Canadian Medicine

A round-up of Canadian health news, from coast to coast to coast and beyond, for Friday, October 10.

Less than a month after Albertan doctors warned of the potential danger of losing rural physicians as a result of a proposed inter-provincial labour mobility and licensing deal, Saskatchewan's physician licensing body has added its voice to the matter. The plan, which was agreed to by all the provinces' premiers at this year's Council of the Federation meetings, would put an end to the licensing body's ability to enforce rural-work requirements, and would mean that doctors licensed to work in Saskatchewan could more easily pick up and move to major centres like Toronto, Calgary or Vancouver. Read more about Alberta's concerns and the proposed deal in our earlier coverage, from September 16.

All pregnant women should be offered and encouraged to use midwife-led models of care, according to a Cochrane Library review by a team from the University of Montreal.

Ontario's auditor general, Jim McCarter, said the province should publish the wait times of all surgeons. But Health Minister David Caplan refused, promising instead "system change."

Read letters to the editor about yesterday's Canadian Medicine article on the Ontario physicians' contract dispute, including a message from Dr Douglas Mark, the president of the Coalition of Family Physicians. [Canadian Medicine]

A Winnipeg man was sentenced to 14 years in jail for having unprotected sex without informing his partners of his HIV-positive status. Clato Mabior, an immigrant from Sudan, could be deported.

McMaster University is opening a new, $15-million digestive diseases research institute. They managed to steal a "super star" pharmacologist away from the University of Calgary as the institute's first director. []

Ottawa bariatric medicine specialist and "nutrition watchdog" Dr Yoni Freedhoff ordered the Single Bypass Burger and the Flatliner Fries at the Heart Attack Grill, in Phoenix. How does an obesity expert and fast-food-industry critic justify something like that? "Simple," he wrote. "We preach that food and calories, while worth monitoring for nutrition and weight, are also used in life for comfort and celebration, and if you can't use food for comfort and celebration from time to time, you're probably on a diet and long-term, it's probably going to fail."

As Ontario doctors vote this week and next on the proposed agreement between the Ontario Medical Association (OMA) and the provincial government, a vocal alliance of Ontario physicians announced it opposed the terms of the deal and asked OMA members to reject it.

“After extensive consultation with members of the OMA negotiating team and other leaders, and careful debate at our Board, we have decided to NOT SUPPORT the new deal,” wrote Dr Douglas Mark, the president of the Coalition of Family Physicians (COFP), on Monday in a letter to all Ontario physicians.

The proposed deal, which offers physicians a 12.25% increase in fees over the next four years (not adjusted for inflation), was announced in September after negotiations dragged on for more than five months after the last contract expired on March 31.

The COFP has produced a controversial analysis of the contract, which essentially says what will be seen in reality will be around half of the advertised numbers, and called the raise “sub-inflationary.” “In other words,” Dr Mark wrote, “if this deal is accepted, you will effectively be earning significantly less at the end of its 4-year term than at present.” (Canadian Medicine has reviewed the full proposed contract; our calculations project an inflation-adjusted total increase in fees by the contract’s end, in 2012, of around one-half of one percent, or 0.5825%.)

“A rejection of the proposed deal,” Dr Mark’s letter concluded, “will send a strong message to the government that we demand to be treated fairly and with respect, and we will no longer subsidize its political agenda with underpaid labour... What do you have to lose by voting no?”

'INACCURACY' DEBATE
The COFP’s analysis, however, has come under fire from an influential group of four physicians, three of whom -- Stephen Chris, Chris Pinto and Allan Studniberg -- are former COFP board members; the fourth is Dr Suzanne Strasberg, who was elected to the OMA board after a COFP endorsement in 2003 and who is now the OMA’s president-elect. All four currently serve as OMA board members from District 11.

In a letter to doctors dated Wednesday, October 8, the four doctors strongly counter the COFP’s argument. “We believe that the [COFP] analysis is misleading and inaccurate,” the letter said. The four doctors’ letter corrected the COFP on the 6% of fees it had alleged would not go to physicians, but failed to address the effect of the currently high Canadian inflation rate on the actual size of the contract’s proposed fee increases.

The four doctors’ strong disapproval of the COFP’s decision not to endorse this year’s proposed contract was evident in the letter: they referred favourably to “the COFP of our day,” and wrote, “… it is unfortunate that COFP has chosen to present the information in a misleading manner,” and ended by asking OMA members to read the contract for themselves.

ECONOMIC PRESSURES
In an interview with Canadian Medicine, Dr Mark admitted that he expects the contract to pass. But he disparaged what he referred to as the OMA’s “inaccuracies” in its messages regarding the contract and its “scare tactics” of warning that doctors ought to take this deal to avoid a protracted conflict with the Ministry of Health. “We urge you not to be guided by fear of rejecting this contract -- it already gives us nearly nothing, except the assurance that we will be worse off in four years than we are today,” his letter said.

Dr Mark’s letter contended that “the OMA’s best efforts are simply NOT good enough for the majority of Ontario’s physicians.” He accused the OMA of conceding to the government’s current desire to rein in spending as the economy founders.

In a letter announcing the proposed deal to members on September 15, the association’s president, Dr Ken Arnold, acknowledged, “This has been a difficult negotiation. Government took a very tough stance on a number of our priority issues.”

The OMA refused to comment for this story.

CONTINUED CONFLICT
The COFP-OMA discord is not new. Founded in 1996, the COFP has been a vocal critic of the OMA, even endorsing “Coalition Candidates” in OMA board elections in order to push forward reforms. The conflict reached its height in 2003, when Dr John Tracey, who was then the Chair of the COFP’s Political Action Committee, won the election to become Ontario’s nominee as Canadian Medical Association president, beating out five former OMA presidents. But a surprise “nomination from the floor” during the CMA’s subsequent vote several months later -- which is usually nothing more than a rubber stamp -- resulted in a dramatic victory by defeated OMA past-president Dr Albert Schumacher.

The last set of OMA-Ministry of Health contract negotations, produced an initial rejection from by Ontario doctors in 2004 after the COFP opposed the deal. The COFP also opposed the revised proposal the following year, exhorting doctors not be afraid of what some feared would become an “all out war” with the Liberal government. “Conflict with government is not new,” Dr Mark insisted. Despite the COFP’s efforts, the 2005 proposal passed. Its expiry earlier this year, and the struggle to agree on how to replace it, prompted the current state of affairs.

The COFP has complained about the OMA’s “union monopoly” before, but this month’s war of words has reached new levels of enmity. Dr Mark’s letter earlier this week read, “We can only wonder why the OMA, our government-appointed and supported bargaining agent, has accepted this stance and urged us to accept the new deal... rationalizing that it is the best deal that we can get. It is time to re-examine the relationship of the OMA to government, its guaranteed funding by compulsory collection of our dues... bearing no relationship to performance as our bargaining agent, and the absence of a binding arbitration mechanism for dispute resolution... We need better negotiating and a better deal.”

In response to OMA president Dr Ken Arnold’s request for comments on the proposed deal, Baker & McKenzie lawyer Stewart Saxe, the OMA’s legal advisor, wrote in a letter on Tuesday that he believed the OMA “achieved a result that obtained from the Ministry ‘every nickel’ available.” “The state of the economy must also be considered,” he wrote, “although I believe this is a good deal regardless of the state of the economy.”

Voting on this year’s proposed contract ends October 15.

Photo: Shutterstock

A round-up of Canadian health news, from coast to coast to coast and beyond, for Thursday, October 9.

Just three weeks after it reopened, four new listeria-infected products were found at the Maple Leaf meat plant where Canada's listeriosis outbreak began. The company's president, Michael McCain, says he's not surprised but that there is no risk to the public from the new discoveries. []

Former Ontario chief coroner Dr James Young and former deputy chief coroner Dr James Cairns are under investigation by the College of Physicians and Surgeons of Ontario. The two faced accusations in last week's Goudge inquiry report of covering up major errors by Dr Charles Smith. In the wake of the controversy, Dr Young this week resigned from his job on a nominating committee at an Ontario hospital.

Quebec failed to fill all of its 346 family medicine residency spots this year; just 300 residents enrolled. "Quebec must develop a strategy for family medicine. The situation is urgent and we must act," urged Quebec Federation of General Practitioners president Dr Louis Godin. Dr Godin is meeting with Health Minister Dr Yves Bolduc today to discuss the problem.

The RCMP defended its decision to pay researchers to produce reports on Insite in the face of serious criticism.

The country's first two non-military physician assistant training programs, at McMaster and the University of Manitoba, attracted substantial demand, receiving 350 applications for just 35 positions.

In a blog post titled "Cui Bono, Carolyn Bennett?" the Western Standard's Adam T Yoshida proposes a conspiracy theory in which a supporter of Dr Carolyn Bennett, the Liberal MP in Toronto, is responsible for vandalizing Liberal supporters' cars and cutting her financial officer's brake lines.

A real-life House MD: a group of patients are asking a judge to authorize a class-action suit against a Connecticut hospital they claim knew of plastic surgeon Ian Rubins's heroin addiction since 1997. Dr Rubins gave up his licence over the controversy last November; he was found dead of an overdose two months later.

Psychologists are seeing an uptick in the number of patients complaining of depression induced by the economy's troubles. The World Health Organization warned of a rise in mental health problems as a result of financial problems. "There is clear evidence that suicide is linked to financial disasters," said WHO mental health and substance abuse director Benedetto Saraceno. "I am not talking about the millionaire jumping out of the window but about poor people."

The Toronto Star's Stuart Laidlaw on journalist's failure to report on researchers' financial conflicts of interest.

Dr Arya Sharma marvels at a case in Ohio in which a man seeks reprieve from capital punishment because his obesity will render his execution inhumane. He blames the obesity on prison food. []

A round-up of Canadian health news, from coast to coast to coast and beyond, for Wednesday, October 8.

New research on Insite, the downtown eastside Vancouver safe-injection site, reveals that the number of lives saved is significantly greater than had previously been believed. A new study by researchers from the BC Centre for Excellence in HIV/AIDS, published online yesterday in the journal PLoS One, found that between two and 12 overdose deaths are averted every year because of Insite. Those figures contradict the data cited frequently by Health Minister Tony Clement and other critics of Insite, who claim it saves just one life per year. "The figure of one is laughable," Dr Thomas Kerr told The Globe and Mail. "I don't think any experienced clinician working in the area... would think that only one person is saved."

Another study by Dr Kerr and his Centre of Excellence colleagues, to be published in next month's issue of Drug and Alcohol Dependence, shows that Insite improves drug users' ability to access primary care and the healthcare system in general.

Yet another recent study by the gang from the BC Centre for Excellence in HIV/AIDS, published online late last month in the journal Sexually Transmitted Infections, found that use of a safe-injection site improved the safety of drug users' sexual behaviour.

The highest-profile critique of Insite was commissioned by the RCMP, according to documents obtained by the Pivot Legal Society through access-to-information requests. Pivot will ask Canada's auditor-general to investigate whether the RCMP payed for the research.* Last fall, I about allegations of bias in that study, by Colin Mangham.
*Update, 1:46 pm: BC-based independent news outfit The Tyee's Monte Paulsen has that the RCMP paid the researchers to produce their reports, and actively worked to ensure no references to the RCMP's payment were disclosed. “The RCMP used federal funds to finance politically motivated research,” Pivot Legal Society lawyer Douglas King said. Emails obtained by Mr King also reveal that an RCMP constable referred to the BC Centre for Excellence in HIV/AIDS as the "Centre for Excrements," and asked one of the paid authors plus 16 others to call in to a radio show to counterbalance the "Pro Insite side." Also, a correction to the above: Mr King is asking the auditor-general to investigate whether the RCMP's payments were "outside the boundaries of their statutory mandate."

Over-the-counter anti-inflammatory drugs cut women's risk of developing breast cancer, report researchers from British Columbia and Spain in the Journal of the National Cancer Institute. Their giant meta-analysis shows that using non-steroidal anti-inflammatory drugs (NSAIDs) reduces the risk of breast cancer by 12%. For acetylsalicylic acid (Aspirin), that number was 13%, and for ibuprofen (Advil) it was 21%. What's the reason for the drugs' ability to prevent breast cancer? Two oncologists explain the general theory in an editorial in the same issue of the journal. Research into the biological functions behind the drugs' effects is still ongoing, and the scientists aren't yet recommending that patients take NSAIDs regularly in order to prevent breast cancer. []

Luc Montagnier, the French scientist who won the Nobel Prize in medicine this month for identifying HIV, predicted in his acceptance speech that a therapeutic vaccine for AIDS will be available in three or four years. In an interview with Nobelprize.org editor Adam Smith, Dr Montagnier says he is now working on just such a vaccine. Meanwhile, however, the Associated Press calls fellow Nobelist Françoise Barré-Sinoussi, who shared half this year's prize with Dr Montagnier, "pessimistic" on the search for a vaccine. She called the search a "succession of failures."

Part of Saskatoon's Royal University Hospital was evacuated yesterday after nearly 200 litres of 10% formaldehyde solution spilled in a laboratory.

CanadianEMR now has a series of podcasts available for download, on subjects including selecting the right printers for your practice, how to deal with power outages, scanning documents, and more. []

Two can play at this game, it seems.

Medical researchers and scientists upset by the "politicization of science" in Canada have decided to turn the tables by interjecting themselves into the political scene as the October 14 federal election draws near.

A petition protesting the "recent mistreatment" of scientific research will be sent to all major federal political party leaders in the coming days, Canadian Medicine has learned.

The petition was drafted by a group of doctors and researchers that has routinely butted heads with Stephen Harper's Conservative government over the last two and a half years: Julio Montaner (above), Thomas Kerr and Evan Wood.

Dr Montaner has become an academic of worldwide renown as the recently appointed president of the International AIDS Society. The three men are all professors of medicine at the University of British Columbia, but they are best known for their roles at the BC Centre for Excellence in HIV/AIDS, which under their leadership has produced some of the world's top medical research on supervised-injection sites, focusing largely on the downtown Vancouver facility Insite.

Insite has served as a flashpoint for the conflict between the Conservative government and scientists. Despite overwhelming evidence of Insite's benefits, the government withdrew funding and then fought a battle in court earlier this year to attempt to establish jurisdiction over the project so that it could shut it down. The attempt failed when a BC judge ruled that the federal government was not within its rights. Soon after that, Health Minister Tony Clement -- who asked the attorney general to appeal the BC decision -- went on the offensive, drawing considerable opposition from the medical community when he questioned the ethics of physicians who support supervised-injection.

The conflict over Insite is not the only complaint the petition mentions. Others include:

• "the closing of the office of the National Science Advisor"
• "the misrepresentation of climate change science"
• "the muzzling of Environment Canada scientists"
• "the political appointments to the Board of Assisted Human Reproduction Canada"
• "the cuts to and reorganizing of the Canadian Wildlife Service"
• "the halting of the Prison-based Tattoo Pilot Study"

In a letter dated October 6, addressed to "friends and colleagues," Drs Montaner, Kerr and Wood write:

In light of our concerns we have prepared a letter addressed to the leaders of the federal political parties and have asked them to make clear the action they are prepared to take to end the politicization of science in Canada. We are inviting you to become a signatory to this letter. We will send this letter to all major media outlets in the coming days.

If you would like to become a signatory to this letter, please notify us at your earliest convenience by emailing us at [email protected] or by calling 604-806-9142.

The full text of the as-yet-unreleased petition reads as follows:

October 6, 2008

The Right Honourable Stephen Harper, PC, MP
Prime Minister of Canada

The Honourable Stéphane Dion, PC, MP
Leader of Her Majesty’s Loyal Opposition

Mr. Gilles Duceppe, MP
Leader of the Bloc Québécois

Mr. Jack Layton, MP
Leader of the New Democratic Party of Canada

Ms. Elizabeth May
Leader of the Green Party of Canada

Re: The Politicization of Science in Canada

Dear Sirs and Madam:

We are a group of concerned scientists writing to call for the end to the politicization of science and related due processes in Canada. Below we highlight some recent examples of the mistreatment of science in Canada:

• The closing of the Office of the National Science Advisor 1
• The misrepresentation of climate change science 1, 2
• The muzzling of Environment Canada scientists 3 4
• The cuts to and reorganizing of the Canadian Wildlife Service 5
• The political appointments to the board of Assisted Human Reproduction Canada 6
• The halting of the Prison Tattoo Pilot Study and the suppression of the results of this study 7
• The firing of the Head of the Canadian Nuclear Safety Commission 8
• The suppression and misrepresentation of research related to Vancouver’s Supervised Injection Site 9-11

The above represent blatant examples of instances when:

• Systems developed to provide non-partisan scientific advice were undermined, interfered with, or dismantled for political reasons;
• Science was interrupted, suppressed and distorted for political reasons;
• Scientific uncertainty was manufactured in instances where none existed;
• Reputable scientists were attacked because the results of their work were unpopular or inconsistent with the views of political parties;

While science is not the only factor to be considered in political decision-making, ignoring and subverting science and scientific processes is unacceptable. In light of these concerns, we are calling on all political leaders to articulate how they will work to improve Canada’s track record with respect to the treatment of science and related due processes.

Yours truly,

Canadian Scientists Against the Politicization of Science

Encl.: Name List of Signatories


References:

1. Science in retreat. Nature 2008;451(7181):866.
2. Smith C. Climate scientist claims Stephen Harper's government has muzzled experts. The Georgia Straight 2008 September 25th, 2008.
3. Munro M. Environment Canada scientist told to toe the line. National Post 2008 January 31, 2008.
4. CBC News. Minister stops book talk by Environment Canada Scientist. 2006 April 6, 2006.
5. Reuters. Canada slashes spending on wildlife protection: CBC. 2007 September 19th, 2007.
6. Hebert PC, Attaran A. A plea for transparency in Canada's "new government". CMAJ 2007;176(5):601, 603.
7. Kondro W. Prison tattoo program wasn't given enough time. CMAJ 2007;176(3):307-8.
8. Curry B. Fired watchdog quits nuclear board. Globe and Mail 2008 September 23, 2008.
9. Wood E, Kerr T, Tyndall MW, Montaner JS. The Canadian government's treatment of scientific process and evidence: inside the evaluation of North America's first supervised injecting facility. Int J Drug Policy 2008;19(3):220-5.
10. Wodak A. Going soft on evidence and due process: Canada adopts US style harm maximization. Int J Drug Policy 2008;19(3):226-8; discussion 233-4.
11. Kerr T, Wood E. Misrepresentation of science undermines HIV prevention. CMAJ 2008;178(7):964.

Update, October 9: The petition has been officially released, including the full list of 85 signatories. You can check it out (PDF).

FURTHER READING
"," Montaner, Kerr, Wood, and Kora DeBeck, National Review of Medicine opinion, September 15, 2007

"Conservatives still spurning science, say addiction and AIDS researchers," Canadian Medicine blog, February 25, 2008

": Minister's mind made up on safe injection sites, warn experts," National Review of Medicine, September 15, 2007

"Insite decision's aftershocks shake Ottawa," Canadian Medicine blog, May 30, 2008

"Tony Clement takes flak for calling doctors' support of harm reduction 'unethical'," Canadian Medicine blog, August 19, 2008

": Rising din of political wrangling threatens to drown out medical concerns," National Review of Medicine, January 30, 2007

Also, McGill communications professor Darin Barney, who holds a Canada Research Chair in Technology and Citizenship, is working on an to track the "subordination of scientific and technological development to political judgment and interests" by what he calls the government's group of "neo-conservatives."


Photo:

A round-up of Canadian health news, from coast to coast to coast and beyond, for Tuesday, October 7.

Wait times in Canada have dropped, a new Fraser Institute study reveals. But they're still embarrassingly long. The full report is available (PDF).

There are more hospital admissions for appendicitis on days with high concentrations of air pollution, says new research by Dr Gilaad G Kaplan and others from the University of Calgary, presented yesterday at the American College of Gastroenterology's annual meeting.

Montreal researchers claim to have proved that antibiotics are not the only cause of C difficile infection. []

The Ontario government has thrown its weight behind a private member's bill that will provide legal protection to doctors and other professionals who apologize for making an error. For some background about apology-protection legislation in Canada, read from March 2008, and my update from April on the Ontario law.

A new book by the Canadian Federation of Nurses Unions says that private, for-profit healthcare will not improve the quality of care or reduce costs. Download the full book for free (PDF).

Toronto physician and health policy analyst Michael Rachlis bemoans the absence of any substantial debate on healthcare in the federal election campaign.

The majority of Canadians believe the election candidates haven't addressed healthcare sufficiently, either because they are too afraid to do so or because they lack the vision needed, according to a new poll. []

Dr Carolyn Bennett, the Toronto MP and former physician, has come under attack in her Toronto riding -- literally. Her chief financial officer had his car's brake lines cut, and Liberal supporters' cars were keyed. Police are investigating. For details, you can check .

Quebec moves ahead with an idea to allow residents to serve as short-term locums.

The pneumonia vaccine may help prevent heart attacks, report a team of researchers from the University of Sherbrooke and McMaster University in this week's Canadian Medical Association Journal. []

Canadian Family Physician features an article on the importance for family physicians of learning "evolutionary medicine."

Analysts with Quebec's public healthcare insurance plan have declined to issue a ruling on the legality of MYCA Santé's video doctor consultation business. The government has asked the provincial medical regulatory board its opinion. [] Some readers may recognize Myca's "Chief Imagineer" Dr Jay Parkinson (yes, that is really his title), the officeless Brooklyn, New York, doctor who we profiled last year.

This week's Grand Rounds medical blog anthology is online today.

The latest Medicine 2.0 blog anthology is also online now.

A round-up of Canadian health news, from coast to coast to coast and beyond, for Monday, October 6.

Canadian Food Inspection Agency employees claim a policy change was made on April 1 that meant food companies were no longer required to report listeria test results to the inspectors. "Before, you had authority, you were like a cop. We were the meat police. Now, you're just looking at the paperwork," one inspector said. The recent outbreak of listeriosis across Canada as a result of tainted meats caused an argument between the inspectors' union and the agency about what role the inspectors should play. The agency's national inspection director told CBC News that the policy is "going through a revision" and could be reversed.

The Ontario Health Coalition's new report, "Eroding Public Medicare," lists 89 private medical clinics across Canada that it claims violate aspects of the Canada Health Act. The claims are substantiated by short telephone interviews with clinic staff, portions of which are reprinted in the report. Among the clinics accused of breaking the law is Cambie Surgical, the clinic owned by Dr Brian Day, the past-president of the Canadian Medical Association. Ironically, the report's well-documented list of private clinics will likely prove to be a useful resource for patients trying to find such services. ["" report (PDF)] []

William Mullins-Johnston, the man jailed for 12 years after being wrongfully convicted on the basis of expert witness testimony by pathologist Charles Smith, has decided to sue Dr Smith and five other physicians, including the former chief coroner and deputy chief coroner of Ontario. Mr Mullins-Johnson is seeking $13 million in damages. The lawsuit was officially introduced just one day after the Goudge inquiry's report into the province's pediatric forensic pathology system came out. If you missed Canadian Medicine's coverage of the Goudge report last week, read part one and part two.

Being overweight raises the risk of developing prostate cancer, report a team of McGill and Harvard researchers performing analyses of follow-up data from the Physicians' Health Study. For men with a BMI of 25 to 29.9, the rate of prostate cancer was 47% higher than normal-weight men. For men with a BMI of 30 or more, the rate of prostate cancer was 166% higher. [ abstract]

Jury selection begins today in the trial of the first Canadian to be charged with first-degree murder for failing to inform his sexual partners of his HIV+ status. Two women Johnson Aziga had sex with have since died of AIDS. Mr Aziga is also charged with 13 more counts of aggravated sexual assault. The trial is slated to start on October 20.

The AIDS virus first jumped to humans from chimps up to 50 years earlier than had previously been thought, say researchers who studied tissue samples in Africa. According to one theory, the spread of HIV/AIDS occurred at almost precisely the same time European powers created colonial cities in Africa, providing an unprecedented population density in affected areas. In related news, two French researchers shared the 2008 Nobel Prize in medicine for their discovery of HIV. American researcher Robert Gallo, who has sometimes been credited with being a co-discoverer, was not named to share the prize, to his disappointment.

Another winner of this year's Nobel Prize in medicine, the German scientist Harald zur Hausen, who discovered the causal link between human papillomavirus (HPV) and cervical cancer, will present the annual Gairdner Foundation lecture at the University of Western Ontario on October 20. Dr zur Hausen is one of the winners of the 2008 Gairdner Awards. [] He will also speak in Hamilton on October 21 at noon, and in Toronto that evening and the next day as part of panel discussions.

Don't miss this great minute-by-minute coverage of the Ig Nobel Prizes, held in Cambridge. An excerpt:

7:49 p.m. Former Ig Nobel winners come to the podium to relive their past glory. One brags of terminating intractable hiccups with digital rectal massage; the other goes on about homosexual necrophilia in the mallard duck. It seems we're not in Kansas anymore. We're not in Stockholm either.

There's more on the Ig Nobel ceremony, from Marc Abrahams.

Dr Randall F White, of Canadian Doctors for Medicare, has written an excellent and insightful essay on the threat by Arizonan investor Melvin J Howard to use a clause of NAFTA to challenge Canada's reluctance to allow private health clinics to operate.

Claude Castonguay, the former Quebec health minister who chaired a commission on public healthcare insurance funding that reported in February, lashed out last week at the partisanship that he sees as the primary reason his recommendations for reform have been ignored. [La Presse, French only] Read the National Review of Medicine's on the report's release in February, and my Q&A with Mr Castonguay.

Rural Alberta physicians and doctors at Calgary's Foothills hospital are using iPhones to transmit medical information, brags the Alberta Medical Association. []

A pair of researchers from the University of Calgary's Department of Community Health Sciences have put together an interesting analysis of research on journalism about complementary and alternative medicine (CAM).

Residents of Fort Erie, in the Niagara region of Ontario, are protesting the closing of the emergency department and operating rooms at the local hospital. They're concerned the entire facility may be shuttered. Niagara Falls Review

The New Brunswick Nurses Union rejected a contract offer from the provincial government by a slim margin.

Quebec Health Minister Yves Bolduc, a former physician and hospital admin, won a provincial by-election in his Quebec City riding in order to gain a seat in the National Assembly. He won the election with 58% support.

With their fancy new prostheses, two men in Alberta have become Canada's "first bionic men."

With the promise of a little-known stem-cell treatment for a certain type of blindness, a Calgary family is paying $75,000 to bring their son to China.

"One tree by itself is very nice, but when they're all crowded together they block the view." That's according to an Inuit elder named Etuangat, quoted by Dr J in his blog about being a doctor in Canada's far north. Dr J and his wife, also a physician, are now back in BC after spending time in Nunavut.

Also, I'm pleased to note that this is Canadian Medicine's 400th entry. Thanks for reading.