Letter from the editor

In the demanding landscape of modern healthcare, physicians bear the weight of both clinical responsibilities and the intricate challenges that come with navigating an evolving health-care system. Physician burdens are a leading cause of practitioner stress and a key factor in early practice exits.  Finally, this is being more openly discussed and we are even seeing regulatory and funding bodies starting to acknowledge, and sometimes start to address, this critical issue.

At TCMP we have started including considerations of physician burdens when choosing and editing our topics, but an inescapable part of practice change is the built-in stress of learning something new and applying it to your practice. Our “What I do now” section has always been aimed at the bottom line change, and we have tried to include relevant resource links and billing codes for BC physicians as part of the articles. This year we have started to build “visual abstracts” to aid learning.

One of our developments this year was the introduction of patient and practitioner handouts for select articles. Here are some of the handouts we’ve added to the articles this year:

1. Hives: Patient Action Plan: This handout accompanies the article “Practical Tips in the Management of Chronic Spontaneous Urticaria (CSU)” by Drs. Kevin Lee and Persia Pourshahnazari, published on May 31, 2023.
2. H. pylori Info Sheet and Treatments: A valuable resource complementing Dr. Sander Veldhuyzen van Zanten’s article “Management of Helicobacter pylori in 2023: Who Should Be Tested, Treated, and How,” released on August 9, 2023.
3. Conversation Starters in Palliative Approach to Care: Dr. Shirley Samuel-Haynes’ article on “Palliative Approach to Care and Serious Illness Conversations,” published on November 21, 2023, now comes with conversation-starting tools to help initiate dialogue.

These handouts are designed to enhance your practice by providing actionable insights and facilitating discussions with patients. We hope you find them valuable and we hope to keep adding more practical tools in 2024.

Per tradition, here is a selection of a few interesting data points from TCMP in 2023:

Top 5 Articles with Intention to Change Practice:

1. “Practical Tips in the Management of Chronic Spontaneous Urticaria (CSU)” by Drs. Kevin Lee and Persia Pourshahnazari (80.34%)
2. “Management of Helicobacter pylori in 2023” by Dr. Sander Veldhuyzen van Zanten (75.00%)
3. “LNG-IUS (Mirena) IUD for Emergency Contraception” by Dr. Emma Coffey (70.16%)
4. “Palliative Approach to Care and Serious Illness Conversations” by Dr. Shirley Samuel-Haynes (68.70%)
5. “Changing the Game for Acute Infectious Diarrhea” by Dr. Ken Tan, Dr. Julia Stewart, Dr. Doug McTaggart, Dr. Sandra Lee, Chase Simms (MPH) (68.58%)

Top 3 Articles Where Learners Indicated Learning Something New and Needing More Information:

1. “Psychedelics: Safely Navigating a New Frontier” by Dr. Rachel Grimminck, Dr. Jo Hoffman, and Dr. Laura McLean
2. “No More Reading Glasses: Daily Eyedrops for Presbyopia” by Dr. Nawaaz Nathoo and Sorayya Seddigh
3. “Thromboprophylaxis in Ambulatory Cancer Patients” by Drs. Domnick Manhas and Tony Wan

Lastly, in the spirit of reducing burdens, here are the top 5 articles where the information helped avoid unnecessary or inappropriate treatment, diagnostic procedures, preventative interventions, or referrals for patients:

1. “Changing the Game for Acute Infectious Diarrhea” by Dr. Ken Tan, Dr. Julia Stewart, Dr. Doug McTaggart, Dr. Sandra Lee, Chase Simms (MPH)
2. “Palliative Approach to Care and Serious Illness Conversations” by Dr. Shirley Samuel-Haynes
3. “Management of Helicobacter pylori in 2023” by Dr. Sander Veldhuyzen van Zanten
4. “Implementing Prescribing Portraits — Therapeutics Initiative” by Drs. Jill Norris and Jessica Otte
5. “No More Reading Glasses: Daily Eyedrops for Presbyopia” by Dr. Nawaaz Nathoo and Sorayya Seddigh

As we look forward to 2024, our commitment to facilitating change in clinical practice remains unwavering. We are always thankful for our authors, editorial board, external reviewers, and especially our readers who help to keep TCMP a vibrant and relevant forum for learning and practice improvement. Thank you all for being part of the TCMP journey.

Wishing you a joyful holiday season and a healthy, prosperous new year!

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