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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.

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.

What do Family Doctors do?
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Family doctor with patient combo, Norman Rockwell painting and photoDr Carmen Eadie, Vancouver BC, Sep 4, 2022.

The biggest problem with being a Family Doctor is that no one knows exactly what we do. We are involved in so many aspects of a person’s life that the lens is not clear to other people.

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.

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.

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 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?

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."

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)?

Request for the Doctors Of BC to send package to all doctors offices to repeal Bill 36.
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The next Board meeting of the Association of Doctors of BC is on Friday January 27. Doctors throughout BC who are concerned about Bill 36 can send an email request to the President and the Board to prepare and send a package to all doctors offices with a poster and the petition to repeal Bill 36. Here is a suggested email that doctors can use or modify.

It's time for all doctors and the Association of Doctors of BC to show their leadership and strength. If the Board adopts the motion to send the package that will be a good thing for everyone in BC, patients and doctors. If the Board refuses to address such a request, the member doctors will have their answer on the substance of the Board.

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.

Is virtual medicine essentially unprofessional?
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How the College of Physicians and Surgeons of British Columbia

Fails the Citizens of the Province

Below the banner of the College of Physicians and Surgeons of British Columbia (CPSBC) web site, College of Physicians and Surgeons of British Columbia (cpsbc.ca), they proclaim that their mission is “Serving the public by regulating physicians and surgeons”.

Is BC NDP new legislation poised to politically interfere with licensing of doctors and health professionals?
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Vancouver, BC - November 24, 2022.

 Health Professions and Occupations ActDoes the BC NDP's new legislation: Bill 36 - Health Professions and Occupations Act, introduced on October 19, 2022, set the stage for political interference in the licensing of physicians and other health professionals? Under sections 519 to 532 of the proposed Act, the Cabinet can make changes to the regulations including disciplinary measures, the composition of discipline panels and the oversight of complaints. In BC, will politics trump science when it comes to health professionals?

The Association of the Doctors Of BC has not alerted physicians and the public of problems and concerns related to the new Act. However, social media has been exploding with comments about the recently tabled legislation.

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.

News Items

Nutrients in Our Food
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USDA Nutrient Database search urlIf you ever find yourself wondering what nutrients are in different foods you might want to take a look at the US Department of Agriculture (USDA) Nutrient database. 

It provides a wealth of information on over 7,500 specific food items and details of the nutrients they contain down to the many different minerals, vitamins, types of fats, carbohydrates, proteins and various amino acids.

There are two very useful ways to look at this information on their website.

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.

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”.

Mistakes were made (but not by me): Cognitive dissonance
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Mistakes were made (but not by me): Why we justify foolish beliefs, bad decisions, and hurtful acts... a book co-authored by Elliot Aronson.

Psychiatrists specialize in the ails of individuals. Social psychologists specialize in the ails of groups. The eminent social psychologist Elliot Aronson was interviewed in a CBC audio "podcast" available from the following site:

http://podcast.cbc.ca/mp3/ideas_20080428_5430.mp3

It is an interesting program from the CBC radio “Ideas” on the subject of cognitive dissonance. It offers some insight into how people can so badly misinterpret things to fit their preconceived notions and prejudices and become incapable of accepting any other view.

The program runs about 50 minutes and I suspect if people even listen to just the first 12 minutes they might find it sufficiently compelling to listen to the rest. (The MP3 file can be imported into iTunes or other music manager or burned to CD.)

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

"Deja Vu" - Dr Norman Rigby
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Dr. Norman Rigby, Retired GP and Former Executive Director BCMA.

"The best thing we had going for us was the District 6 Newsletter."

"It excited the attention of the membership."

"What really changed things was when ... the administrator became the President of the hospital, ... and governments started to deal with the President not the Board."

Video highlight from June 3, 2006 Forum for Physicians, Vancouver.

"Deja Vu"
Dr. Norman Rigby, Retired GP and Former Executive Director BCMA.

Deja Vu, Dr Norman Rigby link to video

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