What's in the news: September 23 -- Delirium, checklists and more

A round-up of Canadian health news, from coast to coast to coast and beyond, for Tuesday, September 23.

Elderly patients on statins have a 28% higher risk of post-surgical delirium, according to a new study by a team of Toronto researchers published in this week's Canadian Medical Association Journal. [CMAJ] MedPage Today reported on the study yesterday, writing:

[...] Dr. Redelmeier said that on the basis of their study, he and colleagues concluded that it was reasonable to stop statin therapy prior to elective surgery and to resume afterwards. "This costs nothing, and it may be beneficial," he said, "but reasonable physicians may disagree about this recommendation."

In fact, one reasonable physician has already disagreed with it. In the same issue of the CMAJ, Harvard Medical School physician Edward Marcantonio criticizes the study's conclusions based on what he believes to be methodological problems, calling the results "plausible" but insisting that the connection must still be confirmed. "What is the clinician to do right now?" he asks. "Unlike the authors, I believe it is premature to recommend stopping the use of statins in elderly surgical patients. The methodology used in this study is simply too limited to compel practice change." [CMAJ commentary]

Officials are looking into allegations that a man died after spending 34 hours in the emergency room in a Winnipeg hospital. [Canadian Press]

On the fifth anniversary of Insite, Dr Julio Montaner, the BC-based president of the International AIDS Society, called the Conservative government's anti-harm reduction policy "genocide." "These people, they have no morals. They want these people (addicts) gone," he said. [Vancouver Province] For someone who's been accused by the federal health minister of becoming an advocate rather than a scientist, Dr Montaner's words are particularly bold and unapologetic: what is clear is that he is supremely confident that the results of his extensive research on Insite are accurate and that they demonstrate the facility's immense value.

Just a week after Ontario doctors were offered a 12.25% raise over the next four years, Manitoba's doctors have signed a deal for a 16.5% raise over three years. [Canadian Press] As seems to be normal these days, the new deal was signed around six months after the last one expired. These delayed and endless negotiations are endemic across the country when it comes to physician remuneration. Everyone knows it's a complicated subject, but six months? That's outrageous -- especially when it happens again and again.

After much news of criticism yesterday of the opening of the private Copeman Healthcare Centre in Calgary, (the Canadian Press reported that one protester accused owner Don Copeman of stealing her family doctor) Western Standard magazine launched a broadside against "the advocates for maintaining the government monopoly on healthcare delivery in Alberta." [Western Standard]

More depressing financial news from south of the border: with the US economy in a tailspin, Americans are cutting back on health spending, seeing the doctor less (to avoid co-pays) and declining to fill prescriptions. [Kaiser Network]

Dr Peter Pronovost, the Johns Hopkins researcher who's been pushing the use of simple but surprisingly effective checklists in hospitals, is one of four physicians selected as recipients of this year's $500,000 MacArthur "Genius Awards." [Wall Street Journal Health Blog] Graham Lanktree wrote about Dr Pronovost's work in the National Review of Medicine, and the influence he's had in Canada, earlier this year. [NRM] An aside: another winner is the excellent classical music critic Alex Ross.

Lucy Maud Montgomery, the famed Canadian author of Anne of Green Gables, committed suicide, revealed her granddaughter in an article in the Globe and Mail. [Globe and Mail]

Lawsuits against bloggers are becoming increasingly common. [Poynter] I recently wrote about a lawsuit in Boston in which a physician's blog resulted in him being forced to settle a serious malpractice case. [Canadian Medicine]


And, the best from Canada's physician bloggers:

Dr Arya Sharma, using a new study as evidence, dissects the claim that obese patients shouldn't be eligible to have knee replacement surgery. [Dr Sharma's Obesity Blog]

In a dictated consultation letter: "... and would appreciate if you would blow the patient together with me." [Rheumination]

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