By Dr. Martha Spencer on September 19, 2018
Fecal incontinence (FI), defined as the involuntary passage of stool or the inability to control the expulsion of stool, is a common but under-reported condition that can affect people of all ages but has increased prevalence in older adults.
By Dr. Carol-Ann Saari on September 5, 2018
In the general population, approximately 75% of Canadians will report having experienced an adverse and potentially traumatic experience in their lifetime, with 9.2% meeting criteria for PTSD. We have to become trauma informed. Trauma informed practice (TIP) is a way of providing services that recognizes the need for physical and emotional safety, choice and control in decisions affecting one’s treatment and an environment where patients do not experience further traumatization.
By Dr. Colleen Varcoe and Dr. Heather Smith on August 15, 2018
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.
By Dr. Maia Love on July 4, 2018
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.
By Dr. Min S. Phang, MRCP, FRCPC and Stacey Miller, PT on June 13, 2018
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!
By Dr. Kelly Luu on May 23, 2018
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.
By Dr. Andrew Howard, Tyler Schwaiger, Dr. Noah Silverberg, and Dr. Will Panenka on May 2, 2018
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.
By Dr. Vanessa Brcic and Dr. Devon Christie on April 18, 2018
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.
By Dr. Leslie Sadownik on April 4, 2018
Women with chronic vulvar disorders will often report years of symptoms before an accurate diagnosis is made, and effective treatment is started.
By Dr. Laura Sauvé on February 7, 2018
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.
By Ruth Elwood Martin on January 23, 2018
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.
By By Dr. Christy Sutherland and Emily Wagner on November 15, 2017
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.
By Dr. Roberto Leon on November 1, 2017
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.
By Dr. Jennifer Robinson on October 18, 2017
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.
By Dr. Eileen Murray on October 3, 2017
When I started out in dermatology, corticosteroids were the only systemic drug available to treat patients with severe allergic contact dermatitis (ACD), atopic dermatitis (AD), drug reactions and those with bullous diseases. Corticosteroids are potent and excellent immunosuppressive agents. The main problem with systemic use is the high risk of drug interactions, as well as multiple serious acute and long-term side effects.
By Dr. Taryl Felhaber on September 20, 2017
Why should physicians encourage early and ultimate return to work whenever they can? In a nutshell, because it is usually in the patient’s best interest to remain in the workforce.
By Drs. Christopher Cheung and Kenneth Gin on August 9, 2017
Perioperative management of anticoagulation is challenging as physicians must consider the risks of stroke, systemic embolism, and perioperative bleeding.
By Dr. Anne Antrim on July 18, 2017
The current definition of Autism Spectrum Disorder has 2 criteria: “persistent impairment in reciprocal social communication and social interactions” AND “restricted, repetitive patterns of behavior”. The symptoms must be present from early childhood, but may not manifest till the social demands exceed the capacity of the child to respond.
By Dr. Roberto Leon on June 20, 2017
One of the most complex decisions that women (and their physicians) occasionally need to take in mid-life is whether to use prescription medications for their menopausal symptoms. Previously known as Hormone Replacement Therapy (HRT), Menopause Hormone Therapy (MHT) is an effective and evidence based treatment for moderate to severe hot flashes and/or night sweats (defined as bothersome enough to interfere with daily activities, impair quality of life and/or interrupt sleep).
By Cait O'Sullivan on May 31, 2017
When I identify strong drug therapy recommendations of particular relevance to my practice scope, I seek collateral information and there are two resources I routinely incorporate into my literature search. I start with the Cochrane Library and then check to see whether a FDA advisory committee has weighed in on key issues.
By Dr. Randall White on May 10, 2017
When psychiatric patients are treated in an emergency department, they are often hypervigilant, manic, or otherwise in an excited, agitated state. The current standard of care to manage acute agitation in adults is using an antipsychotic medication and a benzodiazepine, often loxapine or haloperidol and lorazepam.
By Drs. Charlie Chen and Hayden Rubensohn on April 12, 2017
What is the patient willing to consent to as treatment if his/her condition were to seriously deteriorate? The Serious Illness Conversation Guide developed by Ariadne Labs provides a framework for physicians to engage in care planning with patients in a manner acceptable to the patient.
By Dr. Dan Bilsker on March 8, 2017
Treatment plan should specifically target psychological problems that are barriers to occupational, relationship or emotional function, rather than broadly defined issues. Being able to return to work is a substantial benefit for the individual: staying at home for an extended time is damaging to the individual’s self-esteem, coping ability and psychological health. Practice “positive psychology”, emphasizing the outcomes that determine the meaning and success of one’s life and focus on individual’s strengths to reach goals.
By Dr. Martha Spencer on February 22, 2017
Martha Spencer, MD, FRCPC, Providence Health Care, Clinical Instructor, UBC (biography and disclosures) Disclosures: Education grant from Pfizer to help support my incontinence fellowship in Edmonton, Grant from Pfizer ($10 000) to support start-up costs for the Geriatric Continence Clinic at SPH. Mitigating potential bias: Only published trial data is presented and recommendations are consistent […]
By Dr. Ric Arseneau on February 8, 2017
The PLEASE trial (Persistent Lyme Empiric Antibiotic Study Europe) was published in the New England Journal of Medicine in March 2016. This randomized, double-blind, placebo-controlled study assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment.
By Dr. Alissa Wright on January 25, 2017
Canadians travel a lot and are increasingly traveling to more exotic and remote destinations. Unfortunately, travel does carry certain risks with respect to infection. Post-travel assessment of a febrile patient must be comprehensive, but completed in a timely manner so that patients get the care they need.
By Dr. Ric Arseneau on November 30, 2016
Chronic Fatigue Syndrome (CFS) – also known as Myalgic Encephalomyelitis (ME) and Systemic Exertion Intolerance Disease (SEID) – is a common clinical condition. Yet, it is under- recognized and diagnosed. An estimated 84–91% of patients with the condition remain undiagnosed.
By Dr. Heather Leitch on November 8, 2016
The MDS Clear Path algorithm is an internet-based interactive tool that was developed to support health care providers in the workup, diagnosis and management of MDS. The Clear Path was developed by a group of 60 Canadian hematologists with an interest in MDS.
By Dr. Paul Mullins on October 26, 2016
Alcoholic hepatitis (AH), perhaps more accurately described as alcohol-related cholestatic liver failure, is a clinical syndrome with high mortality. In severe AH at 28 days: 30-40%. STOPAH is a UK multi-centre, double-blind, randomized trial in severe AH to assess the effect of Prednisolone and/or Pentoxifylline on mortality at 28 days, and mortality or liver transplantation at 90 days and at one year.
By Dr. Karen Buhler on October 12, 2016
In BC women are receiving maternity care from fewer providers. To assist practitioners Perinatal Services BC created the Primary Maternity Pathway and the Vancouver Division of Family Practice in 2014 developed a 2-page Early Prenatal Care Summary Checklist for Primary Care.
Recent Comments