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The Future of Psychiatry?
Public

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.

Burnout and Resilience
Public

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.

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:

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."

Health issues for adults born with cerebral palsy
Public

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.

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.

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.

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.

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?

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?

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.

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.

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.

We are in grave danger, we have taken people out of the picture.
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Dr Z. Essak, MD - Vancouver, BC - October 17, 2022

It’s about learning, knowledge, sharing and understanding so we can make our society and the world better.

We are in grave danger. Soon those with memories of how things were different will be gone. We will be left at risk of believing the way we do things is the only way.

We have taken people out of the picture. We have become leaders of entities, not leaders of people.

Are band-aids the right Rx to save family medicine?
Public

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.

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
Public

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
Public

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.
Public

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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Cease fire banner, you don't speak for the people.