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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?

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 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.

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".

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.

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.

Rick Mercer's 2013 Rant - Scientists Muzzled Again
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Rick Mercer Rant Scientists Muzzled Again

This is one of my favorite Rick's Rants. In less than 2 minutes he lays it all out. Beginning with the problem for scientists then in the middle he turns it up a notch, "Get over yourselves. It's not like scientists are the only ones being told to shut up. No, it's everyone." Then after some fine examples he ends with a polite, "Thank you for not talking." A great entertaining and thought provoking rant.

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.

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?

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.

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?

Getting easier to de-Google or de-Apple
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efoundation-ungoogledYou hate those ads and pesky messages from Google, but you’ve become increasingly dependent on their services, right? Cloud storage, Gmail, Google Calendar and so on have just become so necessary that you feel you have to put up with the intrusions on your privacy and constant marketing of 'stuf', and being stalked by trackers everywhere you go? Well, there are alternatives, but one is growing rapidly and can do everything you want and need without those downsides: the eFoundation (Android) operating system.

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

Not the only nail in the coffin of democracy at the Canadian Medical Association
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Not the only nail in the coffin of democracyDr Z. Essak, MD - Vancouver BC - August 11, 2021.

In less than two weeks, on August 22, 2021 the Canadian Medical Association will hold its AGM as a virtual meeting with proposed bylaw amendments that some doctors say will be the end of democracy at the CMA. While the proposed bylaw amendments deserve to be defeated by physician members, it is not the whole story. This is not the only nail in the coffin of democracy in the CMA and in the medical profession throughout the country and the provinces.

News Items

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)?

Rick Mercer's 2013 Rant - Scientists Muzzled Again
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Rick Mercer Rant Scientists Muzzled Again

This is one of my favorite Rick's Rants. In less than 2 minutes he lays it all out. Beginning with the problem for scientists then in the middle he turns it up a notch, "Get over yourselves. It's not like scientists are the only ones being told to shut up. No, it's everyone." Then after some fine examples he ends with a polite, "Thank you for not talking." A great entertaining and thought provoking rant.

are you sure you want to drive this car ?
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You are done driving your bicycle, as you have successfully completed your race car driving school.

You decide that it is time to buy a car and put your training to use, driving people around, to feed your family, pay your student loans, mortgage etc …

You go to the only car dealerships available, all state owned dealerships, and you have no choice as they have a state sanctioned monopoly.

Has the BC Medical Association been stolen from the members?
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Doctors and members of the BC Medical Association (Doctors Of BC) are asking what is happening at the helm of the BCMA? Some are saying they think the new CEO Allan Seckel is not good for the Association and a sign that bad things are happening to the Association.

Who is Allan Seckel? How did he get to be the BCMA CEO? What is he doing as the CEO? And what is the BCMA Board doing?

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

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.

Burnout and Resilience
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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.

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.

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.

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