Category "Medicine Matters"

21Feb

Town Talk: Bob Rennie cues builders on B.C.’s ‘demographic crunch’

by admin


Here readying an at-home dinner for 70 art collectors and professionals, Bob Rennie later addressed building contractors on the “demographic crunch” he said will add “another Vancouver, Burnaby, New West and Coquitlam.”


Malcolm Parry / PNG

CRYSTAL BALLING: Realtor Bob Rennie and his Rennie Group’s intelligence VP, Andrew Ramlo, helped Independent Contractors and Business Association conventioneers digest their bacon and eggs recently. The association president, Chris Gardner, had already told breakfasting colleagues that trade workers’ wages will increase by 5.2 per cent this year, that 54 per cent of contractors can’t obtain enough workers, and that only the Slovak Republic is slower than B.C. among 35 jurisdictions issuing building permits. Rennie and Ramlo’s “demographic crunch” projections included Canadian immigration admissions surging to 350,000 by 2021 (B.C.’s share to be 15 per cent). An aging population and climate change will be the economy’s greatest challenges, they said. Meanwhile, housing the Lower Mainland’s one million more residents by 2040 will require “another Vancouver, Burnaby, New West and Coquitlam.” And though, in constant dollars, millennials’ median household after-tax income exceeds Generation X’s and Baby Boomers’ by 32 per cent, their debt-to-after-tax-income is almost twice as high at 216 per cent. Rennie’s problem: “Twenty years from now, who’s going to be my lawyer, bring my bedpan and pay my taxes?”


Krista Howard chose Railtown as the venue for the Howard495 art gallery-office she’s added to her 14-year business advising global collectors.

Malcolm Parry /

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GIRLY RISER: After 14 years as a global art adviser, Krista Howard has launched a physical gallery and office, Howard495, in the Railtown district. Her debut show, titled Girlie Pics, Someone Else’s History, featured work — some of it a little spicy girlie — by mostly female artists familiar to her existing clients. Catriona Jeffries’ influential gallery recently located nearby on East Cordova’s 900 block. The Monica Reyes Gallery has long operated at Hastings-at-Princess. We’ll likely see more.


David Rowntree and wife Leah whose Curious Minds Productions will launch a current-issues mediation podcast called Hungry Mind, Open Hearts.

Malcolm Parry /

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HIGHER LEAH: Raised in a socialist household, Leah Costello sang in a Salmon Arm-based Hawaiian band, sought North Vancouver’s federal Tory nomination, managed Fraser Institute events, produced policy-issue videos, and founded Curious Minds Productions and the Bon Mot Book Club. The latter’s readings featured such diverse authors as former Pakistani president Pervez Musharraf, U.S. vice-presidential nominee Sarah Palin, Canadian media meteorite Conrad Black and John Cleese of the Monty Python’s Flying Circus TV series. After shelving that project, Costello married the Highland West Capital managing director and former Douglas & McIntyre book-publishing firm partner, David Rowntree. Now, as Leah Rowntree, she’s planning a podcast titled Hungry Mind, Open Heart to talk about current issues. There’s a Hawaiian song for that: I Hei Anau — How Far I’ll Go.


Architect Michael Green worked on Malaysia’s Petronas Towers when their Star of David-shaped cross-section had to be modified to an Islamic pattern.

Malcolm Parry /

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FREE-LUNCH DIVIDEND: Science World’s Lego-skyscrapers exhibition reminds architect Michael Green of his first job. Before designing and advocating mass-wood highrises, Green assisted César Pelli on Kuala Lumpur’s reinforced-concrete Petronas Towers. At 452 metres, the 1996 structures were the world’s tallest until 2004. Green recalls clients nixing Pelli’s original design because his tower cross-sections resembled the six-pointed Star of David. When redrawn with two more to suggest the Muslim Rub El Hizb symbol, and with further facets added, Pelli got the go-ahead. Green has given himself the same for a vegetarian-vegan book based on his lunchtime feeding of Michael Green Architecture’s 65 staff. Its second section will address how “serving food builds culture, connections and collaboration,” and a third “the financial benefits of all businesses giving lunch.” Have your cake and eat it, that is.


Laura Gildner received the $5,000 Philip B. Lind Emerging Artist Prize from its founder at Polygon Gallery where it and others will show to March 16.

Malcolm Parry /

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ART START: North Vancouver’s Polygon Gallery was packed recently when Laura Gildner received the fifth-annual Philip B. Lind Emerging Artist Prize of $5,000. “Being an artist is very hard; I admire you immensely,” Rogers Communications vice chair Lind said to prize contenders. Many feel that way about Lind, who survived a 1998 stroke to continue his 40-year guidance of communications entrepreneur Ted Rogers. Gildner’s work, Informer, contains eight life-size video images addressing viewers. Visit the Polygon gallery exhibition before March 16 to see how artists emerge.


Seen here with nurse-practitioner April Stewart (right), retiring gynecological oncologist-researcher Dr. Dianne Miller will now train more Ugandan cancer surgeons.

Malcolm Parry /

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GOOD ONE GOES: Hospital staff and patients will miss Dr. Dianne Miller who has completed 30 years as a gynecological oncologist and researcher. She received a Vancouver Coastal Health lifetime-achievement award in 2019 that recognized her “revolutionizing the care and prevention of ovarian cancer for women in B.C. and all over the world.” Miller will now spend up to three months a year teaching gynecological-cancer surgery techniques to Ugandan practitioners.


Rather than costume herself for Beaumont Studios’ Robot Dance Party, artist Noa Ben-Mazia, aka Noya, created an immobile partner named BroBot3E5.

Malcolm Parry /

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BOT BALL: Beaumont Studios founder-owner Jude Kusnierz’s recent Robot Dance Party drew participants attired in costumes that could hamper the actual dancing. Artist Noa Ben-Mazia — she goes by Noya — avoided that by creating a life-sized but inanimate robot named BroBot3E5 that, with further tweaking, may master a few dance steps for next year’s wingding.


Despite Disney’s Bambi remake, animator Marv Newland left his Bambi Meets Godzilla unrevised to work on Lisbon-premiering Katalog of Flaws.

Malcolm Parry /

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NO DEER: Much-honoured animator Marv Newland won’t follow the Disney studio’s proposed remake of Bambi by updating his own Bambi Meets Godzilla. The Mayne Island resident and International Rocketship Ltd. founder-principal usually pooh-poohs talk of the 1969 cult-classic he made while studying at Pasadena’s ArtCenter College of Design. Newland does have a new movie, though. Containing contributions by 15 global colleagues, his Katalog of Flaws will premiere at the 20th annual Monstra Animation Festival in Lisbon, Portugal, on March 19.

DOWN PARRYSCOPE: My next column will be published March 14.

malcolmparry@shaw.ca
604-929-8456

29Oct

Bank pledges $2 million for Indigenous health care at St. Paul’s Hospital

by admin


Dr. Jeff Reading, the inaugural FNHA Chair in heart health and wellness at St. Paul’s Hospital.


Allan Tung

Features of First Nations cultures that help promote their health and wellness will be embedded into the planned new St. Paul’s Hospital, thanks to a $2-million donation from BMO Financial Group.

The pledge, announced Tuesday by the St. Paul’s Foundation, will also be used to further work started in 2015 when the First Nations Health Authority Chair in heart health and wellness was established as a $2.5-million 10-year partnership of the health authority, St. Paul’s and Simon Fraser University.

Grand Chief Edward John said then that it was his 1998 heart attack that was the seed of the program focused on the cardiac health of B.C. First Nations people. His medical experiences helped him understand more about medical gaps for Indigenous Peoples and the need for culturally informed care.

In 2016, Jeff Reading was named the First Nations Chair in heart health and wellness and has led research into issues like the obstacles to timely care for First Nations individuals living in B.C.

Broek Bosma, chief development officer at the St. Paul’s foundation, said Reading will decide how to use the new BMO funds, but the pledge — over an unspecified time period — will be spent on salaries, research and design features in the new hospital. On the third floor of the existing St. Paul’s is an All Nations Sacred Space where First Nations patients can participate in smudging ceremonies and other customary healing practices. The new hospital will also have such features.

Reading has created what is called the first Indigenous Health Education Access Research and Training Centre at St. Paul’s (I-HEART). Its goal is to improve the health of Indigenous people by encouraging healthy diet, exercise and recreation, and by helping individuals manage chronic illnesses like diabetes, obesity, lung and kidney disease.

In 2017, Providence Health Care signed a commitment with the First Nations Health Authority to improve Indigenous health services. The hospital set up a team to advocate for patients. It also helps provide them with traditional items like blankets, foods like bison, salmon, and berries for ceremonies and gatherings, and traditional medicines for healing ceremonies. The hospital also has a rooftop garden with a section for traditional medicinal plants.

pfayerman@postmedia.com

Twitter: @MedicineMatters

 

22Oct

Vaccine delayed a bit, but few flu cases being reported yet in B.C.

by admin


The flu shot is coming to a pharmacy or health unit near you … soon.


PASCAL POCHARD-CASABIANCA / AFP via Getty Images

Pharmacies across B.C. are now offering flu shots but public health clinics won’t start administering them until early November because of “minor delays and shortfalls.”

Waiting until early November shouldn’t cause problems if last year’s experience is any indication. At this time last year, there was a very low level of influenza being detected across the province. Indeed, cases were markedly lower than the same periods in 2014 to 2017, according to data from the B.C. Centre for Disease Control. That began to change in early December. Cases of the flu typically peak in early January for children and adults.

Heather Amos, a spokesperson for the Centre for Disease Control and the Provincial Health Services Authority, said there’s nothing unusual about the fact that big flu vaccine shipments aren’t here yet.

“The timing of the delivery of the flu vaccine, and the quantity of vaccine available can, and does, vary from year to year due to a variety of factors related to the manufacturing, testing, and regulatory processes.”

The World Health Organization is the body that recommends which strains of influenza should be targeted in vaccines each year and this year, the recommendations were delayed, which affected manufacturing. That has led to a nationwide delay in the distribution of vaccines. Typically, flu patterns in the southern hemisphere predict the subsequent composition in vaccines and the severity of flu in the northern hemisphere.

Children are given a quadrivalent vaccine that protects against four types, and there is shortage of the quadrivalent vaccine. Public health officials will have sufficient supplies of the trivalent vaccine, which protects against three types, to compensate and those vaccines “should offer a similar level of protection for the types of flu expected to circulate this year, so this shortfall is not expected to be clinically significant.” 

“Despite some minor delays and shortfalls, which are normal and expected, we anticipate this year will be similar to most years in terms of our total quantities of vaccine and the timing of distribution.”

Ninety per cent of the vaccine supply is expected to be shipped to B.C. by the middle of November. Priority will be given to long-term care facilities, hospitals, physicians and pharmacies. And then public health clinics.

An emerging trend is individuals getting their flu shots from pharmacists; the majority of pharmacies now offer vaccinations.

A poll conducted by London Drugs of 624 adults reflects that pattern. The survey, conducted by Insights West on behalf of London Drugs, showed that among those who plan to get a flu shot this year, half will go to a pharmacy. That’s an increase of eight percentage points over last year. By comparison, only six per cent said they would go to a public health flu clinic, down from 10 per cent last year. Another 15 per cent said they’d go to their doctor’s office and 16 per cent said they will get it at their workplace.

Many companies have notified employees that previously scheduled flu clinics have been postponed because of manufacturing and shipping delays.

London Drugs has 82 stores across B.C. Publicly funded vaccines for those eligible are available at all locations now. The remainder of the supply for those who don’t qualify as high risk individuals and therefore must pay about $20 is expected later this week, according to a spokesperson. 

pfayerman@postmedia.com

Twitter: @MedicineMatters

8Oct

Often-abused codeine cough syrups to become restricted drugs

by admin

https://vancouversun.com/


Pharmacist Danny Tam with some of the codeine-containing cough syrups that will require a special type of prescription and will have to be locked up in vaults at pharmacies.


Francis Georgian / PNG

New rules will restrict access to some codeine-based cough syrups because their narcotic ingredient makes them addictive and subject to robberies and abuse.

Cough syrups like Dimetapp-C, Robitussin AC and acetaminophen with codeine are sedating pain relievers that have been marketed for many decades.

But Canadian research has shown adolescents often take them in greater amounts than prescribed in order to get high.

The College of Pharmacists of B.C. said there have been growing concerns about forged prescriptions and pharmacy robberies targeting the codeine formulations. There have also been cases in which such medications have been diverted by health professionals for personal use or to be sold on the street.

The College of Physicians and Surgeons of B.C. says the liquid cough preparations have been too easy to get.

As of Jan. 2, 2020, medications with higher potencies will be reclassified as controlled medications that require special, duplicate prescriptions. Preparations with very low concentrations of codeine will still be available from behind the pharmacy counter.

Dr. Heidi Oetter, the registrar of the College of Physicians and Surgeons, said that apart from being potentially dangerous, codeine cough medications have not been proven effective for anything other than some pain relief.

“The risk is simply too high for something that has no demonstrated benefits,” she said.

Under the new rules, doctors will have to fill out prescriptions on a duplicate pad to help prevent forgeries. Oetter said this should also prompt physicians to “give more deliberate thought” when they are writing such prescriptions. And pharmacies must also store cough syrups with codeine in time-delayed safes along with their other narcotics.

Chris Chiew, general manager of western Canadian pharmacy operations for London Drugs, said that “grab and go” thieves are far less likely to steal from stores with such vaults because they don’t want to wait around for them to unlock.

Chiew said the time delay safes, security cameras and guards in the London Drugs stores are all excellent deterrents. But he agrees with the colleges that other measures to prevent abuse and addiction may also be helpful.

He said that lozenges, drinking water or other fluids, and humid air are all good alternatives to cough syrup.

Because of the opioid epidemic, Health Canada followed the lead of the U.S. Food and Drug Administration and did a safety review of cough and cold products containing opioids like codeine and hydrocodone. It found “limited evidence” linking codeine cough syrups to opioid disorders and other harms in children. It also found, however, that there is little evidence showing any medical effectiveness of the products and so, as a precautionary measure, it advised against the use of such products in those under 18.

Chiew said he understands Health Canada has also been doing consultations on codeine products that do not require a prescription. It is possible those discussions could end up with a new standard that requires every medication containing codeine — in any format including pills and liquid — to require a prescription. Currently, for example, pharmacists can use their professional judgment to sell, without a prescription, acetaminophen with eight mg of codeine and some caffeine to offset the sedative effect.

A 2018 review of the effectiveness and safety of non-prescription medications containing codeine by the Canadian Agency for Drugs and Technologies in Health found there is evidence that low-dose codeine is effective for pain control or chronic cough when compared with placebo or non-opioid analgesics.

“However, the use of codeine can sometimes be less or similarly effective as non-opioid analgesics, while introducing the adverse effects, such as drowsiness, nausea, and constipation.”

pfayerman@postmedia.com

Twitter: @MedicineMatters


PRODUCTS AFFECTED BY THE NEW RULES:

Acetaminophen elixir with 8 mg codeine phosphate syrup

PMS-acetaminophen with codeine elixir

Calmylin ACE

Covan syrup

Dimetapp-C

Robitussin AC

Teva-Cotridin

Dimetane expectorant C

Teva-cotridin expectorant

7Oct

Hospital foundation has raised 75 per cent of its pledge for new St. Paul’s

by admin

https://vancouversun.com/


The Pattison Foundation has made a $75 million donation to fund the Jim Pattison Medical Centre at the new St. Paul’s Hospital. The new facility is described as “a purpose-built, fully-integrated health campus, comprising the entire 18.4-acre site on Station Street in the False Creek Flats.”


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The St. Paul’s Foundation has set its sights on raising $225 million toward the cost of a new hospital to be built three kilometres away, on an unused field in the False Creek flats.

With pledges and donations totalling $168 million to date, the foundation is three quarters of the way to completing what’s been called the largest hospital fundraising campaign in Western Canada. The single largest donation was for $75 million from the Pattison Foundation, the philanthropic arm of Vancouver billionaire Jim Pattison‘s empire.

The health care campus will be called the Jim Pattison Medical Centre.

The price tag for the new 12-storey hospital at 1002 Station Street is an ever changing, ever-escalating target, most recently estimated at almost $2 billion. The site, currently a gravel lot atop a former mud flat at the end of False Creek inlet, will be divided into parcels allowing for phased-in construction of buildings. The hospital, a 69-space child daycare centre, outpatient medical clinics, and offices for administrators and researchers are expected to be completed first, by about 2026.

In the second phase of construction, other parcels will be developed for rental housing offered to health care workers, a hotel with kitchenettes for patients seeking care at the hospital as 40 per cent of St. Paul’s patients come from communities outside the Lower Mainland, more offices and a second daycare centre. The initial business plan approved and funded by the government does not cover other structures, only the hospital, according to Providence Health spokesman Shaf Hussain. 

Geotechnical remediation work on the False Creek Flats land that is susceptible to liquefaction has not yet begun. The rezoning hearing, to change the site from industrial to comprehensive development, is October 22 and although construction is not expected to begin for another year, government and hospital leaders maintain the new facility will open in 2026.

While the proportion being raised through philanthropy may appear small, relative to the overall cost, it is ambitious in relation to other health sector fundraising campaigns, according to material gathered by staff of the St. Paul’s Foundation.

For example, the B.C. Children’s Hospital Foundation capital campaign target for its new hospital was $150 million. And the Lion’s Gate Hospital Foundation target for a new medical/surgical centre was $100 million. The Royal Columbian Hospital Foundation capital campaign target for a multiphase redevelopment is also $100 million while the Richmond Hospital Foundation will try to raise up to $50 million for its new building.

All of those projects pale in size when compared to the new St. Paul’s. 

Paul Hollands, the chairman of A&W Food Services of Canada, and chair of the St. Paul’s Foundation fundraising campaign committee said that private donor fundraising will account for about 10 per cent of the total cost of the hospital.

“We came up with this amount of $225 million after looking at other capital campaigns, talking to key leaders and gauging support in the community. It’s a big number but in the coming months, you will hear about some more big and smaller donations. People are seeing how we are trying to do something extraordinary because this is a once in a lifetime opportunity,” he said, referring to the blank canvas the vacant, 18.4-acre site offers.

“Eight or nine years ago we were more modest in our ambitions. But the fact that we’ve had this very long gestation period means we’ve been able to crystallize our desire to create something really special.”

The existing 6.7 acre St. Paul’s site has already been listed and is expected to yield at least $800 million. Taxpayers will fund the remaining amount of the new hospital construction.

pfayerman@postmedia.com

Twitter: @MedicineMatters

27Sep

Town Talk: Luncheon generates $700,000 for pancreatic cancer clinic

by admin

https://vancouversun.com/


Levi James and Chelsea Brennan simulated a lion and gazelle when the Serengeti-themed Hope Couture luncheon reportedly raised more than $700,000 for the B.C. Cancer Agency’s pancreatic cancer rapid-access clinic.


Malcolm Parry / PNG

HOPE SURPASSED: Susan Chow and Lisa Dalton co-chaired the recent sixth-annual Hope Couture luncheon that reportedly raised more than $700,000 from 415 mostly female guests. Those donations will help the B.C. Cancer Foundation fund a pancreatic cancer rapid-access clinic. At the event, medical oncologist and Pancreatic Centre B.C. co-director Daniel Renouf said a recent wide-scale study of the role of genetics in pancreatic cancer will further B.C.’s pioneering role in screening for the dangerous ailment. He said the clinic will bring together “oncologists, surgeons, geneticists and the scientists. That’s the innovative part.” Along with a fashion show by the Bacci’s and Boboli stores, the Serengeti-themed luncheon had body-painter Christina Rapacz present fitness instructors Levi James and Chelsea Brennan as a lion and gazelle. Fully dressed attendees tucked into an entrée of chermoula crusted B.C. ling cod and vegetables.


Perhaps heartened by a giraffe’s stuck-out neck, Lisa Dalton and Susan Chow co-chaired the Hope Couture luncheon to benefit the B.C. Cancer Foundation.

Malcolm Parry /

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WALL FLOWER: Hope Couture participants Charlotte Wall and daughter Sonya Wall paid $18,000 to name a new bloom donated by Langley breeder Brad Jalbert’s Select Roses concern. The rose will commemorate Sonya’s corgi Joe, who recovered from cancer to die of old age. Joe’s recessive fluffiness makes similar Corgis ineligible for showing and thus not favoured by breeders, or possibly the Queen. Happily, cash raised in his name may help humans survive cancer as the much-loved furry outcast did himself.


At the Hope Couture luncheon, Sonya Wall and mother Charlotte bid $18,000 to name a newly developed rose that commemorates Sonya’s pet Corgi.

Malcolm Parry /

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Sonya Wall’s photo shows Fluffy Corgi Joe, who survived cancer, died of old age and left his name to a bloom from Langley rose breeder Brad Jalbert.

Malcolm Parry /

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SECOND BOUQUET: Inspired by the Walls’ bid, Gloria Au paid $17,500 to do the same for a Select Roses hybrid she has still to name.

LEMON’S ZEST: Ontario-raised architect Robert Lemon recently celebrated his 40th year in Vancouver by hosting a garden party at Shannon, the Granville-at-55th mansion he’s helped restore for two decades. Sugar tycoon B.T. Rogers built the 30,000-square-foot edifice but died before its 1925 completion. Finance and mining tycoon Austin Taylor acquired it in 1935. Developers Peter Wall and Peter Redekop paid a now-pocket-change $750,000 for the mansion and its four-hectare property in 1967. Wall has since built many condos there.

Photos from the Gudewill family’s collection helped Lemon recreate century-past wallpaper, millwork, chandeliers and suchlike. Those features were appraised and appreciated when a deluge squeezed Lemon’s garden party guests indoors for drinks and a recital by University of B.C. School of Music students Jonathan Lopez, Markus Masaites and Nina Weber. Rather than the 1937 hit September In The Rain, the Genesis Trio members performed works by Beethoven, Bruch and Rachmaninoff that likely pleased other Shannon audiences 94 years ago.


The Genesis Trio’s Nina Weber, Markus Masaites and Jonathan Lopez played during Robert Lemon’s reception at the Shannon mansion he’s restoring.

Malcolm Parry /

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CUTTING A RUG: Lemon’s guest Larry Killam pointed to a 1930 photo of Shannon’s great-hall carpet and said: “That’s in my living room.” Killam bought it at auction in the late 1960s when he and three co-developers were reviving a downtown district they named Gastown. Far older than the rug or even pioneer-era Vancouver, Killam and wife Sherry’s Southlands home is built around the framework of a 17th century British barn they bought and erected here, albeit without its straw floor covering.


Late-1960s Gastown co-developer, Larry Killam bought a 1920s Shannon mansion rug for his house with a 17th century British-barn framework.

Malcolm Parry /

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TIME TO LIVE: The recent 15th-annual Gift of Time gala needed very little time to reportedly raise a record $1,530,000 gift for Canuck Place Children’s Hospice. Second-time co-chair, realtor Karley Rice, had Aritzia executive VP Pippa Morgan and Primex Investments VP Lee Rennison join her to help raise that sum and bring the all-time haul to a reported $13.5 million. Founded in 1995, Canuck Place has nine patient beds and four family suites at its original Shaughnessy location, and nine beds and five suites at the recently commissioned Dave Lede House satellite in Abbotsford.


Karley Rice, Pippa Morgan and Lee Rennison co-chaired the Gift of Time gala that reportedly raised $1,530,000 for Canuck Place Children’s Hospice.

Malcolm Parry /

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PARRYNOIA: Unlike the long-ago Russians who sought him as tsar, today’s Britons may not find Boris Godunov.

DON’T BE DUMB: Lake Cowichan-raised Stephanie Nielson didn’t spare potential readers’ sensitivities when titling her dating guidebook Don’t Be A Dumbass: The Every Guy’s Guide To Getting The Girl. Along with stern advice about personal hygiene and being a know-it-all, it ends with the assertion that those who settle for less than they desire end up with exactly what they deserve. Now a divorced mother of two, Nielson expects a Tinder-introduced fellow to end her own “100 dating disasters” by producing a ring this fall. Asked if that might entail living together, Nielsen gave the best — or worst — advice of all: “Not until we’re married.”


Following ‘100 dating disasters,’ divorced mother of two Stephanie Nielson released her Don’t Be A Dumbass guide for men seeking relationships.

Malcolm Parry /

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THE GANJA GANG: New-era dope dealers congregated in Elevator communications firm owner Bob Stamnes’ Mount Pleasant building recently. Association of Canadian Cannabis Retailers (ACCRES) president Jeremy Jacobs welcomed them. He and Stamnes also launched a Vancouver-based cannabis consultancy named Counsel 45 that Stamnes, alluding to a multinational professional-services network, called “the Deloitte of cannabis.” As youngish retailers made merry, it was ironic to recall that some of their same-age forebears were jailed for selling, or even possessing, joints on similar city streets.


Elevator principal Bob Stamnes and Association of Cannabis Retailers of Canada president Jeremy Jacob launched cannabis consultancy Counsel 45.

Malcolm Parry /

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DOWN PARRYSCOPE: As well as having greenhorns and greybeards spout purple prose, ever-colourful Ottawa gave us a blue blood in blackface and caught another red-handed.

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25Sep

Physicians need to do a better job of protecting patient files: B.C. privacy commissioner

by admin

https://vancouversun.com/


BC Information and Privacy Commissioner Michael McEvoy.


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Doctors’ offices regularly breach patients’ privacy so clinics across B.C. must do more to protect the information in their possession, says a report released Wednesday by the Office of the Information and Privacy Commissioner for British Columbia (OIPC).

The audit and compliance report is based on 22 randomly selected medical clinics where at least five doctors worked. The audit sought to find out whether clinics and their staff are meeting legal obligations under the Personal Information Protection Act (PIPA). The act dictates how private organizations collect, use and disclose personal information.

Medical clinics were chosen for the review because of the massive amount of sensitive personal information they collect and because relative to other private sector organizations, physicians’ offices, medical clinics and labs “account for the largest number of complaints and breach files received by the OIPC over the past five years.”

The scope of the review did not entail a physical inspection of electronic medical records systems, patient files storage systems or actual visits to the clinics. Rather, designated staff at the clinics answered questions and provided written material.

Even without a physical inspection of such clinics, the review discovered numerous problems with the way clinics handled patient information. Many lacked a designated privacy officer, put insufficient resources into privacy procedures and failed to stay abreast of technological advances that would help protect information.

The compliance review report says although there’s an inherently strong bond of trust between doctors and patients, the “troubling reality” is that privacy issues occur regularly in the medical field and the privacy commissioner routinely hears complaints about privacy breaches. Such breaches include accidental disclosures by email, files stolen from doctors’ vehicles, and computer systems that are compromised.

“The harms caused by these breaches can be very serious, leaving victims vulnerable to everything from damaged relationships to humiliation, financial loss and more.”

Michael McEvoy, B.C.’s information and privacy commissioner, said the compliance audit focused on medical clinics because of the large volume and sensitivity of the personal information they collect.

“The results show that while some clinics were complying with their obligations, many have work to do when it comes to improving their privacy practices. There is no question about the intense demands medical professionals face. However, respecting and protecting patients’ private information is critically important.

“Doctors and staff at clinics not only owe it to their patients to do their utmost to build and maintain strong privacy programs, but they are also legally obligated to abide by privacy legislation. I hope that the focus of this report underscores the need for clinics to address gaps in how they protect this sensitive personal information and my office’s willingness to assist them in doing so.”

The report has 16 recommendations aimed at helping clinics address the gaps in their privacy management programs, building better policies and safeguards, and ensuring they provide adequate notification about the purposes of collecting personal information online. The report recommends that clinics develop more robust privacy protocols, better responses to breaches, improved monitoring to ensure compliance and prevent breaches, provide more training for staff, and use more caution when collecting and sharing information online.

More to come.

pfayerman@postmedia.com

Twitter: @MedicineMatters

1Sep

Real benefits to stenting multiple blocked arteries, not just the one that caused a heart attack, study says

by admin

Unblocking additional plaque or cholesterol-clogged coronary arteries with stents after a heart attack — instead of just the one that caused the heart attack — leads to a reduction in the risk of dying or having another heart attack, a multinational study involving B.C. experts and patients shows.

Experts predict the “landmark” study will have immediate implications for heart attack patients as interventional cardiologists will now stent additional coronary arteries with significant narrowing (more than 70 per cent) instead of just the culprit artery that caused the heart attack. There are three major coronary arteries and when heart attack patients have one blocked artery, it is not unusual to see blockages in the others, referred to as multi-vessel coronary artery disease.

The study began in 2013 at hospitals in 31 countries, predominately in Europe and North America. It was published in the New England Journal of Medicine and was presented as a late-breaking session at the World Congress of Cardiology in France.

The COMPLETE study, as it is called, involved 4,041 patients (200 in Vancouver) who were followed for about three years. All patients got stents in the culprit arteries as an emergency rescue measure. But in one arm of the study, half were then released from the hospital and prescribed the usual post-angioplasty medications while in the other study arm, patients had their other blocked arteries stented in what is called complete revascularization, either at the same time as the heart attack causing culprit stenting or within 45 days.


Participants in the COMPLETE trial

Deaths from heart disease, further heart attacks or related to the medical procedure occurred in 179 patients (8.9 per cent) in the complete revascularization group, compared to 339 (16.7 per cent) of those who had only one stent put in.

After a median followup of three years, the risk of a second heart attack or death from heart disease occurred in 7.8 per cent of the patients who had complete revascularization while it was 10.5 per cent in those who got one stent.

“In the past, the gestalt was you do an immediate angioplasty to open the culprit blocked artery and then do less with the other ones, put patients on meds and monitor them instead of fixing the additional blockages at the same time or right after,” said Dr. David Wood, the Vancouver co-principal investigator and director of the Vancouver General Hospital Cardiac Catheterization Lab.

“But in this study, the results show that doing more stenting, even within the first 45 days after the heart attack, was beneficial. There was a 26 per cent reduction in the patients’ risk of dying or having another heart attack.”


Dr. David Wood and Dr. John Cairns at Vancouver General Hospital. The pair participated in the COMPLETE trial, focusing on the effect of stenting additional arteries of heart attack victiims. Photo: Arlen Redekop/Postmedia

Arlen Redekop /

PNG

Dr. Shamir Mehta, the principal investigator of the study led by McMaster University and Hamilton Health Sciences, said the data shows that there are benefits to clearing all the arteries and no major downside to the additional procedures.

“Given its large size, international scope and focus on patient-centred outcomes, the COMPLETE trial will change how doctors treat this condition and prevent many thousands of recurrent heart attacks globally every year,” said Mehta, an interventional cardiologist and a senior scientist at the Population Health Research Institute.

Dr. John Cairns, a Vancouver cardiologist who is the former dean of UBC medical school and a study collaborator said: “(Additional) blockages should be fixed in the first 45 days after a patient’s initial heart attack.”

Leslie Carey was one of the trial participants. In 2015, the Burnaby resident had a heart attack while riding a bus to work,

Carey’s chest pains were so severe that he got off the bus and called 911. Paramedics quickly attended to him in a nearby parking lot, whisking him off to VGH.

Life was stressful at the time but his health was pretty good, or so he thought.

“I didn’t have high blood pressure or diabetes but I was taking meds on and off for cholesterol,” said the 58-year old marine administrator for the Royal Vancouver Yacht Club.

Right after a coronary artery was stented, Carey said he felt so much better. His chest pain was gone. Since he was randomly assigned to the trial arm of patients who would get further treatment, he then had another stent inserted into another partly blocked artery. And months later, yet another stent was added so he now has three stents propping open his major coronary arteries.

“I’m fully wired now,” said Carey.

About 20,000 B.C. residents have diagnostic angiograms and angioplasties — usually with stents — each year and another 2,000 have open heart surgery, which is indicated for more serious cases and for patients with diseases like diabetes, according to a Cardiac Services B.C. provincial registry.


Leslie Carey had a heart attack while on a bus to work at Royal Vancouver Yacht Club and had three stents put in. Photo: Arlen Redekop/Postmedia

Arlen Redekop /

PNG

Mehta said patients who had angioplasties were on the right medications to reduce their risk of a heart attack. No one should jump to the conclusion that the medications weren’t effective.

“We don’t know if the same benefit of angioplasty would be there if they were not on the medication. The angioplasty can be considered as an add-on to the medications to prevent further events.”

Mehta, Cairns and Wood agreed that doing more angioplasties on patients with heart attacks is not going to overburden the Canadian health care system. A future study may look at the economics of “front-loading” angioplasties and Cairns said he thinks there could be some cost efficiencies in addition to health benefits.

“We are well equipped in Canada to perform the additional procedures, particularly since the trial shows they can be done any time within 45 days of the index (first) heart attack,” said Mehta.

The median age of trial participants was about 62 and 80 per cent were male. Study authors said that is because more men have large heart attacks.  About 50 per cent of study participants had high blood pressure and 40 per cent were smokers. Just under 40 per cent had high cholesterol.

The study cost over $14 million; $3 million came from the Canadian Institutes of Health Research and just over $11 million from Boston Scientific and AstraZeneca. The companies had no role in trial design, analysis or manuscript writing, according to the authors.

pfayerman@postmedia.com

Twitter: @MedicineMatters

19Aug

False Creek private surgery clinic sold to Toronto equity company

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Dr. Amin Javer and his team perform sinus surgery on a patient at False Creek Healthcare Centre in Vancouver.


Arlen Redekop / PNG

A Toronto private-equity company has bought False Creek Healthcare Centre in Vancouver, one of B.C.’s first private surgery and diagnostic facilities.

In a memo to employees obtained by Postmedia, the owner of the facility and four others in Canada — Centric Health — says the deal is expected to close at the end of September. The buyer is Kensington Capital Advisers.

Doctors and patients can expect a “business as usual” transition followed by an improvement in facilities and quality of care, according to Kirk Hamilton, vice-president of Kensington. The company, which describes itself as an investor in “alternative assets” bought the clinics in Vancouver, Calgary, Winnipeg, Toronto and Mississauga for $35 million. The clinics will be owned by the Kensington Private Equity Fund.

False Creek was opened in the late 1990s by an entrepreneurial Vancouver anesthesiologist, Dr. Mark Godley. In 2011, he sold the Vancouver centre and a sister facility in Winnipeg to Centric Health for $24 million.

The surgical clinics have apparently been a drag on Centric’s financial bottom line. In the memo to employees, David Murphy, the Centric CEO, said the “bittersweet” transaction is the culmination of a year-long review to improve the company’s financial health.

The decision was made “that the most viable path forward was to divest some of our businesses and pursue a more focused strategy built around our seniors’ pharmacy business.”

Murphy nevertheless told employees the growth potential for the private surgery business is “immense” and that Kensington is “the right owner for this business” as it is committed to increasing investment in each of the surgical sites.

“I am confident they will partner with you to help this business realize its tremendous growth potential.”

In B.C., changing government policies initiated by the NDP have been destabilizing the private surgery business. There is the uncertain outcome of the continuing B.C. trial into the constitutionality of paying privately for expedited surgery in such clinics. Closing arguments in the three-year-long trial will not be made before the fall and a judge’s decision is not expected until sometime in 2020.

Murphy mentioned B.C.’s political and legal situation in the company’s latest quarterly report in which Centric cites risks in the private surgery business, including the B.C. trial and NDP government policies.

Asked about the wisdom of buying a private surgery centre in B.C., Hamilton said in an email: “The acquisition includes multiple facilities across Canada and isn’t limited to False Creek. Currently, the False Creek facility does not provide any services to the B.C. government. However, we would be open to providing similar patient services to the B.C. government in the future.”

He was referring to the fact that for many years, health authorities have paid several private clinics to help clear backlogs of scheduled surgeries. But most private clinics also take patients willing to pay out of pocket for expedited surgery, something the government maintains is illegal.

Last fall, the government introduced so-called compliance letters. Surgeons who do any work at private clinics that have contracts with health authorities must sign statements promising they won’t do medically necessary work in both the public and private systems. If they refuse, they could be banned from doing publicly funded operations at private clinics that have contracts with health authorities.

Vancouver Coastal Health has contracted out elective surgery cases to the False Creek clinic in the past, but last year, Health Minister Adrian Dix instructed VCH to sever its contract with False Creek because an audit showed some patients were paying privately to get expedited access, contrary to provincial law.

pfayerman@postmedia.com

Twitter: @MedicineMatters

22Jul

Surgeons in B.C. get fee increase for operations on obese patients

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Dr. Kathleen Ross, president of Doctors of B.C.


Custom Photography / PNG

Some B.C. surgeons who operate on extremely obese patients are being paid a 25 per cent surcharge because surgeries on such patients often take longer and are riskier.

The change came into effect a few months ago for some physicians and will soon kick in for more medical specialists.

It came about after a survey three years ago showed that obese patients were falling through cracks. All but a handful of the B.C. surgeons who responded said they had delayed or declined to perform elective surgery on patients with a body mass index, or BMI, higher than 38. Four in five surgeons said they had delayed or declined to perform surgery over concerns about complications in patients with a BMI of 30 to 34.

Some patients have accused physicians of being biased against them.

Doctors of B.C. and the Ministry of Health have been working to solve the problem. General surgeons and anesthesiologists were the first to negotiate surcharges meant to compensate for added risks and time involved in treating obese patients. Gynecologists/obstetricians are also expected to get a surcharge soon.

Dr. Kathleen Ross, the new president of Doctors of B.C., said the government didn’t come up with extra money. Instead, money was reallocated from what’s called the available amount given to sections of physicians. Within sections like anesthesiology, fees shrunk for some procedures to allow for the surcharge which is referred to as a “BMI modifier.”

Although obesity is typically defined as a BMI over 30, the premium only applies for operations on patients with a BMI over 35. Several other provinces offer surgeons a premium.

BMI is calculated based on a person’s height and weight. For example, a woman who is five-foot-eight and weighs 270 pounds would have a BMI of 41.0.


Body Mass Index Primer; Source: U.S. National Library of Medicine

“This is in recognition of the fact that in obese patients, there may be more complications and areas of the body are more difficult to access,” Ross said. “Operations are more technically complex.”

Dr. Stephen Kaye, an obstetrician/gynecologist, said obesity affects all of patient treatment, making the initial evaluation, the surgery and post-operative care more complex.

Obese patients can have higher rates of infections, require longer hospital stays and more hospital readmissions. It takes longer to prepare obese patients for surgery, including getting them in position on larger operating room tables. Getting them sedated takes longer, said Kaye, who is co-president of the Doctors of B.C. section of obstetrics and gynecologists.

“Specialized equipment and retractors are required in order to visualize and reach the surgical site,” he said. “When operating on the abdomen and pelvis, for example, the distance between the skin surface and the abdominal contents is increased by the thickness of the fat of the abdominal wall.

“These are high-risk patients and increasingly, the care of these patients is being concentrated in the hands of a fewer number of physicians who are willing to accept the patients and have the expertise or who work in hospitals that have greater resources to provide such care,” Kaye said.

In the case of a hysterectomy, for example, the $654 fee paid to a gynecologist/obstetrician would rise by $72 for every 15 minutes beyond the standard two hours. For anesthesiologists sedating hysterectomy patients, the fee would be billed at $38 minutes for every 15 minutes but the BMI modifier would add an extra $20 for every 15 minutes beyond the two-hour typical surgery time.

Some anesthesiologists and other surgical specialists are paid through contracts so their compensation would be structured differently.

Dr. Curtis Smecher, an anesthesiologist at Abbotsford Hospital and president of the B.C. Anesthesiologists Society, said that in the last round of negotiations, each section of physicians was given a pot of money to distribute for pressing needs and the BMI bonus was a high priority for doctors in his area.

“It’s a bit like shuffling deck chairs,” he said about the reallocation, adding that he won’t be surprised if orthopedic surgeons are next to seek the premium since surgeries like joint replacements are far more difficult in obese patients.

Anesthesiologists say their management of obese patients is more complex because of thicker necks, chests, and abdomens in such patients who often have sleep apnea and reduced lung and heart function, which can affect airway management and ventilation during anesthesia.

Physician services cost taxpayers almost $5 billion a year. Ross would not disclose how funds are being shuffled around to pay the premiums, but in the latest Physician Master Agreement with the government, there was also some shifting of funds to address disparities between physician groups. For example, cataract fees to ophthalmologists were reduced about 18 per cent, from $425 a year to $350.

pfayerman@postmedia.com

Twitter; @MedicineMatters




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