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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?

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 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?

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.

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.

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 less than one day had more than 23,000 views and more than 700 comments from people sharing their own experiences and thoughts.

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.

Is BC NDP new legislation poised to politically interfere with licensing of doctors and health professionals?
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Vancouver, BC - November 24, 2022.

 Health Professions and Occupations ActDoes the BC NDP's new legislation: Bill 36 - Health Professions and Occupations Act, introduced on October 19, 2022, set the stage for political interference in the licensing of physicians and other health professionals? Under sections 519 to 532 of the proposed Act, the Cabinet can make changes to the regulations including disciplinary measures, the composition of discipline panels and the oversight of complaints. In BC, will politics trump science when it comes to health professionals?

The Association of the Doctors Of BC has not alerted physicians and the public of problems and concerns related to the new Act. However, social media has been exploding with comments about the recently tabled legislation.

Health issues for adults born with cerebral palsy
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What happens to children born with cerebral palsy when they become adults?

In one case an individual born with cerebral palsy when they were an adult in their early 30’s had progressive deterioration of function involving their affected upper limb.

The individual was reviewed by their orthopedic surgeon who suggested botox injections for spasms and possibly some cosmetic improvement to the upper extremity although not optimistic for functional improvement.

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.)

What do Family Doctors do?
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Family doctor with patient combo, Norman Rockwell painting and photoDr Carmen Eadie, Vancouver BC, Sep 4, 2022.

The biggest problem with being a Family Doctor is that no one knows exactly what we do. We are involved in so many aspects of a person’s life that the lens is not clear to other people.

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

An appeal to heal the wounds from the past: 111 years ago, and from the 2021 CMA AGM
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September 30, Tweet by Dr. Alika Lafontaine2021

Open letter to CMA Board Chair
and CMA President-Elect.

Dr. Suzanne Strasberg, Board Chair, Canadian Medical Association,

The tweet by Dr. Alika Lafontaine, CMA President-Elect, and your re-tweet of his message leave many physician colleagues with the strong impression that some folks are slow to learn and apply the principles of fair democratic practice. Instead, the content reflects arrogance, bias, and contempt.

Judicial Review of Dr. Bonnie Henry’s Orders begins in BC Supreme Court on Monday, November 20, 2023.
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Dr. Z. Essak, MD - Vancouver, BC - November 19, 2023.

Vancouver Law CourtsFinally, an opportunity for everyone to hear a BC Judicial Review of the ongoing orders of Dr. Bonnie Henry, Public Health Officer, and the BC Government that, since November 2021, have impacted the livelihood of thousands of health care workers in BC who are unvaccinated, prohibiting them from working in health care. BC and Nova Scotia are the only jurisdictions in the world that have not allowed unvaccinated health care workers to return to work. Orders and actions that have caused severe division even among health professionals and workers; where nurses, doctors, paramedics, porters and others are not sure who is safe to talk to if they disagree or think consent for vaccination is paramount.

Starting Monday, November 20, 2023, the BC Supreme Court will begin the Judicial Review of Dr Henry’s orders and the October 2023 amendment perpetuating them.

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.

News Items

More than 10,000 people sign petition to repeal BC's Bill 36
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Vancouver, BC - February 13, 2023.

More than ten thousand people sign petition opposing Bill 36A petition to repeal BC's Bill 36 - Health Professions and Occupations Act has already gathered more than 10,800 signatures. It was presented to the BC Parliament when the session resumed earlier this month. More signatures are still being collected and will be presented to the House later. It is already one of the largest petitions introduced to the BC Legislature.

Request for the Doctors Of BC to send package to all doctors offices to repeal Bill 36.
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The next Board meeting of the Association of Doctors of BC is on Friday January 27. Doctors throughout BC who are concerned about Bill 36 can send an email request to the President and the Board to prepare and send a package to all doctors offices with a poster and the petition to repeal Bill 36. Here is a suggested email that doctors can use or modify.

It's time for all doctors and the Association of Doctors of BC to show their leadership and strength. If the Board adopts the motion to send the package that will be a good thing for everyone in BC, patients and doctors. If the Board refuses to address such a request, the member doctors will have their answer on the substance of the Board.

Is BC NDP new legislation poised to politically interfere with licensing of doctors and health professionals?
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Vancouver, BC - November 24, 2022.

 Health Professions and Occupations ActDoes the BC NDP's new legislation: Bill 36 - Health Professions and Occupations Act, introduced on October 19, 2022, set the stage for political interference in the licensing of physicians and other health professionals? Under sections 519 to 532 of the proposed Act, the Cabinet can make changes to the regulations including disciplinary measures, the composition of discipline panels and the oversight of complaints. In BC, will politics trump science when it comes to health professionals?

The Association of the Doctors Of BC has not alerted physicians and the public of problems and concerns related to the new Act. However, social media has been exploding with comments about the recently tabled legislation.

We are in grave danger, we have taken people out of the picture.
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Dr Z. Essak, MD - Vancouver, BC - October 17, 2022

It’s about learning, knowledge, sharing and understanding so we can make our society and the world better.

We are in grave danger. Soon those with memories of how things were different will be gone. We will be left at risk of believing the way we do things is the only way.

We have taken people out of the picture. We have become leaders of entities, not leaders of people.

What do Family Doctors do?
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Family doctor with patient combo, Norman Rockwell painting and photoDr Carmen Eadie, Vancouver BC, Sep 4, 2022.

The biggest problem with being a Family Doctor is that no one knows exactly what we do. We are involved in so many aspects of a person’s life that the lens is not clear to other people.

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.

Are band-aids the right Rx to save family medicine?
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band-aid solutionThe $118 million announced consisting of $75 million new money plus redistribution of existing funds as a "stabilization fund" is an interim measure, a one-time handout over 4 months October 2022 to Jan. 31st, 2023, to help family physicians (FP) in the community, both longitudinal practices and walk-in clinics with overhead costs to keep their doors open until January 2023. This first step is intended to buy more time for the government and DoBC to develop a "new payment model" that will be introduced and implemented. According to DoBC President's letter, the new model will be based on compensation determined by a number of factors including time, patient encounters, and attachments/complexity.

The I Ching or Book Of Changes
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I Ching Wilhelm Baynes translation title page imageThe I Ching, or Book Of Changes, is an ancient Chinese book. While there are many translations, the German translation by Richard Wilhelm rendered into English by Cary F. Baynes (1950) has become a well respected classic. The book includes a foreword by CG Jung, psychiatrist and psychoanalyst, who has elsewhere described using the I Ching in his psychiatric practice from time to time. An electronic version of the text related to the hexagrams (the oracle), from the first part of the translation, can be viewed online or downloaded using the link below.

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.

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