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Who will care for Canada’s seniors?

Our health care system faces a disturbing paradox. While seniors represent the fastest growing age group in Canada, the country faces a growing deficiency of specialist physicians with expertise in caring for the elderly. But with seniors accounting for nearly half of all the country’s hospitalizations and visiting their family physician twice as often as younger

Fewer hospital staff on weekends puts some patients at risk

Fewer hospital staff on weekends puts some patients at risk

In the modern economy, many industries, such as aviation, retail and manufacturing, no longer slow down over weekends. Yet hospitals have mostly resisted this trend, even though demand for many forms of health care is no less on weekends than on weekdays. While most hospitals are open every day of the week, many operate with

Family Care Clinics – filling a gap or costly duplication?

During her campaign for reelection in 2012, Alberta premier Alison Redford promised to create 140 Family Care Clinics (FCCs) over three years. She articulated a vision of primary care that would be one-stop, with many different health care providers under one roof. These clinics would have expanded hours to improve patient access, and would focus

The controversy over “pay-at-risk” for hospital executives

The controversy over “pay-at-risk” for hospital executives

“Pay-at-risk” became a political flash point in Alberta last month when Health Minister Fred Horne fired the Alberta Health Services board when it didn’t agree to withhold the at-risk part of the compensation package for about 100 executives. Alberta Health Services (AHS) had introduced pay-at-risk for health care executives in 2009. With pay-at-risk — also

How much interaction should medical students have with industry?

Is there any role for industry in medical education?

A drug company sales representative stands in front of a class of University of Toronto medical students and delivers her well-rehearsed sales pitch about the benefits of her company’s birth control pill. Hold on: Isn’t this sort of interaction between the pharmaceutical industry and med students supposed to be forbidden because of concerns about conflicts

Wait times for “non-priority” surgeries

Wait times for "non-priority" surgery

Katie’s story Three years ago, Katie (name and some details changed to protect her identity) was in a car accident on a rural road two hours outside of an urban centre. Her ankle was crushed in the accident, and after a delay of several hours due to weather, she was air-lifted to the nearest trauma

New recommendations for Canadian doctors-in-training focus on fatigue

Resident Duty Hours

After finishing medical school, new doctors go through several years of post-graduate, on-the-job training – known as residency – in order to become licensed to practice independently. Historically, residency has involved very long hours spent in hospital, so that residents see a high volume of diverse cases as well as provide patient care. As part

Providing emotional care for patients in a technology-driven health system

“They made me feel genuinely cared for. They listened, made eye contact with me, conveyed warmth and understanding in their voice and repeated back to me what I was saying.” — Sophia, about her visit to a chronic pain clinic, from a “care moment” prepared by the Patient Experience department of Alberta Health Services. Mounting

Access to expensive drugs: greater demand, improved transparency

Each weekday, staff at the Exceptional Access Program (EAP) of the Ontario Ministry of Health and Long-Term Care receive between 250 and 300 requests for special prescription medications. These prescription drugs—typically expensive medications that are felt to be cost effective only when used to treat selected patients with specific problems—are not on the province’s regular

A request from Dr. Andreas Laupacis, Editor-in-Chief of Healthy Debate

Andreas Laupacis healthy debate editor in chief

Dear Healthy Debate community, Working on Healthy Debate for the last few years has been enormously rewarding for our whole team. We’ve been delighted with the response from our community, and even a little surprised by how much our readership has grown. Healthy Debate has gone through a lot of positive change lately. We’ve completely

Can “bottom up” measurement improve the quality of Canadian health care?

Can “bottom up” measurement improve the quality of Canadian health care?

Progress has been made in measuring the quality of Canadian health care. Yet there are still large gaps in what is measured in our health care system, and much of what is measured is only useful to top-level system managers, not to the front-line clinicians whose day-to-day work is so important to the overall quality of the system. This leads experts to question whether measurement is being used effectively to improve the quality of Canadian health care.

Maternity services disappearing in rural Canada

Maternity Services Disappearing rural Alberta

The plan to eliminate obstetrical care at Banff’s Mountain Springs Hospital, and to replace it with enhanced vascular and plastic surgery services, was labelled a potential “quick win” in a 2012 community and rural health planning document. Babies would no longer be delivered in Banff (population about 8,200) and instead obstetrical care would be “consolidated”

Canadian diabetes strategies under fire as diabetes rates continue to rise

Canadian diabetes strategies under fire as diabetes rates continue to rise

In the past six months, the Auditor Generals of both Canada and Ontario have turned their attention to problems with strategies designed to tackle one of Canada’s biggest health threats—the epidemic of diabetes. The government watchdogs have scrutinized the value that Canadians have received from the hundreds of millions of dollars expended on the Canadian

Canadian medical schools struggle to recruit Aboriginal students

Canadian medical schools struggle to recruit Aboriginal students

The featured image for this story is reproduced with permission from the Health Council of Canada. Illustrator: Leah Fontaine Canada’s First Nations, Inuit and Métis peoples have, on average, much poorer health than other Canadians. Chronic diseases like diabetes are significantly more common among Aboriginal peoples, and they have a substantially shorter life expectancy than the general population. Mental illness is also alarmingly common in

Big changes coming to Healthy Debate

Andreas Laupacis healthy debate editor in chief

Dear Healthy Debate community, We have been working quietly on some big changes to the site over the last few months, and we’re finally read to unveil them! Over the coming weeks we are re-launching the website with a new look, lots of interactive features and a new design for mobile devices. But before we

Groundbreaking Canadian cohort studies aim to shed light on risk factors for cancer, chronic diseases

Groundbreaking Canadian cohort studies aim to shed light on risk factors for cancer, chronic diseases

The British Whitehall studies helped establish the importance of the social determinants of health, while a Danish study of children provided strong evidence to disprove the damaging MMR-vaccine-causes-autism hypothesis. Those are just two of many international cohort studies—studies that follow large groups of people over many years. In Canada, starting such studies has never been

Interpretation services in health care

Interpretation services in health care

“We have a large immigrant population, and people sometimes have no English. This program has been a godsend.” –- Winnipeg pediatrician Stan Lipnowski Obtaining a good history is the most important thing in practising medicine, so being able to get that history about the children of new immigrants has made a “humungous difference”, says Stan