Post Archives

Drs. Kam Shojania and Neda Amiri
March 31, 2015

Part 1: Diagnosing Gout in Primary Care Settings: Do we have to tap?

Gout is one of the most common forms of arthritis, affecting 1.4% of the population. Primary care physicians diagnose and manage most patients with gout. While the gold standard for diagnosing gout is visualization of monosodium urate crystals (MSU) in joint fluid under polarization microscopy, this is not always the case. read more...

Dr. Daniel Dodek
March 18, 2015

This app changed my practice: Mindshift App

Mental health problems including anxiety, depression and stress make up a large proportion of a typical day in primary care medicine. They also contribute a huge comorbid burden in specialty care. These conditions all require an intense amount of time to help and manage patients. read more...

Dr. Amin Kanani
March 2, 2015

Does my patient have a food allergy?

Patients are often referred to determine if they have a food allergy. The prevalence of food allergy in Canada is 6.7%, however more than 20% on the population modifies their diet because of perceived food allergy. Approximately 85% of all food allergies are to peanut, tree nut, cow’s milk, egg, wheat, soy, sesame and seafood. read more...

Dr. Breay Paty
February 18, 2015

Incretin Safety: What is the Evidence?

Nausea can be a common side effect of GLP-1 receptor agonist, which can sometimes be dose limiting. However, this usually improves with time. As a new class of agents, evidence for the long-term safety of incretins is still emerging. Most of the safety questions involve cardiovascular (CV) risk, as well as pancreatitis and pancreatic cancer. read more...

Dr. Suren Sanmugasunderam
February 3, 2015

Age-Related Macular Degeneration: New treatments that changed my practice

There are 2 major forms of Age-Related Macular Degeneration (ARMD). The dry form is characterized by drusen, pigmentary mottling and retinal and retinal pigment epithelial atrophy. The wet form is characterized by choroidal neovascular membranes (CNVM). read more...

Dr. Richard Kendall
January 20, 2015

Knee arthroscopy for conditions of the degenerative knee

Arthroscopy is often thought of as an effective, low morbidity procedure for the treatment of arthritis, symptomatic meniscus tears, or possible intra-articular loose bodies. The question is however, “Is arthroscopy effective in the treatment of arthritis or degenerative meniscus tears?” read more...

Dr. Alexander Chapman
January 6, 2015

Non-suicidal self-injury

Often, self-injury is managed and treated in the context of therapy work with a psychologist or psychiatrist. Family physicians, however, are in an excellent position to be first responders, to offer helpful suggestions, and to help refer the patient to appropriate care. read more...

Dr. Steve Wong
December 23, 2014

Letter from the editor

Thanks again to all of our readers, authors, editors and support team. On behalf of all of us at This Changed My Practice, I’d like to wish everyone a safe, happy and healthy holiday season! See you in 2015. read more...

Dr. Greg Rosenfeld
December 10, 2014

Fecal biomarkers in the diagnosis and management of inflammatory bowel disease

Fecal Calprotectin is a simple laboratory investigation performed on a first-morning stool sample which is widely available in BC. read more...

Dr. Chris Stewart-Patterson
November 25, 2014

Can my patient safely drive on long-term daily opioid medication?

A significant number on patients on daily opioid medications may not be safe to drive a motor vehicle and that particular clinical issue can be problematic to assess within a primary care clinic visit. read more...

Dr. Anna Tinker
November 12, 2014

Ovarian cancer and hereditary predisposition

I refer all women diagnosed with a HGSC of the ovary, fallopian tube or the peritoneum, irrespective of age, to the Hereditary Cancer Program for genetic counseling and for BRCA mutation testing. read more...

Glynnis Tidball, MSc (Aud, SLP), RAUD
October 28, 2014

Tinnitus – The Essentials of Patient Care in BC

Tinnitus – the perception of sound generated in the head – is a common complaint, with about 10-15% of the general population reporting tinnitus at least once a week. read more...

Dr. Mustafa Toma and Dr. Christopher Cheung
October 15, 2014

Diuretic strategies in patients with acute decompensated heart failure

In patients presenting with acute decompensated heart failure and previously on oral loop diuretics at home, there is no difference between low-dose and high-dose furosemide, or bolus and continuous infusions, on the patient’s global assessment of symptoms and changes in serum creatinine at 72 hours. read more...

Dr. Alisa Lipson
September 30, 2014

Early diagnosis of autism

Autism rare? Not so now. The current prevalence is a staggering 1 in 68, about four times as common as type 1 diabetes, with a male to female ratio of 5:1. read more...

Dr. Nadia Zalunardo
September 15, 2014

What blood pressure should I target in my patients with chronic kidney disease?

The most common cause of death among individuals with chronic kidney disease is cardiovascular disease. For most people with CKD, the risk of cardiovascular death exceeds the risk of developing end stage kidney disease. read more...

Dr. Keyvan Hadad
September 2, 2014

Routine neonatal oximetry screening for critical congenital heart defects in British Columbia: It’s time!

Congenital heart defects account for more newborn deaths than any other type of congenital defect, representing up to 40% of all deaths from congenital defects and 3–7·5% of all infant deaths. read more...

Dr. Stan Lubin
August 2, 2014


In the 1970’s if you had a suggestive history, physical exam, and no osteoarthritis you would probably have a complete meniscectomy. Often the knee pain persisted postoperatively. Then complete meniscectomy was shown to be associated with a significantly increased risk of osteoarthritis. read more...

Dr. Sylvia Stockler
July 29, 2014

Contributed Works Dr. Sylvia Stockler

1. This App Changed My Practice: Treatable Intellectual Disability Endeavor in B.C. (TIDE): Treatable ID App July 29, 2015 read more...