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The Patient-Physician Covenant: An Affirmation of Asklepios from Annals of Internal Medicine
Public

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.

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.

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:

Will we see changes to copyright laws in Canada?
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2019-06-21 Vancouver, BC

Canadian copyright laws were updated in 2012. Now, in 2019, two Canadian Parliamentary Standing Committees delivered reports with recommendations on changes to copyright laws in Canada.

Will we see any changes to the copyright laws in the near future?

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?

More than 400 doctors attend Bill 36 HPOA Webinar by Doctors of BC
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Update (April 16, 2024): Almost a year has passed and the association Doctors Of BC still has not made the recording of the webinar on Bill36/HPOA available for members to view. Why not?

Dr. Zafar Essak, MD - Vancouver, BC - May 3, 2023.

How important is Bill 36, the new Health Professions and Occupations Act, to doctors, nurses, all health care professionals, and patients? Important enough that more than 400 doctors attended the Doctors of BC Townhall Webinar on Tuesday April 25, 2023 at 6:30 pm. This, in the middle of the week, while doctors are trying to finish work or balancing family and meal time. When was the last time you saw 400 doctors attend a meeting? We haven’t seen a number like that at the DOBC AGM for decades.

It was a very informative webinar organized by DOBC with over 100 questions from doctors to a panel of three Ministry of Health staff, as architects of Bill 36, followed by a panel of the DOBC: President, Dr. Josh Greggain; new CEO, Anthony Knight; staff lawyer, Deborah Viccars; and moderated by Marisa Adair, Director of Communications.

"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.

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.

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.

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.

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”.

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 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".

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

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
Public

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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