By Dr. Steve Wong on December 19, 2022
While I do think AI will become a tool we integrate into all aspects of medical practice in the coming years, we still need our collective human intelligence to reflect on how our choices impact patients, their families, the medical system, and society. We might not always agree, but I’ve always held that respectful debate leads to learning and evolution of knowledge.
By Dr. Caitlin Dunne on November 30, 2022
Polycystic ovary syndrome is the most common endocrinopathy in women of reproductive age. It affects 8%–13% of young women and its symptoms are some of the most prevalent concerns that community physicians encounter. In many cases, diagnosis and management can be carried out in a virtual health setting using clinical criteria and judicious use of laboratory investigations.
By Drs. Piszczek, Wright, and Grant on November 16, 2022
My approach now is to have the confidence to reassure patients who are low risk that SARS-CoV2 infection will most likely be mild for them and that no specific therapy is needed. Those who are of intermediate risk will also generally do well, but it is an opportunity to create a plan of what to do if they have flu-like symptoms, including their preferences should they test COVID positive. For those who are at high risk, especially CEV-1, I ensure them that there is a clear testing and treatment plan. Any physician can prescribe Nirmatrelvir/rt. A step-by-step instruction guide for prescribing is available on the BCCDC website.
By Drs. Cheryl Young and David McVea on November 2, 2022
November is Radon Action Month. There are approximately 3,000 lung cancer deaths in Canada attributable to radon exposure each year, but there is limited awareness of radon both among the public and health care providers.
By Dr. Elisabeth Baerg Hall on October 19, 2022
October is ADHD Awareness Month. Until recently, female presentations of ADHD have been largely overlooked in both clinical and research settings. With increasing awareness and media attention to women and ADHD, adult women are asking if ADHD could explain their longstanding challenges.
By Drs. Fiona Petigara and Joanna Cheek on September 28, 2022
A large part of physician’s day is spent on mental health and wait times to see specialists can be very long. In 2022 the BC Government created “Group Medical Visit” (GMV) codes to promote physicians to deliver services to groups of patients as “an effective way of leveraging existing resources; simultaneously improving quality of care and health outcomes, increasing patient access to care and reducing costs” (BC Gov, 2022). Physicians can now refer their patients to the Group Cognitive Behavioral Therapy program via cbtskills.ca or through PathwaysBC fillable PDF and they can also train to facilitate group medical visits.
By Dr. Konia Trouton on September 12, 2022
Patient satisfaction and continuation rates are very well documented for various contraceptives in Canada. Among the combined hormonal contraceptives — the pill, patch, and ring — only 50% of people are still using them after a year, despite all efforts to improve compliance and reduce side effects. In contrast, over 80% of people are still using long-acting and reversible IUDs a year later.
By Drs. Mel Krajden and Jim Gray on July 28, 2022
WHO observes July 28th as World Hepatitis Day and aims to eliminate Hepatitis B and C by 2030. The Pan-Canadian Sexually Transmitted and Blood-Borne Infections (STBBI) Framework for Action released in 2018 echoes this goal and calls for 80% of eligible people in Canada to receive hepatitis C treatment by 2030. In order to achieve these goals by 2030, high rates of testing and diagnosis are essential. New HCV therapies are well tolerated, require 8–12 weeks of treatment, are publicly funded in BC, and have cure rates of about 95%.
By Dr. Arman Abdalkhani on July 15, 2022
Otolaryngologists receive many referrals for what is classified as Eustachian Tube Dysfunction, aural fullness, and subjective hearing loss. Practitioners frequently encounter ear fullness or subjective hearing loss, in the face of an otherwise normal exam. It may lead practitioners to “read into” their physical exam with abnormal tympanic membrane (TM) findings.
By Drs. Val Stoynova and Celia Culley on June 28, 2022
I have changed my practice to optimize patient care and planetary health by considering the climate impact of my prescribing choices while continuing to provide high-quality, evidence-based, lower cost, patient-centred asthma care.
By Drs. J Marie Kim and William Connors on June 15, 2022
Skin and soft tissue infections (SSTIs) are exceedingly common and account for up to 10% of all hospital admissions in Western countries. The most common SSTIs, cellulitis, refers to diffuse, superficial, spreading skin infections, often with significant inflammation of lymphatic vessels. Cellulitis can frequently recur and studies have shown that up to 29% of admissions with cellulitis were due to repeat episodes. Prophylactic therapies and mitigating of risk factors have been recently shown to reduce recurrence. The focus of this article is the prevention of recurrent, lower-extremity, nonpurulent cellulitis that is not associated with major penetrating trauma, preceding leg ulceration, or surgery.
By Drs. Angela Hu, Jon Chan, and Neda Amiri on May 24, 2022
Low back pain is a common complaint encountered in the general practitioner’s office. In fact, about two-thirds of adults suffer from low back pain at some point in their life, and it is second to only upper respiratory problems as a reason for visits to a physician. Axial spondyloarthritis is an autoimmune disease that results in inflammation in the spine. A number of therapies exist for this condition and early therapy may prevent progressive spinal fusion. Given the sheer prevalence of low back pain, identifying patients with axial spondyloarthritis can be challenging.
By Dr. Katarina Wind on May 3, 2022
Medical school taught me that “obesity” is a cause of morbidity and mortality, and that weight loss is its cure. I recorded patients’ BMIs and counselled them on weight-loss strategies, believing that I was helping them.
By Dr. Michael Diamant on April 19, 2022
The prevalence of ambulatory patients with advanced or end-stage heart failure (HF) is increasing over time, and now comprises as much as 14% of all patients with HF. Patients may be eligible for advanced therapies, including durable mechanical circulatory support (MCS) and heart transplantation, that can change their trajectory and markedly improve long-term survival.
By Shari Hurst on April 6, 2022
There are a few tips and tricks to improve medication tolerance and adherence, and improve quality of life for patients with HF-rEF. Multiple studies have shown that a focus on patient education and empowerment along with clinical follow-up for HFrEF medical treatment improves survival, reduces hospitalizations, and improves quality of life.
By Drs. Shirley Jiang and Hin Hin Ko on March 9, 2022
While liver biopsy is crucial in determining the stage of liver fibrosis in chronic liver disease, it is not the most accessible or appropriate test in most general practice settings. Non-invasive tests (NITs) for liver fibrosis, on the other hand, are more widely available and applicable to different liver conditions. NITs can be a useful tool in general practice to stratify high-risk patients who may require further investigations and referral to specialist care.
By Drs. Alejandro Dau, Agnes Lee, and Tony Wan on February 22, 2022
COVID-19 is associated with an increased risk of venous, arterial, and microvascular thrombosis. Early reports documented high rates of venous thromboembolism (VTE) in hospitalized patients with COVID-19, with pooled incidences of 20-30%, despite standard-dose thromboprophylaxis. Multiple randomized control trials (RCTs) have sought to determine the safety and efficacy of therapeutic anticoagulation in both critically ill and non-critically ill hospitalized patients with COVID-19.
By Brendan McNeely and Dr. Amanda Hu on February 9, 2022
Recent evidence has emerged that shows cannabis smoking is related to significant patient morbidity. Namely, cannabis smoke exposure increased the risk of oropharyngeal cancer in a dose-dependent manner. Cannabis use may also be associated with hearing loss, vestibular dysfunction, tinnitus, and sinusitis.
By Drs. Taylor Drury, Poupak Rahmani, and Tony Wan on January 26, 2022
We continue to use full dose therapeutic low molecular weight heparin (LMWH) for bridging in the pre-operative period. However, we now use post-operative prophylactic LMWH as an alternative bridging strategy in patients undergoing high-risk bleeding procedures. In patients at high risk of thromboembolism (including mechanical mitral valve and atrial fibrillation) undergoing a high-risk bleeding procedure, we are now less aggressive in resuming full dose therapeutic anticoagulation, as we feel comfortable using prophylactic LMWH for up to several days post-operatively before resuming therapeutic anticoagulation.
By Gerri Klein on January 12, 2022
For all my patients who are on hypoglycemic medications, oral or injectable, I suggest using rtCGM or isCGM. Even intermittent use or a short trial of 10 days to two weeks with either of these devices can be enlightening for patients. With the ongoing COVID restrictions, many of my patients have been unable (or unwilling) to obtain an A1C from a lab test. In my practice, I have found it helpful to use glucose TIR to assess glucose control as an adjunct measure to A1C results; when an A1C is not available; and to guide treatment recommendations.
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