Dr. Janet Kushner-Kow is the physician program director of elder care at Providence Health Care and division head of geriatric medicine at the University of British Columbia.
Patients need to be at the centre of their own care, and they need to manage their pain for what it is, a chronic disease. The time to reimagine chronic pain care is now – we can’t afford not to and the millions of suffering Canadians can’t afford to wait.
The Israeli-Palestinian conflict is undoubtedly complex, but the path forward is not as convoluted as it may seem. The solution is simple (perhaps too simple for those in power who aim to confuse us): Stop killing children and lead with love for children while upholding their rights under international law.
Canada is a nation of caregivers. But caregivers and care recipients alike are at risk for burnout. We need a concerted policy response that meets caregivers where they are.
The last guideline on prostate-cancer screening was published in 2014. At the time, the task force approached the Canadian Urologic Association (CUA) and asked that it provide an expert panel of “stakeholders” to provide input....We found that the task force guideline utilized only data from a small number of randomized trials and ignored scores of other relevant studies. The analysis of the studies that were reviewed was superficial and the guideline was flawed.
The Canadian Ophthalmological Society, which represents all ophthalmologists in Canada, recognizes the importance of guidelines but also appreciates the challenges around them. For guidelines to be effective, they need to involve a variety of stakeholders with varying expertise from the beginning to ensure inclusion of all the evidence and consideration of issues where there may not be published data.
One would expect that the priority of the Canadian Task Force on Preventive Health Care on breast-cancer screening would be to recommend practices that would maximally reduce mortality and morbidity from disease. In the case of breast cancer, this suggests focusing on effective guidelines for those who are at increased probability of developing disease or increased risk of late diagnosis and the consequent higher likelihood of premature death or morbidity associated with treating advanced disease.
Most assume that the Canadian task force guidelines are led by content expert specialist clinicians. But this is not the case. The task force says it excludes content experts from genuine involvement in guideline development to avoid conflicts of interest. However, in the Canadian health-care context, this is not a valid argument.
In 2022, the Canadian Task Force on Preventive Health Care released recommendations against using a tool (the Edinburgh Postnatal Depression Scale – EPDS) to screen for depression during pregnancy and the postpartum. These recommendations do not agree with those made by experts in B.C. and Ontario; and around the world in Australia, the United States, England and Scotland. It is important that we look closely at these recommendations and try to understand why they differ.
A three-year family practice program will almost certainly exacerbate the current primary care crisis. For Canadians, this will result in fewer family doctors practicing community care and less access to preventative care, cancer screenings and treatment of chronic diseases.
Private sector activities have a real impact on people's health. We need to promote healthy cross-industry regulation and scrutinize the role that private interests play in the health-policy arena to help safeguard the health of patients.
Breast cancer rates, even among young people, are on the rise. For this Breast Cancer Awareness month, there's more we could be doing to prevent the disease before it starts.
Global health solutions require creativity, innovation and novel thinking. It is imperative for governments and educators to recognize young leaders and their ideas.
No system, public or private, can cover all the health needs and wants of every person all the time. It's time for difficult conversations about our health-care system.
Contraceptives are a key part of health care for half of Canada's population and their benefits extend beyond family planning alone. It is time to expand universal contraception to the entire country.
Does being a patient make you an expert on your condition? Does formal education and credentials to comprehend a disease outweigh the rigor of experiencing life with the disease? There may be more room for patient-expert buy-in in health care decisions.