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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.

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.

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.

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.

Let them eat cake: Why I don't believe Premier David Eby and the BC NDP have what it takes to fix the health care system.

Stay tuned for more to come.

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?

Why I don’t believe Premier David Eby and the BC NDP have what it takes to fix the health care system
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Dr. Zafar Essak, MD - Vancouver, BC - November 29, 2024

I don’t believe Premier David Eby and the BC NDP have what it takes to fix our health care system and government. He hasn’t earned my confidence and there are more reasons to doubt.

After the election, Premier David Eby said he heard the voters and has learned; they need to do better, and they will. Was he just repeating lines to sound good or did he really get the message? Just look at his first actions.

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.

Understanding Generations X, Y, Z and more
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Have you ever felt overwhelmed by the growing list of names for different generations; boomers, gen-X, millenials, zoomers and what follows? Here are a couple of links that may help.

Time to Re-invent the Canadian Medical Association
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Dr Chris Sedergreen - 29 April 2022

The humiliating defeat of the Canadian Medical Association in the Supreme Court of BC is about as clear a statement as it is possible to make that the Canadian Medical Association (CMA) is a failed entity, and that it’s present form should be dismantled forthwith.

‘Humiliating defeat’ you ask? Well, you could certainly be forgiven for not knowing about it, since the CMA, the CMA Journal, and the CMA web site have been deathly silent about it.

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.

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?

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.

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.

 

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.)

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".

News Items

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, 2023 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?

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, 2023. 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.

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