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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.

US launches new MyPlate icon as reminder for healthier food choices
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MyPlate IconOn June 2, 2011 US First Lady Michelle Obama and Department of Agriculture Secretary Tom Vilsack unveiled the federal government's new food icon, MyPlate.  MyPlate is a new generation icon with the intent to prompt consumers to make healthier food choices and to seek more information by going to www.ChooseMyPlate.gov

“This is a quick, simple reminder for all of us to be more mindful of the foods that we’re eating,” said First Lady Michelle Obama. “It’s tough to be a nutritionist, too. But we do have time to take a look at our plates. As long as they’re half full of fruits and vegetables, and paired with lean proteins, whole grains and low-fat dairy, we’re golden. That’s how easy it is.”

Mistakes were made (but not by me): Cognitive dissonance
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Mistakes were made (but not by me): Why we justify foolish beliefs, bad decisions, and hurtful acts... a book co-authored by Elliot Aronson.

Psychiatrists specialize in the ails of individuals. Social psychologists specialize in the ails of groups. The eminent social psychologist Elliot Aronson was interviewed in a CBC audio "podcast" available from the following site:

http://podcast.cbc.ca/mp3/ideas_20080428_5430.mp3

It is an interesting program from the CBC radio “Ideas” on the subject of cognitive dissonance. It offers some insight into how people can so badly misinterpret things to fit their preconceived notions and prejudices and become incapable of accepting any other view.

The program runs about 50 minutes and I suspect if people even listen to just the first 12 minutes they might find it sufficiently compelling to listen to the rest. (The MP3 file can be imported into iTunes or other music manager or burned to CD.)

Federal Privacy Commissioner rules against RCMP Health Services
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RCMP Breach of Privacy

All Canadian physicians should be made aware of a damning report from the Federal Privacy Commissioner regarding breach of confidential medical information by the RCMP Health Services Division.  The report, which is publicly available as File PA-032579, follows a complaint made in July 2013 by a number of RCMP members to the Federal Privacy Commissioner, arising from the disclosure sensitive health information to a third party.

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.

VMA and WMA hosting debate July 12 with President Elect candidates
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The VMA website, http://vancouvermedicalassociation.ca/ has a notice of a Special Event on July 12, 2017 featuring the candidates for DoctorsOfBC President Elect, Dr Cadesky and Dr Mahy, with Dr Arun Garg as moderator.

The event will be held at the Seasons in the Park at Queen Elizabeth Park in Vancouver with pre-dinner cocktails at 17:30, dinner at 18:30 and the debate from 19:30 to 21:00.

The deadline to register for this event is Wednesday July 5th. I think this will be a very interesting event to attend.

With limited seats available I am happy to have mine confirmed and would encourage others interested in attending in person to get their reservations in as soon as possible to avoid disappointment or the risk of forgetting to register in time with the long weekend almost upon us followed by a short week that is bound to be busy as the deadline to register approaches.

Federal Government seeks intervenor status in B.C. health care court case
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Z. Essak, MD - Vancouver - April 26, 2016.

Below is a link to the Globe and Mail article from April 13, 2016.

Hopefully, the debate around the court case, involving Dr. Brian Day's private Cambie Surgery Centre and the BC Provincial Government with a trial scheduled to begin June 6, will not become polarized with views of exclusivity between public and private health care but instead what we could and should do to make public health care more effective so that escape valves, like private care, are less needed without eradicating access to private care by individuals should they need it.

How far do individuals have to go? If the public system delivers the needed service great. If not, is there private care here at home in Canada or do people have to go to other countries?

Dr. James Busser
Public

DrBusser-tweetsI enjoyed the privilege of attending the celebration of the life of the late Jim Busser on this Friday past. I was already aware that he had been an exceptional human being, yet it was a remarkable revelation to listen to the recollections of those who rose to speak of their connections with him. 

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.

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.

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.

Legalizing cannabis with regulations and taxation may simply perpetuate a narrow view rather than create greater openness, understanding and economic growth.

The Canadian Medical Association 2016 survey showed that almost 40% (39.7%) of doctors agreed or strongly agreed that people should be allowed to grow their own plants, another 22.7% didn't know, and less than 40% (37.6%) of doctors disagreed or strongly disagreed.

What will be the recommendations of the Task Force on Marijuana Legalization and Regulation? Chaired by Anne McLellan, former deputy prime minister under Paul Martin and former health and justice minister.

What will Prime Minister Justin Trudeau, the federal Liberal party, and the Government of Canada decide to do?

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?

What are the fiduciary duties of directors of the BC Medical Association?
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Vancouver, BC - Z. Essak, April 22,  2014

The BC Medical Association (BCMA), now rebranding itself as the DoctorsOfBC, is a non-profit Society in BC. It is a voluntary professional association of physicians that purports to represent all BC physicians in negotiations regardless of whether or not physicians choose to be a member.

The 2014 BCMA elections are now underway. Which way are the winds blowing? Are they winds of change? Are they strong enough? Will we see openness, transparency and accountability emerge or continued substitution with opaque communications and marketing?

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?

Health Records and Privacy (Humour?)
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If you haven't already seen this, here is a somewhat humorous piece from the American Civil Liberties Union

http://www.aclu.org/pizza/images/screen.swf

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

http://www.aclu.org

Rick Mercer's 2013 Rant - Scientists Muzzled Again
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Rick Mercer Rant Scientists Muzzled Again

This is one of my favorite Rick's Rants. In less than 2 minutes he lays it all out. Beginning with the problem for scientists then in the middle he turns it up a notch, "Get over yourselves. It's not like scientists are the only ones being told to shut up. No, it's everyone." Then after some fine examples he ends with a polite, "Thank you for not talking." A great entertaining and thought provoking rant.

News Items

Dr. James Busser
Public

DrBusser-tweetsI enjoyed the privilege of attending the celebration of the life of the late Jim Busser on this Friday past. I was already aware that he had been an exceptional human being, yet it was a remarkable revelation to listen to the recollections of those who rose to speak of their connections with him. 

VMA and WMA hosting debate July 12 with President Elect candidates
Public

The VMA website, http://vancouvermedicalassociation.ca/ has a notice of a Special Event on July 12, 2017 featuring the candidates for DoctorsOfBC President Elect, Dr Cadesky and Dr Mahy, with Dr Arun Garg as moderator.

The event will be held at the Seasons in the Park at Queen Elizabeth Park in Vancouver with pre-dinner cocktails at 17:30, dinner at 18:30 and the debate from 19:30 to 21:00.

The deadline to register for this event is Wednesday July 5th. I think this will be a very interesting event to attend.

With limited seats available I am happy to have mine confirmed and would encourage others interested in attending in person to get their reservations in as soon as possible to avoid disappointment or the risk of forgetting to register in time with the long weekend almost upon us followed by a short week that is bound to be busy as the deadline to register approaches.

Why BC needs a change of Government in this election
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Dr. Z. Essak, MD - Vancouver, BC - May 5, 2017.

Yes - this is an important election. Some people have already voted at early polls ahead of the general election day on Tuesday, May 9, 2017. Meanwhile, many are still undecided how they will vote.

After 16 years of the same party, the BC Liberals in office since 2001, there are compelling reasons for a change.

Will the new BC Societies Act transition be a train wreck?
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Dr Z. Essak, MD - Vancouver, BC - February 13, 2017.

Train wreckNo one can deny the importance of BC societies to communities large and small throughout the province, assisting all kinds of people as charitable and not for profit societies, including associations that represent occupations and professions.

What can we learn from the early example of transition by the Doctors of BC, the BC Medical Association, formerly a Reporting Society, declaring themselves to be a member-funded society and escaping public disclosure. Do they even meet the required criteria?

When we ask, it may come as a shock to learn the BC Registry is not confirming compliance requirements are met. Is the BC Government failing to provide proper leadership and oversight to the tasks of government?

Is the public trust being neglected? Will there be havoc on public interest and individual rights? Are we going to see a train wreck?

Viscose rayon and health effects on workers during manufacturing
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 Fake Silk by Paul BlancPaul Blanc, University of California professor of medicine, chair of occupational and environmental medicine and author of the book "Fake Silk - The Lethal History of Viscose Rayon" has written about the dangers and health effects to workers in the manufacturing of these materials.

In a recent radio interview on CBC The Current he talks of the dangers and medical effects of exposure to carbon disulfide used in the manufacturing process and the diversity of products. He speaks of places where there are better working conditions and worker safeguards while there are other places where this is not so.

The toxic effects of carbon disulfide are dramatic and onset early. It easily travels into brain tissue and causes insanity along with other medical problems.

Opinion: B.C. doctors have been kept in the dark about Doctors of BC bylaw amendments
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Dr Caroline Wang, Vancouver BC. January 18, 2017.

Doctors of BC members are being encouraged by the association’s leadership to vote in favour of proposed bylaw amendments to relinquish their democratic right to elect the board of directors. If passed, the new policies and governance structure would, in effect, disenfranchise the approximately 12,000 physician members as the owners of the sole representative association for the medical profession in B.C.

Most worrisome, the majority of doctors appear to be unaware of the profound implications and risks of the proposed changes that would impact physicians, patients and the health-care system. It’s little wonder that the vast majority of doctors, who are interested in practising medicine and not trained in matters of policy governance, would choose to ignore the governance referendum as irrelevant to their practice. They don’t know what they don’t know.

New Governance with Representative Assembly for Doctors of BC - Part 1
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Voting on the Doctors Of BC, BC Medical Association, proposed Bylaws change will close in a few days. Voting on the Governance Referendum began on December 6, 2016 and closes on midnight January 18th, 2017.

The Doctors of BC information provided to members on the proposed bylaws change was also released as news to the public on the Internet and urges members to support the changes.

Cannabis, marijuana, what do we know?
Public

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.

Legalizing cannabis with regulations and taxation may simply perpetuate a narrow view rather than create greater openness, understanding and economic growth.

The Canadian Medical Association 2016 survey showed that almost 40% (39.7%) of doctors agreed or strongly agreed that people should be allowed to grow their own plants, another 22.7% didn't know, and less than 40% (37.6%) of doctors disagreed or strongly disagreed.

What will be the recommendations of the Task Force on Marijuana Legalization and Regulation? Chaired by Anne McLellan, former deputy prime minister under Paul Martin and former health and justice minister.

What will Prime Minister Justin Trudeau, the federal Liberal party, and the Government of Canada decide to do?

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?

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