Better pharmacare for all Canadians will be difficult to achieve without the federal government at the table. The government of Canada could lead on this issue in a way that no single province or territory can do, by supporting the development of a single national list of drugs to be covered for all Canadians and by harnessing the purchasing power of the whole nation to get the best possible bang for our buck.
Studies have shown that inadequate follow-up care after emergency room visits is common, with up to 30 per cent of patients with chronic illnesses not seeing a doctor within 30 days after they've been sent home from the ER. Why? In part, it's because fewer than one in three primary care physicians in Canada report being notified when their patients visit an emergency department.
Current media reports have highlighted that doctors can legally demand a fee to fill out this form because it is not an insured service. But really, the difference between the medical document and a prescription is clearly one of semantics. By paying hundreds of dollars to have doctors fill out medical documents, we are inadvertently reinforcing the stigma surrounding cannabis for medical purposes -- the idea that there is something "illegitimate" about cannabis' therapeutic potential and the patients who use it.
A recent court challenge before the British Columbia Supreme Court threatened to change the rules of the game for the Canadian healthcare system -- should the challenge have made its way to the Supreme Court of Canada and found success there. How our health system should be reformed, and in what measures, is nothing short of a national pastime in Canada. Too bad many get the facts wrong. Here are a few basics everyone should know.
It seems there is a disconnect between Canadians' personal views and their idea of how well the health system works for society at large. Canadians tout the public health care model as a big part of our national identity, say their experiences are mostly positive -- but then worry the system is failing.
This isn't just an American problem. Hundreds of thousands of Canadian children are growing up without enough. Low-income children, especially minorities and aboriginals, are growing up at an increased risk of preventable diseases -- diseases both classically medical and mental health related that arise as a result of their early living conditions and will affect us all. These numbers don't simply represent difficult childhoods; they mark a huge group of Canadians who are growing up without the supportive environments they need to develop into healthy adults.
A 2013 EKOS poll showed that 78 per cent of Canadians are in favour of establishing a universal pharmacare program in Canada. In spite of self-serving lobby groups who insist that the current system is working well and should not be reformed, establishing a national drug plan is the best thing to do for patients, for employers, for employees, for taxpayers, and for the Canadian economy.
he false notion that opioids are safe, effective treatments for chronic pain was inculcated by the companies that manufacture them, with self-styled "experts" preaching this gospel to front-line physicians. Incredibly, this happened in the absence of good evidence that the benefits of long-term opioid use outweigh the risks.
The situation in Canada is not different from the rest of the world. The country is already feeling the consequences of climate change: diminishing quality and quantity of water, increasing pollens and other allergens, coastal erosion, road and infrastructure degradation and floods. The health consequences of those climate change impacts are already being strongly felt.
You may assume that communication between physicians and patients is relatively easy -- which in many ways it is. But no amount of preparation of this connection could have prepared me for the work involved. In primary care, we have a term called "the heart sink patient." This is the patient that dumbfounds you. Nothing you do seems to help them. When you look at your schedule and you see their name on your list, your heart sinks.
How should psychiatrists' roles be defined in order to provide as much specialist care to as many high-needs individuals as possible in the most cost-effective way? Because psychiatrists appear to be organized in a far less than systematic fashion within Ontario's mental health system, there is a fairly steady level of unmet need no matter how many psychiatrists practice in a region.
There have been complaints about the three Ottawa doctors who won't prescribe the birth control pill. They don't prescribe it partly out of religious conviction, but also because they believe it's bad medicine. Research shows plenty of evidence against the pill. If conscience is overturned and doctors who disagree are forced to prescribe it, this will ironically mean the provision of inferior care. Using hearts and minds together is what conscience protection allows for. Does anyone actually want anything less in their doctor?
Instead of falling for false comparators, how can we have a broader, proactive conversation on the future of Canadian health care? Boston's book highlights how isolated and frustrating the experience of a patient seeking treatment for a life-altering disease can be. She describes much of her frustration as stemming from rushed appointments that left little time for asking questions. What improvements in system efficiency or changes to compensation models would enable physicians to spend more time providing quality, patient-focused care?
For those who work in high stress professions, dishing slang is pretty normal. Another important purpose of hospital slang is to help health professionals cope with patients who are in pain and suffering as well as those who die on their watch. There are probably more words and phrases used to talk about patients at or near death than almost any other clinical condition or situation.
WHO research has found that unpaid volunteers provide the safest blood donations. Among donors, this group consistently has the lowest prevalence of blood borne infections. Secondly, reliance on unpaid donations also plays a critical role in maintaining the supply of blood products. When a country permits paid blood donations, the number of voluntary donors actually decreases.
In a recent study researchers called doctors' offices in Toronto while playing the role of a person looking for a family physician. Doctors' offices were 58 per cent more likely to offer an appointment if the caller mentioned that he or she had a high-status job than if he or she mentioned receiving welfare.
What would you think if your doctor handed you a prescription that recommended filing your tax returns or applying for food or income benefit programs instead of the usual medicines for high blood pressure or diabetes? You'd probably say the physician was nuts. Tax refunds? Food? What do they have to do with making you healthier?
I am just one of the millions of people in Canada who has a condition called Trichotillomania, a.k.a. Hair Pulling Disorder. These conditions are also under the umbrella term Body-Focused Repetitive Behaviours. In Canada, there are currently only two doctors who treat these conditions, and they have waiting lists for up to a year or more. This is unacceptable.
Unfortunately, our ability now to test for and find insignificant abnormalities in people often leads to medical interventions that offer little or no benefit but still carry all the potential harms. Harm as a consequence of necessary treatment can be accepted, but exposing healthy people to harm from treatment that they should not have had in the first place is unacceptable.