to behave as such. A patient needs to be able to trust their physician to exercise good judgment and to act in the best interest of their health. This trust is rooted in the confidence that physicians will put …
So far this year, I’ve visited my dentist and optometrist once each for routine checkups. As most people know, the Ontario government does not pay for routine dentistry and optometry for most people. Or at least this is what we think. Indirectly, the government shoulders a significant portion of the cost. In other words, most …
About one in four Ontarians visit a walk-in clinic each year. While the government has made access to family doctors a key priority, there is no policy framework for walk-in clinics. Although walk-in clinics have been part of Ontario’s health care landscape for decades, they remain controversial. Walk-in clinics have generally been excluded from government …
One of the big challenges facing modern health care systems is how to reduce delayed discharge from acute hospitals by patients for whom acute care is not longer medically necessary – better known as the problem of bed blockers. Bed blocking occurs when a patient is ready for discharge, but has to stay in hospital …
Although there is lots of talk about making measures of health system performance available to the public, the reality often falls short of the aspirations. Not only are these measures often difficult for public users to understand and access; evidence suggests that they have little impact. In April of this year, the Canadian Institutes of Health …
There have been a number of Canadian reports recently which paint a gloomy picture of the future sustainability of the Canadian health care system. The reports all go something like this: health costs are inexorably rising and caring for a growing elderly population may eventually bankrupt our health care system. We clearly have choices to …
Recent media reports have highlighted the problem of neglect in nursing homes. Reports from the long-term care sector, in response, have focused on how the quality of care in nursing homes could be improved. However, measuring the quality of nursing home care can be a challenge. Rob Sargeant is a general internist at St. Michael’s …
As a 3rd year medical student, I am a junior member (also known as a clinical clerk) of a large health care team. Throughout my rotations, situations arise where – if I was in charge – I would do things differently. Most of the time, these differences in style or approach are minor in nature …
There’s been a seismic shift in health policy taking place in Canada that has been largely ignored by the mainstream media and gone unnoticed by the general public. Provinces are starting to change the way they fund hospitals. This is no small change and will directly affect the care patients receive — potentially improving access …
From insulin to the pacemaker, Canada has proven itself a global leader in invention. Yet, we rank in the bottom quartile of OECD countries for innovation – a stark contrast to our record on invention. Why? Perhaps it is the challenge of defining innovation, and then measuring its impact so that Canadian health systems can …
Our health care system is based on an on-demand model of physicians and hospitals providing acute and episodic care. While this system works well for the vast majority of citizens, it is a poor match for many of those with chronic diseases. As a nurse and an academic, my particular interest is examining how health …
A number of Canadian hospitals have started publishing live emergency department wait times online in an effort to provide patients with expectations on how long they will have to wait to be seen for non-urgent issues. These efforts are all innovative pilot projects, but there is little evidence available on whether this information makes any …
When talking with my family and friends outside of healthcare I get mixed reactions to what eHealth means. Responses can range from simple to sad. “Is that like MRIs and stuff? “Do we have electronic records like at the store?” “My doctor has a Blackberry…. but I can’t email him, so I don’t know.” However, …
How can the idea of early detection and screening for cancers even be a debate? What could possibly be the downside of catching cancers early, and treating them before they cause great harm, even death? Logic says if you can’t prevent a cancer in the first place, then diagnose it as early as you can, …