Letter from the editor

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By Dr. Steve Wong

I think almost anyone will agree that 2016 will be a very memorable year, with controversial and surprising developments in the geopolitical space, as well as an apparent flurry of deaths in some of our most beloved celebrities, authors and artists.

While we’re in a reflective mood, I thought I’d highlight some articles from this year as well as prior years that we’ve published that focused on the clinician, rather than a disease state. We’ve received some very thoughtful responses and private messages from readers who appreciated seeing articles like this, especially from a CPD-focused website. Given the unique nature of articles like this (it’s hard to proactively identify and solicit authors for these kinds of topics), I’d like to personally invite submissions for articles that are helpful for personal or practice development. If you’re interested, please email us at feedback@thischangedmypractice.com.

Reviewing our stats this year, the following were the articles that our readers rated the highest in terms of influence on practice – the greatest practice change articles:

  1. Enhance the valsalva to (actually) terminate SVT by Dr. Daniel Kim
  2. Nail fungus by Dr. Eileen Murray
  3. Part 2: Treating Gout – Practice Tips and Clinical Pearls by Drs. Neda Amiri and Kam Shojania
  4. Best practice: a tip from an employment lawyer by Julianne Yeager
  5. Screening for occult cancer in unprovoked venous thromboembolism by Drs. Erica Tsang and Iain Mackie

I personally had some fun with the valsalva technique: while the use of blowing into a 10mL syringe to generate the appropriate valsalva strain seems very practical, I found that I personally couldn’t move the plunger even 1 mm!  Distraught at my apparent weakness, I then challenged a bunch of younger, presumably more capable subjects (including nurses, residents, and a unit clerk) on a medical floor – and not one was able to move the plunger!  Perhaps it was just the syringes at VGH, but we all agreed that even if it didn’t move, we all felt significant strain which was higher than most would have generated on their own, unaided valsalva. Thankfully, no one passed out in the attempt!

As always, I’d like to personally thank our authors, readers and editors that make TCMP a rewarding and educational experience. I hope everyone is having a happy, healthy holiday season!

Steve Wong, MD, FRCPC
Internal Medicine
Clinical Associate Professor, Department of Medicine, UBC
Medical Director, This Changed My Practice, UBC CPD




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