Weighing the evidence – should Ontario fund Avastin for brain cancer?
Like many Ontarians, I have been moved by the request of Kimm Fletcher to have the Ontario government pay for the drug Avastin to treat her recurrent brain cancer. Ms. Fletcher is 41 years old and the mother of two young children. It sounds like her brain cancer is growing aggressively despite the best treatments …
Putting the “public” in public reporting on health system performance
As both users and funders of health care, Canadians have a stake in understanding how well their system is performing. Polls repeatedly show health to be a top priority for Canadians and their appetite is strong for performance information, provided it is easy to access and digest. The challenge is in developing reports that are …
Accessing reconstructive surgery after breast cancer treatment
One in nine Canadian women will develop breast cancer in their life time. The growth of screening programs means that breast cancer is being caught and treated earlier. Often, treatment involves surgery – lumpectomy or mastectomy. Increasingly, women are also choosing to undergo breast reconstruction surgery following treatment. However, only some of these breast cancer …
How Canada’s health care reformers quietly bent the cost curve
Health spending in Canada grew by only 2.6% this year, according to the Canada Institute for Health Information (CIHI). That’s a far cry from the 7% annual spending increases between 2000 and 2010. This is the fifth straight decline in the growth rate and the third year that per capita health spending has dropped in …
Is minimally invasive surgery less painful?
Who pays for “free” medication samples?
A student recently started one of my patients on the oral contraceptive pill YAZ. When I asked why that particular birth control pill was chosen instead of all the alternatives, I was shocked by the response: “We have samples.” The student was referring to the medication samples that are delivered to clinics by representatives of …
Decades of restructuring hurts morale of Alberta’s health care professionals
This is the second of a two-part series on Alberta’s health care restructuring. This article examines the impact of constant change at the highest levels of administration on those who work within the health care system. Alberta Health Services (AHS) is the largest health care delivery organization in Canada. AHS provides health care to nearly …
Alberta’s innovative approach to paying for long-term care
Alberta’s provincial health authority has recently come under fire by opposition party MLAs and activists alike for closing 77 long-term care beds in Calgary damaged by the June floods. The angry reaction demonstrates the common misperception that a shortage of beds is the major cause of persistent waiting lists for long-term care. Like other provincial …
How to prepare for end of life care
The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskPaul@Sunnybrook.ca The question: I have been following the news about the Supreme Court of Canada’s ruling involving Hassan Rasouli, the patient who has been on life support for three years. …
Postpartum depression is a family affair
At long last, people are talking about postpartum depression. Dismissed for years as no more than a touch of the baby blues or else unheard of entirely, postpartum depression — or PPD, as it is often known — has become an open subject. Healthcare providers are aware of it, many nurses and physicians routinely screen mothers for …
Experts warn bureaucratic duplication in research ethics delaying important science
Research on human subjects is essential to the advancement of patient care. Every life-saving drug, surgical technique and medical procedure was tested at some point in its development on humans. While research on humans has yielded enormous benefits, it can also carry risks to research participants. It is therefore essential to ensure research is carried …
Gaps in health care coverage when moving between provinces
Working smarter to reduce wait times
The challenges in providing timely access to health care are becoming increasingly common and cross many disciplines. Whether the conversation is around delays for elective surgery, emergency department overcrowding or long waits for specialist appointments, the frustration is felt by patients, practitioners and healthcare administrators alike. The recent Preferential Access Inquiry in Alberta highlighted that long …
Weight loss surgery: what do we know about quality?
Weight loss is a constant struggle for millions of Canadians, with one in four Canadian adults classified as obese. Losing weight is not easy. Many Canadians try to lose weight through diet, exercise, behavioral modification and medications. Bariatric, or weight loss surgery is often the final effort for many on a long, difficult road to …
Why do personal items go missing in nursing homes?
I am addressing this letter to all the caretakers and families in Canada who have family members residing in nursing homes. I want to know if the situations that we are encountering are widespread and if there is anything that we can do to change policies and procedures to help alleviate the problem. My mother …
Ovarian cancer: why does it often evade early detection?
Restructuring Alberta’s health system
Alberta Health Services has had a tumultuous summer. There have been major changes at the highest levels of administration and governance of the province’s health system. A review of the recent history of restructuring in Alberta’s health system might be helpful to understand the recent changes. Moving towards health regions Alberta was part of the …
Why does my mother have to share a hospital room with the opposite sex?
“Expecting Better” from your doctors during pregnancy
Of all the pregnancy taboos I’ve heard in my 34 weeks of this surreal, at times ache-inducing, but ultimately incredible state, caffeine has caused me the greatest chagrin. Strangers in line at Coffee Central offered helpfully: “You’ll get decaf, of course.” My four-year-old nephew looked at a cup of tea in my hands, his brow …