2012-JunedoctorsNS-T - Doctors Nova Scotia

Transcription

June 2012 | Volume 12 | Number 2
The official magazine of Doctors Nova Scotia
Finding out
about Finley
Q & A with the new President
Annual conference
> Business session
> Achievement awards
> Strive Award recipient
> Valedictory highlights
> Conference photos
Board election
Two re-elected,two first-time reps
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ON THE
COVER
Halifax-based paediatric cardiologist Dr. John Finley was
installed as Doctors Nova Scotia’s new President during
the 2012 annual conference. He tells doctorsNS in a Q & A
on page 6 why he became a doctor, his philosophy of life,
his goals for his term as President, and the challenges he
expects to face. (Photo by Marnie Gillis)
A monthly publication of
Doctors Nova Scotia
Editor
Kim Bottomley
Graphic designer
Marnie Gillis
Distribution assistant
Sonia Abi-Ajab
President
John Finley, MDCM, FRCPC
Chief executive officer
Nancy MacCready-Williams
5CEO’s message: New hires will help deliver on commitments
AFFECTING MEMBERS
6Finding out about Finley
8Strategic plan has four main priorities
9Five physicians recognized for exemplary achievements
10 Annual conference photos
12 Strong relationship with government important for
Doctors Nova Scotia
13 Two first-time reps; two re-elected to serve
14 Friends of Ellenwood Park receives 2012 Strive Award
Tel
902.468.1866
1.800.563.3427
15 Resource plan calls for more family doctors
Fax
902.468.6578
WORK UNDERWAY
email
[email protected]
16 Province studies effects of hypersexualization on youth
17 Dr. Gus Grant: Campaign addresses prescription opioid abuse
18 Dr. Rhonda Church: Case conference management
Website
www.doctorsNS.com
code often misbilled
Mail
25 Spectacle Lake Drive
Dartmouth, NS B3B 1X7
PROVINCIAL MATTERS
The opinions expressed in doctorsNS and
the advertisements, as well as flyers or
inserts, are those of the authors and do
not necessarily reflect the opinions of
Doctors Nova Scotia, its members or its
Board of Directors.
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Return all undeliverable mail to:
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25 Spectacle Lake Drive
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20 Physicians’ role vital to help injured workers return to jobs
21 Widening spectrum of gluten-related disorders noted
OF INTEREST
22 Dr. Gerri Frager: Expressing the heart of the healing professions
24 Gender equity in sport has made great strides
BACK OF THE BOOK
25 Events calendar
26 Practice opportunities
28 Electronic Bookshelf: Knowing where to look is key in
quest for information
29 Web round-up
31 STATistics: Dr. John Finley
doctorsNS
Copy editor
Lourdes Fowler
FRONT OF THE BOOK
June 2012 | doctorsNS
3
CEO’s
Message
Nancy MacCready-Williams
CEO, Doctors Nova Scotia
Gone are my messages that “we are
planning, we are planning.” The time
for action has come.
D
octors Nova Scotia will hire five new
employees to deliver on commitments
made in the new four-year strategic plan.
Gone are my messages that “we are planning,
we are planning.” The time for action has come.
The physician resource plan has been released,
our strategic plan is finalized, and the academic
funding plan (AFP) governance framework is
approved. Now we need to turn these various
plans into action...tangible outcomes where you
will actually see a positive change in your professional lives.
Our first step is to put in place a new organization structure and hire people to support
that structure. Several current employees will be
transitioned into new roles where their expertise
and skill sets will position Doctors Nova Scotia
for the greatest success.
The major change will be dividing the
current Health Policy and Economics department into two separate departments: Health
Transformation and Promotion, and Physician
Compensation.
Kevin Chapman, the current director of
the Health Policy and Economics department,
will lead the new Health Transformation and
Promotion team. In the recent membership
survey, 90 per cent of respondents flagged health
transformation as the most important activity
the association needs to tackle when considering
its priorities over the next four years. Under
Kevin’s leadership, the association will be aligned
with government’s many initiatives to evolve the
health-care system, from collaborative practices
to the physician resource plan. The goal is to
ensure physicians are influencing all major decisions that will impact them and patient care.
This new department will also lead the association’s continued commitment to promoting
healthy living in Nova Scotia.
Four employees will be hired into the new
Physician Compensation team, including a
director and three others in compensation roles.
The increased resources were determined as
essential to ensure the association is in the best
position to deal with the many economic issues
on the horizon. These issues include:
• Preparing for Master Agreement
negotiations that will start in 2014
• Transitioning the 15 academic funding
plans into the new governance model and
negotiating 15 new contracts by the end of
2014
• Facilitating the fee schedule modernization
project
• Managing the current Master Agreement
(which has a number of new programs
in the last two years of the contract) and
evaluating the funding programs that were
new to the contract this year
• Rolling out the alternative payment plans
(APP) which are also transitioning to a new
framework
• Negotiating a new contract with the
Workers’ Compensation Board of Nova
Scotia
The Communications Department will
be renamed Physician Engagement and
Communications. The team will increase its
focus to ensure more transparency (specifically
with payment-related issues) and better relevancy
with Doctors Nova Scotia members. The name
change also reflects the increased commitment to
make better strides in reaching out to you – the
membership – and seeking your advice and guidance on how the association can best represent
your interests. This team will also provide a new
focus on promoting to the rest of the province
the important and unique role you, as physicians, play in the health-care system.
Physician Benefits and Services is the new
name of the Member and Corporate Services
department. It will continue to administer and
evolve the many member benefits including
the health and dental plan, CMPA rebates and
the doctorsNS.com Electronic Bookshelf. The
strategic plan calls for an excellent customer
service experience for all members – a goal to
which this team, and the rest of the employees,
will stay true.
The association will continue to have an
Information Technology department focused
on influencing the province’s e-health strategy
while supporting physicians as new technologies,
primarily electronic medical records (EMRs),
are introduced into your practices. This team
will also develop an information management
strategy to support the association in providing
better information and member service. An
employee with the necessary technical expertise
will be added to this team to help deliver on
these commitments.
These changes are expected to be in place by
Sept. 1 to ensure Doctors Nova Scotia is ready
to focus attention on delivering on the first year
business plan.
With these changes Doctors Nova Scotia will
employ a total of 32 employees. Funding has
been reallocated to avoid an increase on membership dues in the upcoming budget year.
The strategic plan is on doctorsNS.com in the
‘governance’ section. Until next time...
The CEO’s blog
I have started blogging on doctorsNS.
com. This is another way for me to keep
you up to date on the association’s
activities, new initiatives, and progress
with ongoing projects.
Subscribe to the CEO’s blog and get my
new posts directed to your inbox.
Don’t be shy – I encourage you to jump
in the conversation and comment to my
posts. This is a platform where I hope
you and your colleagues will engage in
discussion. Share your thoughts, ideas,
concerns and opinions with
Doctors Nova Scotia
and your peers.
See you online!
NEW!
Subscribe to
the CEO’s Blog at
doctorsNS.com
5
New President profile
Finding out
about Finley
Doctors Nova Scotia’s new President eager to establish
financial clarity for physicians, maintain unity in the
medical profession, and meet colleagues from across the
province
F
rom an early age, Dr. John Finley was fascinated
by science. During his Rhodes Scholarship at
Oxford University, attending medical school at
McGill University, and completing paediatrics residencies, he was motivated by his passion of combining
research and caring for people.
This Lunenburg native, who grew up in Saint
John, N.B., has practiced medicine for the past
34 years at the IWK Health Centre as a paediatric
cardiologist. He’s a husband and a father of two adult
6
children; a performer in Halifax-based Irish band
Dicey Reilly; the author of a book on new methods of
teaching auscultation heart sounds; a paediatrics professor at Dalhousie University; and a sailer, kayaker,
cyclist, skier, and traveller.
Dr. Finley went from representing specialists in
Halifax Regional Municipality on the Doctors Nova
Scotia Board of Directors to President-elect, and now
President. Before taking on his new role, he spoke
with doctorsNS about his goals for the year ahead.
doctorsNS: Why did you become a doctor?
Dr. Finley: I initially had a fascination for
science and thought I might become a
physicist. As fascinating as laboratory work
was, I felt I needed something more personal than the somewhat removed life of a
scientist. Medicine appeared to offer a great
opportunity to work for and with people,
and also to apply my interest in science
through research. My interest in paediatrics
was prompted by some wonderful role
models at McGill University and the feeling
that working with children offered a certain
lightheartedness that I really enjoy.
doctorsNS: What is your philosophy of life?
Dr. Finley: My philosophy is to have as
broad of a range of interests as possible
and to balance work and outside interests.
I really enjoy exercise and used to play
pick-up hockey but now I cycle to work most
of the year. My wife and I enjoy sailing and
kayaking in Mahone Bay. I play music, am
quite interested in theatre and the arts, and
find all of these things provide a balance in
my life which really helps me cope with the
frequent stresses and demands of medical
work.
doctorsNS: What trait do you expect to rely
on most as President?
Dr. Finley: I think the ability to listen to our
members and understand their challenges is
extremely important for the President.
doctorsNS: What are your goals for your term
as President?
Dr. Finley: In a recent survey, members
emphasized their priorities for the association such as fee-related issues and maintain
unity in the profession. I hope to build on
our current momentum to drive these priorities along. Of particular importance is establishing clarity on financial arrangements
among our various practice scenarios.
doctorsNS: What are you most looking forward to during your term?
Dr. Finley: Getting to know folks in the medical community throughout the province.
doctorsNS: What are the challenges you
anticipate?
Dr. Finley: Anticipating the traffic getting
across the bridge! But seriously, I expect
I will wear the label of a specialist from
Halifax. Of course I have a good understanding of the issues facing my colleagues in the
city, but I’m also here to represent the needs
of the entire membership. Many of my colleagues may not be familiar with my experiences outside Halifax. My own practice has
involved a lot of time in regional clinics
outside the city, setting up services for children throughout the Maritimes, and communicating with physicians about their young
patients. This has given me an appreciation
of both the joys and challenges of practicing
throughout the province in smaller centres.
I hope to learn more from my colleagues as I
tour the province over the next year.
doctorsNS: What life lessons will you draw
on during your term?
Dr. Finley: First, I will continue to stay physically fit and have a life outside of medicine.
This will give me perspective to deal with
difficult issues. Second, over the years I
have learned that conflicts between good
people often stem from misconceptions
about the other person or group. When
opposing parties get to know each other
there is invariably a greater respect and an
opportunity to move toward resolution of
differences. I hope I can help bridge some of
the gaps which sometimes occur within our
membership.
doctorsNS: How will you maintain your
work/life balance?
Dr. Finley: I have always enjoyed regular
physical exercise, attending concerts, playing music, and spending a lot of time with
my family. I hope to keep doing those things
over the next year. I’m sure through travelling across the province more opportunities
to be active will present themselves.
doctorsNS: What’s one thing your colleagues
across the province would be surprised to
know about you.
Dr. Finley: I am originally from Lunenburg.
doctorsNS: What does your family think
about your new role?
Dr. Finley: They are very encouraging and
pleased I was given this opportunity.
7
Annual general meeting business
Health policy analyst
and University of
Toronto associate
professor Dr. Michael
Rachlis
Strategic plan has
four main priorities
Sustaining medicare, improving cancer
care, tackling caffeinated beverage issue
part of discussions
BY SAMANTHA HOLMES
Staff writer
P
aediatric cardiologist Dr.
John Finley was installed
as Doctors Nova Scotia’s
President during the association’s
annual conference on June 2.
Close to 60 physicians attended
the conference and annual general
meeting, which included the launch
by CEO Nancy MacCreadyWilliams of the association’s strategic plan for 2012-16.
The strategic plan calls for
the association to focus on four
priorities:
1. Enhance the general and
economic well-being of
physicians
2. Strengthen physician
leadership in health
transformation
3. Unify and engage the
membership
4. Help members adapt to
change
The first-year business plan will
largely focus on the first priority,
the general and economic wellbeing of physicians. Work will
include evaluating the current
Master Agreement, beginning the
framework for Master Agreement
negotiations 2015, co-managing
the project to modernize the fee
schedule with the Department
8
of Health and Wellness, moving
15 academic funding plans into a
new governance model, and begin
negotiating new contracts for these
AFP’s. In order to successfully carry out
this work, the association will be
re-organized (see CEO’s message)
with a new focused department on
economics and four new employees
hired to this team. Business session
highlights
Sustaining medicare
Health policy analyst and
University of Toronto associate
professor Dr. Michael Rachlis
challenged the generally-accepted
belief that the aging population is
the major factor in the financial
sustainability of health-care delivery, citing instead failure to make
the right decisions. He believes
Canada needs to complete Tommy
Douglas’s vision of the second stage
of medicare -- a patient-friendly
delivery system focused on keeping
people healthy.
Profiling a number of innovative
and patient-focused models across
the nation, including Cape Breton
general practitioner Dr. Steven
MacDougall who provides his
patients with same-day access, Dr.
Rachlis encouraged Nova Scotia
to take the lead in introducing
other models that will enhance the
patient experience. Improved cancer care
Dr. Carman Giacomantonio, chief
medical director of Cancer Care
Nova Scotia, wants to improve
the health-care system so it’s in a
better position to improve cancer
care. He provided several real
patient examples that demonstrated
how the disconnected system puts
patients through many layers, from
seeing a variety of specialists and
having multiple tests that result in
increased patient anxiety and costs.
He said he believes the first step
toward improvement is to develop
standards of care that will better
define what should be done for the
patient. He said the system will
follow that. Youth and caffeinated
beverages
A series of motions were made
during the business session to have
Doctors Nova Scotia tackle the
issue of youth consuming highlycaffeinated beverages. There’s the
added concern of such drinks being
mixed with alcohol.
The Board of Directors will
review the motions during its
September meeting. Work will include
evaluating the
current Master
Agreement,
beginning the
framework for
Master Agreement
negotiations 2015,
co-managing the
project to modernize
the fee schedule
with the Department
of Health and
Wellness, moving
15 academic
funding plans into
a new governance
model, and begin
negotiating new
contracts for these
same contracts. 2012 awards
l-r: Drs. David
Marsters, Port
Williams; Louis
Fernandez, Halifax;
Richard Hall,
Halifax; Winston
Parkhill, Halifax;
and Dora Stinson,
Halifax received
awards for their
exemplary contributions to their communities and the
medical field during
Doctors Nova
Scotia’s annual
conference.
Five physicians recognized
for exemplary achievements
Honoured for contributions to medical profession
BY KIM BOTTOMLEY
Staff writer
F
ive physicians were honoured
for their contributions to the
medical profession at the 2012
Doctors Nova Scotia achievement
awards ceremony.
Dr. David Marsters received the
Rural Physician of the Year Award
in recognition of his dedication to
stroke-related issues in Annapolis
Valley Health. A longtime rural
physician, Dr. Marsters understands first-hand the unique
challenges of providing stroke care
in rural districts. His strategies
have since been used elsewhere in
the province to improve care for
patients in rural areas.
Dr. Louis Fernandez was recognized with the Senior Membership
Award. Appointed the first head
of Dalhousie University’s Division
of Hematology in 1986, he held
the position until 2001 while
also serving as chief of service of
the hematology division. For the
last 12 years of his tenure, Dr.
Fernandez chaired a successful
Atlantic Hematology Symposium
which brought world leaders in
hematology to Nova Scotia.
The Distinguished Service
Award was presented to Dr.
Richard Ivan Hall. He’s regarded
as pioneering academic critical care
medicine in Nova Scotia, virtually
from its inception. One of Dr.
Hall’s greatest career accomplishments was founding the Canadian
Critical Care Trials Group. It’s
the most successful investigatorinitiated and led clinical trials
network in critical care medicine in
the world.
Drs. Dora Stinson and Winston
Parkhill received the Canadian
Medical Association Honourary
Membership Award.
Dr. Stinson is a practicing
neonatologist at the IWK Health
Centre in Halifax. She’s known for
her outstanding skills in physical
examination and diagnosis that
were honed in an era prior to
extensive imaging equipment. Dr.
Stinson is regarded among her
colleagues as a selfless physician
who is always available for her
patients and their families regardless of whether she’s on call. She’s
a renowned teacher to generations
of medical students and residents
in the Department of Paediatrics at
Dalhousie University.
Dr. Parkhill built a reputation
around his unique teaching style
and his personal, humanistic
approach to patient care. He
practiced plastic surgery in Nova
Scotia for over 35 years and was
involved in outreach clinics in Cape
Breton at a time when no plastic
surgeon was available there. He was
regarded as a leader in the management of patients with rheumatoid
hand deformities and Dupuytren’s
disease. He was also involved with
championing the introduction of
sentinel node biopsy in the care of
melanoma patients. He’s known
for the inspiration and influence
he provided to a generation of
surgeons.
The 2012 achievement awards
were presented during the Doctors
Nova Scotia annual conference at
Digby Pines Golf Resort & Spa on
June 2.
Honourees’
profiles online
Profiles of the 2012 achievement award recipients are
online. Visit doctorsNS.com
> governance > awards &
nominations
9
Annual
conference:
The
weekend
in photos
Past-Presidents breakfast: (l-r) Drs. John Finley, Don Wescott, Roland Saxon, Ed Rafuse, Romesh Shukla, Ross Leighton, Mary Doyle,
Maria Alexiadis, Bill Mason, Louise Cloutier, John Chiasson, Cindy Forbes, Bill Acker, Jane Brooks, Murdock Smith and Don Pugsley.
Bay of Fundy
Dr. Les Wasilewski
on the links
Business session attendees: (l-r) Drs. David Cudmore, Martin LeBlanc,
Jason Williams, Greg Clarke, Laurie McNeill and Beau Blois
Golf tournament
winners: (l-r)
David Dow, Drs. Kevin
Johnson, Michelle Dow
and Heather Johnson
Tasty fare: cucumber stuffed with marinated tomatoes
Golf tournament participants: (l-r) Drs. Mike Flemming, Mary Doyle, Cindy Forbes and Kathy Gallagher
Dr. John Finley gives his first
address as President
Conference attendees Dr. Winston Parkhill and Mary Parkhill
Dr. Don Wescott
The grounds of Digby Pines Golf Resort & Spa
CEO Nancy MacCready-Williams presents Dr. John Chiasson
with a compilation of issues in the media during his term
Past-president Dr. Jane Brooks with Dr. John Finley. Background
Nancy MacCready-Williams and Dr. John Chiasson.
Digby waterfront at night
Dr. John Finley with his wife Carolyn Slade
Outgoing President looks back at term
Dr. John Chiasson
delivers his valedictory address
as outgoing
President.
Strong relationship with
government important for
Doctors Nova Scotia
Advancements made with modernization of
fee schedule, improving audit and appeal process
By KATIE MALLAM
Staff writer
H
aving realistic goals when dealing with government was outgoing President Dr. John
Chiasson’s message to colleagues during his
valedictory address at the 2012 Doctors Nova Scotia
annual conference on June 2.
“I will admit that from all the reading I’d done on
leading change and influencing others, I was left with
an unrealistic view of what I’d be able to accomplish,
particularly in dealing with government,” said Dr.
Chiasson, to a roomful of Doctors Nova Scotia
members.
“Building the relationship with the Department of
Health and Wellness starts anew every June, and it’s
now clear we have to align all our efforts to develop
and enhance this endeavor throughout our strategic
plan,” he added.
Dr. Chiasson said Doctors Nova Scotia has a strong,
12
collaborative relationship with the provincial government at a time when many other medical associations
across the country are struggling to achieve such a
connection.
“We need to continue to foster this relationship
to benefit physicians, patients, and the health-care
system,” he said.
During his term as President, Dr. Chiasson worked
with government on a variety of issues including the
initial steps to modernizing the fee schedule, improving
the process around the establishment of collaborative
emergency centres, making the MSI audit and appeal
process more clear and straightforward, and collaborating on the recently-released physician resource plan.
“Although I have not seen all of these issues be
resolved, I believe we are on the right track and that
my successor, Dr. John Finley, will continue to move
Board of Directors election
forward on the work we’ve accomplished this past year,” said Dr.
Chiasson.
“I’m leaving my role with a
sense of accomplishment. I was
able to reach my goals with help
from my colleagues,” he added.
When Dr. Chiasson took on the
role of President last June, he set
three goals: enhancing communication with Doctors Nova Scotia
members, advancing leadership
initiatives within the association,
and improving the health and lives
of Nova Scotia physicians.
During his term, Dr. Chiasson
toured the province listening to
the needs of physicians and leading
discussion on how Doctors Nova
Scotia, through a new strategic
plan, should focus its attention and
energy during the next four years.
“Listening has been my area of
development over the past year.
I’m still working on it but I know
it’s key to being a great communicator,” said Dr. Chiasson. “My
ears have grown this year and it
has changed me and, I believe, our
association,” he said.
The goal to enhance communication within the association
has guided Doctors Nova Scotia
to become more service-oriented
and better able to meet the needs
of members. One of the services
designed to achieve this communications goal is the Fully at
the Table leadership series, which
is part of the larger Business of
Medicine program. It provides
Doctors Nova Scotia members
with an opportunity to hone their
leadership skills and be better
prepared to influence health-care
changes in the association, community, and province.
“An investment in leadership is
an investment in our future. The
45 physicians who have completed
the series to date will play a strong
role in the future of health care in
this province and will be a valuable
asset to future governments as we
collaborate to transform how we
deliver care,” said Dr. Chiasson.
In order to practice to full scope,
which involves providing a variety
of complex services, and influencing decisions, Dr. Chiasson views
physician health as a key driver,
placing an emphasis on healthy
living.
“We need to take our place in
our communities as champions of
healthy living and promote good
policy. Through doing this, we’ll
make Nova Scotia a desired place
to live one’s life to its fullest. That
is what I desire and that is where
we are moving,” he said.
Dr. Chiasson told those in
attendance that while he didn’t
accomplish everything he had
hoped to during his term, he was
content with what he had achieved.
“I won’t deny that I would love
to be able say I got it all done
during my year but it would be
unrealistic and would deny the
need to constantly anticipate, react
and adapt to an ever-changing reality,” said Dr. Chiasson.
“In terms of wrapping up my
year, it’s also clear to me that the
job I started will never be done,”
he said.
“We haven’t arrived but we are
continuing to advance in the right
direction with purpose, with strategic focus, and with the culture in
place to arrive safely. And when we
arrive, we will already be on a new
path because the journey is continuous with the goal of constant
improvement of our situation,” he
added.
He left his colleagues with
one of his favourite quotations:
“Success is never-ending, failure
is never final. The journey is
constant.”
I won’t deny that
I would love to be
able say I got it all
done during my
year but it would
be unrealistic and
would deny the
need to constantly
anticipate, react and
adapt to an everchanging reality.
Dr. John Chiasson,
Doctors Nova Scotia
President, 2011-12
Two first-time reps;
two re-elected to
serve on Board
Three-year terms now in effect
By CHARMAINE CONNORS
Staff writer
T
wo physicians are serving
on the Doctors Nova Scotia
Board of Directors for the
first time, and and two more are
back for an elected term, following
results of the 2012-13 election.
Dr. Heather Johnson, a family
practitioner from Bridgewater,
was elected to represent general
practitioners from outside Halifax
Regional Municipality (HRM).
Last year, she was appointed to
serve as a regional representative
on the Board. She will now serve a
three-year term.
Newcomers Dr. Lynn Johnston
of Halifax and Dr. Elwood
MacMullin of Sydney were elected
to their first three-year terms.
Dr. Johnston is an internist who
will represent specialists inside of
HRM while Dr. MacMullin is a
general surgeon who will represent
specialists outside of HRM.
Dr. Lisa Bonang, who had
been on the Board as chair of the
Section Forum, was elected to her
first three-year term. She has a
family practice in Musquodoboit
Harbour and will represent GPs
inside of HRM.
The new terms began this
month, following the annual
general meeting.
Of 2,621 eligible voters in the
Board election, 675 cast ballots.
Voting ran from April 16-30.
Election results
2012-13 Board of Directors
Candidate Total votes
received
Percentage of
votes in category
General practitioner inside HRM
Dr. Lisa Bonang 174 Dr. Kathy Gallagher
141
Dr. Stavros Savvopoulos
114
Dr. Frances Moriarty
98
33
27
22
18
General practitioner outside of HRM Dr. Heather Johnson 267
Dr. Celina White
230
53
47
Specialist outside of HRM Dr. Lynn Johnston Nicholas Giacomantonio Dr. Jackie Kinley Dr. Alex Mitchell
Dr. Les Wasilewski
219
164
82
73
51
37
28
14
12
9
Specialist outside of HRM
Dr. Elwood MacMullin Dr. Ron MacEachern
Dr. Mahmood Naqvi
225
192
112
43
36
21
13
Promoting healthy lifestyles
Stephen Sollows
said that Friends of
Ellenwood Park will
use a portion of the
grant to purchase
cross-country ski
equipment and
snow shoes for
public use by
adults and children.
Friends of Ellenwood Park
receives 2012 Strive Award
$5,000 bursary to enhance safety, activity opportunities
By KIM BOTTOMLEY
Staff writer
F
riends of Ellenwood Park, a
group dedicated to improving
outdoor physical activity facilities, is the 2012 recipient of the
Doctors Nova Scotia Strive Award.
The award, given annually
to a community group with an
exemplary record in the promotion
of healthy lifestyles, was presented
during the Doctors Nova Scotia
annual conference on June 2. The
award comes with a $5,000 grant
to spend on advancing health promotion initiatives in the recipient’s
community.
“Receiving this award is validation that we are on the right track
with providing programs and
opportunities that will encourage
our communities to engage in
physically active lifestyles,” said
Stephen Sollows, past chair of
Friends of Ellenwood Park.
“We are confident that having
these types of resources in our area
will encourage adventurous and
active lifestyles for people of all
backgrounds, ages and cultures,”
he added.
Friends of Ellenwood Park works
14
to oversee off-season recreation
use at Ellenwood Provincial Park
as a way to increase and promote
healthy lifestyles for its community
members.
It started about 10 years ago,
when one member of the small
community of Raynardton, N.S.,
in Yarmouth County, began
advocating for a winter activity
centre in the area. That effort led
to the development of Friends of
Ellenwood Park. The group now
consists of over 20 volunteers who
advocate for many forms of active
transportation and outdoor physical
activities at the park.
An initial goal was to provide
a quality venue for cross-country
skiing to address the lack of such
opportunities within Yarmouth,
Digby and Shelburne counties.
Since the establishment of the
group, the park continues to see
increasing activity in the off-season
as more people become aware of
what it offers.
“I am proud to see the growth
within this organization,” said Mr.
Sollows. “Though cross-country
skiing was our main focus, other
members in our group soon realized that Ellenwood Park was a
beautiful area that could facilitate
many other outdoor recreational
activities.”
The group remains active from
October through April, months
during which the park is closed to
camping. This past year it hosted
drumming, kayaking, pumpkin
carving, photography, instructive
nature walks, scavenger hunt,
geocacheing, bicycle training
workshop, brunches, skiing, and
snow shoeing. A cabin on site is
open every Sunday afternoon and
community members count on
being able to stop by and warm up,
socialize and have a cup of coffee
or hot chocolate before they leave
the park.
Because the ski trails are heavily
used in the winter months, they
are often in poor condition. The
committee will use its $5,000 grant
to assist with the purchase of a ski
groomer which will help provide
a safe environment for all trail
users. The committee will also use
a portion of the grant to purchase
cross-country ski equipment and
snow shoes for public use by adults
and children.
Friends of Ellenwood Park
continues to provide and develop
outdoor recreational activities for
all ages in an effort to develop a
more health conscious community.
Most programs are offered at no
cost to the public.
Receiving this
award is validation
that we are on the
right track with
providing programs
and opportunities
that will encourage
our communities to
engage in physically
active lifestyles.
Stephen Sollows,
Friends of Ellenwood
Park past chair
Over next 10 years
Resource plan
calls for more
family doctors
Increase of 187 FTEs; modest reductions in 12 specialist
disciplines recommended over the next 10 years.
By KATIE MALLAM
Staff writer
N
ova Scotia needs more famthe province released its Shaping
ily doctors and generalists,
our Physician Workforce action
according to a report complan. It proposes ways to improve
missioned by the Department of
health-care in the province includHealth and Wellness and released
ing increasing access to primary
last month.
care; enhancing primary, urgent,
“The data confirms what physiand emergency care; and enhancing
cians and many Nova Scotians have recruitment and retention.
been telling me. We need more
“It is clear that change is needfamily doctors and specialists worked,” said then Health and Wellness
ing in rural communities,” said
Minister Maureen MacDonald.
Dr. John Chiasson, Past-President
“Government now has a tool to
of Doctors Nova Scotia, during
help reshape the province’s physia news conference to announce
cian workforce over the next several
details of the report.
years to better meet the needs of
“There’s an unequal distribution Nova Scotians across the province.”
of doctors in our province. The
The government’s response to
data suggests we need to readjust
the consultants’ recommendations
our focus to getting family doctors
shows emphasis on collaborative
and specialists in rural communimedicine, something Doctors Nova
ties,” he added.
Scotia members have identified as
Social Sector Metrics Inc. and
an important factor to help reduce
Health Intelligence Inc., consulworkload.
tants hired by the Department of
Other commitments made in
Health and Wellness
the action plan include
to examine physician
opening four new colsupply and demand
laborative emergency
in the province,
centres by the end of
There’s an unequal 2012, expanding returnare proposing a
change in the mix
distribution of
of-service agreements,
of physicians in the doctors in our
and expanding the scope
province over the
of the locum program.
province. The data
next 10 years. Their
Middleton general
suggests we need
report recommends
practitioner Dr. Jane
to readjust our
an increase of 187
Brooks said as a rural
full-time equivalents focus to getting
doctor with close to
family doctors and
(FTE), most of
8,000 patients in a colwhich will be in the specialists in rural
laborative practice, she
areas of family medi- communities.
already knows there’s
cine, general internal
a need for more family
Dr. John Chiasson, doctors in her area. And
medicine, and general
Doctors Nova Scotia she sees the value of
surgery.
Past-President having access to other
In response to
the consultants’
health-care providers.
recommendations,
“Changes aren’t going
to happen all at once but I look
forward to when there’s better planning for my community. We have a
serious need for family doctors and
generalists,” said Dr. Brooks.
Effect on specialties
For the majority of specialties, the
recommendations call for either no
change or a slight increase in the
forecasted FTEs. There are modest
reductions recommended over the
next 10 years for 12 specialist disciplines, with the largest being seven
FTEs in general paediatrics. A full
list of the specialities affected is on
doctorsNS.com.
Any adjustments that need to be
made to the mix and distribution
of certain specialties will be done
slowly and largely through natural
attrition.
The projections for the next 10
years can be adjusted to meet the
needs of patients and physicians to
accommodate changes in population or physician supply.
The changes are targets based
on data from March 2010 and best
benchmarks identified by the consultants in the report. As more upto-date data and other information
become available it will be added to
the planning tool to provide more
current recommendations.
Dr. Chiasson said while Doctors
Nova Scotia is supportive of the
need for a resource plan, the
consultants are making a series
of recommendations that, if not
managed properly, could have an
impact on physicians.
“Doctors Nova Scotia knows it
must be involved in understanding
and influencing all government
decisions related to this plan. We
have a commitment from government that we’ll be at the table as
decisions are being made” added
Dr. Chiasson.
One of the government’s commitments outlined in its action
plan is to increase planning with
partners such as Doctors Nova
Scotia. Throughout the action plan,
the association is listed as a key
stakeholder to moving initiatives
forward.
Although Dr. Chiasson is supportive of the plan he has some
questions he’d like addressed.
“There are some clear objectives
outlined by the province, but there
are some unanswered questions that
will also need to be addressed,” said
Dr. Chiasson.
He raised questions around
how the province will recruit the
needed physicians, the funding
required to support new models of
care, the mechanics of collaborative
teams, and more specifics on how
the province will reach the desired
complement of specialists.
Plan details
online
Detailed information about
the physician resource plan
for the province is on
doctorsNS.com.
Go to ‘Health policies &
initiatives > Policy positions >
Physician resource plan’
15
Public health
Province studies effects
of hypersexualization
on children and youth
Unprecedented rise in volume
of hypersexualized images, ads
By LISA TOBIN
Department of Health and Wellness
P
hysicians can play an
school and job performance, sexual
important role in identifying
harassment and various forms of
the hypersexualization of
oppression (including sexism, hetyoung patients, an issue that has
erosexism and homophobia).
been studied by public health staff
Experts and researchers in other
in the Department of Health and
parts of the world have also been
Wellness over the last year as part
looking at the phenomenon of
of its Sexualization Project.
hypersexualization. Public health’s
In the last 10-15 years, there has
Sexualization Project team wanted
been an unprecedented rise in the
to discover how this phenomenon
volume of hypersexualized images
is showing up in Nova Scotia,
and advertisements, and the extent
what impacts hypersexualization is
to which they infiltrate public spac- having, and what collective actions
es and everyday life. These images
stakeholders want to take to counand messages are becoming more
ter the harmful effects of hyperexplicit and children and youth
sexualization in the province. The
are increasingly being targeted as
team also wanted to discover what
consumers.
is already happening at the comHypersexualization is a root or
munity level to counter the harmful
underlying environmental factor
effects of hypersexualization and
that contributes to a number of
build resiliency in communities.
poor health outcomes. For examIn the first phase of its
ple, hypersexualization normalizes
Sexualization Project, public health
the objectification of women and
staff had conversations about
helps maintain a climate of violence hypersexualization with stakeholdagainst women including greater
ers in fields that included health
acceptance of intimate partner and
care, education, law enforcement
sexual violence.
and non-government organizaEvidence also links hypertions.. Common themes that
sexualization with
emerged were:
poor mental and
• Youth face a
emotional health
tremendous amount
outcomes (including
of pressure to look
low self-esteem, poor Experts and
and act sexy, and are
body image, negastressed about their
researchers in
tive attitudes toward
appearance.
breastfeeding, eating other parts of the
• Pornography is a
disorders, depression), world have also
common source of
been looking at the education about sex
poor sexual health
outcomes (including phenomenon of
and relationships for
sexually transmitted
hypersexualization children, youth and
infections, unintended
adults.
pregnancy, early sexual
• Parents face many
activity), diminished
challenges in trying
16
to help children and youth
navigate hypersexualized
environments.
Public health staff is now hosting conversations with the same
stakeholders to focus on actions to
shift away from a hypersexualized
environment and help prevent
harms.
Physicians, as members of the
health-care stakeholder group, can
take action toward the development
of healthy communities by:
• becoming aware of
hypersexualization and its
impacts
• taking a media history
(inquire about young patients’
media habits)
• raising awareness of
hypersexualization with
parents/caregivers
• encouraging parents/caregivers
to discuss sexuality and family
values with children and
youth
• being a source of reliable
sexual health information for
young patients
• avoiding waiting room
magazines that perpetuate
hypersexualized images and
messages
• advocating for action to
counter the harmful effects of
hypersexualization
(Lisa Tobin is a sexual health coordinator with the Department of Health and
Wellness.)
Resources
Report on the American Psychological Association Task
Force on the Sexualization of
Girls
www.apa.org/pi/women/programs/girls/report-full.pdf
MediaPulse: Measuring the
media in kids’ lives, A guide
for health practitioners
www.media-awareness.ca
College of Physicians
and Surgeons
of Nova Scotia
Campaign
addresses
prescription
opioid abuse
Encourages written agreements
between doctors, patients
The PMP will track a patient’s opioid prescriptions in comparison
to a treatment agreement.
By DR. GUS GRANT
CPSNS registrar/CEO
A
ments present an excellent opportunity to broach
campaign that encourages doctors and
this often difficult topic.
patients to enter into opioid treatment
The Nova Scotia Prescription Monitoring
agreements was launched last month by
Program (PMP) will register opioid treatment
the College of Physicians and Surgeons of Nova
agreements so that patient compliance can be
Scotia.
routinely reviewed. The PMP will track a patient’s
The “Good Pill, Bad Pill” campaign is a way to
opioid prescriptions in comparison to a treataddress the growing issue of prescription opioid
ment agreement. For information on registering
abuse and diversion within Nova Scotia. As the
agreements, telephone the PMP at
province’s medical regulator,
(902) 496-7123 or 1-877-476-7767.
the College of Physicians and
With support from physicians
Surgeons of Nova Scotia has a
working in pain and addiction, the
responsibility to respond to this
college has also applied for an MSI
issue in ways that are construcAlthough the use
billing code through Doctors Nova
tive, cost-effective and fit within
of opioid treatment
Scotia’s Fee Schedule Advisory
its mandate.
agreements isn’t
Committee under which physicians
The formal, written treatment
mandatory, we hope can be compensated for registering
agreements promoted in the
they will one day
opioid treatment agreements. The
campaign stress the shared
status of this application is pending.
responsibility of doctors and
be used routinely
Although the use of opioid treatpatients to help reduce the misby physicians in
ment agreements isn’t mandatory,
use of opioid medications. The
Nova Scotia. While
agreements are supported by
this campaign alone we hope they will one day be used
routinely by physicians in Nova
the Canadian Guideline for Safe
won’t resolve the
Scotia. While this campaign alone
and Effective Use of Opioids
complex problems
won’t resolve the complex problems
for Chronic Non-Cancer Pain,
of opioid abuse and
of opioid abuse and diversion, we
a definitive national guideline
see it as a small but important part of
endorsed by the college in 2010. diversion, we see
the solution.
The college believes physiit as a small but
For more information about opioid
cians and patients should clearly important part of the
treatment agreements, please don’t
discuss their joint responsibilisolution.
hesitate to call me at (902) 422-5823,
ties when opioid medications
or email: [email protected]
are prescribed for chronic pain,
and that opioid treatment agree-
Good Pill, Bad Pill
campaign details
Sample agreement can be edited to meet
specific needs
Frequently asked questions including information about patient breaches of opioid
treatment agreements
List of professional contacts and resources
Recommended readings, policies and
guidelines
Printable office poster that explains campaign to patients
Online: www.cpsns.ns.ca/agreement.aspx
( Dr. Douglas (Gus) Grant, MD,
is the registrar and CEO of
the College of Physicians and
Surgeons of Nova Scotia.)
17
Common audit
scenarios
Case
conference
management
code often
misbilled
Requirements for billing the case conference
management health
service code have been
outlined in the MSI
Bulletins as well as the
Preamble to the MSI
Physicians’ Manual.
Billing requirements outlined
in MSI Bulletins, Preamble
By DR. RHONDA CHURCH
Medical consultant
T
he case conference management health
service code (03.03D) is one of the most
common inappropriately billed codes.
This code was introduced several years ago as
a means of compensating physicians on occasions when they are requested by non-physician
staff of district health authorities and long-term
care facilities to attend multidisciplinary meetings to discuss specific medical issues that have
using this health service code were incorrect.
arisen with their patients. Requirements for billMSI Bulletin entries have clearly stated this code
ing this health service code have been outlined
can’t be used for regularly scheduled rounds or
in MSI Bulletins as well as the Preamble to the
case conferences. This includes grand rounds,
MSI Physicians’ Manual.
teaching rounds, stroke rounds, tumour rounds,
At the time of audit, it’s common to find that
sign-out rounds or resident care conevery service billed using this code
ferences at long-term care facilities.
by a physician was incorrectly
This code may only be used
billed. The case of Dr. Z outlines a
when a specific medical issue has
typical audit scenario.
arisen that requires the physician to
Dr. Z is a physician in a regional
A summary of
attend a multidisciplinary meeting.
centre. As part of her practice, she
the requirements
For example, it would be appropriprovides care to 40 nursing home
for billing the
ate to use this code in a hospital
residents. Twice yearly, nursing
if an issue has arisen in regard to
home staff schedule resident case
case conference
conferences. At these multidiscimanagement health discharge planning of a frail elderly
patient who requires medical input,
plinary conferences, the plan of care service code is in
or to address escalating behavioural
for the resident is discussed. Notes
the March 2011
issues in a long-term care facility.
are kept by a member of the nursing
MSI Bulletin. It’s
Additionally, as with all timed
home staff. A physician colleague
on doctorsNS.com
codes, start and finish times of the
told Dr. Z she was able to bill the
in the ‘physician
meeting for that specific patient
case conference management
must be recorded on the clinical
health service code for attending
payment > fee-forrecord. This was missing from all of
these conferences.
service’ section.
the entries for the conferences Dr. Z
At the time of audit, it was
had attended. While it’s acceptable
determined that all services Dr. Z
for MSI purposes for a physician to
had billed over a two-year period
18
bill this code when another health-care worker
has kept meeting notes, it’s the physician’s
responsibility to confirm that all required documentation, including start and finish times of
the meeting, is completed before the service is
billed.
In Dr. Z’s case, it was found she had also provided an institutional visit service to the patient
that met Preamble requirements on some of the
days she had attended the conference. As she
hadn’t previously billed MSI for some of these
visits, payment was permitted for them. However,
a recovery to MSI of $1,800 was required.
A summary of the requirements for billing the
case conference management health service
code is in the March 2011 MSI Bulletin. It’s on
doctorsNS.com in the ‘physician payment > feefor-service’ section.
(Rhonda Church, MD, is a medical consultant in MSI Monitoring
at Medavie Blue Cross.)
Congratulations from Doctors Nova Scotia
Doctor of Medicine
Class of 2012
Asra’a Abidali
Elizabeth K. Allen
Elizabeth J. Amos
Kory M. Arsenault
Rosalind J. Ashton
Noel T. Baker
Erica M. Bebbington
Afroza Begum
Sean A. Bennett
William J. Best
Sarah S. Bezanson
Coleman R. Black
Brydon D. Blacklaws
Mathieu M. Blanchard
Mathew P. Bligh
Jeffrey D. Campbell
David A. Carver
Cherie C. Collicott
Nicholas Costain
Jennifer (Jennielee)
Cottenden
Jenna C. Creaser
Natalie P. Cunningham
Datta Nilanjana
Elaine C. Davies
Nicole C. Delaney
Cory M. Dickson
Jillian C. DiPenta
Sarah L. Dobrowolski
Jessica D. Dooley
Alastair P. Dorreen
Tristan C. Dumbarton
Mandy D. Emms
Jason G. Emsley
Sarah A. Fancy
Nicholas A. Forward
Julia L. Gibson
Joshua A. Gillis
Carrie L. Goodine
Thera E. Gouzoules
Marie Elise R. Graham
Jordan A. Green
Kristin E. Greenlaw
Adam A. Harris
Adam R. Kading
Shoan C. Kale
Melissa Keith
Aliya B. Kelly
Haralambos Lavranos
Jeffrey A. Lee
Le Min Lee
Jennifer L. Leighton
Yves A. Leroux
Hilary K. MacCormick
Jeffery E. MacDonald
Jillian M. MacDonald
Lyndsey D. MacDonald
M. Jason MacDonald
Emily H. MacInnes
Brenton J. MacLellan
Robin MacNearney
John R. MacNeil
Scott A. MacNeil
Sarah A. MacSwain
Terrence P. McCarvill
Jennifer E. Melvin
Nur Haizum Mohamed Aris
Craig C. Morton
Thomas F. Muir
Alana M. Newman
Cliona M. O’Brien
Hayley Oulton
Glenn M. Patriquin
Jennifer H. Percy
Timothy J. Phillips
Heather M. Poushay
Katherine E. Quackenbush
Luke Reynolds
Mark W. Robertson
Aaron S. Robichaud
Ahmed A. Rostom
Ian F. Sarty
Kharim J. Schliewinsky
Samuel D. Searle
Andrew M. Simpson
Thomas A. Skinner
Daniel Y. Smith
Thomas Duncan Smith
Michael S. Stevens
Riley D. Stewart
Kailee N. Sutherland
Nadine M. Vaninetti
Stephanie C. Veldhuijzen
van Zanten
Maia E. Von Maltzahn
Sebastian Vuong
Mark R. Williams
David A. Wilson
Andrew C. Wing
Deanna C. Wolfe
Mohd Danial F. Yazid
Jessica L. Yeates
Paul D. Young
19
Workers’ Compensation Board of Nova Scotia
Physicians’ role vital
to help injured
workers return to jobs
Overview of WCB claims process
By DENNITA FITZPATRICK
Workers’ Compensation Board of Nova Scotia
Sharing patient information
with the WCB
Section 109(1) of the workers compensation act
In order for the Workers’ Compensation Board of Nova Scotia
(WCB) to successfully administer the duties and obligations
set out under the provincial Workers’ Compensation Act it
is necessary to collect, use, store and disclose personally
identifying information under appropriate circumstances.
Section 109(1) of the act sets out the expectation upon the
medical community to provide the WCB with any information requested:
109 (1) Every physician, surgeon, hospital official or other
health-care professional consulted regarding any worker
claiming compensation pursuant to this part shall
(a) provide to the board any information requested by
the board; and
(b) provide all reasonable and necessary information or
other assistance to any worker to enable the worker to
establish a claim for compensation.
Section 4.3 of the federal PIPEDA legislation provides for
disclosure without knowledge or consent as follows:
(3) For the purpose of clause 4.3 of schedule 1, and despite
the note that accompanies that clause, an organization may
disclose personal information without the knowledge or
consent of the individual only if the disclosure is
(c.1) made to a government institution or part of a
government institution that has made a request for the
information, identified its lawful authority to obtain the
information and indicated that
(iii) the disclosure is requested for the purpose of administering any law of Canada or a province
These provincial and federal provisions give the WCB with
authorization to request any information from members of
the medical community, necessary for the claiming of compensation under the act.
20
P
hysicians play a vital role in
helping injured workers get
well and return to their regular jobs – and lives – in a safe and
timely manner through collaboration with Workers’ Compensation
Board of Nova Scotia case workers
and other members of the returnto-work team.
WCB case workers serve as central information, communication
and collaboration coordinators who
also maintain a complete electronic
file of all activities related to an
injured worker’s file.
When a workplace injury occurs,
the process that’s followed includes
the following:
Reporting the injury
A WCB claim is opened with an
injury report from the employer/
worker or medical report from
a physician or other health-care
provider. Workers must report
all work-related injuries to their
employer. Many workers seek
health care before reporting
the injury which can make the
reporting process more complex.
Physicians can help streamline the
process and avoid delays by reminding injured workers to report their
injury to their employer.
Case worker assigned
The WCB assesses the claim to
determine complexity and risk,
and then assigns it to the appropriate service level. Generally, the
assigned case worker will handle
the claim from start to finish. If a
claim becomes more complex than
expected, it may be reassigned to a
higher level of service and a different case worker.
Compensation decision
The case worker first determines
whether the claim is compensable
based on information provided
by the worker, the employer, and
health-care providers. The employer must have WCB insurance and
the injury or illness must have been
caused by their work for the claim
to be accepted. Once accepted,
the WCB pays for all health care
deemed necessary and expedient to
support return to work. The WCB
also provides benefits to address
lost wages. If the claim is denied,
the WCB will cover only the cost
of the first medical visit. All costs
are charged against the employer’s
account.
Report Form 810
Once accepted, the case worker
consults with the employee, physician, employer, physiotherapist,
medical advisor, and other
health-care providers to help the
employee return to work. During
this period, the WCB will cover
the cost of office visits/reports.
(The billing code is WCB11.) The
WCB Physician Report Form 810
must be complete and legible to
qualify for payment. Form 810 is
the primary communication vehicle
between the physician and the case
worker, however conferences calls
are also an option. (The confer-
Celiac disease
ence calls billing code is WCB15).
Communication is critical to return
to work success.
Widening spectrum
of gluten-related
disorders noted
Claim decisions
The case worker is supported by
physicians in the role of WCB
medical advisors, physiotherapy
consultants, and others experienced
in handling work-related conditions. The case worker, with these
supports, is responsible for all decisions related to benefits and services
associated with the injury.
Shared responsibility
The employer is responsible to
support the worker and offer transitional work where possible. The
worker is responsible to cooperate
in his or her treatment, and to take
all reasonable steps to minimize
their earnings loss.
Permanent medical impairment
When the claim has concluded, if
the worker has a permanent medical impairment, with or without
earnings loss, it is transferred to
a long-term benefits case worker.
At this point, the WCB will cover
the cost of a maximum of one visit
per month. A report isn’t required.
(The billing code is 03.03). If there
is no permanent medical impairment, the claim is closed.
For more information about the
WCB claims process, visit www.
wcb.ns.ca
For details on the WCB/Doctors
Nova Scotia, visit doctorsNS.com >
physician payment.
(Dennita Fitzpatrick is director of
health and extended benefits at WCB
Nova Scotia.)
WCB case workers
serve as central
information,
communication
and collaboration
coordinators who
also maintain a
complete electronic
file of all activities
related to an injured
worker’s file.
Terminology can be confusing
for both patients and doctors
By DR. MOHSIN RASHID
Canadian Celiac Association
G
luten-related terminology is
getting confusing for both
health-care professionals
and patients as terms like intolerance, sensitivity, and allergy are
being used interchangeably.
The number of people consuming a gluten-free diet is increasing
and, in 2010, global sales of
gluten-free products approached
$2.5 billion (US). This trend
implies that many who don’t have
celiac disease may be on a glutenfree diet for other perceived health
benefits.
Gluten is a protein present in
wheat, rye and barley and their
crossbred grains. Three distinct
clinical disorders of gluten intolerance are now recognized as wheat
allergy (WA), celiac disease (CD)
and non-celiac gluten sensitivity
(GS). The mechanisms involved in
each disorder are different.
Both WA and CD are mediated by the adaptive immune
system. WA can cause anaphylaxis
and may affect the skin (contact
urticaria), gastrointestinal tract or
respiratory system (rhinitis, baker’s
asthma). The IgE antibodies play
a key role in the pathogenesis of
these diseases and a consultation
with an allergist is recommended.
CD, on the other hand, is a
permanent, autoimmune disorder
that causes small intestinal inflammation in genetically-susceptible
individuals. It affects one per
cent of the population but most
individuals remain undiagnosed.
The patients form autoantibodies such as serum anti-tissue
transglutaminase (tTG) and antiendomysial antibodies (EMA) that
play a key role in screening for
CD. Biopsies of the small intestine
reveal varying degrees of villous
atrophy. The treatment is lifelong
adherence to a strict gluten-free
diet. (Dermatitis herpetiformis is
“celiac disease of the skin” and is
managed similarly). Poorly managed CD can lead to complications
such as osteoporosis, infertility,
development of other autoimmune
disorders, and cancer.
In some instances, patients
react to gluten in the absence
of any allergic or autoimmune
mechanism. This phenomenon
is referred to as gluten sensitivity
(GS). Patients have intestinal or
non-intestinal symptoms that
resolve on eliminating gluten from
their diet. While the symptoms
may resemble CD, there is neither
villous atrophy nor production of
anti-tTG or anti-EMA. Currently,
the diagnosis of GS is made by
excluding CD and demonstrating
improvement of symptoms on a
gluten-free diet. GS is believed
to be a very common disorder,
although precise prevalence data is
lacking at present.
For patients presenting to their
health-care providers with clinical
features suggestive of a glutenrelated disorder, CD must be
excluded by appropriate serological
and histological testing. Empiric
treatment with a gluten-free diet
isn’t recommended. The glutenfree diet will normalize the serology and intestinal lesion, making
confirmation of celiac disease very
problematic.
For more information on wheat
allergy, celiac disease or nonceliac gluten sensitivity, contact:
Canadian Celiac Association
www.celiac.ca
Celiac Resource Guide for Health
Professionals
www.celiacguide.org
Suggested reading:
Sapone A et al. Spectrum of
gluten-related disorders: consensus
on new nomenclature and classification. BMC Medicine 2012,
10:13
(Dr. Mohsin Rashid, FRCPC, is
on the Dalhousie University Faculty
of Medicine, and is a member of the
Canadian Celiac Association’s professional advisory board.)
The number of
people consuming
a gluten-free diet is
increasing and, in
2010, global sales of
gluten-free products
approached $2.5
billion (US). This
trend implies that
many who don’t
have celiac disease
may be on a glutenfree diet for other
perceived health
benefits.
21
Health & healing
Caduceus Project
An eight by four foot
winged metal and
clay sculpture, the
Caduceus Project
is a visual narrative compilation
contributed to by
hundreds of medical
and health-care
trainees, faculty, and
staff from Dalhousie
University’s medicine
and the health profession faculties.
Caduceus
Project:
Expressing
the heart of
the healing
professions
Conceived and implemented by
Miro Davis during her artist-inresidency
By DR. GERRI FRAGER
Medical Humanities-HEALS program
T
he Caduceus Project was one of several
developed by an artist-in-residence with
Dalhousie University’s Humanities-HEALS
Program.
Three such projects were funded in 2010-11 by
the Robert Pope Foundation, which fosters art,
education and community health initiatives in an
effort to celebrate life and enhance well-being,
health and healing at all stages of living.
Applications for the residencies were received
from 24 artists representing diverse disciplines:
visual arts (sculpture, fabric, illustration), the
performing arts (dance, film), and the narrative
form (storytelling, poetry).
A selection committee representing undergraduate medicine, clinical care, and the artistic
community chose two visual artists and one performance artist to work in blocks of three months
each throughout 2010-11 with Dalhousie’s
Medical Humanities-HEALS Program.
The charge to the artists-in-residence was to
support medical trainees, staff and faculty at the
medical school, and interdisciplinary students in
the health professions in expressing themselves
though art. A parallel goal within the clinical settings was to engage patients, their families, and
members of their health-care team.
22
One of the artists selected, Miro Davis, conceived and implemented the Caduceus Project
during her artist-in-residency. Miro is a research
fellow with the School of Extended Studies at
NSCAD, where she specializes in community
outreach.
The caduceus, the staff carried by Hermes
in Greek mythology, has long represented the
healing professions. An eight by four foot winged
metal and clay sculpture, the Caduceus Project
is a visual narrative compilation contributed to
by hundreds of medical and health-care trainees,
faculty, and staff from Dalhousie University’s
medicine and the health profession faculties.
The copper snake scales were created in
response to the question: What brought your
heart to work in health care?
This is the art piece reflection of one medical
school student: “My design is a wing, and in particular, a phoenix wing. The story of the phoenix
is that it rose from its own ashes to start anew.
As a cancer survivor, that’s a story that is very
dear to my heart. So I think that survival through
illness and being born anew kind of drove me to
be a doctor.”
The small copper feathers rimming the wings
of the Caduceus Project reflect “What is Spirit,
What is Soul?” The round copper discs around
the edge express “What grounds you in care,
keeps you passionate as a clinician?” The aluminum wings were created by psychiatry residents,
fellows, and staff physicians. Their understanding of the patient’s experience is matched by
a corresponding feather on the opposite wing
reflecting their own perspective as healer and
clinician.
The “staff of knowledge” is ceramic, carved
with words and images learned through one’s
professional practice, which participants wished
to impart to others.
The Caduceus Project recently travelled to the
White Coat Warm Art Exhibit as part of the 2012
Canadian Conference on Medical Education,
and to the 2012 Doctors Nova Scotia annual
conference.
We next take the work on the road to a
Canadian Institute of Health Research symposium entitled Arts and Humanities in Health
Professional Education - What is the Impact?,
and to the Shenkman Gallery in Ottawa.
Project Caduceus will come home to roost at
Dalhousie University with the intent of intermittently migrating to art displays and health-related
conferences and events such as September’s
Lighting Ceremony, marking the third year of
Dalhousie Medical School New Brunswick.
We are delighted to have the Pope Foundation
fund two new artists-in-residence in 2012-13.
Watch this space for some of the magic they will
be helping others create.
(Dr. Gerri Frager is a Dalhousie
University professor and
paediatrician with a longtime
interest in the arts and health.
She is a regular contributor to
doctorsNS.)
Sport Nova Scotia
Gender equity in
sport has made
great strides
Still room to improve in how to train athletes based on gender
By CAROLYN TOWNSEND
Sport Nova Scotia
F
ollowing the addition of
women’s boxing at the 2012
London Olympics, and women’s ski jumping at the 2014 Sochi
Olympics, there will be no sport for
men only at the Olympic Games.
Great strides have been made since
the first Modern Games, in 1896,
excluded women from all but a few
disciplines that were considered
secondary at the time such as golf,
tennis and sailing.
Of the 2,000 athletes from
around the globe expected to
complete at the London Games this
summer, 45 per cent are women.
The balance in all sports, not just
the Olympics, remains weighted in
favour of men, but it is tilting.
While little recent data is
available, a 1998 report by Sport
Canada entitled Sport Participation
in Canada, indicated male coaches
outnumber female coaches but not
to the extent one might expect. At
that time, 56 per cent of coaches
were male and 44 per cent were
female.
While there’s no denying the differences between men and women,
there’s ground to be made up in
how to train athletes based on
gender. Some sport environments
still facilitate the same development
programs, ideals, and expectations for male athletes as they do
for female athletes. But research
shows the physiological differences between the genders should
be factored when designing and
implementing long-term and/or
high-performance athlete training.
There are obvious physical
differences between elite male
and female athletes, but at the
community level the disparity can
be minimal. Coaches BC explains
that more significant differences
can often be found within the
genders rather than between. It
maintains that although men’s and
women’s bodies respond similarly
to exercise, it’s the extent of the
responses that is different. When
it comes to physical measurements
in the general adult population,
the average male tends to have
increased muscle mass, heart and
lung capacity, and aerobic capacity
with increased strength, power and
speed. On the other hand, the average female has increased flexibility
and buoyancy due to less muscle
mass and a higher percentage of
body fat.
Research indicates females are
attracted to sport for the elements
of affiliation, skill development,
personal improvement, a nurturing
environment, and a social network.
Women who have positive sporting experiences may benefit from
enhanced health and well-being,
fostered self-esteem and empowerment, enhanced social inclusion
and integration, and being provided with leadership opportunities.
Regularly active females also show
positive body weight management
skills, stronger psychological development, and enhanced physical
expertise. Participation in sport
brings with it a wide range of physical and psychological benefits such
as protection against cardiovascular
disease, obesity, certain cancers and
Type 2 diabetes.
Despite these valuable benefits,
women are consistently less active
than men at all ages. Only four per
cent of girls aged six to 19 meet
the daily physical activity recommendations in Canada’s Physical
Activity Guide. This compares to
nine per cent of boys in the same
age bracket. The 2011 Get Active
Toronto report states boys are 50
per cent more likely than girls to
participate in secondary school
sports, and less than 10 per cent
of secondary level sports teams are
classified as co-ed.
Adolescent girls report more
barriers to participation than boys
including time, money, resources,
and a concern for safety. Lack of
active, older role models has also
been cited as a contributing factor
to lower participation rates among
girls. Furthermore, if a girl doesn’t
participate in sport by age 10,
there’s only a 10 per cent chance
she will be physically active by the
time she’s 25.
A 2012 report from the
Canadian Association for the
Advancement of Women and Sport
and Physical Activity says to create
a sport system where all women
and girls have opportunities to
contribute in meaningful ways, it’s
necessary to embrace the importance of treating people equitably,
rather than equally. Equity requires
consideration of the unique needs,
interests and experiences of a
target group when developing and
delivering services and allocating
resources. Therefore, some services
may be the same, while others may
be completely different.
There have been some modest
increases in the number of women
and young girls participating in
regular physical activity, recreational sports and elite competitions.
Through research and education, athlete training programs can
become more refined, and these
increases can hopefully continue.
Whether a future Olympic athlete
or someone who enjoys the many
benefits of being physically active,
the goal is to create more enjoyable,
more plentiful and longer lasting
sport experiences throughout their
lives.
Of the 2,000 athletes
from around the
globe expected to
complete at the
London Games this
summer, 45 per
cent are women.
The balance in all
sports, not just the
Olympics, remains
weighted in favour
of men, but it is
tilting.
23
Continuing Medical Education
Upcoming Events
Sep 14 – 15
7th Atlantic Canada Stroke Conference
Specialists, Family
Physicians and Others
902.494.1459
[email protected]
Sept 28 – 29
Atlantic Provinces Inter-Professional Pain
Conference
Specialist, Family
Physicians and Others
Sylvia Redmond, 902.473.6428
[email protected]
Oct 13
Update in Rheumatology
Family Physicians
Kim Lake, 902.494.1588
[email protected]
Nov 29 – Dec 1
86th Annual Dalhousie Refresher Course
See ‘green” announcement below
Family Physicians
Mary Ann Robinson, 902.494.1459
[email protected]
Feb 14 – 16
39th Annual February Refresher:
Emergency Medicine
Family and Emergency
Physicians
902.494.1459
[email protected]
Events are in Halifax unless otherwise indicated. Registration normally opens 6 – 7 weeks before the program.
For updates on these and other Dalhousie CME activities, visit cme.medicine.dal.ca
Nova Scotia Community Hospital Programs
Supported by Doctors Nova Scotia
The following presentations are confirmed as of May 16.
Additional programs may be offered.
Most programs are
recommended for 1-2 credit hours for MAINPRO-M1 and / or
Maintenance of Certification Section 1. Dates may change, so
please watch for notices, sent several weeks before each program,
or visit cme.medicine.dal.ca/chp.htm. For information, contact
902.494.1484, [email protected].
Antigonish
Bridgewater
Sydney
Motivational Interviewing
Wound Management
Neurology: New Epilepsy Drugs
14-Jun-12
14-Jun-12
13-Jun-12
Dalhousie CME Programs Going “Green”
We are eliminating printed brochures for our annual three-day
Refreshers and the Cardiovascular Conference Watch for a
postcard and email messages directing you to
cme.medicine.dal.ca, where you will be able to download a
brochure and register online. If you have not recently been
receiving our email communications, please contact
[email protected] to update your email address. Events are
posted at cme.medicine.dal.ca as soon as they are scheduled
and we encourage you to visit often!
R. Wayne Putnam Award
This award recognizes individuals who consistently contribute in an exceptional way to the
continuing education of physicians throughout the Maritimes. Anyone who has made an
outstanding contribution over several years in teaching and / or organizing any form of
community CME, is eligible. The deadline for nominations is September 30, 2012. For
details, please see the Call for Nominations, posted at cme.medicine.dal.ca.
Continuing Medical Education • C106, 5849 University Avenue • PO Box15000 • Halifax NS B3H 4R2
Fax: 902.494.1479 • cme.medicine.dal.ca
Events Calendar
June-October 2012
June
June 26-30, Toronto
Canadian Ophthalmological Society
annual meeting
The 2012 meeting is an exciting
educational event with great speakers, scientific sessions, networking
opportunities and special social
events. This year’s meeting is
being held in conjunction with the
International Orthoptic Congress.
Visit www.eyesite.ca
June 28-July 2, Ottawa
Canadian Dermatology Association
annual conference
Delegates can expect renowned
Canadian and International speakers present the latest on new
innovations in dermatology, groundbreaking research on therapeutics,
dermatopathology, paediatrics and
oncology, as well as engage in discussions with delegates. Visit www.
dermatology.ca
July
July 21-25, Toronto
International Conference on Head
and Neck Cancer
This year’s conference theme is
Bridging the Gap: Caring for the
Head and Neck Cancer Patient.
The scientific program has been
thoughtfully designed to bring
together all disciplines related to
the treatment of head and neck
cancer. Attendees will participate in
panels, instructional courses, professor lunches and tumor boards.
Visit www.ahns2012.com
July 27-30, Toronto
World Congress on Heart Disease
The congress will provide the opportunity for a comprehensive overview
of the latest research developments
in cardiovascular medicine, primarily in the areas of molecular biology,
coronary artery disease, heart
failure, cardiac arrhythmias and
cardiac surgery. Program areas will
range from clinical pathophysiology
to evaluation and stratification
techniques and molecular and
cellular biology including neurohumoral, immunological and genetic
studies. Integrated into the program
will be an update on the latest
major clinical trials. Visit www.
cardiologyonline.com/wchd12/
index.html
September
Sept. 9-13, Halifax
Canadian Medical Association
Physician Management Institute
(PMI) program
PMI courses ‘Engaging others’
(Sept. 9-11) and ‘Dialogue: navigating complex systems’ (Sept. 12-13)
will provide attendees with leadership and management skills to
complement clinical expertise. Visit
cma.ca/pmi
October
Oct. 25-27, Montréal
International Conference on
Physician Health
This biennial event is organized
in partnership with the American
Medical Association, the British
Medical Association, and the
Canadian Medical Association.
Internationally, there is a growing
awareness and acceptance of the
importance of physician health.
This conference provides an ideal
opportunity to highlight successes
in using this awareness and new
knowledge to advance the health
of physicians. Visit cma.ca/
physicianhealthconferences
Welcome to Doctors
Nova Scotia’s newest members
Dr. Derek Karanwal - Diagnostic radiology, Sydney
Dr. Achal Mishra - Psychiatry, Valley
Dr. Hala Talballa - General practice, Bedford/Sackville
25
Practice Opportunities
To submit a practice opportunity contact:
Melissa Murray
Tel: (902) 468-8935 ext. 229 or 1-800-563-3427
[email protected]
Deadline for next month’s issue is July 6
CUMBERLAND HEALTH AUTHORITY
The Cumberland Health Authority
(CHA) has jurisdiction for the provision of health care in the northern
part of Nova Scotia. The CHA is
actively recruiting specialty and
family medicine positions in beautiful Cumberland County. For more
information on the following opportunities, telephone Shirley Symes
at (902) 661-1090 ext. 4865, email:
[email protected], or
visit www.cha.nshealth.ca
Internal medicine: A general internist with special interest or training
in endocrinology and pulmonary
disease would be welcome. Our
current complement consists of two
internal medicine physicians, one
responsible for gastroenterology
and one responsible for cardiology.
Palliative medicine specialist:
Immediate opportunity for a palliative medicine specialist to provide
consultation services. This is a fulltime, alternate payment plan opportunity, based at the Cumberland
Regional Health Care Centre in
Amherst. This position involves the
provision of consultation services
to all care environments in the CHA
including home, nursing home, and
hospital. The palliative medicine
physician is supported by an
interdisciplinary team consisting of
consult nurses, a continuing care
coordinator, and social worker, as
well as full-time secretarial support.
Family physician (Pugwash):
Cumberland North Rural Practice
Network services the communities
of Pugwash and surrounding areas
has an immediate family physician
opening. The physician will join
two family doctors, a nurse practitioner, and a family practice nurse
(RN). The main clinic is located in
Pugwash.
26
Family physician (Parrsboro):
Cumberland South Rural Practice
Network (CSRPN), serving the communities of Parrsboro, Advocate and
River Hebert, immediately requires a
family physician. The physician will
join two other family doctors, three
nurse practitioners, and a family
practice nurse (LPN). The main clinic
is located in Parrsboro with satellite
offices in Advocate and River Hebert.
Clinics work on a team concept with
shared EMRs through Nightingale.
The CSRPN is part of the first collaborative emergency centre (CEC)
in Nova Scotia, located in Parrsboro.
For more information on the role of
CECs, visit www.gov.ns.ca/health/
bettercaresooner. The CEC operates
8:30 a.m.-8:30 p.m., seven days per
week, year round. Monday through
Friday the CEC will be staffed by two
health-care providers while Saturday
and Sunday it will operate with one
health-care provider. It’s anticipated
the transition to the new model will
allow physicians to have greater control
over their work hours.
CAPE BRETON DISTRICT
HEALTH AUTHORITY
More people are discovering why
Cape Breton Island is a great place
to live, work and play. Just ask one
of the 3,500 health-care professionals and physicians who live and
work in the Cape Breton District
Health Authority (CBDHA).
The CBDHA is looking for a medical officer/staff physician to join its
Mental Health & Addiction Services
team. Based at the Cape Breton
Regional Hospital, the successful
candidate would be responsible
for the medical care of patients
admitted to the hospital’s three
inpatient mental health units (46
beds) and one 18-bed withdrawal
management unit. The physician
would be responsible for admission
history and physicals, follow-up on
identified medical concerns, the
coordination of consults within the
hospital system, making recommendations to the primary care
physicians for follow up in the community and after hours coverage for
emergency medical situations only.
Candidates must be eligible to practice family medicine in Nova Scotia.
Inquiries and applications may
be directed to Dr. M.A. Naqvi,
medical director, Cape Breton
District Health Authority, by mail:
1482 George Street, Sydney NS B1P
1P3, fax: (902) 567-7921, email:
[email protected] or visit:
www.cbdha.nshealth.ca
HALIFAX
Family physicians, specialists:
immediately
Collaborative clinic seeking partners to join an enriched clinical
setting. Practice includes a family
practice nurse and family therapist
with access to a network of collaborative partners with traditional
and non-traditional approaches to
health care. Paperless office with
electronic practice management
and a robust electronic medical
record system. Telephone Dr.
Jayabarathan (902) 403-3898 or
email: [email protected]
Family physician: immediately
Start up a new practice or relocate
a present practice to this new collaborative care medical facility. Join
four other family physicians, along
with a walk-in clinic, in association
with a pharmacy and a full service
rehabilitation clinic (physiotherapy,
osteopathy, chiropractic, massage
therapy, occupational therapy, and
psychological counseling services).
Run your own office or have it
managed by the clinic. EMR option
available. Reasonable overhead.
email Dr. Frank Doane: ldoane@hfx.
eastlink.ca
Family physician: Full-time
The Family Focus Medical Clinic in
the Halifax Professional Building
has an opening for a full-time family physician. Location also offers
walk-in medical services. Clinic
is fully furnished and professionally managed. Telephone Dr. Mark
Fletcher at (902) 497-5892 or email:
[email protected]
Family physician: Part-time
The Family Focus Medical Clinic on
Joseph Howe Drive has an opening
for a part-time family physician to
work alongside one part-time and
two full-time family physicians.
Walk-in medical services are also
offered at this clinic. Clinic is fully
furnished and professionally managed. Telephone Dr. Mark Fletcher
at (902) 497-5892 or email: [email protected]
Locum: July 2-14
Public Gardens Medical Clinic is
seeking a locum from July 2-14. This
well-established clinic is located on
Spring Garden Road and includes
10 GPs. Telephone Kim at (902)
425-5440 or email: sahaamal@
hotmail.com
Locum: July-August
The North End Community Health
Centre is seeking a locum to
provide clinic coverage in July and
August. The centre provides holistic
primary health care to an inner
city, culturally diverse community.
Services and programs include
medical care, outreach, prenatal,
well baby, nutrition and addiction
counselling. Staff includes four physicians, nurses, nurse practitioners,
social worker, mental health workers, dietitian, in addition to support
and administrative assistants.
Telephone Cheryl Shipley at (902)
422-5642 ext. 3 or email: cshipley@
nechc.com
ELMSDALE
Family physician(s): immediately
The Elmsdale Medical Centre is
seeking one or more physicians.
This modern medical facility,
located between Halifax and Truro,
currently has six doctors. Offices
are large and bright with two
examining rooms and main office
for each physician. The clinic uses
the Nightingale EMR system and
each office has its own computer for
patient encounters.
WINDSOR
Locum: July 9-19
Locum required for a solo practice. Four-day-a-week practice with
the provision to work five days if
desired. No nursing home, emergency or in-patient care required.
Telephone Dr. W. J. Machel at (902)
798-0363 or fax: (902) 798-1028
HAMMONDS PLAINS
Family physician: Immediately
The Hammonds Plains Family
Practice and Walk In Medical Clinic
has an immediate opening for a
family physician to join this family
practice. This clinic has one other
full-time family physician as well
as walk-in medical services. Clinic
is fully furnished and professionally managed. Telephone Dr. Mark
Fletcher at (902) 497-5892 or email:
[email protected]
LOWER SACKVILLE
Family physicians: summer
The Family Focus Medical Clinic has
an opening for family physician(s)
to work in a newly-renovated clinic
starting this summer. There is a
high demand for family physician
services in this community. Walk-in
medical services are also offered.
Clinic is fully furnished and professionally managed. Telephone Dr.
Mark Fletcher at (902) 497-5892 or
Locums required: immediately
Established walk-in clinic is looking
for coverage for day, evening and
weekend shifts on an intermittent
or regular basis. Competitive overhead percentage. Telephone Dr. C.
Marshall at Community Care Walk-in
Clinic (902) 865-3335 or email:
[email protected]
2012 Conference Sponsors
Platinum
Sponsor
SPRYFIELD
Locum required: summer
Locum required for a well-established, busy family practice from
July 2-6 and August 13-September 6.
No on-call and obstetrics is optional. Practice utilizes Nightingale EMR.
Telephone Matt at Spryfield Family
Medicine Clinic (902) 444-3514 or
(902) 401-8036 or e-mail: sfmc@
sfmclinic.com
Gold
Sponsor
Silver
Sponsors
NEW GERMANY
Locum: July-September
New Germany Medical Center is
seeking a locum family physician
for Mondays and for any one to
two-week period between July and
September. Clinic is a collaborative
practice with one family physician
and one nurse practitioner, and various other services. Located 20 minutes from Bridgewater. Telephone
Dr. Barb O’Neil (902) 644-2301.
Bronze
Sponsors
(and Private Practice Section)
HRM
Walk-in clinic shifts: immediately
Day, evening and weekend shifts
available in six medical clinics
that offer walk-in medical services.
Flexible scheduling. Excellent
source of supplemental income.
Telephone Dr. Mark Fletcher at (902)
497-5892 or email: familyfocus@
ns.aliantzinc.ca
Submit a practice opportunity
Members of Doctors Nova Scotia may list job opportunities on the
Practice Opportunity section of doctorsNS magazine, members-only
side of doctorsNS.com, the public side of the site, or all three. Practice
opportunities are posted online in 60-day segments and are included
in the magazine on an issue-by-issue basis. Practice opportunities are
listed at no charge.
Hospitals, district health authorities, recruitment agencies, and
members of Doctors Nova Scotia may purchase advertising space for
available hospital positions, office space, etc., at a cost of $200 (HST
included) each. Advertisements for these positions can be posted
in doctorsNS magazine, members-only side of doctorsNS.com, the
public side of the site, or all three. Advertisements are posted online
in 60-day segments and are included in the magazine on an issue-byissue basis.
Membership invoices
coming late August
Invoices for Doctors Nova Scotia membership
dues will be sent to members by their preferred
method of correspondence (email or posted mail)
by late August.
Physicians who have recently changed either
their membership status or mailing address
should report it to Doctors Nova Scotia as soon
as possible.
For more information, or to report a change, contact:
Catherine Carnegy
Membership officer
Tel: (902) 468-8935 ext. 234
[email protected]
Electronic bookshelf
Knowing where to look is
key in quest for information
Resources on doctorsNS.com give
quick answers, in-depth research
By PAT LEE
Librarian
A
key to finding information is
knowing where to look. The
following scenario illustrates
the point.
The patient, a clean, well dressed
elderly woman, presents with a
wound on her arm which she
declares is a spider bite. A careful
assessment suggests the lesion is
probably not a spider bite, but an
abscess due to methicillin-resistant
Staphylococcus aureus. A recent
guideline comes to mind, but
memory doesn’t extend to its actual
location. It appears
that an evidence-based
update on the diagnosis and treatment
The Electronic
of MRSA is in order.
Bookshelf has
Where to start?
full text links for
The doctorsNS.com
approximately 1,500 Electronic Bookshelf
has a suite of resources
journals. That’s
about one-quarter of designed to provide
quick answers as well
the journals indexed as to facilitate in-depth
in PubMed.
research. A search
for evidence-based
information on MRSA
might involve the following steps:
1. Log on to doctorsNS.com
with your username (firstname.
lastname) and password. (Your
Doctors Nova Scotia membership
number plus either three or four
zeros to make eight digits. This is
the password originally assigned
to you. You may have changed
it through the website’s Change
Password feature).
2. Click on the Electronic
Bookshelf link.
28
3. To find a Canadian guideline,
select’ Practice guidelines’ from the
left side of the Electronic Bookshelf
homepage. Links to provincial,
national and international guidelines are provided.
4. For more evidence, go back to
the Electronic Bookshelf homepage
and click on the ‘Evidence-based’
tab.
5. For ACP’s PIER and Pediatric
Clinical Practice Guidelines &
Policies, click on either the website
or mobile site link.
6. Enter “MRSA” in the search
box, and browse through the evidence-based information on screening, treatment and prevention.
For a quick synopsis and a
detailed systematic review, also
in the ‘Evidence-based’ tab, click
on the website link for Cochrane
Library, and search for MRSA.
Links to full text systematic reviews
and meta- analyses are provided.
Review the plain language summary
for a quick synopsis. The details are
available in the full review.
When evidence is hard to find
another excellent resource under
the ‘Evidence-based’ tab is the
TRIP database. It’s a meta search
engine for health like Healia and
Bing except that it grades the
evidence very clearly. Search MRSA
and review the list of synopses,
reviews and guidelines, listed by
country.
If you’re interested in a perspective on drugs and treatment, select
the ‘Drug & Disease’ tab, click on
either the website or mobile site
link to Micromedex, and search for
MRSA.
If patient resources on MRSA
treatment and prevention are
useful, a number of authoritative,
reliable websites are presented
under “Disease Search” on the
doctorsNS.com homepage. The
patient may explore these sites herself, or handouts may be provided
from the Patient Education section
of MDConsult, under the ‘Most
Popular’ tab on the Electronic
Bookshelf.
For journal articles, select
“PubMed” under the Journals tab,
Search for MRSA and when the
results appear select the Abstract
view using the Display button at
the top left. Look for the Doctors
Nova Scotia logo to link to the full
text article when available.
The Electronic Bookshelf has full
text links for approximately 1,500
journals. That’s about one-quarter
of the journals indexed in PubMed.
If there is still some question
in the patient’s mind about the
possibility of a spider bite, navigate
back to MDConsult and search its
images database for spider bite.
To learn more about the Electronic
Bookshelf, or for information
search help, contact:
Pat Lee
Librarian
Tel: (902) 468-8935 ext. 222
1-866-890-5563
[email protected]
Web round-up:
doctorsNS.com
For more information, contact:
Carol Walker
Senior policy analyst
(902) 468-8935 ext. 238
[email protected]
Pat’s pick
Harrison’s point of
care tool
The doctorsNS.com Electronic Bookshelf has the
most recent edition of Harrison’s Principles of Internal
Medicine, found under the
link ‘Harrison’s plus 4 top
texts.’
Harrison’s contains Quick
Answers, diagnosis and
management information
designed for point-of-care
use when a brief summary
is needed.
All five of the McGraw
Hill texts are configured
for smart phones, once
the user creates a free
personal account under
“My Access Medicine” on
the website home page.
Next, open “Harrison’s plus
4 top texts” on a smart
phone from the Electronic
Bookshelf page and log
on with the username and
password specified in the
personalized account.
WEB EDITOR’S PICK
2011-12 Doctors Nova
Scotia annual report
The 2011-12 annual
report focuses on strategic planning, discusses
progress made on the
three-year business plan,
provides an overview
of the association’s
finances, and touches on
results of the membership
survey.
(member site: Governance >
annual report)
Points
View
of
POPULAR PAGES
Membership survey
results
1,417 page views
(member site:
Governance >
Strategic direction)
a Scotia
Doctors Nov nce
fere
Annual Con
2
June 1-2, 201 Resort & Spa
y Pines Golf
Digb
Fee schedule review
and update
550 page views
(member site:
Physician payment >
Fee-for-service)
rt
Annuall Repo
to Counci
2011-2012
CEO’s BLOG
Moderator’s pick
June 4
Surprise! It’s me.
Welcome to the new CEO’s
blog where I’ll be posting
regularly on the association’s
activities, new initiatives, and
progress being made with
ongoing current projects.
POPULAR FILES
Physician resource
planning:
Projected adjustments
99 downloads
(member site: Health
policies & initiatives >
Policy positions)
Shaping our
Physician Workforce:
Department of Health
and Wellness action
plan
81 downloads
(member site: Health
policies & initiatives >
Policy positions)
Twitter
Alison DeLory @aldelory
@Doctors_NS Love you guys for your leadership on this. A terrific way to teach kids about preventive health—and so much
fun! #youthrun
ilovelocalhfx @ILOVELOCALHFX
Thank you @Doctors_NS for getting so many kids active today’s @BNMarathon #youthRun is the culmination of a lot of
hard work
COACH @COACH_HI
Doc peer networks key to boosting EMR uptake, says @
COACH_HI award winner Dr. Mike Wadden of @Doctors_NS
29
Advertorial
Are you biased? The impact
of behavioural finance on
investor decisions
By MD Physician Services
W
hen you’re making investment
decisions, are you confident
your choices are always rational?
Or have you considered there could be
some other factors at work?
Recently, economists and those who
study the effects of human behaviour
on financial markets have increasingly
been turning their attention to the field
of behavioural finance, which examines
how psychology affects the behaviour of
investors and, in turn, impacts markets.
One of the main insights stemming from
this field ofstudy is that investors often
use heuristics, or “rules of thumb” to
make financial decisions at the expense of
rational analysis.
In this article, we’ll take a look at three
basic or core heuristics that may drive
investor behaviour:
ever be attained again), it has now become
an “anchor” in a faulty decision-making
process.
Anchoring
Anchoring takes place when investors
relate to a fixed number, value or stock
price as a mental reference point, or
anchor. Once the fixed anchor point has
been created, the investor then focuses on
this single value as opposed to conducting
a complete analysis when a decision is
required.
When is anchoring a problem?
Anchoring shows up when investors
watch a stock drop to a low price from a
high one and then refuse to sell until the
previous high is matched. While, in reality, the previous high has no relation to
where the stock may go in the future (and
there is no guarantee the anchor value will
Confirmation bias
Confirmation bias occurs when people
look for evidence to confirm beliefs while
overlooking evidence that contradicts
those same beliefs. For investors, this
selective thinking can lead to a focus on
information that supports a preferred
investment idea, rather than obtaining all
relevant information before acting.
Recency effect
The recency effect is a cognitive bias, or
form of irrationality, in which people
place more importance on recent observations or events than is actually warranted.
For example: Consider the number of
people who say they are reluctant to fly
after a plane crash. The probability of a
similar crash in the future hasn’t changed,
but the perception of the riskiness of
flying has changed due to recent events.
This bias can also be witnessed after
dramatic fluctuations in the markets after
which investors perceive stock market
investing as “more risky” than prior to a
fluctuation.
How can you avoid bias?
Heuristics are persistent because they
help us make decisions quickly, especially
when we are faced with complexity and
uncertainty. But relying on simple rules of
thumb can hinder investors from reaching
their financial goals if using heuristics
MD Physician Services provides financial products and services, the MD family of mutual funds, investment
counselling services and practice management products and services through the MD group of companies.
For a detailed list of these companies, visit md.cma.ca.
30
means acting before a fuller picture has
been developed.
One of the ways in which investors
can help to ensure they don’t fall victim
to behavioural biases is to enlist others in
their financial decision-making processes.
If you’re concerned about ensuring your
decisions are free of behavioural bias,
it’s important to consult with a certified
financial advisor to determine which
strategies will work best for you and your
situation.
Statistics
Taking the pulse of Nova Scotia’s physicians
Hometown
Born in Lunenburg, NS
Grew up in Saint John, NB
Based in Halifax for 33 years
Dr. John Powers Finley
What I wish I knew 20 years ago:
That my kids and my wife and I would
all survive their adolescence
How I live green: Taking a bike
to work and recycling as much as
possible
My favorite places: Lunenburg, NS,
and Perth, Australia
Proudest moment in my career:
Receiving the appreciation of friends
and colleagues when retiring as division head of paediatric cardiology
No one knows that: I enjoy listening
to French CBC
My favourite book: Three Men in a
Boat by Jerome K. Jerome, and Sailing
Around the World Alone by Joshua
Slocum
I feel healthy when: I am with my
family, especially sailing, skiing or
kayaking
My favourite flavour of ice cream:
Grapenut
Craziest adventure I’ve been on:
Canoeing with Dr. Andrew Lynk and
other friends on the Margaree River
when our canoe was wrecked on a
tree trunk 100 yards from the start
Specialty
Paediatric cardiology
Years in practice
34
If I wasn’t a doctor, I would be: An
academic and teacher
My biggest regret: Not having
enough time for longer trips
A talent I would most like to have:
A better singing voice
My childhood dream:
To have the powers of
Superman
My most treasured possession: My family
My greatest fear: Losing
the CBC
Introduce
yourself!
To take the STATistics
survey, email:
melissa.murray@
doctorsns.com
31
Insurance Solutions
Designed exclusively for physicians, medical students and
residents.
• Portability: OMA plans move with you wherever you go
• Cancellation protection: Unlike other group plans, your plan cannot be
cancelled by the insurer
• Premium refund: Money not used to pay claims and expenses for certain
plans may be refunded to our members
• Non-commissioned Insurance Advisors: We provide education,
information and advice
Alban Moran (NS, NB, PEI)
1.877.836.8222, [email protected]
Una Barnes (NL)
1.877.782.5113, [email protected]
www.omainsurance.com

2012-JunedoctorsNS-T - Doctors Nova Scotia

Transcription

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