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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?

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.

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.

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.

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.

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?

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.

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.

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.

Will Artificial Intelligence merge with human genetics?
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 The Machine That FeelsAs it hurtles ever faster at us will Artificial Intelligence merge with human genetics or will it be artificial stupidity? See the episode "The Machine That Feels" on CBC The Nature of Things. How AI has been applied to complete Beethoven's Tenth Symphony and how the future might combine genetic material with AI leading to new hybrid life forms. Is it no longer a question of if but when will this happen? Are we going to become these new beings? Do we need to remember who and what we are now, because it will soon be gone?

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.)

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.

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.

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.

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.

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
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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?

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
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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?

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