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Burnout and Resilience
Public

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.

Are medical errors the third leading cause of death or disability and what can we do to protect ourselves?
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TEDx Stanley ParkDr Z. Essak, MD - Vancouver BC - March 4, 2018

The TEDx Stanley Park event at the Queen Elizabeth Theatre in Vancouver on Saturday March 3, 2018 was incredible with 13 (a bakers dozen) memorable and inspiring speakers and 4 brief, fun energerizer programs to keep the audience engaged. Two of the presentations addressed medical errors.

With cancer as the leading cause of death and heart disease as the second leading cause, medical errors are referred to by some as the third leading cause of death and disability.

Whether errors are third or not, it makes sense that anything that helps to reduce or prevent medical errors is worth pursuing. Every error that can be prevented has direct benefit to individuals and their families.

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.

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?

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.

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.

Judicial Review of Dr. Bonnie Henry’s Orders begins in BC Supreme Court on Monday, November 20, 2023.
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Update: The Judgment was released on May 10, 2024 and is available on the BCSC website: Hoogerbrug v. British Columbia, 2024 BCSC 794 – 2024/05/10

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.

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 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."

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 virtual medicine essentially unprofessional?
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How the College of Physicians and Surgeons of British Columbia

Fails the Citizens of the Province

Below the banner of the College of Physicians and Surgeons of British Columbia (CPSBC) web site, College of Physicians and Surgeons of British Columbia (cpsbc.ca), they proclaim that their mission is “Serving the public by regulating physicians and surgeons”.

Celebrating and helping caregivers
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Patti and SherriDr Z. Essak, MD - Vancouver BC - February 16, 2018

According to Statistics Canada there are eight million caregivers in Canada. Most are unpaid, regular people who are taking care of aging and ailing parents, children with disabilities, and friends who need them. Caregivers get little or no attention, despite their massive numbers.

Some caregivers find inspiration and friendship from those they care for and some find themselves with personal challenges through caring for others. Healthcare providers may experience the same themselves and see this in those they serve.

Sharing caregivers' stories may help others find inspiration or recognize the impact on themselves and what they might be able to do.

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?

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 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.

News Items

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".

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.

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
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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.

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, in 2019, two Canadian Parliamentary Standing Committees delivered reports with recommendations on changes to copyright laws in Canada.

Will we see any changes to the copyright laws in the near future?

What are ethics and why are they important?
Public

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."

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.

"Cracked Science" light-hearted in-depth science for everyone
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The youtube channel "Cracked Science" with Jonathan Jerry provides some good humour and scientific knowledge in ten minute episodes to bring you up to speed and get you thinking.

Take a look at CRISPR is a Puppy and learn how gene therapy may be applied to human diseases.

Another episode helps to debunk the media hype on the discovery of a new human organ - "the Interstitium, the largest organ we never knew we had", Does a New Organ Explain Acupuncture? While some of this is opinionated to the reporter's own views on acupuncture, the evidence of the Interstitium is a good reminder of what we already know.

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