Post Archives

Dr. Colleen Varcoe and Dr. Heather Smith
August 15, 2018

Equity-oriented health care

Health equity-oriented care is now part of my daily practice; the tools created with, and provided by, the EQUIP study have helped to make health care inequity an issue that I can screen for and offer options for management. read more...

Drs. Terence Yung and Tony Wan
July 24, 2018

Baby aspirin for extended DVT prophylaxis after elective hip and knee arthroplasty

For those who had an elective hip or knee arthroplasty who have no other risk factors for VTE, after initial 5 days of DVT prophylaxis with rivaroxaban 10mg a day, I complete the remaining DVT prophylaxis with aspirin 81mg once daily for an additional 30 days for hip arthroplasty and 9 days for knee arthroplasty. Those who already were on once-daily 81mg aspirin prior to surgery will receive 162mg aspirin once daily instead in this period. read more...

Dr. Maia Love
July 4, 2018

Wellness and self-care for professional excellence

Defining yourself as a person first, and your role as a professional second, has benefits in preventing burnout and creating more personal energy. Put your own oxygen mask on first. read more...

Dr. Min S. Phang, MRCP, FRCPC
June 13, 2018

Hip surveillance in children with cerebral palsy

I now refer all children with cerebral palsy, or suspected cerebral palsy, to the Child Health BC Hip Surveillance Program. Information about the program is available at www.childhealthbc.ca/hips, including a referral form for physicians. The incidence of hip dislocations can be significantly reduced! read more...

Dr. Kelly Luu
May 23, 2018

The power of storytelling in clinical encounters

Evidence shows that the strategy which physicians frequently employ, educating and training, is only the first step in the process of behavioural change. By helping patients shift their narratives about themselves, we can strengthen their ability to have sustained behavioural change. read more...

Dr. Andrew Howard, Tyler Schwaiger, Dr. Noah Silverberg, and Dr. Will Panenka
May 2, 2018

Concussion management: time to give “brain rest” a rest

Rest might increase symptoms and recovery time following concussion or mild traumatic brain injury. Inactivity has been associated with physical deconditioning, social isolation, discouragement about recovery, and reactive anxiety and depression. Early mobilization and graded exercise programs can reduce post-concussive symptoms and recovery time. read more...

Dr. Vanessa Brcic and Dr. Devon Christie
April 18, 2018

Trauma as a determinant of health

What changed our practice was a fundamental recognition of trauma as a determinant of health, and furthermore, that PTSD is only the tip of the iceberg when it comes to trauma. Much lies under the surface for our patients. read more...

Dr. Leslie Sadownik
April 4, 2018

Practice Tip: “SAIL” through a vulvovaginal examination

Women with chronic vulvar disorders will often report years of symptoms before an accurate diagnosis is made, and effective treatment is started. read more...

Dr. Vincent Hanlon
March 14, 2018

The practice of mindfulness

Mindfulness is the awareness that emerges through paying attention to the unfolding of experience moment by moment. This paying attention is done on purpose, in the present moment, and it’s non-judgmental. read more...

Dr. Duncan Etches
February 21, 2018

Guidelines

In summary, in place of pattern or algorithm driven medicine, clinical experience and ability to determine what is best for our patient lies at the heart of the art of medicine. read more...

Dr. Laura Sauvé
February 7, 2018

Adverse events following immunizations (AEFI)

Vaccines are safe, but sometimes adverse events following immunizations do happen, and can be very concerning to families. If your patient has an AEFI, there is a voluntary reporting system. Public Health Officers in your local Health Authority will be able to answer most questions or concerns. read more...

Ruth Elwood Martin
January 23, 2018

Guidelines for working with formerly incarcerated people

To address the issue of health care discrimination and coordination of care people with incarceration history, the CCPHE has collaboratively developed Guidelines for Family Physicians working with Formerly Incarcerated People. read more...

Doson Chua, PharmD, FCSHP, BCPS(AQ) and Dr. Mustafa Toma
January 10, 2018

Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure with Reduced Ejection Fraction (HFrEF): Sacubiltril/Valsartan and the PARADIGM HF Trial

Sacubitril/valsartan is the first in class of ARNI and has proven its superiority in reducing mortality and morbidity in HFrEF as compared to the use of ACEI. Sacubitril/valsartan should be considered in patients who are symptomatic despite optimal or maximally tolerated guideline-driven HF therapies consisting of a beta blocker, ACEI/ARB and MRA. Monitoring of patients on sacubitril/valsartan is similar to ACEI. read more...

Dr. Steve Wong
December 14, 2017

Letter from the editor

It's hard to believe that this is our 7th year at This Changed My Practice. Thanks for being part of our TCMP family. On behalf of all of us at This Changed My Practice, I wish all of you a happy, healthy holiday season! read more...

Dr. David Topps
November 29, 2017

Managing your passwords

Ever been frustrated by the number of passwords you have to keep track of in your daily life as a professional? At one time, you might have only a few – some simple ones for unimportant sites, some stronger ones and perhaps a really good one for your most important data. read more...

By Dr. Christy Sutherland and Emily Wagner
November 15, 2017

Managing opioid use disorder: buprenorphine/naloxone opioid agonist treatment

I no longer offer rapid methadone tapers to my patients. Buprenorphine/naloxone is now recommended as the first-line opioid agonist treatment for opioid use disorder in British Columbia. This is because of its superior safety profile when compared with methadone as well as an easier transition to take home dosing. read more...

Dr. Roberto Leon
November 1, 2017

Indications and value of self-administered vaginal swabs for STIs and vaginitis

I came across a publication in the British Medical Journal by Sarah A. Schoeman: Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study. Participants took a vaginal swab before a routine gynecological exam, and clinicians then took an endocervical swab during examination. read more...

Dr. Jennifer Robinson
October 18, 2017

MOVE an injury not RICE

MOVE an injury: Movement, not rest. Options: offer other options for cross training. Vary rehabilitation with strength, balance and agility drills. Ease back to activity early for emotional strength. read more...