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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 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:

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

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?

Documentary: Waiting To Die - Canada's Health Care Crisis
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 Waiting to Die - Canada's Health Care CrisisA new one hour documentary by Aaron Gunn, "Waiting To Die - Canada's Health Care Crisis" was released yesterday (August 14, 2023) and in less than one day had more than 23,000 views and more than 700 comments from people sharing their own experiences and thoughts.

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.

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."

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.

Delegation to Campbell River City Council on concerns arising from HPOA
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Screen capture youtube video Cambell River delegation on HPOA, Feb 29.At the Campbell River City Council meeting on February 29, 2024, a delegation of physician Dr Anna Kindy and retired naturopath Dr Ingrid Pincott discussed the Health Professions and Occupation Act, HPOA, and the serious concerns it raises for health professionals, patients, and people living in and around Campbell River. Like most City Council meetings in BC it was streamed live and recorded and can be watched on YouTube. City councillors asked questions and expressed the view that these concerns are important and that they would like to ensure it is discussed when the UBCM meets this year, on September 16-20, 2024.

Don’t FIPPA your PIPA without knowing this when it comes to personal health information.
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Vancouver, BC – May 3, 2010

Stethoscope and keyboardWhen it comes to the privacy of personal health information everyone in British Columbia needs to know how FIPPA (also known as FOIPPA) is different from PIPA, and the same may apply in other jurisdictions across Canada and elsewhere.

This is of particular importance when information is shared between your doctor's private office and a hospital or clinic operated by the Health Authority which is a public body.

In BC, three different legislative Acts govern the privacy and protection of individual personal health information.  There are some very important differences in how these work and the results they have that should be known to all doctors, health providers and patients/clients.

More than 10,000 people sign petition to repeal BC's Bill 36
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Vancouver, BC - February 13, 2023.

More than ten thousand people sign petition opposing Bill 36A petition to repeal BC's Bill 36 - Health Professions and Occupations Act has already gathered more than 10,800 signatures. It was presented to the BC Parliament when the session resumed earlier this month. More signatures are still being collected and will be presented to the House later. It is already one of the largest petitions introduced to the BC Legislature.

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.

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.

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?

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

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”.

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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