Canadian Doctors To Identify Questionable — And Possibly Harmful — Tests And Procedures

One study estimated that the more than two million CT scans of the lower back performed in the U.S. in 2007 will lead to 1,200 new cancers. Most back pain gets better on its own but ared flaga signs that a CT scan may be needed include a history of cancer, unexplained weight loss, or loss of feelings or muscle strength in the legs. Few doctors can boast that they have never ordered a test or intervention athat upon reflection we would agree promises little benefit to the patient,a said Dr. Anna Reid, outgoing president of the CMA. Sometimes itas a case of appeasing an insistent patient awho firmly believes a certain test or treatment is required,a she said. Delegates on Tuesday also called for a national strategy for physician workforce planning to ensure the right number and mix of doctors is deployed across the nation. The last national review was completed in 1975, almost 40 years ago, Reid said. Medical school enrollment has increased by roughly 80 per cent over its low point in 1997. But medical schools are training too many residents in some areas and too few in others. For example, Ontario expects to have 453 more general internal medicine specialists than it needs by 2021 a as well as an oversupply of orthopedic surgeons a but a shortage of 248 psychiatrists. aSome provinces and regions are very good about making sure where the residents need to go a which residency programs need to be expanded and which need to be drawn down. But there is really no strategy across the country,a said Dr. Jesse Pasternak, a fifth-year surgical resident at Hamiltonas McMaster University and chair of the physician resource committee at the CMA.

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Canadian doctor: Zdeno Chara deserved 80 games for Pacioretty hit, condemns NHL violence

Ive always found this to be such a strange argument. Ive watched the NHL for over 25 years. Ive actually been waiting for them to begin promoting violence in a way that would connect with casual American fans who only speak three languages in sports: Scoring, gambling and violence. And since the NHL will never have the first and Americans dont wager on the second, the third option was always the best. Yet for decades, the NHL ran away from violence while the NFL, pro wrestling and MMA captured huge market shares by embracing it. The NHL has a winking acceptance of fighting, for example, as part of the game. Does it promote it? It doesnt ignore it. But its still a League that markets offensive flourish, maudlin nostalgia and championship glory more than it does the Rockem Sockem stuff. That said, the NHL isnt eradicating its violent aspects, at least to Harveys satisfaction: “I wanted my motion to be specific to the NHL because that’s where it happens,” said Harvey. “If the NHL stops doing that or makes a significant move to reduce those concussion rates, I’m sure the whole hockey industry and minor league hockey will follow. We deplore it because it has a significant impact on our players health and those players are major role models for teenagers and kids,” he said.

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Novogi(tm) Announces Purchase Of Ip And Collaboration With Leading Gastroenterologist Dr. Christopher Paul Swain

C.P. Swain for the joint development of an innovative laparoscopic nitinol based compression anastomosis solution for Bariatric surgery. Professor Paul Swain is Professor of Gastrointestinal Endoscopy at Imperial College, London University, UK. Professor Swain is widely published in the area of gastroenterology, with over 180 publications on areas such as endoscopy, gastrointestinal bleeding and technical advances and devices for endoscopy. “I am thrilled to be working again with Gavriel Meron and the novoGI development team to provide a unique solution for the growing need for a simpler and safer bariatric surgical procedure,” commented Dr. Swain. “Bariatric surgery often is the best path for resolving obesity and Type 2 Diabetes, and we believe that our innovative solution may significantly improve outcomes and quality of life, thereby becoming the standard of care worldwide.” “We are delighted to be collaborating with Dr. Swain. A prototype has already been successfully tested in pre-clinical studies and we look forward to jointly developing this solution,” said Gavriel D. Meron, President and Chief Executive Officer of novoGI. “We see this agreement as another important step in expanding our offerings in line with our focus on advancing patient care and seeking better outcomes through our comprehensive approach to GI disease management.” About Dr. Christopher Paul Swain Professor Paul Swain trained in Oxford and London University and specialized in gastroenterology, doing his MD on the use of therapeutic endoscopy for the treatment of gastrointestinal bleeding.Subsequent posts included a DHSS-funded Clinical Research Fellowship to study the effect of lasers in gastrointestinal hemorrhage. In 1987, he was appointed as Senior Lecturer and Consultant in Gastroenterology at the Royal London Hospital. In 1999, he was appointed to become Professor of Gastrointestinal Endoscopy to London University.In 2003, he moved to Imperial College in London University. Professor Swain has contributed chapters to key clinical textbooks such as the Textbook of Gastroenterology (Ed: T Yamada) and Clinical Gastroenterology, Endoscopy: New Techniques in Diagnosis and Therapy (Ed: H D Allescher and M Classen). He is a named inventor of numerous issued patents of devices for flexible endoscopic gastrointestinal surgery.His work has resulted in a number of postgraduate honors, including the Medal of Padua University, the Medal of the Danish Surgical Society, the Hopkins prize of British Society of Gastroenterology on two separate occasions, the Medal of the University of Rome, the Schindler award of the American Society of Gastrointestinal Endoscopy. He contributed to the invention and development of endoscopic sewing devices, the wireless capsule endoscope and new methods and devices for less-invasive surgery including bariatric and laparoscopic surgery.

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First Guidelines Published For Canadian Endoscopy Services

Canadian Association of Gastroenterology: Open Letter to Canadians

Ranging from ethics to facility standards and policies, to quality assurance, the new guidelines provide endoscopists and facilities across Canada with 23 solid recommendations toward ongoing improvements. “Our top priorities are patient safety and quality service wherever endoscopic service is delivered in Canada,” said Dr. David Armstrong, Lead CAG Endoscopy Committee. “Having national guidelines in place will be an invaluable tool for endoscopists and facilities across the country to achieve continuous improvements and best use of resources toward patient safety and care.” Led by the CAG, along with funding partners the Canadian Partnership Against Cancer (CPAC) and the Canadian Institutes of Health Research (CIHR), the Consensus Guidelines were developed by a group of 35 Canadian, European and U.S.-based participants, including CAG members, with expertise in endoscopy, gastroenterology, surgery, nursing, legal and ethical issues, patient perspectives and quality improvement in healthcare. {vpipagebreak} Participants reviewed research published since 1990 to develop recommendations on best practices in the delivery of patient-centered endoscopy services in Canada. Following three rounds of revisions and voting, independent reviewers rated the quality of supporting evidence and strength of each recommendation. Recommendations were endorsed if more than 80 per cent of experts agreed with the statement (consensus). In recent years, the volume of endoscopic procedures in Canada, such as colonoscopies, has been increasing and demand is exceeding supply. In response, over the past decade the CAG has developed and implemented a number of programs to promote greater safety and quality in endoscopic services. For example, Canada has adopted the Global Rating Scale (GRS), a web-based endoscopy evaluation tool that evaluates multiple components of endoscopy service from a patient-focused perspective. The Consensus Guidelinesin the making for three yearsis a natural extension of the GRS and related programs that support the CAG’s commitment to safe, high-quality patient-centered care. “Now that the guidelines are in place, we will work with our members, our partners, provincial gastroenterology associations and other stakeholders to promote their broad implementation across Canada,” said Dr.

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Canadian gastroenterologists are already out of the starting block. The Canadian Association of Gastroenterology has done its homework, talked to patients, and is now armed with information that will be crucial in improving the Canadian health care system. We have developed 24 recommended targets for medically-acceptable wait times for gastroenterology, based on a study conducted by nearly 200 Canadian GI specialists who captured data on 5,500 patient visits. We are ready to work with Canadians to make Paul Martin’s government pay attention. We are not looking for handouts. The simple infusion of federal dollars into the health care system is a band-aid solution. We must now go further, as a society. The Canadian Association of Gastroenterology proposes to work hand-in-hand with Paul Martin’s government to develop the creative strategies that will finally allow us to bring wait times to acceptable levels. The federal government’s wait time initiative must be adapted in the face of current realities. We can no longer accept the unnecessary prolongation of suffering. The lives of Canadians are at risk. The time to reprioritize is now. Work with us to make reduced gastroenterology wait times a reality. Call the Prime Minister’s office or your M.P.

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Australian Premiere For New Doctor Who Stage Spectacular

Composer Murray Gold says the 2014 spectacular will borrow from the Proms program. ”Because Doctor Who is an ongoing show, we like to play music from the most recent episodes,” he says. Peter Capaldi, seen in TV’s The Thick of It and The Hour, is considered a frontrunner for the role. Gold, who occasionally plays piano during the performances, has been Doctor Who musical director since 2005, when the series was relaunched for the first time in 15 years. Writer Russell T Davies (Queer as Folk) was charged with garnering interest among a new generation of viewers who were more likely to be spending time on the internet than in front of the TV, and Gold’s score had to match the melodrama of the new scripts. ”The music became very grand, eventually it became fully orchestral, a kind of filmic soundtrack, and each of the characters developed their own story in musical terms,” Gold says. I Am the Doctor, the theme he wrote for Smith as the latest Doctor, is a personal favourite. ”I write music for drama. The success or failure of it is how much it encapsulates a moment in the show, or how much it encapsulates the character, and I thought that did a pretty good job,” he says. ”Sometimes I’ll hear it on the train, because someone might have it as their ringtone, and that makes me smile.” Smith hosted the Doctor Who Proms last month, and while the presence of some of the show’s monsters, including the Daleks and Cybermen and the more recent, super-sinister Silence,has been confirmed at next year’s Australian Spectacular, it’s unsure if we’ll be graced with special guests. Former Doctor David Tennant made a popular appearance here last year, but Gold says even he was surprised by the cameo of the Doctor’s first screen companion, played by Carole Ann Ford, now 73, at the Proms this year.

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Australian Doctors Get Right to Assist Suicide

The survey was conducted during November to December 2012. Australias personally controlled electronic health record (PCEHR) scheme has had a slow start despite support by government and prominent healthcare CIOs. Most of the Australian doctors surveyed support limiting patients’ ability to update their electronic health records. Only 18 per cent said patients should have full access to their own records. The survey also found 77 per cent of Australian doctors surveyed said that sharing health records electronically reduced medical errors last year. Also, 83 per cent said they actively used electronic medical records and about 70 per cent reported improved quality of diagnostic and treatment decisions by using shared electronic records. Accenture reported a 62 per cent increase since 2011 in the number of Australian doctors who reported routinely accessing electronic health records previously seen by a different health organisation. Australian doctors also increased routine use of receiving patients clinical results electronically by 67 per cent, entering patient notes during or after consultations by 64 per cent, and receiving electronic alerts or reminders while seeing patients by 44 per cent. Despite growth in those areas, only 5 per cent of Australian doctors said they routinely communicate electronically with patients. Most Australian doctors support letting patients update standard information like demographics (87 per cent) and family medical history (78 per cent). But nearly a third of the doctors oppose patients updating medications, medication side effects or allergic episodes, and more than half oppose patients updating lab test results. Accenture said the number of Australian doctors surveyed who limit patients’ control over their electronic records is higher than in other countries. Australian doctors are increasingly embracing electronic medical records to improve the quality of care provided and clinical outcomes, said Leigh Donoghue, managing director of Accentures health business in Australia and New Zealand.

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Australian doctors give patients less control over their e-health records: survey

I can get on with living and know that I can be helped if the time comes.” The legislation is history-making, with the first terminally ill patients expected to make use of the law later this year, and it has drawn an outcry from the Australian Medical Association, church leaders and anti-euthanasia groups. Under the law, a patient whose illness has been diagnosed as terminal by two doctors can ask for death, usually by pill or lethal injection, to put an end to suffering. At least one of the doctors must have a background in psychiatry, and a patient must wait at least nine days — a “cooling-off period” — before the request can be met. Opponents of the bill say it could turn Darwin, the capital of the Northern Territory, into the world’s suicide capital, with patients coming from around the world to this sparsely populated corner of Australia in the knowledge that someone will help them to die. Although individual doctors have come forward to say they would be willing to carry out the law, major doctors’ groups have opposed the bill because, they say, it is a violation of the Hippocratic Oath for doctors to be put in the position of deciding to end a life. Margaret Tighe, chairwoman of Right to Life Australia, said the bill would encourage families to put pressure on aging or mentally ill relatives literally to sign away their lives. “The people who are most vulnerable and least able to speak up for themselves are the ones who will lose their lives in this,” Mrs. Tighe said. “People who don’t think that’s the case are being terribly naive.” The Roman Catholic Archdiocese in Sydney, the nation’s largest city, said in a statement that the bill “in no way resolves the most fundamental issue of all — and that is that no one in society ought to have the right to end someone else’s life.” While euthanasia is legal to some degree in several nations, no place has gone quite so far as the Northern Territory, an area twice the size of Texas with a population of 160,000, about half of them in Darwin. It is Australia’s last frontier. Much of the territory is desolate outback, with roads that are long, straight and usually empty.

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Australia Needs Physician Assistants. So Why Aren’t We Getting Them?

Health Workforce Australia report gives the nod to physician assistants

It would be good to hear your responses to the pro-PA arguments that have been made. Meanwhile, Professor Peter Brooks, director of the Australian Health Workforce Institute, explains below why he believes that Australia needs PAs. (Incidentally, he is also due to speak at at a University of Sydney seminar on May 3 titled Are we training too many doctors?.) Professional self-interest is blocking introducton of physician assistants Peter Brooks writes: Well done Croakey for running these stories on Physician Assistants (PAs). The opposition to the introduction of these health workers mirrors very much what happened in the US some 40 years ago. Strident cries from the American Medical Association that their introduction would end life as we know it. But interestingly it didnt! Why the nurses are so actively against it is interesting but one would have to ask all opposing groups are they interested in opposing for oppositions sake, are they interested in providing health services to patients who currently find it difficult to access them because the workforce is not there, or are they interested in preserving the status quo with siloed health professional practice? The health service and its constituent parts is a very complex organism but every part of it should work together to improve patient care and not work only in the interests of the health professional or have I got that wrong ? The health and social welfare workforce is currently the largest in Australia 1.4 million and like the rest of the population, it is ageing. We will need to recruit about half a million new workers at least to this sector over the next decade a significant challenge that policy makers and politicians do not seem to be fully accepting at present. Where are these new workers to come from? Current recruitment will not achieve these targets so perhaps some innovation is required. Trials of new models of care have been carried out by Queensland Health and the South Australian Health Commission in respect to PAs. These trials, albeit small, did suggest that these new health professionals would be useful across a variety of health care situations.


Despite a decade of discussion and two successful pilot programs, says the report, there remains a high level of misunderstanding about the clinical role and professional attributes of PAs and how they might complement and add value to existing team structures. On a related note, the report says: Those who openly declared their opposition to introducing PAs in Australia were likely to advocate for the interests of existing professions, either nursing or medicine. (Croakey wonders if this gives any hint of the reason for the NSW resistance: are the medical and nursing lobbies more influential in NSW?) The report also notes the potential of PAs to reduce health care costs by providing a new workforce group to provide safe and effective services at lower cost. The report, considered by the Australian Health Ministers Advisory Council (AHMAC) in February, has been keenly awaited by PAs and their supporters, including one of the first PAs to graduate in Australia,Ben Stock, who writes below that action is now needed. *** Report represents overwhelming support for PAs Ben Stock writes: In 2011, Health Workforce Australia commissioned a report into the Physician Assistant and their potential role in the Australian health workforce. This report was completed in November 2011 and earlier this year was tabled to the Australian Health Ministers Advisory Council for consideration and it has now just been formally released. This comprehensive report conducted an extensive literature review of supporting documentation regarding Physician Assistants from overseas evidence and considered the impact of the two Australian Physician Assistant trials, which were conducted in Queensland and in South Australia. In addition the report also considered submissions from various key stakeholders such as personnel from the rule and remote health sector, Physician Assistant graduates and students from the Australian PA programs conducted by University of Queensland and other professional bodies representing nurses and doctors. The findings of this report are overwhelmingly supportive of the introduction of the Physician Assistant into the Australian health workforce. A number of concerns were raised by some respondents about introducing a new health professional, such as the competition of training placements for junior doctors and medical students, and potential competition with the existing nurse practitioner role. It is interesting to note that the report could not find any evidence that supported either of these two arguments. One thing the report alludes to is that the acceptance of the Physician Assistant role is based on the level of understanding. The greater the respondent understood the role of the Physician Assistant that more likely it was to be accepted. What does this report mean for Australian Physician Assistants?

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