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Disagreement is central to progress
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It's never too late to change the world !

Ted Talks - Margaret Heffernan - Dare to disagreeIn this TED talks video Margaret Heffernan demonstrates "that disagreement is central to progress, that the best partners aren't echo chambers and how great businesses allow people to disagree".

http://www.ted.com/talks/lang/en/margaret_heffernan_dare_to_disagree.html

JN Mahy MD FRCSC

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.

"Deja Vu" - Dr Norman Rigby
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Dr. Norman Rigby, Retired GP and Former Executive Director BCMA.

"The best thing we had going for us was the District 6 Newsletter."

"It excited the attention of the membership."

"What really changed things was when ... the administrator became the President of the hospital, ... and governments started to deal with the President not the Board."

Video highlight from June 3, 2006 Forum for Physicians, Vancouver.

"Deja Vu"
Dr. Norman Rigby, Retired GP and Former Executive Director BCMA.

Don't get swept away by the spin on health care
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medical spin2016-08-22 Dr Z. Essak, MD - Vancouver, BC

We better be careful not to get swept away by the spin of BC Liberals pre-election buzz.

And when it comes to the spin on health care they're not alone.

The same spin seems to be coming from the leaders of the medical association DoctorsOfBC. Is this the result of being co-managers of BC healthcare for almost a decade through the GPSC and other initiatives?

Is it any surprise they are all so complimenting of each other?

What are we to believe? That they have a plan? That it's going to work, someday, soon?

Yes, the plan to spend tax payer dollars is happening. Billions of dollars and hundreds of millions over budget. So where are the results?

Do we need public oversight to the conduct of Judges?
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Statue of Themis oversees court room2016-10-05 Dr Z. Essak, MD - Vancouver, BC

Before we reach a crisis with the Judiciary in Canada is it time for public oversight to the conduct of Judges?

Recently, we have seen the case in Alberta where justice has been delayed and could possibly be derailed because a Judge was not up to date with applicable laws.

We have also seen a case of inappropriate remarks by a Judge, on keeping legs together, raising questions as to him continuing as a Judge.

These are not isolated cases. The Canadian Judicial Council receives many complaints annually, 159 in 2014 and 173 in 2015, on the conduct of Judges from across the country. How do they deal with them?

Will the Federal Government introduce legislation to add public oversight to the Canadian Judicial Council and committee responsible for dealing with complaints on the conduct of Judges?

The future of medicine and health care in BC and Canada: Where are we going?
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Norman Rockwell Doctors Office2016-07-21 Dr Z. Essak, MD - Vancouver, BC

What is the future of medicine and health care in BC and Canada? Where are we going?

While everyone is out having fun in the summertime, the Government and other organizations, use this time to put out information they know few will have time to see or digest. Much like they also use the busy time of Christmas and the Winter holiday season to slip through items. Some people may just consider it prudent timing, others may see it as deliberate avoidance of proper public consultation.

In recent weeks we have heard about the "GP for Me" initiative of the BC Government with co-management by the Doctors Of BC, legally incorporated as the British Columbia Medical Association.

This initiative has been one of several emanating from the agreements of 2006 and subsequently.

The goal of "GP for Me", a GP for everyone in BC who wants one by 2015, has not been met.

However, we do not hear the Minister of Health, Terry Lake, or the Doctors Of BC speak of having failed to meet the target.

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.

Requirements to be Deputy Registrar at College of Physicians and Surgeons (CPSBC) – Is something different?
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Z. Essak, MD – Vancouver, BC – 2015 Apr 23

medical regulation shield imageThe College of Physicians and Surgeons of BC is looking to hire a new Deputy Registrar with the deadline for applications of April 30, 2015 fast approaching.

Is there something different about the experience required in this job posting – “a career opportunity in medical regulation”?

The proven experience and qualifications all candidates should have begins with, "minimum 10 years of senior administrative experience in a complex health-related organization (e.g. regulator, health authority, association, etc.)"

Also the requirements, while including "medical degree preferred", are open to others with "master of business/health administration or law degree also accepted".

Is this a sign of changes or a shift underway at the College (CPSBC)?

The Patient-Physician Covenant: An Affirmation of Asklepios from Annals of Internal Medicine
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Medicine is, at its center, a moral enterprise grounded in a covenant of trust. This covenant obliges physicians to be competent and to use their competence in the patient's best interests. Physicians, therefore, are both intellectually and morally obliged to act as advocates for the sick wherever their welfare is threatened and for their health at all times.

Today, this covenant of trust is significantly threatened.

BC Auditor General issues report on Electronic Health Record (EHR) Implementation.
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Health professionals not effectively or adequately engaged.

Approach should ensure health professionals, stakeholders and the public are informed.

BC Auditor General, EHR implementation in BCOn February 17, 2010 the Auditor General of BC, John Doyle, issued his report on “Electronic Health Record Implementation in British Columbia” which is available on their website http://www.bcauditor.com

In his report, the BC Auditor General, acknowledges “The development and implementation of an EHR system … is a complex and high-risk endeavour … because of the large investment of public funds” and “because collecting, storing and disclosing information electronically raises concerns about the privacy and security of personal health information”.

Concerns about the privacy and security of personal health information is not covered to any great extent in the BC Auditor General’s report.  However, several issues have been reported on by the BC Commissioner of Privacy and individual orders are available on their website, http://www.oipc.bc.ca/.  The BC Civil Liberties Association also provides information and discussion on eHealth issues on their website, http://www.bccla.org/ehealth.html

BC is one of five Provincial Auditor General Offices that will issue separate reports for their jurisdictions and the Office of the Auditor General of Canada will be issuing a joint summary report in April 2010.

There’s more in the full report than contained in the news release and Executive summary.  Here are some key highlights.

Cannabis, marijuana, what do we know?
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Chemurgy2016-10-16 Dr Z. Essak, MD - Vancouver, BC

Cannabis is a plant that has been part of human history for thousands of years and on every continent. The uses of cannabis are far beyond just medical and recreational use.

What do we really know about cannabis?

Is cannabis more than just good for medical and health use, is it also good for the economy and the environment?

Internet search activity as measures of human health trends
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With millions of searches done on the Internet every day it is no surprise that search engine giants like Google are exploring many applications of the search activity data.

One interesting application of Internet search activity data is Google Flu Trends that while providing graphs of results from New Zealand, Australia and the United States, says of itself:

Society-changing infections - parallels to the polio epidemic of 1927
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Poliomyelitis – a.k.a. “The Crippler” or “infantile paralysis” - is a viral disease that primarily, and quite harmlessly, infects the gastrointestinal system. But if the poliovirus survives and is able to enter the bloodstream and nervous system it can cause damage to motor neurons in the spinal cord that connect the brain to muscles. Such damage interferes with muscle control, causing weakness or paralysis.

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.

Highlights of the BC OSCAR-EMR Users Group Meeting
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Vancouver, BC - April 27, 2010

Oscar EMRThe two-day meeting held on April 19-20, 2010 in Vancouver was very well attended with over 150 people including physicians, office staff and system providers and integrators.  There was a buzz of excitement throughout the two days of meetings and many “ah-ha” moments amongst those attending.

Here are three highlights from the meeting, not in any particular order: the OSCAR-CAISI integration, the MyDrugRef physician social network for sharing prescribing tips that are also displayed in the new OSCAR prescription module, and the MyOscar personal controlled health record for patients to receive and even provide medical chart information as participants in their own health care with their physician and health team.

News Items

BC Covid-19 Survey gets quite personal
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BC Covid-19 SurveyThe BC Covid-19 Survey has just been launched and people can participate until the end of May 2020.

The survey takes longer than the 10-15 minutes claimed and while the survey does allow people to answer anonymously and answer only the questions they wish to, it does include a number of questions that reveal a lot of private personal information including the individual's PHN if they wish.

Update on CPSBC Bylaw Amendments - Associate Physician
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We wish to express our sincere thanks to the more than 600 BC physicians who signed the group response letter in less than 48 hours. The overwhelming response with more than 150 comments expressed strong concerns about the precedent-setting CPSBC Bylaw amendments and the potential detrimental effect on patient safety and the quality of care delivered in BC. Please see our update letter sharing what we have learned and what can be done to help uphold the integrity of physician practice in BC, keeping our patients, communities, and families safe.

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?

Society-changing infections - parallels to the polio epidemic of 1927
Public

Poliomyelitis – a.k.a. “The Crippler” or “infantile paralysis” - is a viral disease that primarily, and quite harmlessly, infects the gastrointestinal system. But if the poliovirus survives and is able to enter the bloodstream and nervous system it can cause damage to motor neurons in the spinal cord that connect the brain to muscles. Such damage interferes with muscle control, causing weakness or paralysis.

Acupressure Eye Exercises Chinese School Children
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Acupressure eye exercisesThis is a poster used in chinese schools for students to do acupressure eye exercises. It was received by a Canadian in the early days of the opening of relations between Canada and China who later gave it to me and we posted it in our office. It might be of interest to others.

 

 

The Future of Psychiatry?
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Dr. Chris Sedergreen.

A highly respected psychiatrist has recently sent a letter to her patients announcing her decision not to return to clinical practice. I've known her professionally for over 15 years and can attest that her departure will leave a gap in her patient's lives that will be almost impossible to fill.

Will we see changes to copyright laws in Canada?
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2019-06-21 Vancouver, BC

Canadian copyright laws were updated in 2012. Now, this year, there have been two Canadian Parliamentary committees reporting and providing recommendations on changes to copyright laws in Canada.

With an election looming for later this year is this an opportunity for individuals and organizations affected to speak to candidates running for federal election? Will we see any changes to the copyright laws in the near future?

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.

We expect ethical actions of 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.

It's not just ethics in medicine and health: it's 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?

The late Dr Morris VanAndel, a well-respected GP and subsequent Registrar of the BC College of Physicians and Surgeons, reminded doctors in 2002 this way: "An ethical principle, by nature, is not modified by circumstances, regardless of the validity or justification of the reasons leading to the action."

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