A friend of mine took her 98 year old, 98 lb mother to the doctor recently. Additional diabetic medication was prescribed because her A1c (also known as glycated hemoglobin -a proxy measure of average blood sugar levels over the previous months) was “not at target”. When my friend questioned the safety of yet more pills …
As a young person just beginning my career as a physician, it is extraordinarily overwhelming to confront the disconnect between the values that created our Medicare system and the logistics of how it has evolved. Despite those incredible challenges, I am more so struck on a daily basis in practice by the manner in which …
In November of 2011, I published an article in the Canadian Medical Association’s Future Practice journal on the benefits of the use of social media for physicians. Much of the feedback I received from healthcare professionals was positive. However, many commented on the lack of literature regarding patient use of social media. As a resident physician in Family Medicine, …
Each year thousands of medical students across Canada apply for, and are matched to, residency positions in a variety of medical specialties. The allocation of residency training positions among the various specialties is largely decided by academic doctors involved with medical education. Some experts believe that health system decision makers should exert greater influence over …
In my first post, “The Easy Lifting Has Already Been Done”, I noted some of the barriers to change in the health care system. I will write further about barriers and possible solutions. However, first I need to take one step back. That step is to address the necessity of change in how we deliver …
Living on an island where most of the locals are descendants of people who have lived here for generations has given me an interest in local history and genealogy. Many of my older patients’ parents and grandparents lived to a fine old age without the modern conveniences and medical care we take for granted today …
Thirty percent of an individual’s Medicare expenditures in the United States are spent in the last year of life, numbers that are very similar to here in Canada. This, in my opinion, represents a fundamental flaw in our medical economic system and culture. As a soon to be critical care fellow at McMaster University this …
It was sometime before Christmas and I was headed to a meeting at Queens Park when I saw the large bus shelter ad promoting how much money Ontario’s physician’s had saved the province. I knew immediately that it must be contract negotiations time again. Don’t get me wrong. I’m not cynical at all. It’s just …
A recent, Toronto Star article by Martin Regg Cohn struck me as providing a very insightful example of the ethical choices facing health care leaders and stakeholders when advocating for their share of public funds. Cohn notes that ‘in a world of self-interest, it’s refreshing to see one group rise above its own narrow self …
When attending healthcare events with politicians and occasionally with senior healthcare leaders an audience member will ask “do you think X government change or Y hospital practice works”? Then immediately follows up with “what you do we should do instead?” This is the exact moment I start to get nervous. Asking a single individual to …
Improving access to primary care has been a key priority of the Ontario Ministry of Health and Long-Term Care for the past decade. The number of Ontarians who have a regular family doctor has increased dramatically. However, patients who are chronically ill continue to have problems accessing primary care. More family doctors and more rostered …
I see the effects of poverty everyday in my job as a health promoter at a Community Health Centre. Many of our clients live in deep poverty conditions, relying on social assistance, food banks, and meal programs to get by each month. They have little stability, living day to day, month to month in a …
Ontario’s Information and Privacy Commissioner recently ordered Cancer Care Ontario to stop sending paper copies of screening reports containing personal health information to physicians. However, a massive amount of personal health information is mailed or faxed every day in Ontario. The implications of this order to information sharing and transfer across the health care …
For health policy wonks, 2011 ended not with a whimper, not with a bang but with a wallop. Federal Finance Minister Flaherty thumped the federal government’s 2014 Accord ‘offer’ on the table. A special kind of offer, in fact a fait accompli: there’ll be no negotiation, no debate, no to-ing and fro-ing. This is what …
In recent years, health care has embraced the concept of “evidence based” practice. We incorporate this daily in our diverse work settings. We invoke it when we mentor students. We know, for example, that rigorous control of blood sugar levels in people with diabetes reduces their risk of organ damage – and so we aim …
The challenges facing the health care system are massive and despite some occasional messages to the contrary, the overwhelming opinion is that the health care system is not sustainable. Despite the mounting chorus, internal and external, telling us that the system isn’t sustainable, surprisingly little has been done. We have been nibbling around the edges …
Have you ever wondered why ordinary people get involved in the healthcare debate? It seems that one or two voices will never achieve any change or improvement in the services Canadians receive and how they are provided. An overwhelming feeling of hopelessness and frustration kept me silent until recently, and I am an ordinary Canadian. …