COLLEGE

Snapshots

Interface between health and health care

It’s time to differentiate between health and health care in Canada, argues the Honourable Dr Carolyn Bennett, former Minister of State (Public Health) in Paul Martin’s government and current Liberal Opposition Critic of Social Development. Dr Bennett, a family physician from Ontario, spoke compellingly to family physicians in Banff at the recent 51st Annual Scientific Assembly of the Alberta College of Family Physicians and discussed how family physicians can put the health back into health care.

Canada needs to work on improving Canadians’ health as well as health care, Dr Bennett said. Currently there’s too much stress on the “repair shop” in health care and on fixing people’s illnesses. Good health is determined by many factors, including social and physical environments, she pointed out. The focus needs to be on keeping well rather than on making repairs.

Physicians, because of their patients’ trust in them, can be very effective advocates for change, argued Dr Bennett. Physicians can be “extraordinarily powerful” advocates for their patients, for the medical community, and for their communities across Canada, she believes.

“My job is to bridge the gap between physicians’ distaste for politics and understanding that politics is the art of making the necessary possible. Doctors are deciding what’s necessary; therefore, that means taking political action, whether it’s through the College of Family Physicians of Canada or in their local community, fighting for the things that keep people well.”

“I think Carolyn’s talk reaffirmed the importance of family medicine, and in particular the 4 principles of family medicine, as they link to what the ultimate goal of everyone in our health care system should be, which is the health and well-being of our population,” said National College Executive Director and Chief Executive Officer Dr Cal Gutkin.

—Barbara Kermode-Scott
On location in Banff, Alta

Upgrading skills at Ontario’s most remote hospital

The Mushkegowuk Territory consists of 6 remote, fly-in communities along the west coast of James Bay. For the past several decades, this predominantly Cree population numbering approximately 12 000 has had obstetrical services provided at the hospital in Moose Factory, the Weeneebayko Health Ahtuskaywin. The volume of deliveries has exceeded 500 yearly. Recently, however, an acute shortage of physicians, and particularly of physicians able to provide obstetrics care, forced the hospital’s obstetrics department to close.

Dr Murray Trusler and colleagues Drs Ronald Henbest, Karen Slatkovsky, and Adrian Levytsky applied for funding to upgrade their obstetrical skills. In 2005, the team shared a Janus CPD/CME Scholarship and a CFPC Scholarship in Women’s Health to pursue a 2-week hands-on clinical traineeship at the Timmins District Hospital. The traineeship proved to be extremely valuable and facilitated the safe reopening of the obstetrics program at the Weeneebayko Health Ahtuskaywin. Expectant mothers no longer have to travel to Timmins for prenatal consultations and confinement. The burden of deliveries in Timmins was proportionally lightened, and Native Patient Services could spend that much less on transporting expectant mothers and their partners. Finally, the physicians had much greater comfort with their knowledge and skills to manage obstetrics, as well as greater ability to function as consultants and backup for their colleagues.

Dr Trusler’s team report is available at www.cfpc.ca/awards-in-action.

—Kiki Ziten
Mississauga, Ont

Questioning preparations for next pandemic

Alberta family physicians were engrossed recently when Dr Tom Marrie, Dean of the Faculty of Medicine and Dentistry at the University of Alberta, gave a keynote address at the Alberta College of Family Physicians’ Annual Scientific Assembly in Banff. Dr Marrie, a specialist in infectious diseases, discussed how physicians, professional associations, regional health authorities, governments, and others can best prepare for the next pandemic. He outlined what provincial, national, and international organizations (including the World Health Organization) are doing to plan for a major pandemic and what still needs to be done.

It is impossible to prevent a pandemic, but it is feasible to slow its arrival and lessen its effect through advanced planning at all levels, pointed out Dr Marrie. Other than influenza, the only other 2 viruses that have emerged in the last 15 years are the sudden acute respiratory syndrome coronavirus and the human immunodeficiency virus, both of which jumped the species barrier, he explained.

“Those are 2 new definite viral threats. However, they pale in comparison to influenza. What’s different about influenza is the ease of spread from person to person. My guess is that we’re not going to see another thing like it. [Sudden acute respiratory syndrome, or SARS] was not that contagious, believe it or not, even though it’s hard to tell that to a person in Toronto who got it.”

Doctors attending Dr Marrie’s talk were very interested in the protective measures they should take in the event of devastating respiratory illness in Canada. Influenza is spread very effectively by hand-to-hand contact, much more effectively than by droplet, responded Dr Marrie. To avoid influenza, it is critical to wash your hands often and to avoid shaking hands with others.

“Masks are probably important, but it’s hard to know how important they will be for infection control,” he explained. “The N95 mask is the best kind of mask.” The problem with the N95 mask, however, is that the wearer must be fitted for it beforehand because, if the fit is incorrect, the mask will not work, he added. The N95 mask will not work on men with beards, for instance. Fit is very important, and fitting large groups can prove costly.

—Barbara Kermode-Scott
On location in Banff, Alta

Alberta physicians learn the art and science of casting

Alberta family doctors looked as though they were having lots of fun placing casts on each others’ limbs at the recent 51st Annual Scientific Assembly of the Alberta College of Family Physicians. These physicians were learning the art and science of general casting as they practised applying short arm casts and scaphoid casts.

“We’re teaching family physicians basic casting techniques, such as splinting of patients’ limbs,” said Pat Ennis, a Registered Orthopedic Technologist in Calgary, Alta. “We’re showing them that, when patients come into the clinic, this is the type of casting they can do. If there’s anything beyond this, then they would be referring [patients] to an orthopedic surgeon and not dealing with it themselves.”

“The cast must be put on in the proper position and with the proper technique,” added Ennis.

—Barbara Kermode-Scott
On location in Banff, Alta

More family physicians teaching at 51st ASA

A higher percentage of primary care physicians presented continuing medical education at the 51st Annual Scientific Assembly (ASA) of the Alberta College of Family Physicians in Banff recently. Family physicians with expertise on a variety of traditional and innovative topics attended the ASA to educate their colleagues. “We have a great program with very relevant topics,” said Alberta College President Dr Patricia Heard (below). “We normally ask specialists to present at the ASA; this time we asked more family physicians to present, to recognize their knowledge within family medicine. The expertise and knowledge within family medicine is quite incredible, so we’re trying to bring more family medicine teachers into the ASA. … Family doctors tend to view themselves as the underdogs. They think specialists must know better than they do, but we can learn a lot from each other.”

Toronto family physician Dr June Carroll gave a keynote address on genetics. The Honourable Carolyn Bennett, a Fellow of the College of Family Physicians of Canada, discussed the interface between health and health care. Calgary family physicians Drs Ted Braun, Charles (Chuck) Samuels, Wendy Smeltzer, Susan Lea, Ardythe Taylor, and Lesley Coulter presented on palliative care, sleep disorders, esthetic treatments, health screening, and aftercare for breast cancer patients, respectively. Edmonton family physicians Drs Michael Allan and Donna Manca discussed family medicine research, Dr Steven K.H. Aung presented a workshop on traditional Chinese medicine, and Dr Jeffrey Robinson tackled fitness injuries. Quebec family physician Dr Réjean Hébert spoke about the frail elderly, and Dr Eric Grief of Ontario reported on vitamin B12.

—Barbara Kermode-Scott
On location in Banff, Alta

New initiative on patient involvement

Patient involvement and patient partnerships are topical issues in health care, mostly in the context of service and delivery and, more recently, research. In November 2005, an international conference on “Where’s the Patient’s Voice in Health Professional Education?” was held in Vancouver, BC. The conference brought together patients, educators from various health professions, researchers, and students to share experiences and ideas. The 134 presentations illustrated many ways in which patients and laypeople are becoming involved in educating health professionals in such countries as the United Kingdom, Canada, and the United States. Little of this work has been published. A network has been established to help disseminate this work and to carry out recommendations from the conference. For more information or a copy of the conference summary, contact Angela Towle, Conference Chair, at isdm@interchange.ubc.ca or visit http://www.health-disciplines.ubc.ca/DHCC.

—Angela Towle
On location in Vancouver, BC