JAMA: Role Reversal

The Anatomy of the Brain Artist: Sir Charles Bell

“’Helmet, helmet!’ squealed my daughter, excitedly. I followed behind as she ran to the back door, ready to start the day. The bike ride to her daycare center had become our shared morning ritual, a ritual that I had started long before she entered the world 16 months ago. The bike ride to the research laboratory or hospital had become one of the most cherished parts of my days. The ride gave me time to reflect on the day ahead and to be present. Now it is something that my daughter has come to love as much as I do.

I watched my daughter run inside and then hopped back on my bicycle, heading to the hospital on my first day as a third-year medical student. To say I was nervous was an understatement. I timidly found the neurology resident in the crowded work room. Together with another medical student, resident, and attending physician, we made up the team that treated patients who had been admitted with strokes. The senior resident told me I would be caring for JoAnne, a 92-year-old woman with a left posterior circulation stroke, resulting in almost complete loss of movement, sensation, and pain in the right side of her body.

As a medical student, I was expected to perform a full neurologic examination on this patient in the presence of the entire stroke team. Because I had just been thrust into the medical school clinical period after 4 years of working on my PhD thesis in a basic science laboratory, my confidence in my clinical skills was meager. I internally recited the neurologic examination as I trotted to JoAnne’s room followed by the rest of the team and the patient’s nurse. Am I sweating? What’s the first part of the neuro exam again? I walked in to find a small, frail-appearing woman lying on the bed. She looked somber with glassy blue eyes staring off into the distance. I introduced myself as the third-year medical student who would be taking care of her. She turned to me and gave me the smallest nod. Was that a smile? I started the examination with what I knew best, the cranial nerves. I watched her eyes move slowly from side to side and then up and down. Did I see neglect of the right side? Now to the deep tendon reflexes. As I swung the reflex hammer and met her biceps tendon, she winced in pain. Should I keep going or should I stop? I needed the information… right? I stopped with the reflex hammer in mid-air and looked to my attending physician for an answer as I cut the reflex examination short.”

Read more on Role Reversal via JAMA A Piece of My Mind.

New Family Physician Payment Model

“One million people in British Columbia do not have a family doctor. In response to this crisis, Doctors of BC, BC Family Doctors, and the provincial government have been in discussions since May to develop a new payment model that will help to address the challenges in primary care.

The new payment model, which will launch February 1, 2023, is based on what physicians told us they need to stabilize and strengthen longitudinal family practice. The hope is this new model will not only stabilize longitudinal family practice, but begin to make it both sustainable and rewarding. Everyone deserves a family doctor, and Doctors of BC believes the new model is a significant step forward to achieving that goal. There is still much more work to be done, please watch for updates in the coming weeks and months.”

New family physician payment model to help doctors and patients via Doctors of BC.

Plan to License More Internationally Trained Doctors

“British Columbia announced several new measures to bring more doctors to the province, amid an ongoing shortage of physicians and strained emergency departments.

Premier David Eby says the province is tripling the number of seats in the Practice Ready Assessment program, going from 32 spots to 96 by March 2024.

The program allows internationally-educated family doctors to become licensed to work in B.C, placing them in rural and urban communities who need more physicians and requiring they work that placement for at least three years. 

Eby says the pandemic has exposed challenges and added further strains in the health-care system, with too many British Columbians struggling to find a family doctor.

Some, he said, are proposing to respond to that stress by undercutting the principles of universal public health care and promoting an approach that would allow the wealthiest to buy their way to the front of the line. He insisted the public system is the only way forward, calling it one of Canada’s greatest achievements.

“‘We can’t privatize our way to a better health-care system and we can’t cut supports and get more doctors,’ Eby said.”

B.C. announces plan to license more internationally trained doctors via CBC News.

Our Economy, Our Health, & Our Nature

“What a living whale is worth — and why the economy should protect nature
How much is one living blue whale worth in the fight against climate change? A lot more than you may think, says financial economist Ralph Chami. He explains the value of bringing the language of dollars and cents to conservation — and offers his vision of a new economy that would profit off regenerating nature, not extracting from it.”

Learn more:
‘They teach us’: how whales can help dispel the myth of green capitalism via The Guardian.
Several humpback whales found dead on B.C.’s coast in a matter of weeks via CBC.

A Lancet Series Launch: Racism, Xenophobia, Discrimination, & Health

“Join us and Race & Health as we launch a new Lancet Series assessing the pervasive impacts of racism, xenophobia, and discrimination on health inequities globally—and what we can do to improve the lives of minoritised people.

The Series will be published in The Lancet’s special issue: Advancing racial and ethnic equity in science, medicine, and global health.

This is a hybrid event, kindly supported by Wellcome Trust. Register to attend in person or online.”

Fri, Dec 9, 2022, 6:00 AM – 8:00 AM (PST)

Online Event link https://www.raceandhealth.org/events/

Infections Overwhelm Children’s Hospitals

“Surges in respiratory illnesses are overwhelming children’s hospitals across Canada, prompting calls to reintroduce masking in schools.

‘It’s a pediatric healthcare crisis of a proportion that I don’t think anybody has seen in their careers at this point,’ said Lennox Huang, chief medical officer and vice-president of medical and academic affairs at Toronto’s Hospital for Sick Children.

Across Ontario, all pediatric intensive care units are operating at more than 100% capacity. The situation is impacting adult services, too, as hospitals are diverting pediatric patients to adult ICUs.

The province has instructed all hospitals to work at up to 150% of their usual operating capacity, up from 120% under normal surge plans.

SickKids is redeploying staff and cancelling scheduled surgeries to prioritize emergency procedures, Huang told CMAJ. ‘It’s all hands on deck.’

‘We’re seeing nurses, physicians, and respiratory therapists working in areas they wouldn’t have otherwise,’ he said. ‘Physicians are, in many cases, doubling up on the number of shifts, clinical work, and calls that they’re doing to meet the clinical demand.’

Calls for masking in schools as respiratory infections overwhelm children’s hospitals via CMAJ.

Postpartum thoughts of infant-related harm

Learning Objectives:

  1. Learn about the nature and prevalence of postpartum thoughts of infant-related harm.
  2. Learn about the types of infant-related harm thoughts associated with a risk to infant safety and those that are not.
  3. Learn about the relationship between postpartum harm thoughts and mental health.​  ​

Click here for Zoom Link​ or paste the following:

https://phsa.zoom.us/j/69384121933?pwd=eERJK1FrdTJYbEx1NzFrQStHbCt2UT09 ​          

Alternatively, you can join the virtual health visit by entering the following info in Zoom:​

Meeting ID: 693 8412 1933
Password: 581699

If you can’t connect by computer or by mobile device, or if your microphone or speakers don’t work properly, you can join t​he virtual health visit by phone:

Dial 1-833-955-1088 (Toll-free) followed by the Meeting ID and Passcode
Meeting ID: 693 8412 1933 / Password: 581699​​

Primary Care Conference for Physicians

This annual conference in primary care medicine provides an opportunity to refresh your knowledge about, and enthusiasm for, primary care medicine. This conference will focus on an evidence-based review of practical information, new trends and discuss controversial topics useful for primary care physicians practicing in urban or rural areas. Educational activities include a Main Lecture Series which will provide a comprehensive review on Cardiology, Sports Medicine / Rheumatology, Internal Medicine, Dermatology, Therapeutics, Brain & Aging, Women & Children’s Health, and Surgery. Exemplary guest speakers have been chosen for their ability to communicate information and skills relevant to daily clinical practice. The speakers will also provide ample time for questions.

Main Lecture Series
Tuesday, Nov. 22 – Friday, Nov. 25, 2022

Participants will be able to:

  • Analyze current issues in primary care medicine and review new guidelines for the treatment of a number of diseases and disorders commonly encountered in family practice.
  • Discuss cases regarding new treatment options and technological advances.
  • Identify new evidence based treatments using the most up to date clinical and scientific information.

To learn more and register, click here.

Shifting to Structural Competence in the Healthcare Profession: The Role of Anti-Oppression in Patient Safety and Provider Competence

The Office of Faculty Development and the Centre for Health Education Scholarship are pleased to co-facilitate the CAME Webinar Series at UBC. Designed to bring practical, evidence and experience-based advice to Canadian health educators, the webinars offer the opportunity to engage online with an expert and with colleagues in a live discussion on a key topic in health professions education.

*Please note that while these sessions are free to attend, registration is required. See registration link below.

Presenter: Dr. Mariam Abdurrahman, McMaster University
Date: Tuesday, November 22, 2022
Time: 12:00 to 1:00pm PDT
You need to be affiliated with UBC to register. Click here to register.

Pollution & The Fishing Industry

“Ghost gear can consist of all lost, abandoned or deteriorating fishing nets and commercial fishing gear, as well as plastic waste from aquaculture. Recent studies indicate that ghost fishing gear may make up 46-70% of all macro-plastics in the ocean by weight, and pose threats to marine animals like whales and turtles.

Now, the Department of Fisheries and Oceans (DFO) is investing $8.3 million into what will be known as the Ghost Gear Fund. It will support 22 projects in Canada and four internationally over the next two years, targeting categories such as gear retrieval, eco-disposal, acquisition and the piloting of new gear technology.”

Canada invests $8.3M in fishing gear removal to fight marine plastic pollution via Environmental Science & Engineering

A Detailed Review Study on Potential Effects of Microplastics and Additives of Concern on Human Health via PubMed.

More on defining a “majority” via Wikipedia.