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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?

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:

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.

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.

An appeal to heal the wounds from the past: 111 years ago, and from the 2021 CMA AGM
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September 30, Tweet by Dr. Alika Lafontaine2021

Open letter to CMA Board Chair
and CMA President-Elect.

Dr. Suzanne Strasberg, Board Chair, Canadian Medical Association,

The tweet by Dr. Alika Lafontaine, CMA President-Elect, and your re-tweet of his message leave many physician colleagues with the strong impression that some folks are slow to learn and apply the principles of fair democratic practice. Instead, the content reflects arrogance, bias, and contempt.

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.

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.

Is this still the right way to give injections?
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injection technique with pullbackIs this still the right way to give injections, or are some of us just old fashioned, insisting on pulling back first to avoid injecting into a blood vessel? After seeing so many video clips on the news of vaccine injections being given without pulling back it may come as a relief to see this one from Global TV National news on November 26, 2021.

Attached is a video clip and an animated gif.

 

Documentary "Duty To Document" highlights the erosion of democracy in BC, in Canada, and around the World
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Duty to DocumentDr Z. Essak, MD - Vancouver BC - June 6, 2021.

This is a very important and timely documentary illustrating from our own governments in BC and Canada how critical records are disappearing from public view. It highlights the "triple delete scandal" from 2015 when it came to light the BC Government was improperly deleting email records concerning missing and murdered indigenous women along the "Highway of Tears". The documentary illustrates the escalating, troubling trend in the use of post-it notes and the failure to keep records. A trend seen not only in government, but in associations and corporations striking at the heart of transparency and democracy.

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?

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 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.

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.

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.

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.

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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