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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.

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)?

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?

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.

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

"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.

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?

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.

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 Karpiak on Bill Good CKNW - Bureaucracy in health care is not sustainable
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Dr Dennis Karpiak, Internist and former BCMA Board Director from the Interior of BC speaking on the Bill Good Show CKNW radio 980 on July 10, 2012.

"It's become increasingly more difficult to sustain a practice in this province."

"The BCMA 20 years ago formed the Regionalization committee that predicted the rise of bureaucracy and a decline in patient care funding."

"Currently you can walk through any hospital and you'll see more administration offices than patient rooms."

Listen to the whole interview.

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.

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 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.

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”.

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.

News Items

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.

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.

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?

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.

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?

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?

Don't get swept away by the spin on health care
Public

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?

The future of medicine and health care in BC and Canada: Where are we going?
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Norman Rockwell Doctors Office2016-07-21 Dr Z. Essak, MD - Vancouver, BC

What is the future of medicine and health care in BC and Canada? Where are we going?

While everyone is out having fun in the summertime, the Government and other organizations, use the time to put out information they know few people will have time to see or digest. Much like they also use the busy time of Christmas and the winter holiday season to slip through items. Some people may just consider it prudent timing, others may see it as deliberate avoidance of proper public consultation.

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.

Federal Government seeks intervenor status in B.C. health care court case
Public

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?

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