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Not the only nail in the coffin of democracy at the Canadian Medical Association
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Not the only nail in the coffin of democracyDr Z. Essak, MD - Vancouver BC - August 11, 2021.

In less than two weeks, on August 22, 2021 the Canadian Medical Association will hold its AGM as a virtual meeting with proposed bylaw amendments that some doctors say will be the end of democracy at the CMA. While the proposed bylaw amendments deserve to be defeated by physician members, it is not the whole story. This is not the only nail in the coffin of democracy in the CMA and in the medical profession throughout the country and the provinces.

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?

Media depiction of Flu shot technique
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David Naismith (retired physician), Vernon BC, January 15, 2019.

On January 11th I was so disturbed by the portrayal of health professionals on TV, both in adverts and on the National, that I fired off an email to some colleagues. As usual, I learnt something as the thread progressed, so here is a distillate of that exchange.

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.

Is this still the right way to give injections?
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injection technique with pullbackIs this still the right way to give injections, or are some of us just old fashioned, insisting on pulling back first to avoid injecting into a blood vessel? After seeing so many video clips on the news of vaccine injections being given without pulling back it may come as a relief to see this one from Global TV National news on November 26, 2021.

Attached is a video clip and an animated gif.

 

The 3D defence; Deny, Delay, Destroy.
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Corporate Personality Disorder book coverBook Review

The book, "Corporate Personality Disorder, Surviving & Saving Sick Organizations" by Eli Sopow, PhD draws heavily on medical practice examples and describes how "at the core of the Organizational Family Tree is the Triangle of Trust, which combines authority, responsibility, and accountability through a harmonious balance of communications, cooperation, and connectivity to others." He offers critical success factors for each of these six factors.

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 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.

Documentary "Duty To Document" highlights the erosion of democracy in BC, in Canada, and around the World
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Duty to DocumentDr Z. Essak, MD - Vancouver BC - June 6, 2021.

This is a very important and timely documentary illustrating from our own governments in BC and Canada how critical records are disappearing from public view. It highlights the "triple delete scandal" from 2015 when it came to light the BC Government was improperly deleting email records concerning missing and murdered indigenous women along the "Highway of Tears". The documentary illustrates the escalating, troubling trend in the use of post-it notes and the failure to keep records. A trend seen not only in government, but in associations and corporations striking at the heart of transparency and democracy.

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?

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.

The courts will not save Canada's sick health system; Dr Day is not a gadfly
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The BC ruling, after grinding through the courts for a decade, is but a reminder that Canada's sick health care system will not be cured by its dysfunctional legal system. To expect our system to be saved by the courts amounts to, at best, magical thinking, while more and more Canadians who suffer in silence and risk dying from inability to access essential care will "just have to wait".

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.

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”.

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.

News Items

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 "Duty To Document" highlights the erosion of democracy in BC, in Canada, and around the World
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Duty to DocumentDr Z. Essak, MD - Vancouver BC - June 6, 2021.

This is a very important and timely documentary illustrating from our own governments in BC and Canada how critical records are disappearing from public view. It highlights the "triple delete scandal" from 2015 when it came to light the BC Government was improperly deleting email records concerning missing and murdered indigenous women along the "Highway of Tears". The documentary illustrates the escalating, troubling trend in the use of post-it notes and the failure to keep records. A trend seen not only in government, but in associations and corporations striking at the heart of transparency and democracy.

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.

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:

Provincial Health Ministries disregard for the five principles of the Canada Health Act
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In a farewell editorial published in the March 2023 issue of the BC Medical Journal, Dr Brian Day chronicles how the five principles of the Canada Health Act have been disregarded by provincial governments and health ministries across the country. Does this help us understand the sorry state of our medicare system as we see all the media attention related to the nationwide suffering of patients?

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