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Are medical errors the third leading cause of death or disability and what can we do to protect ourselves?
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TEDx Stanley ParkDr Z. Essak, MD - Vancouver BC - March 4, 2018

The TEDx Stanley Park event at the Queen Elizabeth Theatre in Vancouver on Saturday March 3, 2018 was incredible with 13 (a bakers dozen) memorable and inspiring speakers and 4 brief, fun energerizer programs to keep the audience engaged. Two of the presentations addressed medical errors.

With cancer as the leading cause of death and heart disease as the second leading cause, medical errors are referred to by some as the third leading cause of death and disability.

Whether errors are third or not, it makes sense that anything that helps to reduce or prevent medical errors is worth pursuing. Every error that can be prevented has direct benefit to individuals and their families.

The Bhagavad Gita Comes Alive
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The Bhagavad Gita Comes Alive coverDr Chris Sedegreen.

Some time before the Christmas holiday a colleague mentioned a book, The Bhagavad Gita Comes Alive, on the Doclounge listserve. I’d like to thank him for bringing this lovely book to our attention. I ordered and received the paperback version (somewhat cheaper than the hard cover, but in retrospect I wish I'd ordered the hard cover). This publication is beautifully printed.

Canadian Medical Association Board breached principles of natural justice and fairness
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Vancouver Law CourtsDr Z. Essak, MD - Vancouver, BC - May 20, 2022

In a BC Supreme Court Judgment released on April 22, 2022 Justice Nathan Smith found that the Canadian Medical Association (CMA) Board breached principles of natural justice and procedural fairness when it suspended the membership of Dr Charles Webb denying him the opportunity to run as a candidate in the election for the BC nominee for CMA President-Elect in February 2022.

Health Records and Privacy (Humour?)
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In 2004, the American Civil Liberties Union (ACLU) produced a satirical video called “Ordering Pizza in 2015”. If you haven't already seen this, here it is, a humorous piece. 

https://www.youtube.com/watch?v=RNJl9EEcsoE

You can also check out their home page for other interesting news stories,

http://www.aclu.org

Dr Ian McWhinney, Canada's "Founding Father of Family Medicine"
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Photo of Dr Ian R. McWhinneyDr Ian R. McWhinney was an English physician and academic who moved to the University of Western Ontario as the first chair of family medicine in Canada where he started the country's first Department of Family Medicine in 1968. He became known in Canada and around the world as the "Father of Family Medicine".

He published over 100 articles during his lifetime and is well known for his influential book, Textbook of Family Medicine. The opening chapter, The Origins of Family Medicine, provides a brief history of medicine including the emergence and need for Family Medicine.

Nutrients in Our Food
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USDA Nutrient Database search urlIf you ever find yourself wondering what nutrients are in different foods you might want to take a look at the US Department of Agriculture (USDA) Nutrient database. 

It provides a wealth of information on over 7,500 specific food items and details of the nutrients they contain down to the many different minerals, vitamins, types of fats, carbohydrates, proteins and various amino acids.

There are two very useful ways to look at this information on their website.

Celebrating and helping caregivers
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Patti and SherriDr Z. Essak, MD - Vancouver BC - February 16, 2018

According to Statistics Canada there are eight million caregivers in Canada. Most are unpaid, regular people who are taking care of aging and ailing parents, children with disabilities, and friends who need them. Caregivers get little or no attention, despite their massive numbers.

Some caregivers find inspiration and friendship from those they care for and some find themselves with personal challenges through caring for others. Healthcare providers may experience the same themselves and see this in those they serve.

Sharing caregivers' stories may help others find inspiration or recognize the impact on themselves and what they might be able to do.

What are ethics and why are they important?
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PM Justin Trudeau, politics and tech giants.2019-03-12 Dr Z.Essak, MD - Vancouver, BC

Ethics are a big part of our lives as principles that govern our actions. Doctors take an oath to serve the patient's interest and not their own or that of others.

It doesn't just apply to doctors. We expect ethics in people involved with our daily lives: teachers, accountants, professionals, merchants and others. It is the basis of the trust we have in them. We depend on them as people with privilege and power over ourselves, children and others.

We also expect ethics in politics, in technology, in corporations and the list goes on. People are growing more concerned about the decline of ethical leadership in politics and also business tech giants like Facebook, Google and others.

What happens when an individual's actions run contrary to ethical principles?

Telehealth, what does it mean?
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Telehealth collageWith tongue in cheek some might say it was about time we made more use of the tech we've got and now here we are all using telehealth. What does it mean? What does it look like? How does it work?

Rethinking the Internet: How We Lost Control and How To Take It Back
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Rethinking the Internet, scene of the debate.This is an interesting and thought provoking 1 hour video interview and debate. It begins with a 5 minute overview and then proceeds with an interview by moderator Bill Blakemore with Jaron Lanier, a long-time computer scientist and developer and the father of virtual reality, who is concerned about the use of behaviour modification "to engage and addict you to algorithmic exploration until we find whatever it is that will get you".

Following the interview there is a debate with four speakers; Tim Hwang, Meredith Whittaker, Aviv Ovadya, and Brett Frischmann. They touch on many aspects of not only the Internet but also power in organizations, how it's lost and who has it.

Burnout and Resilience
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Vancouver BC - Oct 19, 2011.

burning candleA talk on burnout in doctors at a recent conference in Vancouver provided good information and stimulated further exploration.

During questions the speaker said the prevalence of burnout in doctors is 20 percent and tends to occur in pockets or clusters.

The talk focused on burnout resulting from lack of recognition while caring for others. Although burnout can also result from lack of recognition from colleagues and co-workers, lack of resources, and degree of bureaucracy.

Burnout can also occur in other aspects of our lives besides our work.

Good news from the talk is research shows that when individuals examined their level of burnout and attended to the risk of burnout they were not only able to reduce their current risk but their future risk of burnout continued to remain less and even improved further over time.

Delegation to Campbell River City Council on concerns arising from HPOA
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Screen capture youtube video Cambell River delegation on HPOA, Feb 29.At the Campbell River City Council meeting on February 29, 2024, a delegation of physician Dr Anna Kindy and retired naturopath Dr Ingrid Pincott discussed the Health Professions and Occupation Act, HPOA, and the serious concerns it raises for health professionals, patients, and people living in and around Campbell River. Like most City Council meetings in BC it was streamed live and recorded and can be watched on YouTube. City councillors asked questions and expressed the view that these concerns are important and that they would like to ensure it is discussed when the UBCM meets this year, on September 16-20, 2024.

Don’t FIPPA your PIPA without knowing this when it comes to personal health information.
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Vancouver, BC – May 3, 2010

Stethoscope and keyboardWhen it comes to the privacy of personal health information everyone in British Columbia needs to know how FIPPA (also known as FOIPPA) is different from PIPA, and the same may apply in other jurisdictions across Canada and elsewhere.

This is of particular importance when information is shared between your doctor's private office and a hospital or clinic operated by the Health Authority which is a public body.

In BC, three different legislative Acts govern the privacy and protection of individual personal health information.  There are some very important differences in how these work and the results they have that should be known to all doctors, health providers and patients/clients.

What loud bells will wake BC doctors and the public to the dangers of Bill 36, the HPOA?
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Dr. Zafar Essak, MD - Vancouver, BC - November 6, 2023.

Image of the great bell ben.There is a sleeping sickness throughout our land. It has found its way into health care and affected all the doctors. It is not some esoteric thing happening in some small political arena or lawyers club. This impacts all of BC and all of us: the ability of doctors to practice medicine the way they were taught and trained, according to their conscience and oath for the benefit of patients.

The significance of Bill 36, the Health Professions and Occupations Act, is profound and the association, Doctors of BC, should be ringing alarm bells. Instead, they are subduing the importance of it, convincing all doctors to move on to the regulations, like lemmings over the cliff. Not only is this unhelpful to doctors, it is actually dangerous for doctors with their purpose and professional obligations to deliver health care to patients. Bells need to ring everywhere, and the association should be dissolved.

Dr Karpiak on Bill Good CKNW - Bureaucracy in health care is not sustainable
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Dr Dennis Karpiak, Internist and former BCMA Board Director from the Interior of BC speaking on the Bill Good Show CKNW radio 980 on July 10, 2012.

"It's become increasingly more difficult to sustain a practice in this province."

"The BCMA 20 years ago formed the Regionalization committee that predicted the rise of bureaucracy and a decline in patient care funding."

"Currently you can walk through any hospital and you'll see more administration offices than patient rooms."

Listen to the whole interview.

News Items

Why is our health care system and government broken?
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Dr. Zafar Essak, MD - Vancouver, BC - October 6, 2024

I decided to write a series of posts covering different aspects of our health care system and government to help us apply our thinking to the problems and solutions. We need a change in our expectations of professional leaders, government leaders and how government works if we are to save our publicly funded health care system and our democratic rights.

Part 1. How health care administration over took funding for doctors.

Part 2. Early closure of debate erodes our parliamentary democracy.

Part 3. The importance of open dialog and informed consent.

Part 4. No consent called "passive consent" as BC elementary and high school students are presented survey questionnaires.

Stay tuned for more to come.

AI-powered transcription tool used in hospitals invents things no one ever said
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On October 26, 2024, Associated Press published a story detailing findings of researchers that the OpenAI transcription tool Whisper, used by clinics and hospitals, is prone to making up chunks of text or even entire sentences according to interviews with more than a dozen software engineers, developers and academic researchers.

Experts said that such fabrications are problematic because Whisper is being used in a slew of industries worldwide to translate and transcribe interviews, generate text in popular consumer technologies and create subtitles for videos.

The Tenth Nerve: a brain surgeon's stories of the patients who changed him
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Graphic image of book cover, The Tenth NervePenguin Random House Canada has published this book and I hope you will enjoy it.

These are the stories of seven brave patients whose close encounters changed me into a better person and surgeon. It is a book about discoveries—both medical discoveries (including two new diseases) that I have provided my patients and personal discoveries that my patients have prompted in me. The scalpel can only go so deep, and technical skill can only take you so far. Real understanding of an illness requires listening and genuine care. The Tenth Nerve is a book about curiosity, the wonder of the human brain, and the courage of a few remarkable patients.

Delegation to Campbell River City Council on concerns arising from HPOA
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Screen capture youtube video Cambell River delegation on HPOA, Feb 29.At the Campbell River City Council meeting on February 29, 2024, a delegation of physician Dr Anna Kindy and retired naturopath Dr Ingrid Pincott discussed the Health Professions and Occupation Act, HPOA, and the serious concerns it raises for health professionals, patients, and people living in and around Campbell River. Like most City Council meetings in BC it was streamed live and recorded and can be watched on YouTube. City councillors asked questions and expressed the view that these concerns are important and that they would like to ensure it is discussed when the UBCM meets this year, on September 16-20, 2024.

What loud bells will wake BC doctors and the public to the dangers of Bill 36, the HPOA?
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Dr. Zafar Essak, MD - Vancouver, BC - November 6, 2023.

Image of the great bell ben.There is a sleeping sickness throughout our land. It has found its way into health care and affected all the doctors. It is not some esoteric thing happening in some small political arena or lawyers club. This impacts all of BC and all of us: the ability of doctors to practice medicine the way they were taught and trained, according to their conscience and oath for the benefit of patients.

The significance of Bill 36, the Health Professions and Occupations Act, is profound and the association, Doctors of BC, should be ringing alarm bells. Instead, they are subduing the importance of it, convincing all doctors to move on to the regulations, like lemmings over the cliff. Not only is this unhelpful to doctors, it is actually dangerous for doctors with their purpose and professional obligations to deliver health care to patients. Bells need to ring everywhere, and the association should be dissolved.

Documentary: Waiting To Die - Canada's Health Care Crisis
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 Waiting to Die - Canada's Health Care CrisisA new one hour documentary by Aaron Gunn, "Waiting To Die - Canada's Health Care Crisis" was released yesterday (August 14, 2023) and in the first day it had more than 23,000 views and more than 700 comments from people sharing their own experiences and thoughts.

Times-Colonist OpEd: Dix needs to listen to healthcare providers
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Dix needs to listen to healthcare providers, The Times Colonist.Please read the OpEd by a BC family doctor that while Health Minister Adrian Dix uses findings of the Cayton report to defend the rapid introduction of Bill 36, the HPOA, he refuses to comment on the contradictory content in the report and snubs the issues raised by the Doctors of BC.

More than 400 doctors attend Bill 36 HPOA Webinar by Doctors of BC
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Update (April 16, 2024): Almost a year has passed and the association Doctors Of BC still has not made the recording of the webinar on Bill36/HPOA available for members to view. Why not?

Dr. Zafar Essak, MD - Vancouver, BC - May 3, 2023.

How important is Bill 36, the new Health Professions and Occupations Act, to doctors, nurses, all health care professionals, and patients? Important enough that more than 400 doctors attended the Doctors of BC Townhall Webinar on Tuesday April 25, 2023 at 6:30 pm. This, in the middle of the week, while doctors are trying to finish work or balancing family and meal time. When was the last time you saw 400 doctors attend a meeting? We haven’t seen a number like that at the DOBC AGM for decades.

It was a very informative webinar organized by DOBC with over 100 questions from doctors to a panel of three Ministry of Health staff, as architects of Bill 36, followed by a panel of the DOBC: President, Dr. Josh Greggain; new CEO, Anthony Knight; staff lawyer, Deborah Viccars; and moderated by Marisa Adair, Director of Communications.

Three Reasons for a Chat with Dr. Bonnie Henry, BC Health Minister Adrian Dix and BC Premier David Eby
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Dr. Zafar Essak, MD - Vancouver, BC - April 5, 2023

Trojan horse imageHaving worked for 40 years as a family physician in BC, when I heard the media announcements recently: that on April 3 vaccine mandates will be lifted on BC public service government workers but not on health care workers until it can become a permanent condition of work in health care, and that we may see only combined vaccines in the fall; it struck me that it’s time we had a real chat. This can’t wait.

Politics is often seen as a glamorous, shiny and sometimes slimy affair. But, seriously, politics is about how we make collective decisions and manage the affairs of our society in our democracy.

There are three things I believe we need to talk about now:

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