Park Rx

Photo credit: Stephen Hui. Copyright (c) 2018 Stephen Hui. All rights reserved.

“At his office in Washington, D.C., Dr. Robert Zarr, a pediatrician, writes prescriptions for parks. He pulls out a prescription pad and scribbles instructions—which park his obese, diabetic, anxious or depressed patient should visit, on which days, and for how long—just as though he were prescribing medication.

Zarr says it’s important to give concrete advice instead of repeating the vague admonitions (Exercise more! Get outside!) that people are used to hearing. Zarr is part of a small but growing group of healthcare professionals who are essentially medicalizing nature. He relies on a compendium of 382 local parks—the product of meticulous mapping and rating of green spaces, based on accessibility, safety, and amenities—that he helped create for DC Park Rx, a community health initiative. The Washington program was one of the first in the United States; there are now at least 150 others. ‘We work with the doctors, nurses and health care providers around the country and show them why it’s so relevant to prescribe parks and how easy it is to do so that they can make it a part of their daily routine.’ The group refers to this program as Ecotherapy.”

More on Prescribing Nature (2019) By Jennifer Walsh with Beth McGroarty via the The Global Wellness Summit.

*Photo taken in the woods of Lookout Mountain Forest Preserve, Bellingham, Washington.

#PrescribingNature #ParkRx

Pub & Papers 2019!

UBC FAMILY PRACTICE bpw_template_3inch_round_coaster_bleed copy.jpg

This is going to be fun! Join our UBC Abbotsford-Mission Family Practice Residency Program as we recognize our Residents’ scholarly achievements and celebrate our Preceptors who have contributed to our Residents’ journey! This informal evening is an opportunity for our Residents to share their research with our surrounding community and for our program to continue to network, collaborate, and build upon the ideas and insights emerging from our Residents’ work.

Date: Thursday, June 6, 2019
Location: Abbotsford Regional Hospital & Cancer Centre
Learning Centre Conference Rooms 3A & 3B
32900 Marshall Road, Abbotsford
Time: Dinner (alcohol-free) begins at 7:00 p.m. / Presentations from 7:30 to 9:00 p.m.
RSVP here!

Peruse the Agenda & Scholar Project Summaries here. If you have any questions, please feel free to contact me at

Timing May Mean Everything

“Among a network of 33 primary care practices, ordering of breast and colorectal cancer screening rates decreased as the clinic day progressed, most notably toward the end of the morning and afternoon shifts. A 1-year follow-up found that completion of these cancer screening tests had similar patterns. To our knowledge, this is the first study of its kind to demonstrate that primary care clinic appointment time is associated with both ordering and completion of screening for breast and colorectal cancer.”

Learn more on Association of Primary Care Clinic Appointment Time With Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening (2019) by Hsiang, Mehta, & Small via JAMA. Listen to the CBC 8-minute podcast Goldman Column: Time of Day and Treatment.

#WhatTimeIsIt #EarlyBirds #CancerScreening #FatigueBias #TakeABreakAndRejuvenate

Meaningful Connections Through Giving

“We’re used to thinking about giving as something we should do. And it is. But in thinking about it this way, we’re missing out on one of the best parts of being human: that we have evolved to find joy in helping others. Let’s stop thinking about giving as just this moral obligation and start thinking of it as a source of pleasure.”

Congratulations to UBC’s Dr. Elizabeth Dunn on her inspiring TEDTalk. (Already hit 1,000,000 views 🙂
Learn more about the Canadian programs she highlights including Group of Five and Plenty of Plates!
#UBCWomen #ElizabethDunn #GoCanada

Becoming Homeless: A Human Experience

“There is a growing body of evidence on the efficacy of VR for empathy. Fernanda Herrera just published a large-scale, longitudinal set of studies. People who went through ‘Becoming Homeless’ in immersive VR were more likely to sign a petition supporting affordable housing compared to control conditions. Moreover, effectiveness of VR outpaced controls even when looking two months after the experience.” Interview with Jeremy Bailenson, Director of Stanford University’s Virtual Human Interaction Lab.

In the midst of conducting research on the topic of simulation and empathy, I came across Stanford University’s Becoming Homeless: A Human Experience. This immersive virtual reality experience engages the participant in better understanding some of the challenges and choices one is confronted with when addressing unemployment, eviction, and finding a safe shelter. What moved me most were the narratives and voices of my surrounding bus riders.

For those who don’t have a VR headset, watch the video posted above to get a sense of “Becoming Homeless” via desktop.

To learn more, listen to the podcast ‘Becoming Homeless’: Stanford’s Empathy Experiment in Embodied Perspective-Taking and check out Building long-term empathy: A large-scale comparison of traditional and virtual reality perspective-taking (2018) by Fernanda Herrera, Jeremy Bailenson, Erika Weisz, Elise Ogle, & Jamil Zaki.

Warm regards,


#StanfordUniversity #VirtualHumanInteractionLab #BecomingHomeless #BuildingEmpathyAndAdvocacy

This Changed My Practice

“It’s not survival of the fittest, but survival of the nurtured.” 

Attachment Researcher, Dr. Louis Cozolino

Have you taken a peek at the UBC FoM’s This Changed My Practice Series on “The Myth of the ‘Manipulative Personality Disorder’: Taking the Blame Out of the Illness” (May 8, 2019) by Dr. Joanna Cheek? Many pearls embedded in that piece about targeting specific symptoms, exploring the patient’s psychosocial story, focusing on collaborative problem solving, setting healthy boundaries, as well as seeking to understand your own emotional reaction as a clinician. “Not only is compassion and empathy central to providing effective care for the patient (Gilbert, 2010), it is also central to the well-being of the doctor.” Learn more here.

#UBCFacultyOfMedicine #ThisChangedMyPractice #Nurture #RethinkingDarwin

Developing Competency & Confidence in Care

“Confidence is recognized as one of the most influential factors to affect performance. Individual, leader, and team confidence play essential roles in achieving success and the absence of confidence has been connected with failure. While confidence is not a substitute for competency, it creates trusting relationships, empowerment, and resiliency to persevere when challenges arise.

Our study revealed that organizations with higher confidence performed higher than organizations with lower confidence. In every organization, the workforce rated the experience lower than patients; however, hospitals with higher degrees of confidence in the patient experience had better performance outcomes for the patient experience.

There are four sources recognized as creating efficacy and confidence that we can cultivate to develop patient experience competencies: personal accomplishments, vicarious experience, verbal persuasion of encouragement, and psychological states of positive expectancy.

For healthcare leaders to be successful in the present and future it is not a matter of hope to deliver a better experience but cultivating competencies and building demonstrable confidence in the quality of the patient experience provided.”

Read more on Exploring Workforce Confidence and Patient Experiences: A Quantitative Analysis (2018) by Katie M. Owens and Stephanie Keller via Patient Experience Journal.

#CompetenceAndConfidenceInCare #IdeasGrowOutOfOtherIdeas

AHD: Special Guest Dr. Victoria Lee

Victoria_Lee_CEO_330_x_220.pngPresident and CEO of FraserHealth, Dr. Victoria Lee, will be joining us for our Academic Half Day on:

Thursday, May 16, 2019
ARHCC Baker 103 Conference Rm
11-12:00 p.m.
UBC Faculty, Preceptors, Residents, and Students are invited!

Dr. Lee will be discussing her involvement with Canada Health Infoway and how the organization has been working to improve patient health through the use of digital health solutions. She’ll also share her perspective on BC’s healthcare system and what challenges her team are currently addressing. Victoria is responsible for overall strategic direction and operations of Fraser Health Authority including a wide range of integrated health services – acute care hospitals as well as community-based residential care, home health, mental health, and public.

Victoria joined Fraser Health in 2010 as a medical health officer. She held progressive leadership positions including her most recent role as the vice president for population health and chief medical health officer. Prior to joining Fraser Health, she worked in collaboration with national and international organizations including the United Nations Development Programme and the World Bank in the areas of comparative health systems, health policy, health financing and ecohealth. Victoria also worked as a travel physician in rural communities in Chile and Brazil. Her research activities include health equity, community-based primary health system, health performance and clinical prevention. She serves on the board of Canada Health Infoway and the Canadian Partnership Against Cancer. Victoria obtained her medical degree from the University of Western Ontario, her Royal College fellowship in Community Medicine from the University of Toronto and postgraduate degrees in Public Health, Business Administration from Johns Hopkins University.

#BCHealthInnovation #WomenInMedicine

The Brain & Nature

“It’s not clear exactly why outdoor excursions have such a positive mental effect. Yet, in a 2015 study, researchers compared the brain activity of healthy people after they walked for 90 minutes in either a natural setting or an urban one. They found that those who did a nature walk had lower activity in the prefrontal cortex, a brain region that is active during rumination — defined as repetitive thoughts that focus on negative emotions.

‘Anything from 20 to 30 minutes, three days a week, to regular three-day weekends in the woods is helpful,’ says Dr. Strauss. ‘The point is to make your interactions a part of your normal lifestyle.'”

Read more on Get Back to Nature: Research Suggests That Mood Disorders Can Be Lifted by Spending More Time Outdoors (July 2018) via Harvard’s Men’s Health Watch.

Images of Cheakamus Centre (2019) via Jacqueline Ashby.

#GetBackToNature #EnjoyTheOutdoors