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Friday, March 20, 2009

What's in the news: Mar. 20 -- A quick round-up

Today, an abbreviated version of our regular "What's in the news" feature with a round-up of recent health news from across the country.

The government of British Columbia has filed a countersuit against former Canadian Medical Association president Dr Brian Day and other private clinic owners, alleging the private clinics have been using illegal billing practices. [Vancouver Sun] [Vancouver Sun] The Canadian Health Coalition has made available several legal documents related to the case, here and here (both PDFs). The clinic owners' lawsuit, filed in late January, argues that the province's restrictions on private clinics violate patients' constitutional rights. [Canadian Medicine]

Foreign-trained doctors demand an inquiry into Quebec's medical residency system to determine why so many international medical graduates were not assigned residencies. [Montreal Gazette]

A provocative American blogger wondered out loud whether the Canadian healthcare system might be at fault in the death of actress Natasha Richardson, who fell and hit her head while skiing at Mont Tremblant. [Kennedy's Tumor] Dr Kevin Pho answered: probably not. [KevinMD]

Being shot in the head by a Taser can cause a seizure, a group of Ontario researchers reported in a case report in the Canadian Medical Association Journal. [CMAJ] [CTV News]

A Montreal nurse and three other aid workers kidnapped in Darfur were freed in short order. [Montreal Gazette] [Voice of America]

A Cooksville, Ontario, tattoo parlor named Moonshin Tattoo is at the centre of a public health investigation into the potential spread of HIV and hepatitis C because of sterilization problems. A $20 million class-action lawsuit has been launched. [Mississauga News] [Sudbury Star]

To accompany a new marketing campaign to encourage patients to report adverse events they experience from medications, Health Canada has issued a brief new guide for health professionals on when and how to report adverse events through the MedEffect system. [Health Canada]

Recommending that Canadians eat two servings of fish per week, as Canada's Food Guide does, is a bad idea, some researchers and environmentalists said. Eating so much fish may be unsustainable and has uncertain public health benefits. [Globe and Mail]

The city of Calgary set new regulations on the content of trans fat that foods served in restaurants could contain, but the new provincial Alberta Health Services board has reversed that policy and eliminated the regulations. [CTV News] [CBC News]

The federal Minister of State for Science and Technology, Gary Goodyear, refused to answer questions about whether he believed in evolution or not. "I am a Christian, and I don't think anybody asking a question about my religion is appropriate." [Globe and Mail] Mr Goodyear is a chiropractor, which some in the medical profession might believe to be even less scientific than creationism.

Ontario Government Services Minister Ted McMeekin wrote to Health Canada to ask for clarification on where licenced users of medical marijuana are permitted to smoke. Current regulations don't specify. [Canwest News Service]

Ontario issued more medical licences last year than it has in any year since 1985. [Canadian Press]

The majority of McGill medical school graduates elect to leave the province to find work. Dr Gilles Aubé, who ran for the Parti Québécois in the last election, has suggested getting students to sign a return-of-services contract to keep them in Quebec for at least a little while. [Toronto Star]

Alberta's doctors are behaving themselves: for the third year running, the number of complaints filed against them dropped. [Canadian Press] [Edmonton Journal]

Elliot Rappaport, a Montreal ex-doctor who lost his licence to practise in 2002, was charged with two charges each of sexual assault and forcible confinement for allegedly tying up female patients, using a blindfold and a gag, and touching them. In 1995, when similar complaints were levied against him, he claimed it was a medical technique. At the time he was suspended for one year but allowed to return to practice thereafter. The Quebec College of Physicians and Surgeons refused to make public the reason he lost his licence in 2002. [Montreal Gazette]

Former Quebec health minister Philippe Couillard's surprisingly fast jump from the National Assembly to a private health-sector investment firm last year did not violate any lobbying laws, a review found. [Montreal Gazette]

Dr Mehmet Oz -- of Oprah fame -- wrote that the drama ER was his "my other med school." "Our mirror neurons fired away as we identified with George Clooney’s Dr. Doug Ross and Julianna Margulies’ Carol Hathaway exorcising their demons." [The Daily Beast]

The Pope, whose advice on prophylaxis one is loathe to trust, said that condoms cannot stop the spread of HIV. "On the contrary," he said, "it increases the problem." [CBC News]

The health bloggers' Grand Rounds is online. [ACP Internist]

And the health policy bloggers' Health Wonk Review is online, too. [HealthBlawg]

Michael Jackson may have expressed interest in having his body plastinated for public display by the doctor and anatomist Gunther von Hagens after he dies. [Der Spiegel] I interviewed the rather strange Dr von Hagens when his Body Worlds exhibit came through Montreal in 2007. [National Review of Medicine]

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Will Canada's next astronaut be an MD?

The medical profession is well represented among the 16 remaining candidates in the Canadian Space Agency's unusual Survivor-like process to select Canada's next two astronauts, with two MDs and one med student still in the hunt.

The 16 candidates -- winnowed down from 5,351 applicants via a series of physical and skill tests (check out the photos) -- were introduced earlier this week. In addition to one microbiologist, one zoologist, and all the engineers and physicists, who dominate the list, the CSA chose Drs Christopher Denny and David Saint-Jacques, as well as med student Keith Wilson.

Here's what the CSA's bios say about each of them:

Christopher Denny
Born and raised: Toronto, ON
Current residence: Toronto, ON
Education:
-BA, Queen's University (1994)
-MD, McMaster University (1998)
-MSc, Clinical Epidemiology, University of Toronto (2004)
Christopher currently works as a Staff Physician and Trauma Team Leader in Emergency Medicine at the Sunnybrook Health Sciences Centre. He is also a Base Hospital Physician for Toronto Emergency Medical Services, a Transport Physician for Ornge Transport Medicine and a Team Physician for Toronto's Heavy Urban Search and Rescue Team. He also works as an Assistant Professor in the Department of Medicine at the University of Toronto.


David Saint-Jacques
Born: Québec, QC
Raised: Saint-Lambert, QC
Current residence: Montreal, QC and Puvirnituq, QC
Education:
-BEng, Engineering Physics, École polytechnique de Montréal (1993)
-PhD, Astrophysics, Cambridge University, UK (1998)
-MD, Université Laval (2005)
David is currently a medical doctor practicing at Inuulitsivik Health Centre in Puvirnituq, Northern Quebec. He also works as a Clinical Faculty Lecturer at McGill University's Faculty of Medicine.


Keith Wilson
Born and raised: Winnipeg, MB
Current residence: Winnipeg, MB
Education:
-BA, Commerce, Royal Military College (1992)
-BSc, General, University of Waterloo (2007)
-MD, University of Manitoba (ongoing)
Keith is currently a medical student at the University of Manitoba. His career with the Canadian Forces included 14 years as a military Search and Rescue helicopter pilot and test pilot. While with the military, he also worked at the Aerospace Engineering Test Establishment, where he most recently was responsible for the coordination, conduct and efficiency of AETE air operations.

To decide amongst the 16, the CSA plans to conduct interviews with all the remaining candidates and subject them to medical tests.

The two selected to join the agency will be named in May, which happens to be the same month that Dr Bob Thirsk, a Canadian physician and astronaut, will blast off from Russia to join the crew of the International Space Station for a six-month stay, making him the first Canadian to live in space for an extended period of time.

Keep your eyes on Canadian Medicine over the next month or two for a Q&A with Dr Thirsk.

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Wednesday, March 18, 2009

MDs warming to environmentalism

In this month's issue of Parkhurst Exchange magazine, I have an article about the ten-fold rise in membership that the Canadian Association of Physicians for the Environment has seen in just the last two years, going from 400 members in September 2006 to over 4,000 today.

"It's been an exciting time for us," said executive director Gideon Forman. "We think it's a very exciting development that doctors are playing a leadership role in the environmental movement,” he said. “Docs are trusted so much by the public, and they have huge credibility with policy-makers. We have access to decision-makers that other groups don’t.”

The medical profession’s interest in environmentalism is relatively recent, said Mr. Forman. Though CAPE’s membership grew 10-fold in the last two and a half years, it didn’t attract a great deal of doctors’ involvement in its previous 13 years.
What sparked the group's sudden popularity? Read the rest of the article here.

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Tuesday, March 17, 2009

Can Canadian doctors fire their patients?

In short: yes.

It's not easy. Doctors have to avoid violating ethics guidelines, regulatory policies and even human rights laws. But if a doctor is inundated with patients, then firing patients is permitted.

Several cases have already come up in which doctors have fired hundreds of patients en masse, using a lottery to determine which ones get cut and which ones get care. That's not the most ethical way of doing things, experts say, but with family doctors under perpetual pressure to accept more and more and more patients, this sort of situation is not likely to disappear. "The challenge from an ethical standpoint is how to decide which patients to discontinue," said Dr Jeff Blackmer, the executive director Canadian Medical Association's office of ethics. "It’s not clear-cut how to decide that."

To read my full article on how Canadian doctors can fire their patients, click here to visit the Parkhurst Exchange website.

What do you think of this practice? Should regulatory bodies forbid doctors from firing patients? Should it be made simpler, so as not to overburden doctors?

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